Abstract:The objects of fine-grained image categories(e.g., bird species) are various subclass under different categories. Because the differences between subclass are very subtle and most of them are concentrated in multiple local areas, the task of fine-grained image recognition is very challenging. At the same time, some fine-grained networks tend to focus on a certain region when judging the target category, resulting in the lack of other auxiliary regional features. To this end, Inception V3 is used as the backbone network, and an enhanced and complementary fine-grained image classification network is designed. While adopting the method of reinforcement learning to obtain more detailed fine grain image features, the complementary network can obtain the complementary discriminant area of the target through the method of attention erasure to increase the network's perception of the overall target. Finally, experiments are conducted on CUB-200-2011, FGVC Aircraft and Stanford dogs three open datasets. The experimental results show that the proposed model has better performance.

Phenylketonuria (PKU) is an inherited disorder of protein metabolism. It is generally treated using dietary management with limited intake of phenylalanine (Phe). Partial breastfeeding (BF) is encouraged among mothers of infants with PKU, together with a Phe-free mixture of synthetic amino acids. We aimed to describe our current BF rates and complementary feeding practices, as well as examining parental experiences of infant feeding. The aim was to better understand the challenges faced by families so improvements can be made to clinical care. A chart review was carried out on 39 PKU patients, examining the BF rate and duration, use of second stage synthetic protein (SP) and average complementary feeding age. A parental questionnaire on complementary feeding and BF experience was designed. 26% of babies were partially breastfed at three months. 70% of mums would like to have breastfed for longer and cited PKU as a reason for stop-ping. 52% parents reported challenges during the complementary feeding process including food refusal, protein calculation and anxiety around maintaining good Phe levels. Suggestions to improve BF continuation and duration include active promotion of the benefits and suitability, access to lactation consultant and peer support. The delay in introducing a second stage SP may contribute to long-term bottle use for SP. Improved patient education, written resources and sup-port is necessary to improve food choices and long term acceptance of SP.

The study evaluated the functional and sensory properties of infant complementary foods formulated from millets, orange-flesh sweet potatoes, carrots, periwinkle and oyster. Experimental/cross-sectional design was used. Millet, orange-flesh sweet potato (OFSP), carrots, periwinkle and oyster were purchased, processed into flour using standard methods. The complementary food was formulated on protein basis for infants 6–12 months. The formulated foods were millet/OFSP flours (70:30), millet/OFSP/carrot/periwinkle (49:29:7:15), and millet/OFSP/carrot/oyster (65:20:5:10). Functional properties were carried out using standard methods. Sixty nursing mothers attending Orogbum Health Centre were systematically sampled for the sensory evaluation. ANOVA was used for the study. The result showed packed density (0.77 g/mL) was significantly higher (p < 0.05) in food formulated from millets/OFSP than in millet/OFSP/carrot/oyster (0.68 g/mL). Loosed density was lowest (0.40 g/mL) in millet/OFSP/carrot/oyster. Carr index from ranged from 42.23 in millet/OFSP/carrot/oyster to 44.41 in millet/OFSP. Wettability was highest (45.03) in millet/OFSP/carrot/periwinkle compared to wettability value (26.53) for millet/OFSP. Solubility ranged from 18.36 to 46.62, with the highest (46.62) in millet/OFSP/carrot/periwinkle. The peak viscosity of the infant complementary food samples ranged from 64.53 rapid visco analyzer units (RVU) to 89.33 RVU. The infant complementary food formulated from millet/OFSP had significantly higher (p < 0.05) acceptability score (6.35).

Cardiovascular disease is the first leading cause of death in the world. Patients with cardiovascular disease may experience various problems, including physiological and psychological problems. Apart from pharmacological therapy, complementary therapy is necessary as a support to conventional medicine. This review aims to describe complementary and alternative therapies for pain and anxiety in patients with cardiovascular disease. This review utilized data from ProQuest, ScienceDirect, and PubMed with search keywords of "Complementary" AND "Nursing" AND "Pain" AND "Anxiety" AND "Coronary artery disease". Ten articles that met the inclusion criteria were analyzed. The results show that nursing actions increasingly develop along with the patient needs. One form of holistic nursing action is complementary and alternative therapy (CAT) that consists of three categories: body-based methods, mind therapies, and sensory therapies. CAT has positive impacts on patients with heart disease. It can reduce anxiety and pain, lower blood pressure, and improve the quality of life. This review also shows that CAT has a positive impact on the recovery of patients with heart disease. Proper therapeutic management should be implemented to reduce the risks of physiological and psychological problems in patients.

An increasing number of persons with cancer decide to choose complementary and alternative medicine. The purpose of the paper was to check the status of the use of complementary and alternative medicine methods in oncological patients and to compare health behaviours of patients using Complementary and Alternative Medicine (CAM) with those using neither of these methods. The studies were conducted from August till January 2020 in the Oncology Center in the south-eastern Poland. A cross-sectional study was conducted in a group of 208 oncological patients. The authors' own questionnaire and the standardized Health Behaviour Inventory were used. Most of the patients (85,09%) declared that they used complementary and alternative medicine methods. The most common methods chosen by the respondents included vitamin C, green tea and prayer. The vast majority of the respondents did not inform their oncologist about the use of CAM. 45,19% of the respondents had a high rate of health behaviours. It was observed that there was no communication related to the use of CAM among the patients and healthcare staff. Patients using CAM demonstrated more positive health behaviours than those who were not using these methods.

In recent years, the advent of Single Electron Transistor (SET) technology has opened new avenues for low power and high density circuit design. This paper presents an optimized design of an Arithmetic Logic Unit utilizing Single Electron Transistor MOSFET (SET-MOSFET) technology. The proposed design leverages the unique properties of SETs such as Coulomb blockade and quantum tunneling to achieve significant reductions in power consumption and increased speed. Through comprehensive simulations and analysis the performance metrics of the SET-MOSFET based ALU architecture includes optimized arithmetic and logical units are compared with conventional MOSFET based designs demonstrating the superiority of the proposed approach in terms of energy efficiency and operational speed. Comprehensive simulations demonstrate that the SET-MOSFET based ALU achieves a 99.97 % to 99.99 % reduction in power consumption, a 5 to 50 times increase in speed compared to conventional MOSFET based designs.

Background: The use of complementary therapies in the population is increasing, so it is necessary to understand the training that health professionals receive in this type of therapy in their training plans, as they are often the primary source of information for patients. Our objective was to investigate Spanish universities that offer subjects on complementary therapies in their Nursing degree programs. Methods: Observational descriptive cross-sectional study. For this purpose, we used the document published on the website of the Ministry of Universities as a working document. Additionally, a literature search was conducted up to September 2023 in the PubMed database, along with reverse searches. Results: Out of a total of 62 universities, only 16 (29%) offer a subject related to this type of therapy, with most of them being elective courses. Conclusions: The training content on complementary care in Nursing degree programs in Spanish universities is scarce, highlighting the potential benefit of expanding and promoting it, in line with the recommendations of the World Health Organization.

An experimental ultra wideband ground penetrating radar based on Golay complementary sequences is proposed to locate underground pipes. Golay complementary sequences with the code length of 1024 and frequency of 1 GHz are used as the probe signals. Two-dimensional image of the buried pipes is achieved by correlation method and back projection algorithm. The experimental results show that both the plastic pipe and metallic pipe can be located with a range resolution of 10 cm. Furthermore, as the Golay complementary sequences are a pair of complementary sequences, the sum of their correlation function yields twice the value of the peak at the target position and zero elsewhere. Thus, compared with the stepped frequency signal radar or chaotic signal radar, the Golay-based radar can significantly improve the signal noise ratio and has capability of deep detection.

Background and Objectives: Botulinum toxin injections are commonly used for the treatment of spasticity. However, injection procedures are associated with pain and procedural anxiety. While pharmacological approaches are commonly used to reduce these, inno-vative technology might be considered as a potential non-pharmacological alternative. Given this context, immersive virtual reality (VR) has shown effectiveness in the man-agement of procedural pain[1]. Our retrospective pilot study aimed to assess the potential added value of virtual reality in the management of pain and anxiety during intra-muscular injections of botulinum toxin. Materials and Methods: Twenty-one adult patients receiving botulinum toxin injections were included. A numerical rating scale was used to assess pain and anxiety during the injection procedure. The patient reported the pain experienced during previous injections without VR before injection and the pain expe-rienced in the current procedure with VR after the end of the procedure. Level of satis-faction of VR experience, if they agreed to reuse VR for the subsequent toxin botulinum injection, and if they would recommend VR to other patients were assessed. Results: The use of virtual reality showed a decrease of 1.8 pain-related points compared to without technology. No significant improvement in the level of anxiety was reported. Patients were very satisfied by their VR experience (7.9 out of 10) and would agree to reuse VR in their next injection procedure (88%) and to recommend the use of VR in other patients (100%). Conclusion: VR was useful for managing procedural pain related to botulinum toxin injection in adults, with a high level of satisfaction reported by the patient. VR should be considered as a valuable alternative to pharmacological approach to manage procedural pain during Botulinum toxin injection in adults.

1) Background: Parents are increasingly fascinated by alternative weaning methods, such as ba-by-led or vegetarian weaning. However, international pediatric societies are still cautious to-wards alternative weaning methods, due to their significant risk of nutritional deficiencies. The aim of this study is to describe the attitude of Italian pediatricians towards unconventional weaning, with particular regard to vegetarian and baby-led. (2) Methods: A 20-question ques-tionnaire was sent to Italian pediatricians, from January to December 2019; (3) Results: Responses were received from 73/1000 (7.3%) pediatricians. The vast majority of surveyed pediatricians (78.1%) is familiar with baby-led and vegetarian weaning, but only 24.7% is in favor of their practice. A significant number of pediatricians (63.0%) received request from parents for an al-ternative weaning regimen. (4) Conclusions: The survey revealed a significant gap between pedi-atricians’ attitude and parental demand concerning unconventional weaning. This could signifi-cantly impair the alliance between parents and pediatricians with the risk to expose infants and children to severe nutritional deficiencies due to self-management by parents with poor surveil-lance from health professionals.

Cancer treatment is a significant focus in medicine owing to the increasing global incidence. Patients with advanced cancers that do not respond to conventional therapies have limited options and an unfavorable prognosis. Consequently, researchers are investigating complementary approaches to conventional treatments. One such approach is alkalization therapy, which aims to neutralize the acidic tumor microenvironment (TME) by increasing its pH level. The acidic TME promotes inflammation, tumor progression, and drug resistance. Alkalization therapy has been demonstrated to be effective for various cancers. In addition, natural products, such as triterpenoids, parthenolides, fulvic acid, Taxus yunnanensis, and apple pectin have the potential to alleviate symptoms, maintain physical fitness, and improve treatment outcomes of cancer patients through their anti-inflammatory, antioxidant, and anticancer properties. In this review, we focus on the effects of alkalization therapy and natural products on cancer. Furthermore, we present a case series of advanced cancer patients who received alkalization therapy and natural products alongside standard treatments, resulting in long-term survival. We posit that alkalization therapy together with the supplementation of natural products may confer benefits to cancer patients by mitigating the side effects of chemotherapy and complementing standard treatments. However, further research is warranted to validate these clinical findings.

A millimeter-wave microstrip leaky-wave antenna array based on the substrate-integrated waveguide (SIW) and the complementary split-ring resonator (CSRR) is proposed in this paper. The slow wave characteristics of the SIW are enhanced by etching two rows of symmetrical CSRR-type slots on the surface of the SIW layer. The magnetic coupling between the CSRR-SIW layer and equally spaced circular patches array on the upper layer realizes the radiation of electromagnetic energy. In the 23~30 GHz (relative bandwidth 26.4%) operating frequency band, the horizontal polarization radiation beam scanning from -62° to -2° is realized, with a peak gain of 9.6~11.7 dBi, and the cross-polarization ratio is more than 43.8 dB.

Many research work has demonstrated that taken the Combined Cooling Heating and Power system (CCHP) as the core equipment, the integrated energy system (IES) can bring obvious benefit to energy efficiency, CO2 emission reduction and operation economy in urban areas. Compared with isolated IES, integrated energy micro-grid (IEMG) which is formed by connecting multiple regions IES together, through distribution and thermal network, can further improve the reliability, flexibility, cleanliness and economy of regional energy supply. Based on the existing IES model, this paper describes the basic structure of IEMG and built a IEMG planning model. The planning based on the mixed integer linear programming, and economically construction planning scheme are calculated by using known electricity, heating and cooling loads information and the given multiple equipment selection schemes. At last, the model is validated by a case study. The results show that the application of IEMG can effectively improve the economy of regional energy supply.

Continued high rates of both under- and over-nutrition in low- and low-middle-income countries highlight the importance of understanding dietary practices such as early and exclusive breastfeeding, and dietary patterns such as timely, appropriate complementary feeding—these behaviors that are rooted in complex cultural ecologies. A systematic review and synthesis of available qualitative research related to infant and young child dietary patterns and practices from the perspective of parents and families in low income settings is presented, with a focus on barriers and facilitators to achieving international recommendations. Data from both published and grey literature from 2006-2016 was included in the review. Quality assessment consisted of two phases (CASP guidelines and assessment using GRADE-CERQual), followed by synthesis of the studies identified, and subsequent thematic analysis and interpretation. The findings indicated several categories of both barriers and facilitators, spanning individual and system level factors. The review informs efforts aimed at improving child health and nutrition, and represents the first such comprehensive review of the qualitative literature, uniquely suited to understanding complex behaviors leading to infant and young child dietary patterns.

Childhood malnutrition is one of the most persistent public health problems throughout developing countries including Nigeria. This study focused on the evaluation of complementary food produced by solid-state fermentation of Fonio and Soybean using Rhizopus oligosporus (2710) and Orange-fleshed sweet potatoes (OFSP) using Lactobacillus planterum, (B-41621). Solid state fermentation (SSF) was carried out by inoculating Fonio and Soybean with spore suspension (1×10⁶spores/ml) of Rhizopus oligosporus (2710) and OFSP with spore suspension (1×10⁶spores/ml) of Lactobacillus planterum (B-41621). The samples were blended in the following ratios: Fonio and Soybean 100: 100 (AS), fonio/soybean and OFSP 50: 50(ASO), and compared with a commercial infant formula which served as the control (CTRL). Quality characteristics of the samples were evaluated. Results showed that moisture, crude protein, fibre, ash content, beta carotene and titratable acidity increased significantly (p<0.05) as fermentation progressed. The iron content ranged from 6.57–8.41mg/100g while the beta carotene content ranged from 15.80 –17.35mg/100g. Viscosity ranged from 8200 –15400cP, while that of swelling capacity ranged from 2.25-3.41(g/g). In sensory scores, there were no significant (p>0.05) difference between the average mean scores of the samples. SSF improved the nutritional content and flavour of the developed complementary food which is needed for infant growth and development.

The endocannabinoid system (eCB) began to be studied from the identification of the molecular structures present in the cannabis sativa plant. The ECS is constituted of cannabinoid receptors, endogenous ligands and all the associated enzymatic apparatus responsible for maintaining homeostasis. Several physiological effects of cannabinoids are exerted through interaction with various receptors such as CB1 and CB2 receptors, vanilloid receptors, and the recently discovered [GPCRs (GPR55, GPR3, GPR6, GPR12 and GPR19). Endogenous ligands such anandamide and 2-arachidonoylglycerol might modulate these receptors. eCB has proved to play a critical role in some human diseases and has been extensively studied due to its wide therapeutic potential and because it is a promising target for the development of new drugs. Phytocannabinoids and synthetic cannabinoids have shown varied affinities to eCB, which are relevant to the treatment of various diseases. They may also have potential as lead compounds in the development of cannabinoid-based pharmaceuticals for a variety of diseases. Furthermore, Integrative and Complementary Health Practices (ICHP) appear to influence the endocannabinoid system through modulation. This review will show a description of ECS components and discuss how phytocannabinoids, other exogenous compounds, and PICS may operate the eCB balance.

Background: Adiposity rebound (AR) refers to the second rise of the BMI curve that usually occurs physiologically between 5 and 7 years of age. AR timing has a great impact on children´s health, being the early adiposity rebound (EAR) associated with the development of metabolic disease later in life. Aim: We aimed to investigate the prevalence of EAR in a cohort of preterm newborns. Secondary outcomes evaluated if some determinants such as (1) gender (male/female), (2) type of delivery (caesarean/vaginal), (3) birth weight (SGA/NGA/LGA), (4) type of feeding (5) duration of breastfeeding, (6) timing of introduction of solid food, (7) parental education and (8) parental pre-pregnancy BMI can influence EAR in this cohort. Tertiary aim was to evaluate the prevalence of obesity or overweight at 7 years of age in children according to early versus timely AR. Methods: This is a perspective, population-based longitudinal study, where infants born preterm were evaluated at birth and at 1, 3, 6, 9, 12, 15, 18, 24 months and 3, 4, 5, 6, 7 years of gestational-corrected age. Weight and height data were analyzed, and BMI was calculated. AR was assessed in the growth trajectory in a body mass index (BMI) plot. Results: Of the 250 preterm newborns included, 100 completed the 7 years follow-up and entered in the final analysis. The prevalence of EAR in our cohort of preterm newborns was 54%. EAR was associated with being LGA at birth. No other factors were associated to EAR. Early adiposity rebounders have a significant higher BMI at 7 years compared to children with timely AR (17.2 ±2.7 vs 15.6 ± 2.05, p=0.021). No significant differences were found in the prevalence of obesity or overweight at 7 years of age in children with early or timely AR (29% vs 14% p=0.202). Conclusions: Clinical management of preterm infants should focus on reducing excess weight gain to prevent long-term metabolic risk. Others neonatal factors are not associated to an higher risk of EAR.

As a holistic medical school, Iranian traditional medicine (ITM) considers the human body as a dynamic and intricate network of interconnecting processes. Currently, systems biology and more precisely systems medicine and pharmacology can be an aid in providing rationalizations for many traditional medications and treatments and elucidating a great deal of knowledge they can offer to guide future research in medicine. Therefore, re-organization and standardization of traditional medicine data are requested more than ever before. To address this issue, we have constructed UNaProd, a Universal Natural Product database for materia medica of ITM. Primarily based on Makhzan al-Advieh, which is the most recent encyclopedia of materia medica in ITM with the largest number of monographs, this database was created using both text mining methods and manual editing. UNaProd is currently hosting to 2696 monographs from herbal to animal to mineral compounds in 16 diverse attributes such as origin and scientific name. In the current version, UNaProd is hyperlinked to IrGO and CMAUP databases for Mizaj and molecular features respectively and it is freely available at http://jafarilab.com/unaprod/.

Purpose: this paper evaluates the effect of thermo-formed aligners with complementary biomechanical attachments (CBA) on periodontal ligaments (PDL) during the expansion process of the maxillary arch using simulations based on the finite element method (FEM). Methods: four types of teeth (canine 3, premolar 4, premolar 5 and molar 6) were modeled using 3D CAD. In addition, aligners, CBAs and PDL were also 3D modeled. With this information, a FEM model was generated, and a clinical rehabilitation scenario was simulated. For the validation of the results, a comparison with medical records was performed. Results: for canine 3, the displacement was 0.134 mm with a maximum stress of 4.822 x10-3MPa in the amelocemental junction. For premolar 4, the displacement was 0.132 mm at a maximum stress of 3.273x10-3MPa in the amelocemental junction. Premolar 5 had a displacement of 0.129 mm and a stress of 1.358 x10-3MPa at 1 mm from the amelocemental junction. Molar 6 had a displacement of 0.124 mm and a maximum stress of 2.440 x10-3MPa. Conclusions: The simulations showed that the use of CBA reduces tooth tipping. The model with Vestibular CBA presented the best results in terms of the dental movement of expansion of the maxillary arch with the use of thermoformed aligners. Significance: Considering the difficulty of performing in vivo tests that evaluate the configuration effectiveness of the different CBA alternatives in thermoformed aligners, FEM techniques were used to reduce time and costs, and get accurate results with minimal errors.

In an $m$-person symmetric game, all players are identical and indistinguishable. In this paper, we find that the payoff tensor of the player $k$ in an $m$-person symmetric game is $k$-mode symmetric, and the payoff tensors of two different individuals are the transpose of each other. Furthermore, we reformulate the $m$-person symmetric game as a tensor complementary problem and demonstrate that locating a symmetric Nash equilibrium is equivalent to finding a solution to the resulting tensor complementary problem. Finally, we use the hyperplane projection algorithm to solve the resulting tensor complementary problem, and we present some numerical results to find the symmetric Nash equilibrium.

The consumption of contaminated water contributes to the global burden of diarrhea and other water-borne diseases, especially among young children. While the decentralized solar water disinfection treatment system remains a viable option to have safe drinking water, our understanding of the effects of household water treatment before use on willingness to accept and adopt a decentralized solar water disinfection treatment system is limited. In this study, a complementary log-log regression analysis of the compositional and contextual factors that systematically vary with willingness to accept and adopt a decentralized solar water disinfection treatment system in the Sawla-Tuna-Kalba (STK) district of Ghana was carried out. Based on our findings, a greater proportion of households’ (97%) are willing to accept and adopt a decentralized solar water disinfection treatment system. Compositional and contextual factors such as age, marital status, education, religion, and geographical location significantly contribute to households’ willingness to accept and adopt a decentralized solar water disinfection treatment system in the STK district of Ghana. Households that treat their water before use (66%, P&lt;0.05) are more likely to accept and adopt a solar water disinfection treatment system compared to those that do not treat their water before use. The findings therefore suggest that scaling up solar water disinfection systems in the STK district is sacrosanct, and highlight the necessity to analyze compositional and contextual factors influencing willingness to accept and adopt solar water disinfection systems. Our findings will inform policies and programs aimed at implementing solar water disinfection systems in the study area to improve the health of communities that must rely on poor quality drinking water sources.

The revolutionary idea of complementary intelligence involves a unique strategy in which artificial intelligence (AI) works with human cognitive abilities embodied by natural intelligence (NI), creating a harmonious partnership instead of engaging in a competitive relationship. This innovative concept can potentially revolutionize how we approach scientific research and discovery. This cutting-edge process capitalizes on pooling the vast information from various distinct and autonomous sources to generate forecasts that frequently outshine human perspectives by significant margins, leading to groundbreaking advancements in scientific development based on hybrid intelligence. Multilayer networks extend traditional network theory to adjacent layers linked through copula nodes. Artificial intelligence, with its retrieval capacity to collect and interpret big data, sharply increases the number of nodes and their linking interpretation. This process, amplified by multilayer networks, dramatically improves the scalability of the networked ecosystem. Multilayer networks can represent NI and AI in complementary hyperplanes, connecting them with copula nodes and edge properties. Thus, it is possible to measure the interaction of NI and AI, assessing their scalable value co-creation properties. This study examines the interaction of NI and AI with an innovative and multidisciplinary approach. A theoretical framework of these related concepts precedes practical insights for possible applications in future research.

Chronic conditions like type 2 diabetes mellitus (T2DM), arterial hypertension (HTN), and obesity are major global health issues, causing significant morbidity and mortality. In Latin America, these conditions contribute to millions of premature deaths annually, posing challenges exacerbated by limited healthcare access and poor primary care quality, particularly in Mexico. Complementary medicine presents a potential solution, offering minimally invasive techniques to improve physical, mental, and spiritual well-being. Effective treatment adherence, crucial for positive outcomes, is influenced by self-efficacy, the ability to manage one's behavior in response to medical conditions. However, treatment adherence rates remain low, indicating a pressing public health concern. This study aimed to explore how perception of complementary medicine and treatment adherence predict self-efficacy among individuals with chronic conditions in Mexico. Analyzing data from 113 participants revealed significant correlations between variables, with treatment adherence positively associated with self-efficacy and perception of holistic medicine negatively correlated with self-efficacy. Regression analysis showed that incorporating perception of complementary medicine and treatment adherence significantly explained self-efficacy levels, suggesting the potential of complementary therapies in holistic healthcare approaches. However, collinearity between variables highlights the need for further research to better understand these relationships and their implications for improving healthcare outcomes in Mexico. Integrating complementary therapies with conventional treatments could enhance overall well-being and treatment adherence, offering promising avenues for addressing chronic conditions in the region. These findings underscore the importance of comprehensive healthcare approaches that integrate both conventional and complementary modalities to optimize health outcomes and quality of life for individuals with chronic conditions in Mexico and beyond.

Background and objectives: The inadequate knowledge of complementary and alternative medicine (CAM) among health professionals may put their clients in risky situation because they then would find information about CAM from unreliable sources. Clinical psychologists (CPs), as health professionals, have also the opportunity to provide psychoeducation on the latest CAM scientific research to their clients. The current study aimed to explore knowledge and educational needs of CAM among CPs in Indonesia because previous studies on exploring CAM knowledge and educational needs of CAM were primarily conducted in Western countries. Materials and Methods: Data were collected through semi-structured face-to-face interviews with 43 CPs in public health centers (PHCs) in Indonesia. Most interviews were held at the PHCs where participants worked and interviews lasted for 55 minutes, on average. The interview recordings were transcribed and were analyzed using deductive thematic analysis. Results: Five main themes emerged within participants’ responses regarding CAM knowledge and educational needs. First (CAM understanding), participants’ responses ranged from those with little or no prior knowledge of CAM treatments and uses, to those with much greater familiarity. Second (source of knowledge), participants’ access ranged widely in terms of references, from popular to scientific literature. Third (why is it important?), participants identified CAM essentially as part of Indonesian culture and it was therefore crucial to have this cultural knowledge. Fourth (the challenges and what is needed?), the challenges for improving participants’ knowledge came from personal and institutional levels. Fifth (what and how to learn?), participants advised that only CAM treatments that fit in brief psychotherapy sessions should be introduced in professional training. Conclusions: This qualitative study discovered that CAM was neither well-known nor understood widely. Participants advised that professional associations and health institutions should work together in enhancing knowledge of CAM and incorporating CAM education into psychology education.

Background: Complementary and alternative medicines (CAM) are widely used, with pharmacies accounting for a significant share of the distribution market. Despite their popularity, many CAMs lack scientific evidence for effectiveness, and some can cause adverse health effects. Limited research exists on CAM-related adverse events and the effectiveness of CAM labels in conveying crucial information. Methods: This cross-sectional study aimed to investigate CAM utilization, consumer perspectives, and the influence of labels on CAM usage in Melbourne, Australia. Data were collected through an online questionnaire and analysed using descriptive statistics, Pearson's correlation, MANOVA, and regression analyses. Results: The study enrolled 125 current CAM users, primarily recruited from pharmacy and supermarket customers (age: predominantly 31-50; gender: 20.8% male, 79.2% female). Participants' perceptions of effectiveness and safety were positively correlated. Label warnings prompted information-seeking, but consultation with healthcare professionals (HCPs), particularly pharmacists, was infrequent (24%). Adverse reactions were reported by 18.5% of participants, with 8.3% experiencing severe reactions. The analysis revealed relationships between CAM usage and demographics. Ordinal logistic regression showed a significant association between calcium consumption and higher age groups (coefficient = 1.658, p = 0.006), while binary logistic regression identified higher iron consumption among females (coefficient = 2.177, p = 0.007). Conclusions: Label warnings significantly prompted consumers to seek more information about CAMs. However, a limited engagement of HCPs, especially pharmacists, suggests an opportunity for improved consumer education and pharmacist involvement in CAMs-related discussions. The findings highlight demographic influences on CAM usage being essential for developing targeted health interventions and policies. Addressing these aspects may lead to safer CAM practices and informed consumer decision-making.

In most countries, the incidence of nasopharyngeal carcinoma (NPC) is no more than 1 per 100,000 for both men and women; however, it is much higher for men and women in Taiwan. The use of traditional Chinese medicine (TCM) as complementary and alternative medicine for the treatment of NPC and its treatment-related side effects has been increasing. The National Health Insurance (NHI) covers 99.6% of Taiwan’s residents. In the present population-based cohort study, we aimed to investigate the pattern of utilization of Chinese herbal products (CHPs) for NPC from 2001 through 2011 in Taiwan. We identified a total of 30294 patients with newly diagnosed NPC from the Registry for Catastrophic Illnesses Patient Database (RCIPD). Descriptive statistics and multiple logistic regression analysis were employed to estimate the adjusted odds ratios (aORs) for CHP utilization. From 2001 through 2011, 17816 patients aged ≥20 years were newly diagnosed with NPC. Of these, 4749 patients used TCM outpatient services for NPC treatment. TCM users were more likely to be women, young, residents of Central Taiwan, and white-collar workers. The most commonly prescribed formula CHP was Gan-Lu-Yin, followed by Xin-Yi-Qing Fei-Tang and Shan-Shen-Mai-Men-Dong-Tang. The most commonly prescribed single CHP was Hedyotis diffusa, followed by Radix Scrophulariae and Radix Ophiopogonis. These findings provide information regarding personalized therapies for NPC and can promote further clinical experiments and pharmacological research on CHPs for NPC treatment in Taiwan. Further well-designed randomized controlled studies and basic mechanistic studies should assess the safety and effectiveness of CHPs for NPC treatment.

There is a growing body of research exploring Complementary and Alternative Medicine (CAM) for the overall population; however, few studies have examined the effectiveness and applications of CAM practices in the paediatric population. According to the World Health Organization (WHO), parent's prevalence using CAM in their dependents is estimated to be as high as 80%. This literature review identified broad, heterogeneous, and inconclusive evidence regarding CAM applications and effectiveness caused mainly by variances in sociodemographic factors and national healthcare systems differences. Additionally, a lack of consensus and polarised positions among mainstream professionals regarding the CAM mechanism of action, applications, and effectiveness were identified. This narrative review shows debatable results for most CAM therapies and their applications. However, some evidence suggests that acupuncture, Yoga, Tai Chi, and massage might benefit users' physical and mental health. Additionally, meditation's available evidence indicates that it might be only helpful in the enhancement of mental health, whereas Reiki only displays an effect on patients' perceptions of comfort. Lastly, herbal medicine was observed to have non-specific evidence to support its claim, given the diverse nature and complexity of herbal compounds and procedures. This comprehensive narrative review might offer health professionals a reference to guide their health practices towards a personalised approach, taking into account the patient's values and beliefs, both important aspects of integrated, evidence-based practice, aiming to improve the quality of the offered health services and patients' satisfaction.

Currently, some non-conventional therapies (NCT), such as acupuncture, homeopathy, osteopathy, naturopathy, herbology, and Traditional Chinese Medicine are structured and well-regulated for a market of teaching and clinical practice in Portugal, among which acupuncture has become one of the most appealing and functional branches. Through investigation of acupuncture laws, field surveys, teaching work and interviews with people from NCT field in Portugal, we showed the current acupuncture education in Portugal and found that according to the academic norms and rules of education in Portugal, there is a gradual difficulty in the progression and maintenance of the degree training dynamics, due to the lack of more tolerant transitional measures and also, a timid commitment on the part of the institutions that embark on these complementary programs. Therefore, it will be necessary to promote additional programs and measures that avoid a total emptiness of the teaching of acupuncture and at the same time losses of clinicians, competencies and quality of information that are difficult to recover. It could be very meaningful and thought-provoking to the future development and improvement of acupuncture in Portugal and in other countries that welcome acupuncture and intend to have a better legislation and application.

This article is devoted to the results of in-depth analysis of the system of binary-oppositional structures in DNA n-plet alphabets and their algebraic-matrix representations. These results show that the molecular complementary replication of DNA strands is accompanied by the presence of an algebraic version of the principle "like begets like" in matrix representations of DNA alphabets having internal structures. This algebraic version is based on binary-oppositional structures in the genetic molecular system, which can be represented by binary numbers and corresponding matrices of DNA alphabets. The received results allow thinking that the phenomenon "like begets like" (or a complementary replication in a wide sense) is systemic in the genetic organization and is connected with algebraic features of biological organization. Correspondingly, the biological principle "like begets like" can be additionally modeled by algebraic-matrix methods and approaches. Such algebra-matrix modeling of the genetic coding system gives new ways for studying and understanding the key role of the named principle in genetic and other inherited physiological complexes. On this way, the author discovered general rules of stochastic organization of information binary sequences of genomic DNAs of eukaryotes and prokaryotes. The presented rules are connected with information dichotomies of probabilities and corresponding fractal-like trees of probabilities, which fundamentally differ from constructional dichotomies in biological bodies. The received phenomenological data and rules lead to new biological ideas.

This study investigated the roles of low-molecular-weight fucoidan (LMWF) in enhancing the anti-cancer effects of fluoropyrimidine-based chemotherapy. HCT116 and Caco-2 cells were treated with LMWF and 5-FU. Cell viability, cell cycle, apoptosis, and migration were analyzed in both cell types. Potential mechanisms underlying how LMWF enhances the anti-cancer effects of fluoropyrimidine-based chemotherapy were also explored. The cell viability of HCT116 and Caco-2 cells was significantly reduced after treatment with a LMWF-5-FU combination. In HCT116 cells, LMWF enhanced the suppressive effects of 5-FU on cell viability through the 1) induction of cell cycle arrest in the S phase and 2) late apoptosis mediated by the Jun-N-terminal kinase (JNK) signaling pathway. In Caco-2 cells, LMWF enhanced the suppressive effects of 5-FU on cell viability through both c-mesenchymal–epithelial transition (MET)/ Kirsten Rat Sarcoma virus (KRAS)/ extracellular signal-regulated kinase (ERK) and c-MET/ phosphatidyl-inositol 3-kinases (PI3K)/ protein kinase B (AKT) signaling pathways. Moreover, LMWF enhanced the suppressive effects of 5-FU on tumor cell migration through the c-MET/ matrix metalloproteinase (MMP)-2 signaling pathway in both HCT116 and Caco-2 cells. Our results demonstrated that LMWF is a potential complementary therapy for enhancing the efficacies of fluoropyrimidine-based chemotherapy in colorectal cancers (CRCs) with the wild-type or mutated KRAS gene through different mechanisms. However, in vivo studies and in clinical trials are required to validate the results of the present study.

The circuitry of the summarized "floating" differential stages (FDS) based on complementary field-effect transistors with a control p-n junction (CJFET), intended for use in low-noise analog microcircuits, for example, operational amplifiers. The results of modeling the flow characteristics of one of the CJFET FDSs in the LTSpice XVII environment at low temperatures (down to -197 ⁰С) and exposure to a neutron flux in the range of 1e13 ÷ 1e15 n / cm² are presented.

Background: allergic diseases and, in particular food allergy (FA), have been identified as one of the major diseases in the world. The first 1000 days of life can be a “window of opportunity” or a “window of susceptibility” during which several factors can predispose children to FA development. Changes in gut microbiota composition, from pregnancy to infancy, could have a pivotal role in this regard: some bacterial genus such as Lactobacillus or Bifidobacterium seem to be protective from FA development, on the contrary Clostridium and Staphylococcus appear to be unprotective. Methods: we conducted a research through the most recent literature (2013-2023), using Pubmed and Scopus as databases. We included English original papers, clinical trials, metanalysis and reviews. Case reports, series and letters have been excluded. Results: during pregnancy, maternal diet can play a fundamental role in influencing gut microbiota composition of newborns. After birth, human milk can promote the development of protective microbial species by human milk oligosaccharides (HMOs), that play a prebiotic role. Also complementary feeding can modify gut microbiota composition. Conclusions: the first two years of life are a critical period where several factors, in genetic predisposed children, can increase the risk of FA development.

Complementary and alternative treatment approaches are becoming more common among children with chronic conditions. The pravelance of CAM use among US adults was estimated to be around 42% in 2015, and around 44% to 50% among adults with neurologic disorders. Studies report children with chronic illnesses such as cancer, asthma, attention-deficit/hyperactivity disorder (ADHD), genetic disorders, and other neurodevelopmental disorders are treated with complementary and alternative treatments at higher rates. Dietary therapies are gaining increasing popularity in the mainstream population, due to the heavy media involvement. Although, majority of “fad” diets do not have enough supporting evidence, some dietary therapies have been utilized for decades and have numerous published studies. The objective of this review is to describe the dietary interventions used in children with the specific chronic conditions, to evaluate their efficacy based on published data, and to encourage pharmacist involvement in the management and care of such patients.

Background: The rise of new SARS-CoV-2 mutations brought challenges and progress in the global fight against COVID-19. Mutations in spike and accessory genes affect transmission, vaccine efficacy, treatments, testing, and public health strategies. Monitoring emerging variants is crucial to halt virus spread. Methods: 44 nasopharyngeal/oropharyngeal swabs from Kenyan patients were sequenced with the Illumina platform. Galaxy's bioinformatic tools were used for genomic analysis. SARS-CoV-2 genome classification was done using PANGOLIN and mutation annotation with the COVID-19 Annotator tool. Results: The study showed 5 clades to be circulating in the region. 38(86%) were BA.1.1; 2(5%) were BA.1.1.1; 1(2%) was BA.1; 1(2%) was BA.1.14 and 2(5%) were AY.46. These clades had a cumulative of 173 mutations among them with 50 novel mutations. Forty-eight of these novel mutations occurred in a low frequency of 2.3% of the sequences tested while the other two, S:R214R, and NSP2:A555A, were for 43.2% and 18.2% of the cases respectively. Conclusions: The high-frequency novel mutations were synonymous mutations, a phenomenon that was previously viewed as phenotypically silent but recent studies indicate they can affect viral fitness with potential functional associations. These findings add to the understanding of the SARS-CoV-2 virus future evolutionary and immunological dynamics in the region

Preliminary clinical data suggest pain reduction through fasting in different diagnoses. This uncontrolled observational clinical study examined the effects of prolonged modified fasting on pain and functional parameters in hip and knee osteoarthritis. Patients admitted to the inpatient department of Internal Medicine and Nature-based Therapies of the Immanuel Hospital Berlin between February 2018 and March 2020, answered questionnaires at the beginning and end of inpatient treatment, as well as 3, 6 and 12 months after discharge. Additionally, selected blood and anthropometric parameters were routinely assessed during the inpatient stay. Fasting was performed as part of a multimodal integrative treatment program, with daily caloric intake of <600 kcal for 7.7 ± 1.7 days. N=125 consecutive patients were included. Results revealed an amelioration of overall symptomatology (WOMAC Index score: -14.8±13.31; p<0.001; d=0.78), and pain alleviation (NRS Pain: -2.7±1.98, p<0.001, d=1.48). Pain medication was reduced, stopped, or replaced by herbal remedies in 36% of patients. Improvements were also observed in secondary outcome parameters, including increased quality of life (WHO-5: +4.5±4.94, p<0.001, d=0.94), reduced anxiety (HADS-A: -2.1±2.91, p<0001, d=0.55) and depression (HADS-D: -2.3±3.01, p<0.001, d=0.65), decreases in body weight (-3.6 kg ± 1.65, p< 0.001, d=0.21), and blood pressure (systolic: -6.2±15.93, p<0.001, d= 0.43; diastolic: -3.7±10.55, p<0.001, d=0.43). Results suggest that patients with osteoarthritis of the lower extremities may profit from a prolonged fast embedded in a multimodal integrative treatment regarding quality of life, pain, and disease-specific functional parameters. Confirmatory RCTs are warranted to further investigate these hypotheses.

Different nutraceuticals are often considered by parents of infants and children with abdominal pain and disorders of the gut-brain interaction. Herb extracts and natural compounds have long been used in traditional medicine, but clinical pediatric trials are very limited. This narrative review based on relevant studies identified through Pubmed-Medline literature search updated to October 2023, focused on the effect of nutraceuticals in infantile colic, functional abdominal pain and irritable bowel syndrome in children and adolescents. Significant reduction of colic episodes and crying time was reported in two studies on fennel (seeds oil or tea), in three studies on different multiple herbal extracts (all including fennel), in one study on Mentha piperita, and in at least two double-blind randomized controlled studies on Lactobacillus reuteri DSM 17938 and Bifidobacterium lactis BB-12 (108 CFU/day for at least 21 days) in breast-fed infants. Compared to placebo, in children with functional abdominal pain or irritable bowel syndrome a significant reduction of pain was reported in two studies supplementing peppermint oil capsules or psyllium fibers, in one study on corn fiber cookies or partial hydrolysed guar gum or a specific multiple herbal extract (STW-5) or vitamin D supplementation. To date, there is a moderate certainty of evidence with a weak grade of recommendation for Lactobacillus reuteri DSM 17938 (108 CFU/day) for reducing pain intensity in children with functional abdominal pain and for Lactobacillus rhamnosus GG (1-3 x109 CFU twice daily) for reducing pain frequency and intensity in children with IBS. Further large and well-designed pediatric studies are needed to prove efficacy and safety of different herbal extracts and prolonged use of studied products in infants and children with pain disorders of the gut-brain interaction.

Dietary supplements are widely embraced by cancer patients seeking complementary and integrative approaches to their care. Unfortunately, many patients do not discuss supplement use with physicians, often due to perceptions of physician indifference or negativity toward supplements. This communication gap exposes patients to unreliable information sources and, potentially, unnecessary risk. As the healthcare landscape evolves, patients increasingly value physicians who recognize their pivotal role in shaping healthcare decisions. This patient-centered perspective emphasizes the provision of evidence-based information tailored to individual needs, open discussions on potential risks, and shared decision-making. It underscores the importance of respecting patient autonomy, offering alternative options, documenting preferences, and ensuring ongoing support while coordinating with the healthcare team. To address these needs, healthcare providers should transform their perspectives and become expert guides who embrace patients as informed, empowered participants. This approach prioritizes open dialogue that considers both facts and uncertainties regarding dietary supplement use, allowing for mutually informed decision-making. Here, we review the literature and present a practical approach emphasizing open discussions, transparency, and respect for patient autonomy. Following this approach, healthcare providers can empower patients to navigate the complexities of dietary supplement use in the context of cancer care, ultimately safeguarding patient safety and well-being.

The plant productivity-richness relationship (PPR) is one of the most debated and important issues in ecology. There have been distinct stages in the research of this issue, including the discovery of the different PPR shapes, respective tests of influencing processes, and integrative research with vegetation investigation, manipulation experiments, and theoretical analysis. The debate largely focuses on what the dominant shapes and underlying mechanisms are. Recent integrative research works following analyses of respective processes affecting PPR have found that the humped, asymptotic, positive, negative, and irregular shapes of PPR are linked to each other. One shape of PPR may change into another. The balance between positive and negative processes determines the different shapes of PPR. Plant diversity has a globally positive effect on plant productivity.

The SARS (severe acute respiratory syndrome)-CoV (Coronavirus)-2 S(spike)-protein mRNA/cDNA currently being used as vaccines are antigenic but not antigens against SARS-CoV-2, that causes COVID (Coronavirus Disease) -19. Furthermore, the mRNA and cDNA antigenic vaccines also have potentials for homologous as well as heterologous recombination, primarily into the somatic cell DNA of the vaccine recipients. On the contrary, a SARS-CoV-2 RBD-protein antigen, a part of the S-protein, will directly stimulate antibody production against SARS-CoV-2. Hence, a vaccine composed of SARS-CoV-2 RBD-protein as a safer, fast acting, and effective vaccine against SARS-CoV-2 and thus against COVID-19. This is also useful for some immune compromised individuals.

Combining wind and solar photovoltaic (PV) generation can provide complementary renewable power production, but depends on correlated resources. This study analyzed 10 years of wind data from Naama, Algeria to evaluate the potential for evening wind generation to offset the loss of solar at sunset. Average wind speeds showed a distinct increase during evening hours, coinciding with the decrease in solar irradiance. Wind turbine simulations using a 1.5 MW turbine and the wind data showed sufficient resources for profitable power production after sunset. Statistical analyses confirmed significantly higher wind speeds and simulated power output in evening vs daylight periods (p&lt;0.05). The Pearson correlation coefficient between evening wind speeds and decreasing solar irradiance was 0.63, supporting a strong positive relationship. These findings indicate Naama has adequate wind resources to deploy economically viable wind power capacity that can complement existing solar infrastructure and provide renewable electricity after dark , .

Short-range Internet of Things (IoT) sensor nodes operating at 2.4 GHz need to provide ubiquitous wireless sensor networks (WSNs) with energy-efficient, wide-range output power (POUT) and fully integrated on a single chip for wireless body area networks (WBANs) and wireless personal area networks (WPANs) using low-power Bluetooth (BLE) and Zigbee standards. The proposed fully integrated transmitter (TX) utilizes a digitally controllable current-mode class-D (CMCD) power amplifier (PA) with a second harmonic distortion (HD2) suppression to reduce VCO pulling in an integrated system while meeting harmonic limit regulations. The CMCD PA is divided into 7-bit slices that can be reconfigured between differential and single-ended topologies. Duty cycle distortion compensation is performed for HD2 suppression, and an HD2 rejection filter and a modified C-L-C low-pass filter (LPF) reduce HD2 further. Implemented in a 28 nm CMOS process, the TX achieves a wide POUT range of from 12.1 to -31 dBm and provides a maximum efficiency of 39.8% while consuming 41.1 mW at 12.1 dBm POUT. The calibrated HD2 level is -82.2 dBc at 9.93 dBm POUT, resulting in a transmitter figure of merit (TX_FoM) of -97.52 dB. Higher order harmonic levels remain below -41.2 dBm even at 12.1 dBm POUT, meeting regulatory requirements.

As a complementary and alternative medicine in the western countries for decades, traditional Chinese medicine (TCM) has been used for more than 2000 years in China. Because of the characteristics of the philosophical style and the unknown mechanism of action, TCM sometimes has been biasedly described as "fraught with pseudoscience". From the scientific basis of the systems biology, here we promoted a novel medical model called the entropic systems medicine which could be applied to scientize TCM in future. In entropic systems medicine, TCM and Western modern biomedicine target the different variables of the entropic system. For instance, while Western modern biomedicine directly targets the phenotypes and its SOCs of macrostates, TCM differently targets the microstates, entropy and entropic force to generate SOTFs gradually causing the differentiated syndromes to be slowly rearranged. The prerequisites to modernize TCM are the entropic systems biology having been well established so that the variables could be precisely monitored and mathematically calculated.