The present study examines the long-term care service awareness, needs, and usage intention of elderly male homosexuals in Taiwan and their ideal long-term care service model. This study of five elderly male homosexual subjects aged 66 to 73 years was intended as a preliminary exploration. Interviews were used to collect data. The study determined that the five subjects had high awareness of long-term care services, as they had actual experience of long-term care services or even participated in care service staff training to obtain certificates. Some even had experience in applying for home care services and experienced problems during use. The subjects perceived that they were very likely to require long-term care services in the future and tended to use home care services if they required long-term care services. Due to their personal experiences, the subjects had negative awareness of long-term care services and worried that long-term care service staff had poor attitudes toward homosexuals. The subjects considered the most important aspects of long-term care to be basic medical care and lifestyle care. However, they worried that long-term care staff would delay or refuse to provide such services due to the subjects’ sexual orientation or stereotypes, and they were concerned above all about the “friendly attitude” of long-term care staff. They hoped that long-term care staff were friendly toward homosexuals and did not discriminate against them, and they felt that it would be more appropriate for homosexual long-term care staff to provide assistance. In terms of vision, while preferring organizations with homosexual employees, the subjects worried that they would be stigmatized and discriminated against . With regard to ideal long-term care services, while considering institutions with homosexual staff to be ideal, the subjects also worried that these would be labeled as institutions that were dedicated to homosexuals, potentially resulting in discrimination. Therefore, they hoped that the sexuality sensitivity of long-term care staff could be improved and that they would undergo professional continuing education to learn about homosexuals, the situation and care needs of homosexuals, and care techniques for homosexuals.

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

Background: There are ongoing workforce challenges with the delivery of long-term care (LTC), such as staffing decisions based on arbitrary standards. The Synergy tool, a resident-centered approach to staffing, pro-vides objective, real-time acuity and dependency scores (Synergy scores) for residents. The purpose of this study was to implement and evaluate the impact of the Synergy tool on LTC delivery. Methods: A longitudinal mixed methods study took place within two publicly-funded LTC homes in British Columbia, Canada. Quantitative data included weekly Synergy scores for residents (24 weeks), monthly aggregated resident falls data (18 months) and a six-month economic evaluation. Qualitative data were gathered from family caregivers and thematically analyzed. Results: Quantitative findings from Synergy scores revealed considerable variability for resident acuity/dependency needs within and across units; and falls decreased during implementation. The six-month economic evaluation demonstrated some cost savings by comparing Synergy tool training and implementation costs with savings from resident fall rates reductions. Qualitative analyses yielded three positive impacts themes (improved care delivery, better communication, and improved resident-family-staff relationships), and two negative structural themes (language barrier and staff shortages). Conclusions: The Synergy tool provides useful data for enhancing a ‘fit’ between resident needs and available staff.

The rapid ageing of populations around the World is creating complex challenges for national governments. The establishment of sustainable and equitable long-term care systems for old and dependent people is one of the main issues of social policy in developed countries. The aim of this work is to define a cost model for residential and day care centres for dependent persons in Cantabria (Spain). The cost model will make it possible to establish the theoretical cost of attending to the needs of the different types of dependent persons in the different types of care centres, and the methodology used could be extrapolated to other regions. The daily cost per user for elderly residential care is €53.72. The cost per user in elderly day centres (5 days) is 32.56 euros. In residential centres for people with disabilities, the values range between €47.41 and €75.25 depending on the category of the centre. In three categories of centres the public price is not enough to cover the cost (physical disability, intellectual disability, mental illness – low care), and therefore the administration should reconsider their public prices for these kind of centres if they want to really contribute to the sustainability of these residential care centres. This research will have important implications for policy-makers in a context of fulfilment of SDGs and where better support for old and disabled people and their carers, as well as fair and efficient financing of social care services, are essential to address the current and future challenges of dependency.

Objectives: A wealth of literature has established risk factors for social isolation among older people, however much of this research has focused on community-dwelling populations. Relatively little is known about how risk of social isolation is experienced among those living in long-term care (LTC) homes. We conducted a scoping review to identify possible risk factors for social isolation among older adults living in LTC homes. Methods: A systematic search of five online databases retrieved 1535 unique articles. Eight studies met the inclusion criteria. Results: Thematic analyses revealed that possible risk factors exist at three levels: individual (e.g., communication barriers), systems (e.g., location of LTC facility), and structural factors (e.g., discrimination). Discussion: Our review identified several risk factors for social isolation that have been previously documented in literature, in addition to several risks that may be unique to those living in LTC homes. Results highlight several scholarly and practical implications.

Objective: The long-term care insurance (LTCI) system was introduced in 2000 to provide financial support for long-term care services to older adults. What is known on this topic report focuses on a comparative analysis of how the LTCI system has affected older people in Japan. Methods: We obtained data from the literature about the LTCI system, compared and analysed the collected articles, and concluded. Results: The LTCI system has improved access to long-term care services, with more older adults receiving care than before the system’s implementation. This service has improved the quality of life for many elderly individuals who require assistance with daily activities. Furthermore, the LTCI system has alleviated the financial burden of long-term care services since the insurance covers a large portion of the costs. It has made older adults maintain their independence and dignity, as they can afford the necessary care without relying solely on their savings or burdening their families. Conclusions: Japan’s LTCI system has positively impacted older adults by improving access to long-term care services and alleviating financial burdens. However, challenges such as increasing demand and variations in service quality need to be addressed to ensure the system effectively supports older people in Japan.

Alzheimer’s disease and related dementias (ADRD) remain a public health challenge in developing counties. We developed a needs-based essential care service package (ECSP) for care planning of persons living with dementia (PLWD) using a cross-sectional survey among PLWD in institutions in six cities in China (n= 1,299). Face-to-face interviews were conducted with caregivers of PLWD by trained staff between 2018 and 2019. Care service needs and utilization by the level of cognitive impairment were summarized. The average age of PLWD was 80.7 years. 76% of participants had severe cognitive impairment. The needs-based ECSP with 30 service items would be sufficient in supporting care services of PLWD in China, of which seven items are core care. The selection plan for ECSP at different levels is designed as “General Care Services + Selective Care Services”, in which service items for low-, mid-and high-level care for PLWD are 7+3, 7+6, and 7+10, respectively. The findings provide the first large-scale data on service needs and utilization of PLWD in mainland China. The ECSP for PLWD advanced in the paper was a practicable and effective quantitative management means. It is deserved to application in a large scale.

Long-term care (LTC) settings are increasingly used for palliative care in Japan. This study aimed to assess the proportion of LTC settings that provide palliative care services for older clients with advanced dementia in Japan and the trends across the types of settings. A nationwide questionnaire survey was conducted between November 2022 and January 2023, targeting 1,000 geriatric hospitals (GHs), 1,000 geriatric health services facilities (GHSFs), and 1,000 home nursing care stations (HNCSs). The palliative care practices for older patients with advanced dementia and their families in the agencies were assessed. Less than half of the GHs supported family participation or the spiritual needs of their older clients with dementia, while many had access to pain and symptom assessments and analgesic prescriptions by physicians. Less than half the GHSFs used pain assessment tools, assessed and supported family caregivers' pain and distress, and supported family participation in palliative care. More than 80% of the HNCSs practiced most of the listed palliative care. Current palliative care practices for older adults with dementia vary among GHs, GHSFs, and HNCSs. This emphasizes the need for targeted approaches to improve the provision of palliative care for patients with dementia across LTC settings in Japan.

This paper examines whether the Great Recession has altered the disparities of the US regional health care expenditures. We test the null hypothesis of convergence for the US real per capita health expenditure for the period 1980-2014. Our results indicate that the null hypothesis of convergence is clearly rejected for the total sample as well as for the pre-Great Recession period. Thus, no changes are found in this regard. However, we find that the Great Recession has modified the composition of the estimated convergence clubs, offering a much more concentrated picture in 2014 than in 2008, with most of the states included in a big club, and only 5 (Nevada, Utah, Arizona, Colorado and Georgia) exhibiting a different pattern of behavior. These two estimated clubs diverge and, consequently, the disparities in the regional health sector have increased.

Multicomponent training is recommended for people with dementia living in long-term care homes. Nevertheless, evidence is limited and people with severe dementia are often excluded from trials. Hence, the aim of this study was to investigate (1) the feasibility and (2) the requirements regarding a multicomponent training for people with moderate to severe dementia. The study was conducted as an uncontrolled single arm pilot study with a mixed methods approach. 15 nursing home residents with a mean age of 82 years (range: 75-90 years; female: 64%) with moderate to severe dementia received 16 weeks of multicomponent training. Feasibility and requirements of the training were assessed by a standardized observation protocol. Eleven participants regularly attended the intervention. The highest active participation was observed during gait exercises (64%), the lowest during strength exercises (33%). It was supportive if exercises were task-specific or related to everyday life. This study confirms that a multicomponent training for the target group is (1) feasible and well accepted. To enhance active participation (2) individual instructions and the implementation of exercises related to everyday life is required. The effectiveness of the adapted training should be tested in future randomized controlled trials.

Due to its devastating consequences, late life depression is an important public health problem. The aim of the study was the analysis of variables which may potentially influence risk of depression (GDS-SF). Furthermore, the aim was to study possible mediating effect of given variables on the relationship between the total protein concentration and risk of depression in older-adults with chronic diseases, and physical function impairment. The research sample included a total of 132 older adults with chronic conditions and physical function impairments, remaining under a long-term care in residential environment. Negative linear correlation was observed between patients’ physical functionality, total protein concentration, concentration of HDL cholesterol, arm circumference, and the risk of depression. Considerably stronger relationship was observed between total protein concentration, and GDS-SF, in elderly suffering from sensory dysfunction (b = −6.42, 95% CI = −11.27; −1.58). The effect of the mediation between depression risk is correlated to total protein concentration in blood serum, and the mediators are probably low function impairment and low levels of 25 (OH)D vitamin. Cohort control research is suggested to confirm the hypothesis.

Healthcare workers (HCWs) in long-term care (LTC) faced and continue to experience significant emotional and psychological distress throughout the pandemic. Despite this, little is known about the unique experiences of LTC workers. This scoping review synthesizes existing research on the experiences of HCWs in LTC during the COVID-19 pandemic. Following Arksey and O’Malley’s framework, data were extracted from six databases from inception of the pandemic to June 2022. Among 3,808 articles screened, 40 articles were included in the final analysis. Analyses revealed three interrelated themes: carrying the load (moral distress); building pressure and burning out (emotional exhaustion); and working through it (a sense of duty to care). Given the impacts of the pandemic on both HCW wellbeing and patient care, every effort must be made to address the LTC workforce crisis and evaluate best practices for supporting HCWs experiencing mental health concerns during and post-COVID-19.

Abstract Introduction: Long COVID (LC) affects multiple systems and has a significant health impact on patients and society. Therefore, long COVID services should address patients’ needs through a holistic assessment and monitoring of patients’ symptoms. Aim: The aim was to understand which of the symptoms were most and least likely to improve, after our rehabilitation intervention so that the rehabilitation measures in the clinic could be modified to meet patients’ needs. At the same time, we wanted to assess the feasibility of using C19-YRS ELAROS application in monitoring of LC symptoms during and after the rehabilitation clinic attendance. Methodology: In this study, a total of 50 patients who have attended long COVID rehabilitation clinic in Salford, UK; were assessed by using digitalised C19-YRS ELAROS application. A total of 100 eligible initial and final post rehabilitation assessments were analysed. Conclusion: Pain and anxiety symptoms were the two most likely symptoms to improve after intervention at LC rehabilitation clinic, whereas swallowing difficulty is least likely to improve. Issues with caring for family/ social life (symptoms affecting social role) are likely to worsen even after treatment. It is feasible to monitor and track Long COVID symptoms utilising the digitalised version of C19-YRS via the ELAROS App. This also allows the tracking of symptoms overtime.

Objective: To examine variations in end-of-life care for breast cancer, heart failure, and dementia patients. Data and methods: Data from four Norwegian health registries were linked using a personal identification number. Longitudinal trends over 365 days and the type of care on the final day of life were analyzed using descriptive techniques and logistic regression analysis. Results: Patients with dementia were most commonly placed in nursing homes, while patients with heart failure and breast cancer were more frequently hospitalized. Breast cancer and heart failure patients had a higher likelihood of dying at home. The presence of general practitioners increased the probability of home-based end-of-life care for cancer patients, while non-physician healthcare workers increased the likelihood of home-based care for the other patient groups. Conclusion: Diagnoses, individual characteristics, and service availability are all associated with the place of death in end-of-life care.

Work disparities experienced by nurses in long-term care (LTC) can impact the retention, well-being, and health of this workforce. Despite the significant impact disparities experienced by nurses have on the workforce and LTC sector, a review of the available literature on work disparities has not been conducted on work disparities experienced by nurses in LTC. Consequently, this scoping review aimed to explore the nature and extent of research on meso-level work disparities experienced by nurses in LTC and how such disparities are linked with nurse health and well-being. Five databases were searched: MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), and CINAHL (EBSCO host). Of the 5,652 articles retrieved, 16 studies published between 1997 and 2024 met the inclusion criteria. The average number of work disparities within each study was 3.06 (minimum = 1, maximum = 6, SD = 1.62). Types of work disparities across the 16 studies were work opportunities (n = 19), work treatment (n = 18), job security (n = 8), and work compensation (n = 8). Only four articles investigated the association of a work disparity with a variable of health and well-being. Future research on how macro-level disparities intersect with meso-level work disparities may inform a contextual understanding of how disparities transpire in the work of nurses in LTC. Studies are required to address the gaps in knowledge regarding how work disparities negatively influence the health of nurses to inform better retention, well-being, and health of nurses in LTC.

This report is a narrative of a certified nurse working on a long-term rehabilitation ward for patients with dementia in Japan during the early phase of the COVID-19 pandemic. During this time visitation restrictions had been implemented to prevent the spread of COVID-19 causing psychological distress for patients and their families which nurses had to cope with . The nurse was interviewed twice September–October 2020. The recordings were transcribed verbatim and analysed thematically. Three themes were identified relating to changes in care in response to the pandemic which nurses had to adapt to: the risk of collapse of family members’ roles, anxiety caused by patients forgetting family members and family memories and increased disorientation. During the pandemic, nursing care needs to adapt, ensuring that family attachments and ties continue and minimizing the disruption caused by the pandemic, while ensuring that everyone remains Covid-safe.

Background: To analyze long-term outcomes in patients undergoing thoracic endovascular aortic repair (TEVAR). Methods: All consecutive 97 patients undergoing TEVAR between September 2014 and September 2022 were included in the study. Primary outcome was long-term incidence of overall death and major adverse cardiovascular and cerebrovascular events (MACCE). Results: Mean age was 70.4 years, and 22(23.2%) had cerebrovascular disease (CBVD). A total of 49(51.6%) of patients had prior cardiac surgery intervention and 8(8.5%) had prior aortic valve replacement. Twenty-eight patients(28.8%) presented with aortic dissection, 60(61.8%) had aortic aneurysm, 4(4.1%) had intramural hematoma, and 5(5.1%) had other presentations. An emergent procedure was performed in 6(6.2%) patients, an urgent procedure in 37(38.1%) patients and 54(55.7%) patients had an elective procedure. Intraoperatively, 78.3% had percutaneous TEVAR, 5.1% had ministernotomy TEVAR, while 10.3% had concomitant full sternotomy TEVAR repair. Hospital mortality was 7 patients(7.2%). At 8-years follow-up, 76% were alive, 25.8% had MACCE, 21.6% were diagnosed with endoleaks(13 patients type II and 2 patients type 1) while 10.3% un-derwent repeat intervention. Conclusions: This single center experience in patients undergoing TEVAR evidenced good short and long-term survival and MACCE. Nonetheless, almost half of the patients underwent an ur-gent/emergent procedure, clinical results were favourable for TEVAR.

Virtual reality (VR) describes a family of technologies which immerse users in sensorily-stimulating virtual environments. Such technologies have increasingly found applications in the treatment of neurological and mental health disorders. Depression, anxiety, and other mood abnormalities are of concern in the growing elderly population – especially those who reside in long-term care facilities (LTCFs). The transition from the familiar home environment to the foreign LTCF introduces a number of stressors that can precipitate depression. However, recent studies reveal that VR therapy (VRT) can promote positive emotionality and improve cognitive abilities in the elderly, both at home and in LTCFs. VR thus holds potential in allowing elderly individuals to gradually adapt to their new environments – thereby mitigating the detrimental effects of place attachment and social exclusion. Nevertheless, while the current psychological literature is promising, the implementation of VR in LTCFs faces many challenges. LTCF residents must gain trust in VR technologies, care providers require training to maximize the positive effects of VRT, and decision makers must evaluate both the opportunities and obstacles in adopting VR. Here, we concisely review the implications of depression related to place attachment in LTCFs, and explore the potential therapeutic applications of VR.

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

Restraint use in Australian residential aged care has been highlighted by the media, and investigated by researchers, government and advocacy bodies. In 2018, the Royal Commission into Aged Care selected ‘Restraint’ as a key focus of inquiry. Subsequently, Federal legislation was passed to ensure restraint is only used in residential aged care services as the ‘last resort’. To inform and develop Government educational resources, we conducted qualitative research to gain greater understanding of the experiences and attitudes of aged care stakeholders around restraint practice. Semi-structured interviews were held with 28 participants, comprising nurses, care staff, doctors, physiotherapists, pharmacists and relatives. Two focus groups were also conducted to ascertain the views of residential and community aged care senior management staff. Data were thematically analyzed using a pragmatic approach of inductive and deductive coding and theme development. Five themes were identified during the study: 1. Understanding of restraint; 2. Support for Legislation; 3. Restraint-free environments are not possible; 4. Low-level restraint, and 5. Restraint in the community is uncharted. Although most staff, health practitioners and relatives have a basic understanding of restraint, more education is needed at a conceptual level to enable them to identify and avoid restraint practice, particularly ‘low-level’ forms and chemical restraint. There was strong support for the new restraint regulations, but most interviewees admitted they were unsure what the legislation entailed. With regards to resources, stakeholders wanted recognition that there were times when restraint was necessary and advice on what to do in these situations, as opposed to unrealistic aspirations for restraint-free care. Stakeholders reported greater oversight of restraint in residential aged care but stated that community restraint use was largely unknown. Research is needed to investigate the extent and types of restraint practice in community aged care.

In order to reconstruct the origin and pathways of variola virus (VARV) dispersion, we analyzed 47 VARV isolates available in public databases and their SNPs. The mean substitution rate of the whole genomes was 9.41x10-6 (95%HPD:8.5-11.3x10-6) substitutions/site/year. The time of the tree root was estimated to be a mean 68 years (95%HPD:60.5–75.9). The phylogeographical analysis showed that the Far East and India were the most probable locations of the tree root and of the inner nodes, respectively, whereas for the outer nodes it corresponded to the sampling locations. The Bayesian Skyline plot showed that the effective number of infections started to grow exponentially in 1915-1920, peaked in the 1940s, and then decreased to zero. Our results suggests that the VARV major strains circulating between 1940s-1970s probably shared a common ancestor originated in the Far East; subsequently moved to India, which became the center of its dispersion to eastern and southern Africa, and then to central Africa and the Middle East, probably following the movements of people between south-eastern Asia and the other places with a common colonial history. These findings may help to explain the controversial reconstructions of the history of VARV obtained using long- and short- term calibrations.

Recently, several reports have emerged describing the long-term consequences of COVID-19 that may affect multiple systems, suggesting its chronicity. As further research is needed, we conducted a longitudinal observational study to report the prevalence and associated risk factors of long-term health consequences of COVID-19 by symptom clusters in patients discharged from the Temporary COVID-19 Hospital (TCH) in Mexico City. Self-reported clinical symptom data were collected via telephone calls over 90 days post-discharge. Among 4670 patients discharged from the TCH, we identified 45 symptoms across eight symptom clusters (neurological; mood disorders; systemic; respiratory; musculoskeletal; ear, nose, and throat; dermatological; and gastrointestinal). We observed that the neurological, dermatological, and mood disorder symptom clusters persisted in >30% of patients at 90 days post-discharge. Although most symptoms decreased in frequency between day 30 and 90, alopecia and the dermatological symptom cluster significantly increased (p<0·00001). Women were more prone than men to develop long-term symptoms and invasive mechanical ventilation also increased the frequency of symptoms at 30-days post-discharge. Overall, we observed that symptoms often persisted regardless of disease severity. We hope these findings will help promote public health strategies that ensure equity in the access to solutions focused on the long-term consequences of COVID-19.

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

The goal of newborn screening is to improve health outcomes by identifying and treating affected newborns. This manuscript provides an overview of a data tool to facilitate the longitudinal collection of health information on newborns diagnosed with a condition through NBS. The Newborn Screening Translational Research Network (NBSTRN) developed the Longitudinal Pediatric Data Resource (LPDR) to capture, store, analyze, visualize, and share genomic and phenotypic data over the lifespan of NBS identified newborns to facilitate understanding of genetic disease, and to assess the impact of early identification and treatment. NBSTRN developed a consensus-based process using clinical care experts to create, maintain, and evolve question and answer sets organized into common data elements (CDEs). The LPDR contains 24,172 core and disease-specific CDEs for 118 rare genetic diseases, and the CDEs are being made available through the NIH CDE Repository. The number of CDEs for each condition average of 2,200 with a range from 69 to 7,944. The LPDR is used by state NBS programs, clinical researchers, and community-based organizations. Case level, de-identified data sets are available for secondary research and data mining. The development of the LPDR for longitudinal data gathering, sharing, and analysis supports research and facilitates the translation of new discoveries into clinical practice.

(1)Background: Evidence on the association between air pollution and the risk of exacerbations of chronic obstructive pulmonary disease (COPD) is scarce and inconsistent. We aimed to analyze the association between long-term exposure to particulate matter with a diameter of less than 2.5 µm (PM2.5) and nitrogen dioxide (NO2) and exacerbation of COPD (COPD-E) in Bogotá, Colombia; (2) Methods: Retrospective cohort study of 722 COPD patients in the AIREPOC program of the Colombian Pneumological Foundation between 2018 and 2021. Exposure to PM2.5 and NO2 was estimated for residential locations using the inverse squared distance weighted regression (IDWR) method. Hazard Ratios (HR) were calculated for the first COPD-E during follow-up using Cox models, adjusted for meteorological, demographic, and clinical variables; (3) Results: COPD-E was associated with long-term exposure to PM2.5 (HR:1.03, 95%CI: 1.02-1.05) and NO2 (HR:1.05, 95%CI: 1.03-1.07) controlling for the effect of quality of life, history of COPD-E, Forced Expiratory Volume in One Second (FEV1) pre-bronchodilator and exposure to solar radiation. An association was found between COPD-E and concentrations ≥ 25µg/m3 of NO2 (HR:1.49, 95%CI: 1.12-1.98) but not with concentrations ≥15 µg/m3 of PM2.5; (4) Conclusions: This study suggests that people with COPD exposed to higher concentrations of PM2.5 and NO2 had an increased risk of COPD-E. Solar radiation was also associated with an increased risk of COPD-E. The results highlight the importance of continuing efforts to reduce air pollution.

Background: Donor shortage limits the utilization of heart transplantation making it available for only a fraction of the patients on the transplant wait list. Continuous flow left ventricular assist devices have therefore risen in importance as a standard of care for end-stage heart failure. Short, mid and long-term survival rates as well as quality of life are now being studied with newer and more sophisticated machines. This study attempts to assess the impact of several commonly associated risk factors on long-term survival of LVAD recipients. Methods The TriNetX dataset comprises de-identified patient information across healthcare organizations. The study assesses the impact of demographics, infections, comorbidities, types of cardiomyopathies, arrhythmias, and end-organ dysfunction on long-term LVAD survival. The Log-rank test was used to assess post-implant survival effects, while Cox regression was used in univariate analysis to obtain Hazard Ratio (HR). Patients with unknown lab results were removed before the univariate analysis and K-M survival curves were generated. Samples with missing values or data errors (e.g., implantation is after recorded death) were excluded. All analyses were conducted using the Python programming language and the lifelines library. This study is IRB-exempt Results This study identified common risk factors that significantly impact survival such as CMV, hepatitis A exposure, atrial fibrillation, paroxysmal ventricular tachycardia, ischemic cardiomyopathy, renal dysfunction, diabetes, COPD, mitral valve disease, and hypertension. Conclusions This is the first report of a detailed long-term survival assessment of several risk factors that impact the LVAD population.

We conducted a hybrid-design study on a historical cohort of 359 adult recipients of a liver graft who received transplants between 1996 and 2002. The study aimed to identify predictors of survival and investigate the prevalence of co-morbidities among long-term survivors. The actuarial (95% CI) patient survival of the overall study cohort was 96% (94.6%-98.3%), 69% (64.2%-73.6%), 55% (49.8%-59.9%), 42.8% (37.6%-47.8%), and 34% (29.2%-38.9%) at 1, 5, 10, 15, and 20 years, respectively. The actuarial (95% CI) graft survival was 93.8% (91.6%-97.2%), 67.6% (62.2%-71.5%), 54.3% (49.6%-59.3%), 42.1% (37.3%-47.4%), and 33.8% (29.0%-38.4%) at 1, 5, 10, 15, and 20 years, respectively. The leading cause of death was hepatitis C virus recurrence (24.6%), followed by extrahepatic malignancies (16.9%), infection (14.4%), and hepatocellular carcinoma recurrence (14.4%). The Cox proportional hazards analysis revealed that several independent factors were associated with the survival probability. These factors include younger donor and recipient ages (p=0.001 and 0.004, respectively), female recipient sex (p<0.001), absence of HCV (p<0.01), absence of HCC (p=0.001), and absence of diabetes mellitus at one year (p<0.01). At the latest follow-up, the leading comorbidities in the long-term survivors were hypertension (53.6%), obesity (18.7%), diabetes mellitus (17.1%), hyperlipidemia (14.7%), chronic kidney dysfunction (14.7%), and extrahepatic malignancies (13.8%), with 73.9% of patients having more than one complication. The Kaplan-Meier probability (95% CI) of complication-free survival was 65.4% (60.2%-70.3%), 38.4% (33.4%-43.7%), 17.8% (14.1%-22.2%), 7.2% (4.8%-10.5%), and 1.94% (0.85%-4.15%) at 1, 5, 10, 15, and 20 years, respectively. Aging with a liver graft is associated with an increased risk of complications and requires ongoing care to reduce the long-term attrition rate resulting from chronic immunosuppression.

Conclusive evidence that specic long-term memory formation relies on den- dritic growth and structural synaptic changes has proven elusive. Connec- tionist models of memory based on this hypothesis are confronted with the so-called plasticity stability dilemma or catastrophic interference. Other fun- damental limitations of these models are the feature binding problem, the speed of learning, the capacity of the memory, the localisation in time of an event and the problem of spatio-temporal pattern generation. This paper suggests that the generalisation and long-term memory mechanisms are not correlated. Only the development and the improvement of the feature ex- tractors in the cortex involves structural synaptic changes. We suggest the long-term memory has a separate mechanism which involves protein synthe- sis to encode the information into the structure of these proteins. A model of memory should be capable of explaining the dierence between memorisation and learning. Learning has in our approach two dierent mechanisms. The generalisation in the brain is handled by the proper development of the links between neurons via synapses. The Hebbian learning rule could be applied only for this part of learning. Storing an internal ring pattern involves, in our approach, a new mechanism which puts the information regarding this ring pattern into the structure of special proteins in such a way that it can be retrieved later. The hypotheses introduced in this article includes a physiological assumption which has not been yet verified because it is not currently experimentally accessible. Keywords: Waves, Protein Synthesis, Resonance, Long Term Memory Preprint submitted to Neural Networks

The rainfall study in the long term is essential for climatic change understanding and socioeconomic development. The main goal of this study is to explore the spatial and temporal variations of precipitation in different time scales (seasonal and annual) in Cameroon. The Mann–Kendall and Pettitt tests were applied to analyze the precipitation variability. On temporal plan, the different regions of Cameroon have recorded significant drops in annual rainfall that Pet-titt's test generally situates around the 1970s. The decreases observed for the northern part of Cameroon regions are between –5.4% (Adamawa) and –7.4% (Far North). Those of west-ern part regions oscillate between –7.5% (South-West) and –12.5% (West). The southern part of Cameroon regions recorded decreases varying between –4.3% (East) and –5.9% (Center). On spatial plan, the divisions of the northern, western and southern parts of Cameroon respectively recorded after the 1970s (a pivotal period in the evolution of precipitation on temporal plan), a precipitation decrease towards the South, the South-West and the West. This study's findings could be helpful for planning and managing water resources in Cameroon.

Muscarinic acetylcholine receptors are well-known for their crucial involvement in hippocampus-dependent learning and memory, but the exact roles of the various receptor subtypes (M1-M5) are still not fully understood. Here, we studied how M1 and M3 receptors affect plasticity at the mossy fiber (MF)-CA3 pyramidal cell synapse. In hippocampal slices from M1/M3 receptor double knockout (M1/M3-dKO) mice, the signature short-term plasticity of the MF-CA3 synapse was not significantly affected. However, the rather unique, NMDA receptor-independent and presynaptic form of long-term potentiation (LTP) of this synapse was much larger in M1/M3-deficient slices compared to wild type slices, in both field potential and whole-cell recordings. Consistent with its presynaptic origin, induction of MF-LTP strongly enhanced the excitatory drive onto single CA3 pyramidal cells, with the effect being more pronounced in M1/M3-dKO cells. In an earlier study [1], we found that deletion of M2 receptors in mice disinhibits MF-LTP in a similar fashion, suggesting that endogenous acetylcholine employs both M1/M3 and M2 receptors to constrain MF-LTP. Importantly, such synergism was not observed for MF long-term depression (LTD). Low-frequency stimulation, which reliably induced LTD of MF synapses in control slices, failed to do so in M1/M3-dKO slices and gave rise to LTP instead. In striking contrast, loss of M2 augmented LTD when compared to control slices. Taken together, our data demonstrate convergence of M1/M3 and M2 receptors on MF-LTP, but functional divergence on MF-LTD, the net effect being well-balanced bidirectional plasticity of the MF-CA3 pyramidal cell synapse.

Inside hippocampal circuits, neuroplasticity events that individual cells may undergo during synaptic transmissions occur in the form of Long Term Potentiation (LTP) and Long Term Depression (LTD). The high density of NMDA receptors expressed on the surface of the dendritic CA1 spines confers to hippocampal CA3-CA1 synapses, the ability to easily undergo NMDA-mediated LTP and LTD, that is essential for some forms of explicit learning in mammals. Providing a comprehensive kinetic model that can be used for running computer simulations of the synaptic transmission process is currently a major challenge. Here, we propose a compartmentalized kinetic model for CA3-CA1 synaptic transmission. Our major goal was to tune our model in order to predict the functional impact caused by disease associated variants of NMDA receptors related to severe cognitive impairment. Indeed, for variants Glu413Gly and Cys461Phe, our model predicts negative shifts in the glutamate affinity and changes in the kinetic behavior, consistent with experimental data. These results pinpoint to the predictive power of this multiscale viewpoint, which aims to integrate the quantitative kinetic description of large interaction networks typical of system biology approaches with a focus on the quality of few, key, molecular interactions typical of structural biology ones.

Stock price prediction has long been a critical area of research in financial modeling. The inherent complexity of financial markets, characterized by both short-term fluctuations and long-term trends, poses significant challenges in accurately capturing underlying patterns. While Long Short-Term Memory (LSTM) networks have shown strong performance in short-term stock price prediction, they struggle with effectively modeling long-term dependencies. In this paper, we propose an advanced stock price prediction model based on the Extended Long Short-Term Memory (xLSTM) algorithm, designed to enhance predictive accuracy over both short and long-term periods. We conduct extensive experiments by building and evaluating models based on xLSTM and LSTM architectures for multiple stocks. Our results demonstrate that the xLSTM model consistently outperforms the LSTM model across all stocks and time horizons, with the performance gap widening as the prediction period extends. The observations underscore the superior capability of the xLSTM-based model to capture long-term patterns in financial data, offering a promising approach for more accurate and reliable stock price predictions.

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

Landsat and Sentinel-2 data archives provide ever-increasing amounts of satellite data for studying land cover and land use change (LCLUC) over the past four decades. However, the availability of cloud-, shadow-, and snow-free observations varies spatially and temporally due to climate and satellite data acquisition schemes. Spatio-temporal heterogeneity poses a major issue for some time-series analysis approaches, but can be addressed with pixel-based compositing that generates temporally equidistant cloud-free or near-cloud free synthetic images. Although much consideration is given to methods identifying the ‘best’ pixel value for each composite, determining the aggregation period receives less attention and is often done arbitrary, or based on expert intuition. Here, we evaluated data compositing windows ranging from five days to one year for 1984-2021 Landsat and 2015-2021 Sentinel‑2 time series across Europe. We considered separate and joint use of both data archives and analyzed spatio-temporal availability of composites during each calendar year and pixel-specific growing season. We reported mean annual composites’ availability investigating differences among biogeographical regions, checked feasibility of pan‑European analyses for three LCLUC applications based on annual, monthly and 10-day composites, and analyzed the shortest feasible compositing window ensuring ≥50% temporal data availability and interpolation of the remaining composites for individual years and across a variety of medium- and long‑term time windows. Our results highlighted low data coverage in the 1980s, 1990s, and in 2012, as well as spatial variability in data availability driven by climate and orbit overlaps, which altogether impact spatio-temporal consistency of medium- and long-term time series, limiting feasibility of some LCLUC analyses. We demonstrated that prior to 2011 monthly composites ensured overall 50-62% data coverage for each calendar year, and ~75% afterwards, with further increase to ~82% when Landsat and Sentinel-2 were combined. Temporal consistency of monthly composites was overall low and temporal interpolation augmenting up to 50% missing data each year and across a time window of interest, ensured feasibility of analyses. Applications based on shorter than monthly composites were challenging without joining Landsat and Sentinel‑2 archives after 2015, and beyond the Mediterranean biogeographical region. Using pixel-specific growing season data typically boosted data availability in most geographies and diminished most of the latitudinal differences, but feasibility of complete time series with sub-monthly compositing windows was still restricted to the most recent years, and required data interpolation. Overall, our analyses provided a detailed assessment of Landsat and Sentinel-2 data availability over Europe, and based on selected application examples, highlighted often lacking spatio-temporal consistency of time series with sub-monthly compositing windows and long-time periods, which might hinder feasibility of some LCLUC applications.

Memory is probably one of the most complex cognitive functions of the human, and in many years, thousands of studies have helped us to better recognize this brain function. One of the reference textbooks in neuroscience, which has also elaborated on the memory function, is written by Prof. Kandel and his colleagues. In this book, I encountered a number of ambiguities when it was explaining the memory system. Here, I am sharing those points, either to find an answer for them, or to let them be a suggestion for our future works. Prof. Kandel has spent most of his meritorious lifetime on studying the memory system; however, the brain is extremely complex, and as a result, we still have many years to comprehensively understand the neural mechanisms of brain functions.

The Eastern Mediterranean is a highly populated area with air quality problems as well where climate change already is noticed by higher temperatures and changing precipitation pattern. The anthropogenic aerosol affects health and changing concentra-tions and properties of the atmospheric aerosol affect radiation balance and clouds. Continuous long-term observations are essential in assessing the influence of anthro-pogenic aerosols on climate and health. We present 6 years of observations from Navarino Environmental Observatory (NEO), a new station located at the south west tip of Pelo-ponnese, Greece. The two sites at NEO, were evaluated to show the influence of the local meteorology but also to assess the general background aerosol possible. It was found that the background aerosol was originated from aged European aerosols and was strongly influenced by biomass burning, fossil fuel combustion, and industry. When subsiding into the boundary layer, local sources contributed in the air masses moving south. Mesoscale meteorology determined the diurnal variation of aerosol properties such as mass and number by means of typical sea breeze circulation, giving rise to pronounced morning and evening peaks in pollutant levels. While synoptic scale meteorology, mainly large-scale air mass transport and precipitation, strongly influenced the season-ality of the aerosol properties.

Great Britain’s stocks of coal, natural gas, and petroleum have seen major changes to the levels of stored energy over the years 2005 to 2019, a reduction of 200 TWh (35%) from 570 TWh to 370 TWh. The transformation of its electrical system over this timeframe saw a reduction in coal generation, leading to a corresponding reduction of the levels of stockpiled coal of 85 TWh (68%), partially offset by an increase in the stocks of biomass for electrical generation. The reduction in natural gas storage of 24 TWh (44%) was primarily due to the closure of Britain’s only long-term seasonal natural gas storage facility in January 2018. This was partially offset by the construction of medium-term natural gas storage facilities and the use of LNG storage in the years preceding its closure. For stocks of crude oil and oil products the reduction was 35 TWh (21%), linked to the overall reduction in demand.

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

The marathon sport events and those who participate in these have grown over the last years reflecting notably an augmentation of women and master runners participation. The aim of the present narrative review was to briefly present the results of studies on anthropometric, physiological and training characteristics, as well as predictors of performance, in marathon runners. It was observed that performance was better in runners with small body weight, body mass index, body fat percentage, and rate of endomorphy. With regards to physiology, an increased maximal oxygen uptake, anaerobic threshold, and improved running economy could result in faster race time. The training variables that could predict performance involved weekly training volume (distance) and intensity (running speed), as well as history of training (years). A combination of these three broad categories of characteristics may offer an approximate estimation of the race speed considering that other aspects (e.g., nutrition, biomechanic and motivation) influence race performance, too. In summary, the findings of the present study provided an overview of anthropometric, physiological and training characteristics associated with marathon race time; thus, an optimization of any of these characteristics would be expected to improve race time.

The key to the practical application of organometal–halide–crystals perovskite solar cells (PSCs) is to achieve thermal stability through robust encapsulation. This paper presents a method to significantly extend the thermal stability lifetime of perovskite solar cells to over 5,000 h at 85 °C by demonstrating an optimal combination of encapsulation methods and perovskite composition for carbon–based multiporous–layered–electrode (MPLE)–PSCs. We fabricated the four types of MPLE-PSCs using two encapsulation structures (over– and side–sealing with thermoplastic resin films) and two perovskite compositions ((5–AVA)x(methylammonium (MA))1–xPbI3 and (formamidinium (FA))0.9Cs0.1PbI3), and analyzed the 85 ºC thermal stability followed by ISOS–D–2 protocol. Without encapsulation, FA0.9Cs0.1PbI3 exhibited higher thermal stability than (5–AVA)x(MA)1–xPbI3. However, encapsulation reversed the phenomenon (that of (5–AVA)x(MA)1–xPbI3 became stronger). The combination of (5–AVA)x(MA)1–xPbI3 perovskite absorber and over–sealing encapsulation effectively suppressed the thermal degradation, resulting in the PCE value at 91.2% of the initial value after 5,072 h. On the other hand, another combination (side–sealing on (5–AVA)x(MA)1–xPbI3, over– and side–sealing on FA0.9Cs0.1PbI3) resulted in decreased stability. The FA–based perovskite was decomposed for these degradation mechanisms by the condensation reaction between FA and carbon. For side–sealing, the space between the cell and the encapsulant was estimated to contain approximately 1,260,000 times more H2O than in over–sealing, which catalyzed the degradation of the perovskite crystal. Our results demonstrate that MA–based PSCs, which are generally considered to be thermally sensitive, can significantly extend their thermal stability after the proper encapsulation. Therefore, we emphasize that finding the appropriate combination of encapsulation technique and perovskite composition is quite important to achieve further device stability.

Background: Severe eosinophilic asthma (SEA) represents a substantial global health burden. Benralizumab has been shown to restore good control of asthma. Robust data on benralizumab effectiveness over periods longer than 2 years are still scarce. Methods: This retrospective multicentric study was conducted on 108 Italian SEA patients treated with benralizumab for up to 36 months. Clinical outcomes were evaluated at 6, 12, 24 and 36 months. Partial and complete clinical remission (CR) were also assessed. Data were analysed either with descriptive statistics or using linear, logistic, and negative binomial mixed-effect regression models. Results: Benralizumab induced a persistent reduction in exacerbation rates (p

The atmospheric concentrations of sodium, aluminum, silicon, sulphur, chlorine, potassium, calcium, titanium, vanadium, chromium, manganese, iron, nickel, copper, zinc, bromine and lead were measured in air filters at the Finnish Meteorological Institute station, in Helsinki, Finland, during a period of 44 years (1962-2005). The mean annual concentrations were calculated and are presented from the lowest values to the highest ones Cr&lt;Ni&lt;Ti&lt;Br&lt;V&lt;Mn&lt;Cu&lt;Zn&lt;Cl&lt;Al&lt;Fe&lt;K&lt;Ca&lt;Na&lt;Pb&lt;Si&lt;S. Most of the elements (Fe, Si, Ti, K, Ca, Zn, Br, Pb, V, Ni, S, Cr, Na, Al, Cl) present higher values during spring and winter season while in summer the elements (Ti, Ca, S, Na) are found in higher concentrations. There is a strong correlation between the elements (V-Ni, Si-Pb, Fe-Ca, V-Cr, Si-K, K-Ca, Fe-Ti, K-Na, Si-Ca, V-S), indicating their common source. The identification of the sources of trace elements was performed based on positive matrix factorization analysis, using SoFi software. Four PM sources were identified: road dust (due to usage of leaded fuel), heavy oil combustion/secondary sulfates, traffic emissions and natural dust (soil). For the total of 44 years studied, significant decreases in concentrations were observed for all trace elements, most of which were over 50%: Na (-74%), Al (-86%), Si (-88%), S (-82%), K (-82%), Ca (-89%), Ti (-80%), V (-89%), Cr (-82%), Mn (-77%), Fe (-77%), Ni (-61%), Zn (-72%), Pb (-95%). The current data are consistent with previous air studies covering the whole territory of Finland. Finally, a significant decline has been observed in the majority of the elemental concentrations since the end of 70s, underlying the effectiveness of different environmental policies that have been applied during the last decades.

Background: this RCT assesses the 18 months clinical outcomes after regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and electrolytic method (PEC). Materials and Methods: Twenty-four patients (24 implants) suffering from periimplantitis were randomly treated by EC or PEC followed by augmentation and submerged healing. Probing pocket depth (PPD), Bleeding on Probing (BoP), suppuration and standardized radiographs were assessed before surgery (T0), 6 months after augmentation (T1), 6 (T2) and 12 (T3) months after replacement of the restoration. Results: Mean of PPD changed from 5.8 ± 1.6 mm (T0) to 3.1 ± 1.4 mm (T3). While BoP and suppuration at T0 was 100 % BoP decreased at T2 to 36.8 % and at T3 to 35.3 %. Suppuration could be found 10.6% at T2 and 11.8% at T3. Radiologic bone level measured from the implant shoulder to the first visible bone to implant contact was 4.9 ± 1.9 mm at me-sial and 4.4 ± 2.2 mm at distal sites (T0) and 1.7 ± 1.7 mm and 1.5 ± 17 mm at T3. Conclusions: Significant radiographic bone fill and improvement of clinical parameters were demonstrated 18 months after therapy.

Introduction Early prediction of long term outcomes in patients resuscitated after cardiac arrest (CA) is still challenging. Guidelines suggested a multimodal approach combining multiple predictors. We evaluated whether the combination of the electroencephalography (EEG) reactivity, somatosensory evoked potentials (SSEPs) cortical complex and Gray to White matter ratio (GWR) on brain computed tomography (CT) at different temperatures could predict survival and good outcome at hospital discharge and after six months. Methods We performed a retrospective cohort study including consecutive adult, non-traumatic patients resuscitated from out-of-hospital CA who remained comatose on admission to our intensive care unit from 2013 to 2017. We acquired SSEPs and EEGs during the treatment at 36°C and after rewarming at 37°C, Gray to white matter ratio (GWR) was calculated on the brain computed tomography scan performed within six hours of the hospital admission. We primarily hypothesized that SSEP was associated with favorable functional outcome at distance and secondarily that SSEP provides independent information from EEG and CT. Outcomes were evaluated using the Cerebral Performance Category (CPC) scale at six months from discharge. Results Of 171 resuscitated patients, 75 were excluded due to missing of data or uninterpretable neurophysiological findings. EEG reactivity at 37 °C has been shown the best single predictor of good outcome (AUC 0.803) while N20P25 was the best single predictor for survival at each time point. (AUC 0.775 at discharge and AUC 0.747 at six months follow up) Predictive value of a model including EEG reactivity, average GWR, and SSEP N20P25 amplitude was superior (AUC 0.841 for survival and 0.920 for good outcome) to any combination of two tests or any single test. Conclusion Our study, in which life-sustaining treatments were never suspended, suggests SSEP cortical complex N20P25, after normothermia ad off sedation, is a reliable predictor for survival at any time. When SSEP cortical complex N20P25 is added into a model with GWR average and EEG reactivity, the predictivity for good outcome and survival at distance is superior than each single test alone.

Refractive surgery is an increasingly popular procedure to decrease spectacle or contact lens dependency. The two most commonly used surgical techniques to correct myopia is Photorefractive keratectomy (PRK) and Femtosecond- Lasik (FS-LASIK)There are few publications that gathers such a long term follow up of both surgical techniques (2) Methods It has been performed a retrospective non-randomized study 509 PRK eyes and 310 FS-LASIK surgeries were followed for 10 years for the treatment of myopia and compound myopic astigmatism. Patients were followed up three months, one year, 2 years, 5 and 10 years. The safety index of both procedures was defined as a quotient between the postoperative BCVA (Best Corrected Visual Acuity) and the preoperative BCVA. The predictability is calculated as difference between the expected spherical equivalent and the achieved spherical equivalent. The efficacy index was calculated as a quotient between postoperative UCVA divided by the preoperative BCVA (3) Results. The results were: a safety index higher than 100% (109%) and an efficacy index of 82.4% after 10 years of PRK surgery in both groups. FS-LASIK was the safest surgery after 10 years and the most efficacy technique although in this case there were no statistically significant differences (4) Conclusions. All these data demonstrated better indexes for FS-LASIK

Stroke represents one of the neurological diseases most responsible for death and permanent disability in the world. Different factors, such as thrombus, emboli and atherosclerosis, take part in the intricate pathophysiology of stroke. Comprehending the molecular processes involved in this mechanism is crucial to developing new, specific and efficient treatments. Some common mechanisms are excitotoxicity and calcium overload, oxidative stress, and neuroinflammation. Furthermore, non-coding RNAs (ncRNAs) are critical in pathophysiology and recovery after cerebral ischaemia. ncRNAs, particularly microRNAs, and the long non-coding RNAs (lncRNAs) are essential for angiogenesis and neuroprotection, and they have been suggested to be therapeutic, diagnostic and prognostic tools in cerebrovascular diseases, including stroke. This review summarizes the intricate molecular mechanisms underlying ischemic and hemorrhagic stroke and delves into the function of miRNAs in the development of brain damage. Furthermore, we will analyze new perspectives on treatment based on molecular mechanisms in addition to traditional stroke therapies.

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

The current study investigated the neuroprotective effects of rutin hydrate (RH) in an Alzheimer’s disease (AD)-like learning and memory impairments rat model. Since AD is an age-related degenerative brain disorder characterized by a progressive worsening in cognitive function and memory, RH may be a potential drug for the treatment of AD-like memory loss, and this work is aimed to evaluate whether RH has neuroprotective effects in memory deficits induced by scopolamine (SCO). In our study, RH demonstrated beneficial effects as a neuroprotector in the brain and improved learning, memory, and synaptic plasticity in a rat. Rats were administered RH (100 mg/kg) and SCO (1.5mg/kg), and performed behavioral tests such as Morris water navigation test, Y-maze test, and passive avoidance test to evaluate the ability of learning and memory. In accordance with these findings, RH behaviorally attenuated SCO-induced shortening of step-through latency in the PA test, increased the percent of alternation in the Y-maze, and increased the time spent in the target zone in the MWN. Moreover, the neuroprotective effect of RH on learning and memory was investigated through the long-term potential on organotypic hippocampal slice cultures. RH increased the total activity of field excitatory postsynaptic potential (fEPSP) following theta burst stimulation and attenuated SCO-induced blockade of fEPSP. This approach could potentially be used as a therapeutic strategy for the restoration of learning and memory function and the prevention of the progression of AD. SCO treatment decreased the levels of BDNF/TrkB/ERK/CREB/Bcl2 and increased the Bax protein level in rat hippocampus. RH ameliorated the expression of these proteins by attenuating SCO-induced up or downregulation in the hippocampus. Based on these findings, the results highlight the molecular and cellular mechanisms through which RH is proposed to exert its neuroprotective effects in the prevention and treatment of learning and memory deficit disorders.

Newborn screening (NBS) is hailed as a public health success, but little is known about long-term outcomes following a positive newborn screen. There has been difficulty gathering long-term follow-up (LTFU) data consistently, reliably, and with minimal effort. Six programs developed and tested a core set of minimal LTFU data elements. After an iterative data collection process and the development of a data collection tool, the group agreed on minimal LTFU data elements. The denominator captured all infants with an NBS diagnosis, accounting for children who moved or died prior to the follow-up year. They also agreed on three LTFU outcomes: if the child was still alive, had contact with a specialist, and received appropriate care specific to their diagnosis within the year. The six programs representing NBS public health programs, clinical providers, and research programs provided data across multiple NBS disorders. In 2022, 83.8% (563/672) of the children identified by the LTFU programs were alive and living in the jurisdiction; of those, 92.0% (518/563) saw a specialist, and 87.7% (494/563) received appropriate care. The core LTFU data elements can be applied as a foundation to address the impact of early diagnosis by NBS within and across jurisdictions.

Landsat and Sentinel-2 acquisitions are among the most widely used medium-resolution optical data adopted for terrestrial vegetation applications, such as land cover and land use mapping, vegetation condition and phenology monitoring, and disturbance and change mapping. When combined, both data archives provide over 40 years, and counting, of continuous and consistent observations. Although the spatio-temporal availability of both data archives is well-known at the scene level, information on the actual availability of cloud-, snow-, and shade-free observations at the pixel level is lacking and should be explored individually for each study to correctly parametrize subsequent analyses. However, data exploration is time and resource consuming, thus is rarely performed a-priori. Consequently, the spatio-temporal heterogeneity of usable data is often inadequately accounted for in the analysis design, risking ill-advised selection of algorithms and hypotheses, and thus inferior quality of final results. Here we present precomputed data on the daily 1982‑2023 availability of usable Landsat and Sentinel-2 acquisitions across the globe, sampled at a pixel-level in a regular 0.18°-point grid. The dataset comprises separate Landsat- and Sentinel‑2‑specific data records, and is accompanied by a pixel-specific growing season information to facilitate data exploration. The dataset was derived based on freely available 1982-2023 Landsat surface reflectance (Collection 2) and Sentinel-2 top-of-the-atmosphere reflectance (pre‑Collection-1 and Collection-1) scenes from 2015 through 2023, following the methodology developed in the recent study on data availability over Europe [1]. Growing season information was derived based on 2001‑2019 time series of the yearly 500 m MODIS land cover dynamics product (MCD12Q2; Collection 6) [1]. As such, the dataset presents a unique overview of the spatio-temporal availability of usable daily Landsat and Sentinel-2 data at the global scale, hence offering much needed a-priori information aiding identification of appropriate methods and challenges for terrestrial vegetation analyses at local to global scale.

In view of the expected climate changes, a paradigm shift in soil management, through reduced tillage and/or a different use of crop residues, can be a key point in the mitigation of the climate impacts. The transition from a traditional cropping system (i.e., durum wheat in continuous cropping system under conventional tillage and/or straw removal) to those undergoing the conservative practices require to be evaluated in a medium to long time frame to reach an equilibrium and thus to be properly investigated. In this regard, cropping system simulation models are fundamental tools for the in-silico evaluation of the response of crop growth and soil organic matter dynamics to varying cropping scenarios. This paper reports the evaluations on the parameterization and reliability of the ARMOSA crop simulation model calibrated and validated on experimental datasets collected on durum wheat grown in continuous cropping system under several straw and soil management strategies in a Mediterranean environment.

Training has a significative effect on physiology of blood coagulation both in humans and in horses. Several hemostatic changes have been reported after exercise in the horse but data available are inconclusive. The aim of this study was to investigate the platelet activation and primary platelet-related hemostasis modifications in young untrained Thoroughbred racehorses in the first 4-month timeframe incremental training period in order to improve knowledge on this topic. Twenty-nine clinically healthy, untrained, 2-year-old Thoroughbred racehorses. Never trained Thoroughbreds were followed during their incremental 4-month sprint exercise schedule. Blood collection was performed once a month (T-30, T0, T30, T60, and T90). Platelet aggregation was measured by light transmission aggregometer in response to various agonists: adenosine diphosphate (ADP), collagen and calcium ionophore A23187. Platelet function was evaluated using the Platelet Function Analyzer (PFA-100®) using collagen/ADP and collagen/adrenaline cartridges. Nitrite-nitrate (NOx) plasma concentrations were measured by a colorimetric assay to assess in vivo nitric oxide bioavailability. Platelet activation was investigated also through gene expression analyses (selectin P-SELP, ectonucleotidase CD39-ENTPD1, prostaglandin I2 synthase-PTGIS, endothelial nitric oxide synthase 3-NOS3). Differences among the time points were analyzed and mean±SEM were calculated. Significant modifications were identified compared with T-30 with increase of platelet aggregation (collagen:32.6±4.8 vs 21.6±4.9%; ADP: 35.5±2.0 vs 24.5±3.1%; A23187: 30±4.7 vs 23.8±4%) and a shorter closure time of C-ADP cartridges (75.6±4.4 vs 87.7±3.4 sec) that tended to return to baseline value at T90. NOx concentrations in plasma significantly increased after 30 days of training program compared with baseline. The first long-term training period induce platelet hyperactivity already after 30 days in untrained Thoroughbreds. Regular physical training blunts the negative effects of acute efforts on platelets activation.

The chemically synthesized polymer polyacrylamide (HPAM) in conventional reservoirs has achieved excellent oil displacement, but its oil displacement is poor in extreme reservoir environments. To develop biopolymer oil flooding agent under extreme reservoir conditions, the viscosity increasing and rheological properties of three biopolymers, diutan gum, xanthan gum, and scleroglucan, were studied under extreme reservoir conditions (high salt, high temperature, strong acid, and alkali), and the effects of temperature, mineralization, pH, and other factors on their viscosities and long-term stability properties were analyzed and compared. The results showed that under the temperature of 90℃ and below, the three kinds of biopolymers had the best viscosity-increasing ability. The viscosity of the three kinds of biopolymers was 80.94, 11.57, and 59.83mPa·s, respectively, when the concentration was 1500mg/L and the salinity was 220g/L. At the shear rate of 250s-1,100℃~140℃, scleroglucan has the best viscosification. At 140℃, the solution viscosity is 19.74mPa·s, and the retention rate can reach 118.27%. The results of the long-term stability study showed that the solution viscosity of scleroglucan with mineralization level of 220 mg/L was 89.54% viscosity retention in 40 days, and the diutan gum could be stabilized for 10 days, and the viscosity was maintained at 90 mPa·s. All three biopolymers are highly acid and alkali-resistant, with viscosity variations of less than 15% in the pH3~10 range. Rheological tests have shown that both of them have better viscoelastic properties than xanthan gum due to the peculiar double-helix structure of xanthan gum and the rigid triple-helix structure of scleroglucan. Therefore, the two biopolymers, diutan gum, and scleroglucan have the potential for extreme reservoir oil displacement applications, and it is recommended to use diutan gum for oil displacement in reservoirs up to 90℃ and scleroglucan for oil displacement in reservoirs between 100℃ and 140℃.

Humeral resurfacing arthroplasty (HRA) entails the substitution of the articular surface alone with a prosthetic cap without stem. It is a more conservative procedure which can be easily converted in a total arthroplasty if necessary. The present study aimed to evaluate the clinical and radiographical outcomes in a series of patients treated with HRA. 33 patients with a mean fol-low-up of 11 years were clinically (Constant score; Disability of the Arm, Shoulder and Hand score, DASH) and radiographically assessed before and after surgery. Constant and DASH score improved significantly after surgery, and only 2 cases needed revision surgery. HRA represents a valid therapeutic option in selected cases to improve the quality of life and delaying the need for more invasive procedures.

The dynamics of suspended sediment involves inherent non-linearity and complexity as a result of the presence of both spatial variability of the basin characteristics and temporal climatic patterns. As a result of this complexity, the conventional sediment rating curve (SRC) and other empirical methods produce inaccurate predictions. Deep neural networks (DNNs) have emerged as one of the advanced modeling techniques capable of addressing inherent non-linearity in hydrological processes over the last few decades. DNN algorithms are used to perform predictive analysis and investigate the interdependencies among the most pivotal water quantity and quality parameters i.e., discharge, suspended sediment concentration (SSC), and turbidity. In this study, the Long short-term memory (LSTM) algorithm of DNNs is used to model the discharge-suspended sediment relationship for the Stony Clove Creek. The simulations were run using primary data on discharge, SSC and turbidity. For the development of the DNN models and examining the effects of input vectors, combinations of different input vectors (namely discharge, and SSC) for the current and previous days are considered. Furthermore, a suitable modelling approach with an appropriate model input structure is suggested based on model performance indices for the training and testing phases. The performance of developed models is assessed using statistical indices such as root mean square error (RMSE), mean absolute error (MAE), and coefficient of determination (R2). Statistically, the performance of DNN-based models in simulating the daily SSC performed well with observed sediment concentration series data. The study demonstrates the suitability of the DNN approach for simulation and estimation of daily SSC, opening up new research avenues for applying hybrid soft computing models in hydrology.

This article presents the implementation of a model to estimate the future price of commodities in the Brazilian market from time series of short-term technical evaluation. For this, data from two databases were used, one referring to the foreign market (opening values, maximum, minimum, closing, closing adjustment and volume) and the other, from the Brazilian market (the price of the day), considering commodities, sugar, cotton, corn, soybean and wheat. Subsequently, the technical indicators were calculated from the TA-Lib technical analysis library. Pearson’s correlation coefficient was applied, records with low correlation were removed, and then the database was consolidated. From the pre-processed data, Long Short-Term Memory (LSTM) recurrent neural networks were used to perform data prediction at the one and three day interval. These models were evaluated using the mean square error (MSE), obtaining results between 0.00010 and 0.00037 on test data one day ahead, and from 0.00017 to 0.00042 three days ahead. However, based on the results obtained, it was observed that the developed model obtained a promising forecasting performance for all the commodities evaluated. As a main contribution, there is the consolidation of databases that can be used in future scientific research. Furthermore, based on its interpretation, it can assist in decision making regarding the buying and selling of commodities to increase financial gains.

Glioblastoma (GBM) is a very aggressive malignant brain tumor with the vast majority of patients surviving less than 12 months (Short-term survivors [STS]). Only around 2% of patients survive more than 36 months (Long-term survivors [LTS]). Studying these extreme survival groups might help in better understanding GBM biology. This work aims at exploring application of machine learning methods in predicting survival groups(STS, LTS). We used age and gene expression profiles belonging to 249 samples from publicly available datasets. 10 Machine learning methods have been implemented and compared for their performances. Hyperparameter tuned random forest model performed best with accuracy of 80% (AUC of 74% and F1_score of 85%). The performance of this model is validated on external test data of 16 samples. The model predicted the true survival group for 15 samples achieving an accuracy of 93.75%. This classification model is deployed as a web tool GlioSurvML. The top 1500 features which retained classification efficiency (Accuracy of 80%, AUC of 74%) were studied for enriched pathways and disease-causal biomarker associations using the HumanPSD^TM database. We identified 199 genes as possible biomarkers of GBM and/or similar diseases (like Glioma, astrocytoma, and others). 57 of these genes are shown to be differentially expressed across survival groups and/or have impact on survival. This work demonstrates the application of machine learning methods in predicting survival groups of GBM.

Deep neural networks (DNNs) have made a huge impact in the field of machine learning by providing unbeatable humanlike performance to solve real-world problems such as image processing and natural language processing (NLP). Convolutional neural network (CNN) and recurrent neural network (RNN) are two typical architectures that are widely used to solve such problems. Time sequence-dependent problems are generally very challenging, and RNN architectures have made an enormous improvement in a wide range of machine learning problems with sequential input involved. In this paper, different types of RNN architectures are compared. Special focus is put on two well-known gated-RNN’s Long Term Short Memory (LSTM) and Gated Recurrent Unit (GRU). We evaluated these models on the task of force estimation system in pouring. In this study, four different models including multi-layers LSTM, multi-layers GRU, single-layer LSTM and single-layer GRU) were created and trained. The result suggests that multi-layer GRU outperformed other three models.

In fisheries monitoring, catch is assumed to be a product of fishing intensity, catchability, and availability, where availability is defined as the number or biomass of fish present and catchability refers to the relationship between catch rate and the true population. Ecological monitoring programs use catch per unit of effort (CPUE) to standardize catch and monitor changes in fish populations; however, CPUE is proportional to the portion of the population that is vulnerable to the type of gear that is used in sampling, which is not necessarily the entire population. Programs often deal with this problem by assuming that catchability is constant, but if catchability is not constant, it is not possible to separate the effects of catchability and population size using monitoring data alone. This study uses individual-based simulation to separate the effects of changing environmental conditions on catchability and availability in environmental monitoring data. The simulation combines a module for sampling conditions with a module for individual fish behavior to estimate the proportion of available fish that would escape from the sample. The method is applied to the case study of the well-monitored fish species Delta Smelt (Hypomesus transpacificus) in the San Francisco Estuary, where it has been hypothesized that changing water clarity may affect catchability for long-term monitoring studies. Results of this study indicate that given constraints on Delta Smelt swimming ability, it is unlikely that the apparent declines in Delta Smelt abundance are due to an effect of changing water clarity on catchability.

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

Metastatic pancreatic ductal adenocarcinoma pancreatic (PDAC) is characterized by poor prognosis and short survival. Today, the use of new polytherapeutic regimens increases clinical outcome of these patients opening new clinical scenario. A crucial issue related to the actual improvement achieved with these new regimens is represented by the occasional possibility to observe a radiological complete response of metastatic lesions in patients with synchronous primary tumor. What could be the best therapeutic management of these patients? Could surgery represent an indication? Herein we reported a case of a patient with a PDAC of the head with multiple liver metastasis, who underwent first line chemotherapy with mFOLFIRINOX. After 10 cycles, he achieved a complete radiological response of liver metastases and a partial response of pancreatic lesion. A, duodenocephalopancreasectomy was performed. Due to liver a lung metastases after 8 months from surgery, a second line therapy was started with a disease free survival and overall survival of 8 months and 45 months, respectively. Improvement in the molecular characterization of PDAC could help in the selection of patients suitable for multimodal treatments.

A long-term investigation of D. suzukii dynamics in wild blueberry fields from 2012 - 2018 demonstrates relative abundance is still increasing seven years after initial invasion. Relative abundance is determined by physiological date of first detection and air temperatures the previous winter. Date of first detection of flies does not determine date of fruit infestation. The level of fruit infestation is determined by year, fly pressure, and insecticide application frequency. Frequency of insecticide application is determined by production system. Non-crop wild fruit and predation influences fly pressure; increased wild fruit abundance results in increased fly pressure. Increased predation rate reduces fly pressure, but only at high abundance of flies, or when high levels of wild fruit are present along field edges. Male sex ratio might be declining over the seven years. Action thresholds were developed from samples of 92 fields from 2012 - 2017 that related cumulative adult male trap capture to the following week likelihood of fruit infestation. A two-parameter gamma density function describing this probability was used to develop a risk-based gradient action threshold system. The action thresholds were validated from 2016-2018 in 35 fields and were shown to work well in two of three years (2016 and 2017).

The rapid growth rate of the elderly population is a serious current issue in most countries, affecting them economically through needed medical treatment and healthcare planning. The priority concern is how to reduce the number of elderly people requiring long-term healthcare and raise the number who are able to live independently. This study executed a behavior assessment of elderly person’s self-reported use of electric scooters and analyzed their degree of acceptance of these assisted living tools, partly through a related factor analysis of our survey instrument. We used this questionnaire survey as our research method, applying SPSS22 software for factor analysis that revealed five survey facets.

This study introduces session-aware recommendation models, leveraging GRU (Gated Recurrent Unit) and attention mechanisms for advanced latent interaction data integration. A primary ad-vancement is enhancing latent context, a critical factor for boosting recommendation accuracy. We address existing models' rigidity by dynamically blending short-term (most recent) and long-term (historical) preferences, moving beyond static period definitions. Our approaches, pre-combination (LCII-Pre) and post-combination (LCII-Post) with fixed (Fix) and flexible learning (LP) weight configurations, are thoroughly evaluated. We conducted extensive experiments to as-sess our models' performance on public datasets such as Amazon and MovieLens 1M. Notably, on the MovieLens 1M dataset, LCII-PreFix achieved a 1.85% and 2.54% higher Recall@20 than II-RNN and BERT4Rec+st+TSA, respectively. On the Steam dataset, LCII-PostLP outperformed these models by 18.66% and 5.5%. Furthermore, on the Amazon dataset, LCII showed a 2.59% and 1.89% improvement in Recall@20 over II-RNN and CAII. These results affirm the significant enhancement our models bring to session-aware recommendation systems, showcasing their po-tential for both academic and practical applications in the field.

Asthma is a chronic respiratory disease characterized by hyperreactivity in the airways, which can lead to significant lung damage if not properly managed. While placebos—medications with no active therapeutic ingredients—are sometimes used in clinical trials to gauge the effectiveness of asthma treatments, their long-term use raises concerns. Placebos work primarily through psychological mechanisms by enhancing patients’ expectations of treatment. However, prolonged reliance on placebo treatment in asthma could potentially mask symptoms, delay proper management, and lead to undetected lung damage or other adverse effects. This study explores the potential risks and consequences associated with long-term placebo use in asthma management.

This study examines the feasibility of using event-related potentials (ERPs) obtained from electroencephalographic (EEG) recordings as biomarkers for long-term memory item classification. Previous studies have identified old/new effects in memory paradigms associated with explicit long-term memory and familiarity. Recent advancements in convolutional neural networks (CNNs) have enabled the classification of ERP trials under different conditions and identification of features related to neural processes at the single-trial level. We employed this approach to compare three CNN models with distinct architectures using experimental data. Participants (N = 25) performed an association memory task while recording ERPs that were used for training and validation of the CNN models. The EEGNET-based model achieved the most reliable performance in terms of precision, recall, and specificity compared with the shallow and deep convolutional approaches. The classification accuracy of this model reached 70% for known items and 62% for unknown items. Good overall accuracy requires a trade-off between recall and specificity and depends on the architecture of the model and the dataset size. These results suggest the possibility of integrating ERP and CNN into online learning tools and identifying the underlying processes related to long-term memorization.

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

With the escalation of size and complexity of modern Denial of Service attacks, there is a need for research in the context of Machine Learning (ML) used in attack execution and defense against such attacks. This paper investigates the potential use of ML in generating behavioral telemetry data using Long-Short Term Memory network and spoofing requests for the analyzed traffic to look legitimate. For this research, a custom testing environment was built, that listens for mouse and keyboard events and analyzes them accordingly. While the economic feasibility of this attack currently limits its immediate threat, advancements in technology could make it more cost-effective for attackers in the future. Therefore, proactive development of countermeasures remains essential to mitigate potential risks and stay ahead of evolving attack methods.

In patients with prior Takotsubo syndrome (TTS), long lasting functional cardiac limitations were described as compared with normal subjects. Emotions-triggered Takotsubo syndrome (E-TTS) has more favorable outcomes than TTS preceded by a physical trigger or by no identifiable fac-tors. The aim of the present study was to assess long-term cardiac functional limitations in a co-hort of asymptomatic E-TTS patients. We enrolled n=39 asymptomatic patients with a diagnosis of E-TTS. Cardiopulmonary exercise tests (CPET) were performed at 30 [12-40] months median fol-low-up from the acute event. A cohort of n=39 individuals matched for age, sex, body mass index and comorbidities served as control. Despite recovery of left ventricular ejection fraction, patients with prior E-TTS had lower peak VO2 and percentage of predicted peak VO2 (17.8 ± 3.6 vs 22.5 ± 6.5; P < 0.001 and 75.2 ± 14.1 % vs 100.6 ± 17.1%, P <0.001), VO2 at anaerobic threshold (AT) (11.1 [10.1-12.9] vs 14.4 [12.5-18.7]; P <0.001), peak O2 pulse (9.7 ± 2.5 vs 13.1 ± 3.5; P <0.001) and higher VE/VCO2 slope (30.4 ± 3.7 vs 27.2 ± 3.5; P <0.001) compared with matched controls. We found no statistically significant differences in heart rate reserve (HRR), respiratory equivalent ratio (RER), mean blood pressure and peak PetCO2 between patients and controls. Despite its favorable out-come, patients with E-TTS in our population were found to have subclinical long-term functional cardiac limitations as compared with a control cohort.

Background: PFO (Patent foramen ovale) is a common defect that affects about 25% of the population. Although its presence is asymptomatic in the majority of the cases, the remaining part becomes overt with different symptoms, including cryptogenic stroke. The PFO closure procedure is widely available to date with the most used Amplatzer PFO Occluder, also in complex anatomy, but the performance of another device, the GORE Septal Occluder (GSO), has not been completely explored with regard to different septal anatomies. Methods: From March 2012 to June 2020, 118 consecutive patients with an indication for PFO closure were treated using the GSO system and included in a prospective analysis and followed. After 12 months, every patient underwent transcranial Doppler to evaluate the effectiveness of treatment. Results: of 111 patients evaluated, 107 showed effective PFO closure (96,4%) and 4 showed a residual shunt (3,6%). To better evaluate the device performance, the overall population was sorted into 2 clusters based on the echocardiographic characteristics. The main difference between groups was for PFO width (4,85 ± 1,8 vs 2,9 ± 1 mm, p <0,001) and PFO tunnel length (12,6 ± 3,8 vs 7,2 ± 2 respectively, p <0,001), allowing identification of complex anatomy and simple anatomy, respectively. Regardless of the aforementioned cluster, the GSO performance to reach an effective closure was independent of anatomy type and the chosen device size. Conclusion: GSO device showed efficacy and safety at 1-year follow-up in patients with at least 1 anatomical factor of complexity of PFO, irrespectively from the level of complexity itself.

Fluctuating stock prices make it difficult for investors to see investment opportunities. One tool that can help investors overcome this is forecasting techniques. Long Short-Term Memory (LSTM) is one of deep learning methods used in forecasting time series. The training and success of deep learning is strongly influenced by the selection of hyperparameters. This research uses a hybrid method between the Genetic Algorithm (GA) and LSTM to find a suitable model for predicting stock prices. GA is used in optimizing the architecture such as the number of epochs, window size, and the number of LSTM units in the hidden layer. Tuning optimizer is also carried out using several optimizers to achieve the best value. From method that has been applied, it shows that the method has a good level of accuracy with MAPE values below 10% in every optimizer used. The error rate generated is quite low, in case-1 with a minimum RMSE value of 93.03 and 94.40, & in case-2 with an RMSE value of 104.99 and 150.06 during training and testing. A fairly stable and small value is generated by setting it using the Adam Optimizer.

This article presents the research results on developing professional capital in Lithuanian schools during the national project "Time for leaders". The longitudinal national initiative aimed to develop professional capital as the synergy of human, social and decisional components (Hargreaves and Fullan, 2019) of schools through the various cooperation-based learning experiences of educational professionals. The article provides an overview of project interventions (activities that stimulated cooperative learning of educational professionals) in the light of cooperative learning principles. The assessment of change over two project years in education professionals' perceptions of professional capital is presented using Cohen's d effect size measure. The measurement sample consisted of teachers (n1=5105; n2=4683) and school leaders (n1=439; n2=405) from 189 schools in 30 Lithuanian municipalities. The findings show a statistically significant medium positive change in professional capital. The most considerable change was estimated in the social and decisional capital dimensions and the relatively smallest - in the field of human capital.

Coincident changes in abundance and behavior pose a challenge for interpreting abundance data from monitoring programs. In the San Francisco Estuary, long-term monitoring documented the declines of many species including the anadromous Longfin Smelt (Spirinchus thaleichthys). We identified seasonal patterns in reginal presence of Longfin Smelt through its life cycle using monitoring data and generalized additive modelling. We then investigated the year-to-year variability in the seasonal patterns of presence using functional data analysis (FDA). FDA separated the variability due to population size from variability due to differences in timing of presence. We found that Longfin Smelt have consistent seasonal distribution patterns and that two trawl types were needed to accurately describe those patterns. After accounting for variability due to year-class strength, shifts in the timing of presence were evident in three regions. The most variable period for the upstream regions Suisun Bay and West Delta was for age-0 fish in summer and for the downstream region Central Bay was for age-0 fish in late fall. This manifested as a delay in the typical fall re-occupation of upstream regions that comprise the study area for another monitoring study (Fall Midwater Trawl). Thus, a portion of the recent reductions in Fall Midwater Trawl abundance of Longfin Smelt resulted from changes in behavior rather than a decline in abundance. The presence of multiple monitoring surveys allowed analysis of distribution from one data set to aid interpretation of patterns in abundance from another monitoring survey. This study highlights how identifying portions of the life cycle with the most and least variability in distribution can help inform the types of management strategies that will be most effective. It also illustrates an analytical method that can be used to address the problem of confounded effects of abundance and behavior on patterns in monitoring data.

While the ongoing climate change is well documented, the impacts exhibit a substantial variability, both in direction and magnitude, visible even at regional and local scales. However, the knowledge of regional impacts is crucial for the design of mitigation and adaptation measures, particularly when changes in the hydrological cycle are concerned. In this paper we present hydro-meteorological trends based on observations from a hydrological research basin in Eastern Austria between 1979-2019. The analysed state variables include the air temperature, the precipitation, and the catchment runoff. Additionally, trends for the catchment evapotranspiration were derived. The analysis shows that while the mean annual temperature was decreasing and annual temperature minima remained constant, the annual maxima were rising. The long-term trends indicate a shift of precipitation to the summer with minor variations observed for the remaining seasons and at an annual scale. Observed precipitation intensities mainly increased in spring and summer between 1979-2019. The catchment evapotranspiration, computed based on catchment precipitation and outflow, showed an increasing trend for the observed time period.

Beer fermentation is typically monitored by periodic sampling and off-line analysis. In-line sensors would remove the need for time-consuming manual operation and provide real-time evaluation of the fermenting media. This work uses a low-cost ultrasonic sensor combined with machine learning to predict the alcohol concentration during beer fermentation. The highest accuracy model (R2=0.952, MAE=0.265, MSE=0.136) used a transmission-based ultrasonic sensing technique along with the measured temperature. However, the second most accurate model (R2=0.948, MAE=0.283, MSE=0.146) used a reflection-based technique without the temperature. Both the reflection-based technique and the omission of the temperature data are novel to this research and demonstrate the potential for a non-invasive sensor to monitor beer fermentation.

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

COVID-19 patients can recover with a median SARS-CoV-2 clearance of 20 days post initial symptoms (PIS). However, we observed some COVID-19 patients with existing SARS-CoV-2 for more than 50 days PIS. This study aimed to investigate the cause of viral clearance delay and the infectivity in these patients. Demographic data and clinical characteristics of 22 long-term COVID-19 patients were collected. SARS-CoV-2 nucleic acid, peripheral lymphocyte count, and functionality were assessed. SARS-CoV-2-specific and neutralization antibodies were detected, followed by virus isolation and genome sequencing. The median age of the studied cohort was 59.83±12.94 years. All patients were clinically cured after long-term SARS-CoV-2 infection ranging from 53 to 112 days PIS. Peripheral lymphocytes counts were normal. Interferon gamma (IFN-ƴ)-generated CD4+ and CD8+ cells were normal as 24.68±9.60% and 66.41±14.87%. However, the number of IFN-ƴ-generated NK cells diminished (58.03±11.78%). All patients presented detectable IgG, which positively correlated with mild neutralizing activity (ID50=157.2, P=0.05). SARS-CoV-2 was not isolated, and a cytopathic effect was lacking. Only three synonymous variants were identified in spike protein coding regions. In conclusion, decreased IFN-γ production by NK cells and low neutralizing antibodies might favor SARS-CoV-2 long-term existence. Further, low viral load and weak viral pathogenicity was observed in COVID-19 patients with long-term SARS-CoV-2 infection.

Modeling brain dynamics to better understand and control complex behaviors underlying various cognitive brain functions are of interests to engineers, mathematicians, and physicists from the last several decades. With a motivation of developing computationally efficient models of brain dynamics to use in designing control-theoretic neurostimulation strategies, we have developed a novel data-driven approach in a long short-term memory (LSTM) neural network architecture to predict the temporal dynamics of complex systems over an extended long time-horizon in future. In contrast to recent LSTM-based dynamical modeling approaches that make use of multi-layer perceptrons or linear combination layers as output layers, our architecture uses a single fully connected output layer and reversed-order sequence-to-sequence mapping to improve short time-horizon prediction accuracy and to make multi-timestep predictions of dynamical behaviors. We demonstrate the efficacy of our approach in reconstructing the regular spiking to bursting dynamics exhibited by an experimentally-validated 9-dimensional Hodgkin-Huxley model of hippocampal CA1 pyramidal neurons. Through simulations, we show that our LSTM neural network can predict the multi-time scale temporal dynamics underlying various spiking patterns with reasonable accuracy. Moreover, our results show that the predictions improve with increasing predictive time-horizon in the multi-timestep deep LSTM neural network.

The land subsidence occurring in goafs after coal mining is a protracted process. The accurate prediction of long-term land subsidence in goafs relies heavily on the availability of long-term monitoring data. However, the scarcity of continuous long-term land subsidence monitoring data subsequent to the cessation of mining significantly hinders the accurate prediction of long-term land subsidence in goafs. To address this challenge, this study proposes an innovative method based on Interferometric Synthetic Aperture Radar (InSAR) for predicting long-term land subsidence of goafs following coal mining. The proposed method employs a concatenation approach that integrates multiple short-term monitoring data from different coal faces, each with distinct cessation times, into a cohesive and uniform long-term sequence by normalizing the subsidence rates. The method was verified using actual monitoring data from the Yangquan No.2 mine in Shanxi Province, China. Initially, coal faces with same shapes but varying cessation times were selected for analysis. Using InSAR monitoring data collected between June and December of 2016, the average subsidence rate corresponding to the duration after coal mining cessation of each coal face was back-calculated. Subsequently, a function relating subsidence rate to the duration after coal mining cessation was fitted to the data. Finally, the relationship between cumulative subsidence and the duration after coal mining cessation was derived by integrating the function. The results indicated that the relationship between subsidence rate and duration after coal mining cessation followed an exponential function for a given coal face, whereas the relationship between cumulative subsidence and duration after coal mining cessation conformed to the Knothe time function. Notably, after the cessation of coal mining, significant land subsidence persisted in the goaf of the Yangquan No.2 mine for a duration ranging from 5 to 10 years. The cumulative subsidence curve along the long axis of the coal face ultimately exhibited an inclined W-shape. The proposed method enables the quantitative prediction of residual land subsidence in goafs, even in cases where continuous long-term monitoring data are insufficient, thus providing valuable guidance for construction decisions above the goaf.

The Dutch PET@home Toolkit was developed to mitigate challenges and foster conversations and planning concerning pets in long-term care at home. This process evaluation study aimed to evaluate the practical application of the toolkit on four topics: 1) satisfaction; 2) relevance; 3) feasibility; and 4) integration of the PET@home Toolkit materials in home care. Outcomes may be used to improve the toolkit materials to better align with the long-term care at home setting. Accounting for data saturation, professional caregivers (N=6), clients (N=2), and family caregivers (N=2) who used toolkit materials participated in semi-structured interviews. Interviews were analysed by two researchers in ATLAS.ti using an inductive-iterative approach. The researchers reached consensus on themes and clustering within interview topics. This led to the identification of the following topics and (themes): satisfaction (general impression, suggestions for improvement), relevance (awareness, planning, pet-related aspects in practice, impact on healthcare quality), feasibility (healthcare practice, competence, quantity), and implementation (digitalisation, task owner, piloting, timing). Several improvements were made to toolkit materials, such as providing clearer instructions for clients in the information booklet. Participants acknowledged the toolkit could lead to better planning while mitigating potential challenges concerning pets which may lead to longer-lasting relationships between clients and their pets.

This study introduces a novel method for early prediction of Kimchi cabbage (Brassica rapa subsp. pekinensis (Lour.) Hanelt) height, utilizing drone imagery and a long short-term memory (LSTM) model. The research was conducted on a testbed at the National Institute of Agricultural Sciences (NAS) in South Korea, encompassing two distinct soil types (loam and sandy loam) to investigate their impact on growth. High-resolution drone images were captured throughout the growing season to generate a canopy height model (CHM) for estimating plant height at various stages. Missing height data were interpolated using a logistic growth curve, and an LSTM model was trained on this data to predict the final height of Kimchi cabbage at harvest. Three LSTM models were developed using time-series data collected at 29, 36, and 44 days after planting (DAP). The model trained on data from DAP 44 demonstrated the highest accuracy with a coefficient of determination (R²) of 0.83, a mean absolute error (MAE) of 2.48 cm, and a root mean square error (RMSE) of 3.26 cm, outperforming models trained on earlier data. Color-coded maps were generated to visualize the spatial distribution of predicted Kimchi cabbage heights, revealing variations in growth patterns across the testbed and confirming the model's potential for site-specific management. Considering the trade-off between accuracy and prediction timing, the model trained on DAP 36 data (MAE = 2.77 cm) was deemed optimal for informing cultivation management decisions. This research demonstrates the feasibility and effectiveness of integrating drone imagery, logistic growth curves, and LSTM models for early and accurate prediction of Kimchi cabbage height. The proposed technology enables data-driven decision-making for farmers, facilitating timely interventions based on predicted growth patterns. This could lead to improved crop yields, resource optimization, and a more sustainable agricultural future. Future research will focus on refining the model's accuracy and exploring its applicability to other crops, further expanding the potential of precision agriculture technologies.

The demand for precise indoor localization services is steadily increasing. Among various methods, fingerprint-based indoor localization has become a popular choice due to its exceptional accuracy, cost-effectiveness, and ease of implementation. However, its performance degrades significantly as a result of multipath signal attenuation and environmental changes. In this paper, we propose an indoor localization method based on fingerprints using self-attention and long short-term memory (LSTM). By integrating a self-attention mechanism and LSTM network, the proposed method exhibits outstanding positioning accuracy and robustness in diverse experimental environments. The performance of the proposed method is evaluated under two different experimental scenarios, which involve 2D and 3D moving trajectories, respectively. The experimental results demonstrate that our approach achieves an average localization error of 1.76 m and 2.83 m in the respective scenarios, outperforming the existing state-of-the-art methods by 42.67% and 31.64%.

Fungi belong to the species with the highest biodiversity and high potential for use in biotechnology and industry. Therefore, their long-term quality conservation is very important and it is necessary to continuously develop new methods and improve existing methods. Currently, cryopreservation appears to be the best available technique for the preservation of fungi. This study summarises the latest trends and advances in fungal cryopreservation over the last 7 years, i.e. findings from scientific publications from 2017 to 2023 dealing with cryopreservation of both basidiomycetes and non-basidiomycete fungi. The work analyzed the studied organisms and the cryopreservation method used, focused on the use of new procedures and modifications of existing methods; summarized the conditions for successful cryopreservation, such as cryopreservation time and temperature, as well as the substrate and cryoprotectant used.

Considering future tasks in soil health, resources management and environmental protection, farmers are challenged to develop sustainable strategies for managing soil and land resources. In this study, the long-term sustainability of two fertilization strategies, - current, with synthetic fertilizers (SYN) vs conservative, with organic sources of nitrogen (organic amendments plus green manure with a legume - CONS) - was assessed in a processing tomato/durum wheat rotation. The EPIC model was used, validated with field data then run to simulate the management for 30 years under 3 current and future climates. Yield, soil organic carbon (SOC) stock change, nitrogen use efficiency (NUE), water use efficiency (WUE) and nitrate leaching were considered as sustainability indicators. Under all the future climate scenarios, tomato yield increased in CONS, remaining almost stable in SYN. Wheat yield increased both in CONS and SYN, but the average yield in CONS was considerably lower than in SYN. NUE and nitrate leaching followed the same trend, both decreasing in CONS, while WUE was higher in CONS compared to SYN. The effect of CONS on SOC was always positive. Thus, the alternative N fertilization strategy proposed can be a favorable option for maintaining soil health and a sustainable crop production.

Dynamic neural networks (DNN) are types of artificial neural networks (ANN) that are designed to work with sequential data where context in time is important. In contrast to traditional static neural networks that process data in a fixed order, dynamic neural networks use information about past inputs, which is important if dynamic of a certain process is emphasized. They are widely used in natural language processing, speech recognition and time series prediction. In industrial processes, their use is interesting for the prediction of difficult-to-measure process variables. In an industrial process of isomerization, it is crucial to measure the quality attributes affecting the octane number of gasoline. Process analyzers that are commonly used for this purpose are expensive and subject to failures, therefore, in order to achieve continuous production in case of malfunction, mathematical models for estimating the product quality attributes are imposed as a solution. In this paper, mathematical models were developed using dynamic recurrent neural networks (RNN), i.e., their subtype of a long short-term memory (LSTM) architecture. The results of the developed models were compared with the results of several types of other data-driven models developed for an isomerization process, such as multilayer perceptron (MLP) artificial neural networks, support vector machines (SVM) and dynamic polynomial models. The obtained results are satisfactory, which suggests a good possibility of application.

Coronavirus infection disease -2019 (COVID-19) was a global pandemic with high mortality and morbidity, that lead to an increased health burned all over the world. Although the virus affects mostly pulmonary tract, cardiovascular implications were often among COVID-19 positive patients, and are predictive for poor outcomes. Increased values of myocardial biomarkers such as Troponin I or NT-proBNP were proven to be risk factors for respiratory failure (26). Although the risk of acute coronary syndromes (ACS) was greater in acute-phase of COVID-19, there were lower rates of hospitalization for ACS, due to patient’s hesitation for presenting at the hospital (22). Hospitalized ACS patients with COVID-19 infection, had a prolonged symptom-to-first medical contact time, and longer door-to-balloon time. The mechanisms of myocardial injurie in COVID -19 patients are not still not clear, most often is incriminated: the down-regulation of ACE2 inhibitors, endothelial disfunction, pro-coagulant status, increased levels of pro-inflammatory cytokines. The aim of this paper is to evaluate the long-term outcomes of COVID-19 survivors that presented an acute myocardial infarction by reviewing existing data.

This study investigates the long-term impact of soil tillage systems and crop residue incorporation on agrophysical properties. A long-term field experiment has been conducted since 1999 at the Ex-perimental Station of Vytautas Magnus University Agriculture Academy. According to the latest edition of the International Soil Classification System, the soil in the experimental field was classified as Planosol, with a silty medium loam texture at a depth of 0–20 cm and a silty light loam at a depth of 20–40 cm. This investigation aimed to assess the long-term impact of reduced tillage systems, straw, and green manure combinations on soil physical properties, including soil shear strength, and soil aggregate stability. Studies were carried out on winter wheat crops in 2014, 2017, and 2023. The treatments were arranged using a split-plot design. In a two-factor field experiment, one part of the experimental field had straw removed, while the other part had the entire straw yield chopped and spread at harvest (Factor A). The subplot factor (Factor B) included three different tillage sys-tems: conventional deep ploughing, cover cropping for green manure with no-till, and no-tillage. Soil samples were analysed in the Laboratory of Agrobiology at Vytautas Magnus University Ag-riculture Academy. The findings indicate that long-term application of reduced tillage significantly increases soil shear strength. Shallower tillage depths lead to higher soil shear strength, while the effect of spreading plant residues is relatively lower. Long-term tillage of different intensities, spreading plant residues, and catch crop cultivation for green manure did not significantly affect soil structure. However, soil structural stability was found to be highly dependent on soil tillage. Cover cropping for green manure with no-till and no-tillage positively affected soil aggregate sta-bility in the upper (0–10 cm) and 10–25 cm layers.

Attention Deficit-Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder with high incidence in children and adolescents characterized by motor hyperactivity, impulsivity, and inattention. MRI-based evidences support that neuroanatomical abnormalities as the volume reduction of neocortex and hippocampus are shared by several neuropsychiatric diseases as schizophrenia, autism spectrum disorder and ADHD. In addition, it is well documented the abnormal development and postnatal pruning of dendritic spines of neocortical neurons in schizophrenia, autism spectrum disorder and intellectual disability. A recent report using the prenatal nicotine exposure murine model of ADHD support a delay in spine maturation in CA1 neurons correlated with impaired working memory and hippocampal long-term potentiation (LTP). In vivo spine imaging show that dendritic spines are dynamic structures exhibiting Hebbian and homeostatic plasticity triggering intracellular cascades involving glutamate receptors, calcium influx and remodeling of F-actin network. The LTP-induced insertion of postsynaptic glutamate receptors is associated to the enlargement of spine head and long-term depression (LTD) to the spine shrinkage. In this review, we summarize recent evidence emerged from meta-analysis of brain imaging data from ADHD patients, risk loci from global genome-wide analysis and new reports focused on spine molecular structure and dynamics using in vivo imaging in neocortex and hippocampus.

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

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

Background: Heart rate variability is a non-invasive, measurable, and established autonomic nervous system test. Long-term COVID-19 sequelae are unclear; however, acute symptoms have been studied. Objectives: To determine autonomic cardiac differences between long COVID-19 patients and heathy controls and evaluate associations among symptoms, comorbidities, and laboratory findings. Methods: This single-center study included long COVID-19 patients and healthy controls. The heart rate variability (HRV), a quantitative marker of autonomic activity, was monitored for 24 h using an ambulatory electrocardiogram system. HRV indices were compared between case and control groups. Symptom frequency and inflammatory markers were evaluated. The significance level of 5% (p-value 0.05) was adopted. Results: A total of 47 long COVID-19 patients were compared to 42 healthy controls. Patients averaged 43.8 (SD14.8) years old, and 60.3% were female. In total, 52.5% of patients had moderate illness. Post-exercise dyspnea was most common (71.6%), and 53.2% lacked comorbidities. COVID-19 patients had 4 times more dyslipidemia. CNP, D-dimer, and CRP levels were elevated (p-values of 0.0098, 0.0023, and 0.0015, respectively). The control group had greater SDNN24 and SDANNI (OR = 0.98 (0.97 to 0.99; p = 0.01)). Increased low-frequency (LF) indices in COVID-19 patients (OR = 1.002 (1.0001 to 1.004; p = 0.030)) and high-frequency (HF) indices in the control group (OR = 0.987 (0.98 to 0.995; p = 0.001)) were also associated. Conclusions: Patients with long COVID-19 had lower HF values than healthy individuals. These variations are associated with increased parasympathetic activity, which may be related to long COVID-19 symptoms and inflammatory laboratory findings.

This paper presents the development and implementation of a machine learning model to estimate the future price of commodities in the Brazilian market from technical analysis indicators. For this, two databases were obtained regarding the commodities sugar, cotton, corn, soybean and wheat, which were submitted to the steps of data cleaning, pre-processing and subdivision. From the pre-processed data, recurrent neural networks of the long short-term memory type were used to perform the prediction of data in the interval of 1 and 3 days ahead. These models were evaluated using mean squared error, obtaining an accuracy between 0.00010 and 0.00037 on the test data for 1 day ahead and 0.00015 to 0.00041 for 3 days ahead. However, based on the results obtained, it can be stated that the developed model obtained a good prediction performance for all commodities evaluated.

Our study provides guidelines on how to build long-term customer relationship in the non-contract mechanism context. More specifically, the findings show that special, social, and core benefits influence calculative commitment, and operational and special benefits influence affective commitment. This study also supports that calculative and affective commitment play a crucial role in understanding multi-channel agencies’ loyalty. In sum, this study revealed that calculative and affective commitment can be considered as partial or full mediators in the relationship between RBs (relational benefits) and loyalty. This study not only contributed to the existing SET (social exchange theory) and RBs paradigm but also provided practical implications for food distribution management.

Important policy developments in dementia and palliative care in nursing homes between 2010 and 2015 in Flanders, Belgium might have influenced which people die in nursing homes and how they die. We aimed to examine differences between 2010 and 2015 in the prevalence and characteristics of residents with dementia in nursing homes in Flanders, and their palliative care service use and comfort in the last week of life. We used two retrospective epidemiological studies, including 198 residents in 2010 and 183 in 2015, who died with dementia in representative samples of nursing homes in Flanders. We found a 23%-point increase in dementia prevalence (P-value<0.001), with a total of 11%-point decrease in severe to very severe cognitive impairment (P=0.04). Controlling for this difference in resident characteristics, in the last week of life, there were increases in the use of pain assessment (+20%-point; P<0.001) and assistance with eating and drinking (+10%-point; P=0.02) but no change in total comfort. The higher prevalence of dementia in nursing homes with no improvement in residents’ total comfort while dying emphasize an urgent need to better support nursing homes in improving their capacities to provide timely and high-quality palliative care services to more residents dying with dementia.

There are a large number of wildlife and insect species that are in trouble on this planet, and most believe that monarch butterflies in eastern North America are too, because of the well-publicized declines of their winter colonies in central Mexico in the last 25 years. A small number of studies over the last decade have cast doubt on this claim by showing declines are not evident at other stages of the annual cycle. To determine how extensive this pattern is, I conducted an exhaustive review of peer-reviewed and grey literature on (eastern) monarch population censuses and studies, conducted across all seasons, and extracted data from these sources to evaluate how monarch abundance has or has not changed over time. I identified 20 collections of data that included butterfly club reports, compilations of citizen-science observations, migration roost censuses, long-term studies of isotopic signatures, and even museum records. These datasets range in duration from 15 years to over 100 years, and I endeavored to also update each with information from the most current years. I also re-examined the winter colony data after incorporating historical records of colony measurements dating back to 1976. This represents the most complete and up-to-date synthesis of information regarding this population. When I examined the long-term trajectory within each dataset a distinct pattern emerged. Modest declines are evident within the winter colonies (over the full 45 year dataset), and, within three censuses conducted during the spring recolonization. Meanwhile, 16 completely separate monitoring studies conducted during the summer and fall (and from varying locations) revealed either no trend at all or in fact an increase in abundance. While each of these long-term studies has inherent limitations, the fact that all 16 sources of data show the same pattern is undeniable. Moreover, this evidence is consistent with recently-conducted genetic work that shows a lack of decline. Collectively, these results indicate that despite diminishing winter colonies and spring migrations, monarchs in eastern North America are capable of rebounding fully each year, implying that milkweed is not limiting within their collective range. Moreover, there is no indication from these data that the summer population was ever truly diminished by changing agricultural practices in the Midwest that reduced milkweed in crop fields within that region. It is possible that the larger population is not as dependent on Midwestern agricultural milkweed as once thought, and/or that monarchs are adapting to increasingly human-altered landscapes. These results are timely and should bear on the upcoming USFWS decision on whether the monarch requires federal protection in the United States. Importantly, they argue that despite losses of many insects globally, the eastern North American monarch population is not in the same situation.

Precipitation downscaling is widely employed for enhancing the resolution and accuracy of precipitation products from general circulation models (GCMs). In this study, we propose a novel statistical downscaling method to foster GCMs’ precipitation prediction resolution and accuracy for monsoon region. We develop a deep neural network composed of convolution and Long Short Term Memory (LSTM) recurrent module to estimate precipitation based on well-resolved atmospheric dynamical fields. The proposed model is compared against GCM precipitation product and classical downscaling methods in the Xiangjiang River Basin in South China. Results show considerable improvement compared to the ECMWF-Interim reanalysis precipitation. Also, the model outperforms benchmark downscaling approaches, including 1) quantile mapping, 2) support vector machine, and 3) convolutional neural network. To test the robustness of the model and its applicability in practical forecast, we apply the trained network for precipitation prediction forced by retrospective forecasts from ECMWF model. Compared to ECMWF precipitation forecast, our model makes better use of the resolved dynamical field for more accurate precipitation prediction at lead time from 1 day up to 2 weeks. This superiority decreases along forecast lead time, as GCM’s skill in predicting atmospheric dynamics being diminished by the chaotic effect. At last, we build a distributed hydrological model and force it with different sources of precipitation inputs. Hydrological simulation forced with the neural network precipitation estimation shows significant advantage over simulation forced with the original ERA-Interim precipitation (with NSE value increases from 0.06 to 0.64), and the performance is just slightly worse than the observed precipitation forced simulation (NSE=0.82). This further proves the value of the proposed downscaling method, and suggests its potential for hydrological forecasts.

Speech/music classification that facilitates optimized signal processing from classification results has been extensively adapted as an essential part of various electronics applications, such as multi-rate audio codecs, automatic speech recognition, and multimedia document indexing. In this paper, a new technique to improve the robustness of speech/music classifier for 3GPP enhanced voice service (EVS) using long short-term memory (LSTM) is proposed. For effective speech/music classification, feature vectors implemented with the LSTM are chosen from the features of the EVS. Experiments show that LSTM-based speech/music classification produces better results than conventional EVS under a variety of conditions and types of speech/music data.

Although the majority of mobile phone (MP) users do not attribute adverse effects on health or well-being to MP-emitted radiofrequency (RF) electromagnetic fields (EMFs), the exponential increase in the number of RF devices necessitates continuing research aimed at the objective investigation of such concerns. In this work, we investigate the effects of acute exposure from Long Term Evolution (LTE) MP EMFs on thermal pain threshold in healthy young adults. We use a protocol that was validated in a previous study in a capsaicin-induced hyperalgesia model, and was also successfully used to show that exposure from an RF source mimicking a Universal Mobile Telecommunications System (UMTS) MP led to mildly stronger desensitization to repeated noxious thermal stimulation relative to the sham condition. Using the same experimental design, we did not find any effects of LTE exposure on thermal pain threshold. The present results are in accordance with previous evidence suggesting that effects are likely to be placebo/nocebo effects and are unrelated to the brief acute LTE EMF exposure itself. The fact that this is dissimilar to our previous results on UMTS exposure implies that RF modulations might differentially affect pain perception, and points to the necessity of further research in the topic.

Purpose: To analyze the five-year results of Trabectome ab interno trabeculectomy of a single glaucoma center. Method: In this retrospective interventional single-center case series, data of 93 patients undergoing ab interno trabeculotomy between September 2010, and December 2012 were included. Kaplan-Meier analysis was performed using success criteria defined as postoperative intraocular pressure (IOP) ≤21 mm Hg, or >20% reduction from preoperative IOP, and no need for further glaucoma surgery. Risk factors for failure were identified using Cox proportional hazards ratio (HR). Results: The retention rate for five years follow-up was 66%. The cumulative probability of success at 1, 2, 3, 4 and 5 years was 82.6%, 76.7%, 73.9%, 72.3%, and 67.5%. Risk factors for failure were lower baseline IOP (HR=0.27, P=0.001), younger age (HR=0.25, P=0.02), and higher central corneal thickness (HR=0.18, P= 0.01). Pseudoexfoliation was associated with a higher success rate (HR= 0.39, P=0.02). IOP was decreased significantly from 20.0±5.6 mmHg at baseline to 15.6±4.6 mmHg at 5-year follow-up (P=0.001). The baseline number of glaucoma medications was 1.8±1.2, which decreased to 1.0±1.2 medications at 5 years. Conclusion: Trabectome surgery was associated with a good long-term efficacy and safety profile in this single-center case series with a high retention rate. A higher baseline IOP, older age, thinner cornea, and pseudoexfoliation glaucoma were associated with a higher success rate.

This study outlines the development and optimization of a Long Short-Term Memory (LSTM) network designed to analyze and classify time-series data from tribological experiments, with a particular emphasis on identifying stationary phases. The process of fine-tuning key hyperparameters was systematically optimized through Bayesian optimization, coupled with K-fold cross-validation, to minimize the inherent randomness associated with training neural networks. The refined LSTM network achieved a weighted average accuracy of 84%, demonstrating a high level of agreement between the network's identified stationary phases and those manually determined by researchers. This result suggests that LSTM networks can reliably mimic manual identification processes in tribological data, providing a promising avenue for automating data analysis. The study underscores the potential of neural networks to transcend their traditional role in predictive modeling within tribology, opening up new possibilities for their application across a broader spectrum of tasks within the field.