Hearing-loss (HL) is a major public health issue albeit data is limited. Objectives: were to determine the frequency and factors. Design: was descriptive cross-sectional using web-based self-administered google-form questionnaire. Data analyzed by-IBM SPSS-V-24-Windows. Results: In 789 responses, 6.6 % reported HL, 62.4% from Eastern-region of which 41.2% were employed and 31.7% students. Despite 36.5% reported HL > 5-years, 21.2% sought treatments. 19.2% reported diabetes and 51.9% had family-history. Ages 11– 50 years showed female predominance (females 59.1%, males 41%). Age was significant in HL (P <0.001) irrespective of gender (males 6.8%, females 6.4%, P value =0.838) reaching peaks at 17.2% 51-60 years and 25% in 71-80 implying a potential risk (OR = 1.43, 95% CI: 0.78-2.81, p = 0.032). 34.6% indicated genetics then noise (26.9%), while infections, stroke, and fevers made 19.2%. Air or sea travels (7.7%) were insignificant (P = 0.628) while head injuries (11.5%), or low- and high-altitudes showed 21.2%. Noise-hazard (P = 0.048) and medications (P = 0.017) were significant in HL. Conclusion: thus, we show geriatric age, noise, and inheritance-history as major predispositions. However, the study was limited by small sampling. Future large cohort multicenter studies on factual clinical data would gain more insights into the HL.

Introduction: Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline and memory loss, predominantly affecting older adults. Understanding the multifaceted factors contributing to AD is crucial for developing effective prevention and intervention strategies. This narrative review synthesizes current literature on the various factors influencing the development and progression of AD in older adult populations.Methods: A comprehensive search was conducted across electronic databases including PubMed, Web of Science, and PsycINFO using relevant keywords such as "Alzheimer's disease," "risk factors," "genetics," "environmental factors," and "lifestyle." Studies published between 2000 and 2023 were included, focusing on factors associated with AD in individuals aged 65 years and older.Results: The review identified several key factors contributing to AD in older adults. Genetic predisposition, particularly the presence of apolipoprotein E (APOE) ε4 allele, emerged as a significant risk factor. Environmental factors such as air pollution, pesticides, and heavy metals were also implicated. Furthermore, lifestyle factors including physical inactivity, poor diet, and smoking were associated with increased AD risk. Chronic conditions such as diabetes and cardiovascular diseases were found to exacerbate cognitive decline in older adults.Conclusion: This narrative review highlights the complex interplay of genetic, environmental, and lifestyle factors in the development and progression of Alzheimer's disease among older adults. Understanding these factors is crucial for targeted interventions aimed at reducing AD risk and improving cognitive health outcomes in aging populations. Future research should focus on longitudinal studies and personalized medicine approaches to elucidate specific mechanisms underlying AD pathogenesis and to develop effective preventive strategies.

The aim of this study was to develop and validate a predictive early tooth loss multivariable model for periodontitis patients before periodontal treatment. A total of 544 patients seeking periodontal care at a university dental hospital were enrolled in the study. Teeth extracted after periodontal diagnosis and due to periodontal reasons were recorded. Clinical and sociodemographic variables were analyzed, considering the risk of short-term tooth loss. This study followed the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) guidelines for development and validation, with two cohorts considered as follows: 455 patients in the development phase and 99 in the validation phase. As a result, it was possible to compute a predictive model based on tooth type and clinical attachment loss. The model explained 25.3% of the total variability and correctly ranked 98.9% of the cases. The final reduced model area under the curve (AUC) was 0.809 (95% Confidence Interval (95% CI): 0.629 - 0.989) for the validation sample and 0.920 (95% CI: 0.891 - 0.950) for the development cohort. The established model presented adequate prediction potential of early tooth loss due to periodontitis. This model may have clinical and epidemiologic relevance towards the prediction of tooth loss burden.

The rise in precocious puberty cases can be attributed to a combination of genetic and environmental factors. Genetic factors play a significant role, with studies identifying genetic abnormalities in genes such as KISS1, KISS1R, MKRN3, DLK1, GABRA1, LIN28B, NPYR, TAC3, and TACR3, which are associated with central precocious puberty (CPP). Epigenetic factors like DNA methylation and histone modifications may mediate the relationship between genetic and environmental influences on CPP development. Environmental factors such as exposure to secondhand smoke, cesarean section, and BMI have also been linked to precocious puberty, particularly in girls, highlighting the multifactorial nature of this phenomenon. Understanding the interplay between these genetic and environmental factors is crucial in addressing the increasing prevalence of precocious puberty in children. The published literature in the past five years was systematically reviewed and summarized highlighting the interplay of genetic and environmental factors for the rise in the precocious puberty.

The quantity of soil loss as a result of soil erosion is dramatically increasing in catchment where land resources management is very weak. In this paper, a RUSLE model-based soil loss quanti-fication technique is presented to estimate the annual soil loss and identify the severity of the erosion in the catchment. This study uses Fincha catchment in Abay river basin as the study area to quantify the annual soil loss by implementing Revised Universal Soil Loss Equation (RUSLE) model developed in ArcGIS version 10.4. Digital Elevation Model (12.5 x 12.5), LANDSAT 8 of Operational Land Imager (OLI) and Thermal Infrared Sensor (TIRS), Annual Rainfall of 10 stations and soil maps of the catchment were used as input parameters to generate the significant factors. Rainfall erosivity factor (R), soil erodibility factor (K), cover and management factor (C), slope length and steepness factor (LS) and support practice factor (P) were used as soil loss quantification significant factors. A model builder for the RUSLE model was developed and raster map calcula-tion algebra was applied in ArcGIS version 10.4 to quantify the total annual soil loss. It was found that the quantified average annual soil loss ranges from 0.0 to 76.5 t ha-1 yr-1 was obtained in the catchment. The area coverage of soil erosion severity with 55%, 35% and 10% as low to moderate, high and very high respectively were identified. The information about the spatial variation of soil loss severity map generated in RUSLE model has a paramount role to alert land resources man-agers and all stakeholders in controlling the effects via implementation of both structural and non-structural mitigations. The results of the RUSLE model can also be further considered along with the catchment for practical soil loss quantification that can help for protection practices.

Obesity in children is associated with vitamin D (VD) deficiency and cardiometabolic abnormalities. To analyze the effects of VD supplementation in adolescents with obesity enrolled in a weight-loss program. Adolescents with obesity (n=26) and with normal weight (n=23; controls) were matched for age, sex, and puberty stage. The obesity group followed a 3-month weight-loss program that combined a reduced caloric intake with interval training physical activity and during which they received or not VD supplementation (4000 IU/d) (n=13/group; random assignation). The anthropometric parameters (BMI z-score, fat mass); serum levels of 25(OH)D, calcium and parathyroid hormone (PTH), cardiometabolic factors (triglycerides, HDL, and LDL cholesterol), fasting glucose and insulin, and homeostasis model assessment of insulin resistance index; diastolic, systolic and mean blood pressure, and inflammatory status (C-reactive protein, CRP) were measured at baseline and at the end of the 3-month program. At baseline, 25(OH)D concentration was lower and VD insufficiency (25(OH)D levels <50 nmol/L) rate was higher (73% vs 22%) in the obesity than in the normal-weight group. All cardiometabolic factors were altered in the obesity compared with the normal-weight group. After the 3-month weight-loss program, 25(OH)D levels was >50 nmol in all adolescents with obesity, but only in 46% of normal-weight adolescents. Moreover, the weight-loss program improved the cardiometabolic factors, inflammatory status (CRP) and physical performance, but VD supplementation did not have any additional effect. Analysis only of the adolescents with obesity and VD deficiency (25(OH)D <50 nmol/L) at baseline showed a significant correlation between the change in PTH and CRP (p=0.02) in the supplemented obesity group, while the increase in 25(OH)D only tended to be correlated with CRP decrease. Vitamin D supplementation could reduce VD insufficiency in adolescent with obesity, but does not have any additional effect on cardiometabolic factors when combined with a weight-loss program.

Microalgae and their bioproducts hold significant potential across various applications, for instance, in wastewater remediation, CO2 fixation, and the synthesis of nutraceuticals, pharmaceuticals, and biofuels. The production of these organisms heavily relies upon environmental conditions, including factors like temperature, light, and nutrient supply, which can significantly impact growth. Furthermore, the limitations in nutrients or certain extreme environments can result in productivity increases. As such, microalgae growth systems have become a critical consideration for both research and industry. Both open and closed systems, such as raceway ponds and photobioreactors, respectively, have their own advantages and drawbacks in microalgae cultivation. However, for microalgae growth, photobioreactors may address most concerns, as the system has a lower risk of contamination and can deliver specific growth factors in a controlled manner. This review will summarize the growth and incubation factors of microalgae and the uses of bioreactors in both research and industrial capacities.

Jamaica has one of the highest teenage pregnancy rate and therefore identifying the context of adolescent sexual and reproductive health is important, especially since there is paucity of research on preadolescents in the Jamaican context. The study was a nationally representative cross-sectional, interviewer administered, school-based survey of 10 -15 year olds. Summary statistics of the demographics and bivariate analyses were performed to assess the association of sexual initiation and given risk and resiliency factors. 1,422(47.4%) males, 1,581 (52.6%) females, mean age (SD) 12.5 (1.6) years were surveyed. Mean age of first sex was 11.0 (±2.5) years. Factors significantly with sexual initiation were, female sex (OR 0.17; 95% CI 0.12-0.23), caring relationships inside the home (OR 0.85; 95%CI 0.83-0.97) rare church attendance (OR1.36; 95%CI1.0-1.8), age (OR 1.75; 95%CI1.6-1.9) and community disorganization (OR 1.02 95% CI 1.01-1.07). Sexual initiation of early adolescents is positively influenced by environmental factors such as family connectedness and religious involvement. The negative correlates are societal risk factors such as community disorganization. Empowerment through learned sexual negotiation skills, should be incorporated into the education programme of pre-adolescents to facilitate adolescents embracing their intrinsic power to delay sexual debut and if sexually active to insist on condom use.

Factors responsible of species distribution were intensively investigated in the past, including response at different spatial scales. The aim of the present research is to review the most relevant factors explaining chironomid species distribution focusing to factors operating at different spatial scales, such as latitude, longitude, altitude, water temperature, dissolved oxygen, nutrients acting at regional, country, water basin extension. Data including chironomid species abundances from different lentic and lotic waters from Italy and other surrounding countries were analyzed with different multivariate methods: partial canonical correspondence analysis and multiple discriminant analysis. Spatial analysis included univariate Moran’I correlograms, multivariate Mantel correlograms and Moran’s Eigenvectors Maps (MEM) calculation. The results confirmed previous conclusions, that is habitat type including different running waters reaches (kryal, krenal, rhthral, potamal) and different lake types is the most significant factor in separating chironomid assemblages and spatial factors act only as indirect influencers..

Neonatal mortality remains a public health concern and timely identification and prompt intervention in the delivery room could improve the outcome in neonatal morbidity and mortality. We performed a retrospective study to help us finding the profile of the high-risk newborn regarding the need for NICU admission, necessary to establish a protocol regarding the mobilization of human and material resources for the urgent management of these situations. All deliveries and neonates born in Maternity of Bihor County Emergency Clinical Hospital from Romania were reviewed, including relevant maternal, foetal and perinatal data to identify risk factors that result in birth of newborns needing resuscitation at birth between 2012-2019. The number of births showed a downward trend but around 90% of the births were on term. The incidence of neonatal emergencies is increasing, the most frequently were respiratory, sepsis and other infections, cardiovascular emergencies, and extreme prematurity. It is noted that in 2021 the incidence of these neurological emergencies increased by three times compared to previous years. The neonatal and maternal risk factors associated with admission to the NICU were mother's age over 35 years, low level of education, second/more gestation, weight under 2500 g, Apgar score under 7, premature rupture of membranes, macrosomia and mother's infectious pathology. Accurate identification of risk factors and anticipation at the birth of a high-risk neonate would result in adequate preparation and prompt resuscitation of neonates who need some level of intervention and thus, reducing neonatal morbidity and mortality.

Purpose: This integrated review aims to identify and analyze the multifactorial contributors to the longevity of direct restorations, focusing on tooth-, patient-, and dentist-related factors. Materials and Methods: A literature search was performed using an electronic database, PubMed/Medline, Web of Science, and Scopus, between 1980 and 2024. Titles and abstracts of papers that evaluated aspects categorized into tooth-related, patient-related, and dentist-related factors influencing restoration failure were selected and screened. Full-text assessments were conducted, and the extracted data were compiled, summarized, and synthesized. The reference lists of the collected papers were also screened, and relevant citations were included in this review. Data were gathered from clinical and laboratorial studies, systematic reviews, and meta-analyses to provide a comprehensive understanding of restoration longevity. Results: Among the tooth-related factors, multiple-surface restorations, deep margins, tooth location, and tooth vitality significantly impact restoration survival. Patient-related factors such as medical conditions, risk predictors of caries, age, sex, parafunctional habits, smoking, periodontal health, number of restorations, and socioeconomic status all play crucial roles. Regarding dentist-related factors, the decision-making process, age, experience, and dentist manual dexterity are vital aspects. Furthermore, the technique used, including isolation methods for moisture control, as well as the type of dental practice (large group vs. small practice), notably influenced the restoration survival. Conclusions: The longevity of dental restorations is influenced by a complex interplay of tooth-related, patient-related, and dentist-related factors. Strategies to improve restoration outcomes should consider all these multifactorial contributors. Continuing professional education, diligent patient guidance on the factors that influence restoration survival, careful material selection and restorative technique, and tailored individual treatment are crucial factors to reduce failure rates and improve the lifespan of restorations.

From the existing millions of fungal species only a few cause disease. In this study, we investigated invasive fungal infections in the head and neck over a 19-year period (2005 to 2024) at a large academic healthcare system. Among 413 cases, 336 were noninvasive, and 77 were invasive. The highest incidence of invasive infections occurred in the sinonasal cavities, with a 15-fold difference compared to other sites. Most infections affected adults over 40 years old. The most common organisms were Mucorales (51%), hyaline molds (29%), and Candida (11%). Risk factors included malignancy, transplant, diabetes, and illicit drug use. Mortality was high in patients with malignancy and/or transplant. Infections affecting the mandible were usually a complication of osteoradionecrosis and were associated with coinfection of Candida and Actinomyces. At other sites, infections were rare and were usually the result of penetrating injuries or immunosuppression. Treatment typically involved a combination of antifungals and surgical procedures.

Glial cell line-derived neurotrophic factor GDNF is among the strongest dopamine neuron function and survival promoting factors known. Due to this reason, it has clinical relevance in dopamine disorders such as Parkinson’s disease and Schizophrenia. In the striatum, GDNF is exclusively expressed in interneurons which make up only about 0.6% of striatal cells. Despite clinical significance, histological analysis of striatal GDNF system arborization and relevance to incoming dopamine axons, which bear its receptor RET, has remained enigmatic. This is mainly due to the lack of antibodies able to visualize GDNF and RET positive cellular processes; here we overcome this problem by using knock-in marker alleles. We find that GDNF neurons chemoattract RET+ axons at least 7 times longer in distance than medium spiny neurons (MSNs), which make up 95% of striatal neurons. Furthermore, we provide evidence that tyrosine hydroxylase, the rate limiting enzyme in dopamine synthesis, is enriched towards GDNF neurons in the dopamine axons. Finally, we find that GDNF neuron arborizations occupy approximately twelve times less striatal volume than 135 times more abundant MSNs. Collectively, our results improve our understanding of how endogenous GDNF affects striatal dopamine system function.

The most important prognostic factors in curatively treated prostate cancer at the initial diagnosis are T and N stage, histological subtype, Gleason score, initial PSA, PSA density and percentage of core biopsy positivity. Newer, but non-standard prognostic factors are urine PCA3 and genetic markers of prostate cancer. A simple, but seemingly underestimated standard test is serum Calcium (Ca) level, which has been shown by a previous study group to be a good predictor of lethal prostate cancer, but there is scarce evidence regarding the prognostic value of calcium levels at diagnosis. We aimed to determine whether a Ca level in the upper part of normal values has a prognostic value in curatively treated prostate cancer. We have retrospectively included 84 consecutive patients with prostate cancer, who underwent curative radiotherapy (primary or adjuvant; external beam RT with or without brachytherapy). We have performed statistical analysis of available prognostic factors. Ca level at diagnosis was found to be a statistically significant predictor of disease-free survival.

Solid waste management in Accra is a major challenge to the Metropolitan Authorities and inhabitants. The rapidly increasing population coupled with poor capacity of the municipal and private waste management companies to management waste effectively has created issues of environmental concern. Due to poor waste managements systems, most household dispose waste indiscriminately leading to floods and health issues. The study showed that about 60% of household waste is organic materials which has the potential to be converted to compost for agriculture purpose. Meanwhile plastics and rubbers which litters the environment as well as blocking major storm drains and gutters hence creating huge environmental hazard is made of 11% of the total component of most household waste generated daily. The study also revealed that among the methods of disposing waste, dumping waste in skip containers located at authorized places was the preferred means of disposing waste by household though others also dispose waste by other means such as burying and burning. Inadequate skip containers per population of household in an area coupled with irregularity of tracks picking these containers makes skip containers dumping site ugly scene, hence creating health issues. Among the constraints that impact negatively on sustainable waste management in Accra Metropolis, economic constraints was perceived as the main challenge which affect efficient waste management. Currently the country is going through serious economic challenges so government does not release money timely to fund projects which waste management is key. Most donor partners that use to support the government with funds have either reduced or redrawn their services as they have no confidence in the state of Ghana economy. Aside the constrains, the study also indicated that factors such as poor public attitude towards waste management, poor enforcement of sanitation by-laws, inadequate and untimely release of government funds were also seen as the main factors affecting waste management.

Ovarian cancer (OC) represents a significant challenge in the realm of gynecological cancers, characterized by poor survival rates and complex etiology. In this review, we delve into the se-lected genetic, environmental, and hormonal factors underpinning OC development. We have reviewed scientific databases searching for ovarian cancer genetic and epigenetic factors. We have included studies based on their relevancy. As a result of exploring ovarian carcinogen-esis, this systematic review contains data collected from 126 various works. The role of prominent genetic players such as BRCA mutations, DNA repair mechanisms, un-derscores the intricate landscape of OC susceptibility. We explore Li-Fraumeni and Lynch syn-drome, which impart a heightened predisposition to OC development. Hormonal factors such as estrogen, progesterone, and androgens are also discussed. Environmental alterations, ranging from lifestyle influences on OC to microbiome dysbiosis and lifestyle factors such as obesity, al-cohol consumption, and physical activity intersect with genetic and epigenetic pathways, shaping the risk landscape for OC. Through a meticulous examination of current literature, this review provides a nuanced under-standing of the multifactorial nature of OC, emphasizing the need for holistic approaches to prevention, diagnosis, and treatment.

Severe early childhood caries remains the most common chronic disease affecting children. Its multifactorial etiology has established a controversy about which risk factors were more significant to its development. Therefore our study aimed through meticulous statistical analysis to arrange the “well agreed upon” common risk factors in order of significance, to aid the clinician in tailoring an adequate preventive program for this affected age group. The study reshuffled the risk factors contributing to severe early childhood caries and placed them in the order of their significance as follows: snacking of sugary food several times a day, increased number of siblings to 3 or more, night feeding, child self-employed brushing, mother caries experience, 2 siblings, on demand feeding, once/day sugary food, sharing utensils, 1 Sibling, male gender, father’s education, late first child dental visit, brushing time, mother’s education, no dental visit, decreased brushing frequency & no night brushing.

Background: Condoms have proven to be an effective contraceptive barrier method of family planning and have played a vital role in preventing sexually transmitted diseases including HIV. However, existing evidence shows that utilization of condoms still remains low, especially among youth and adolescents. We aimed to determine the prevalence of condom use and associated factors among the students of Gulu university in Uganda. Methods: A cross-sectional study was conducted among undergraduate students of Gulu University between June and December 2023. The students were accessed from their respective faculties and chosen using a simple random sampling method. Data were collected using a pretested self-administered structured questionnaire. Condom use was defined as use of either male or female condom in the last sexual encounter in the previous six months. Results: A total of 404 participants, with a median age of 23 years (interquartile range (21.5-24) years) were enrolled in the study, 54.2%(n=219) of whom were male. Overall, 81.4%(n=329) of the participants were in senior classes (year 2,3,4, and 5) and 18.6%(n=75) were in their first year of study. The prevalence of condom use was 53.7%(n=217). Prevalence of condom use was 50.2%(n=109) among male and 49.8%(n=108) among female students. Year of study (senior class)(aPR = 1.4, 95% CI = 1.59, 3.54), having a sexual partner (aPR = 2.4, 95% CI = 1.89, 2.94), having a sexual partner within campus (aPR = 2.0, 95% CI = 1.69, 2.45), experience of condom bursting (aPR = 1.3, 95% CI = 1.08, 1.61), having sex in absence of condoms (aPR = 0.6, 95% CI = 0.44, 0.70), alcohol use (aPR = 1.2, 95% CI = 1.01, 1.45) were independently associated with condom use. Conclusion: Just over half of undergraduate students of Gulu university used condoms during sexual encounters. There should be heighten campaigns on condom use to prevent unintended pregnancies and sexually transmitted infections.

Due to its intriguing applications across a wide range of industries, nanotechnology is generating a lot of interest globally. Titanium dioxide (TiO2) nanoparticles are one type of nanoparticle (NP) that is commonly utilised in everyday use and can be produced using a variety of physical, chemical, and environmentally friendly techniques. Green synthesis is an economical, environmentally benign, and non-toxic method of synthesising NPs. Under normal circumstances, the application of TiO2 greatly enhanced the plants' shoot length, leaf area, and root dry weight. These growth-promoting factors coincided with elevated proline, soluble sugar, and chlorophyll B levels as well as improved antioxidant enzyme activity. Thus, higher levels of proline and other metabolites played a role in osmo-protection, while increased antioxidant enzyme activities helped to explain the observed decrease in hydrogen peroxide and malondialdehyde contents. Taken together, these factors significantly improved plant growth under salinity. TiO2 nanoparticles have demonstrated efficacy in treating contaminated water and have been shown to positively impact plant physiology, particularly in response to abiotic stresses. However, the reaction to these nanoparticles varies depending on characteristics such as metal species, type, size, shape, dose, duration of exposure, and other variables. One of the most popular nanomaterials in customer goods, agricultural, and energy industries is TiO2 NPs. Therefore, harm to ecosystems and living things will unavoidably result from high demand and widespread usage. Gaining more knowledge about the toxicity of TiO2 NP to living things could help with risk assessments and safe handling procedures for these nanoparticles. The synthesis of titanium oxide, its many uses, the toxicity of titanium dioxide nanoparticles, and their mode of toxicity are all summarised in this paper.

Interactions between human immunodeficiency virus type 1 (HIV-1) and the host factors or restriction factors of its target cells determine the cell’s susceptibility to, and outcome of, infection. Factors intrinsic to the cell are involved at every step of HIV-1’s replication cycle, contributing to productive infection and replication, or severely attenuating HIV-1’s chances of success. Furthermore, factors unique to certain cell types contribute to the differences in infection between these cell types. Understanding the involvement of these factors in HIV-1 infection is a key requirement for the development of anti-HIV-1 therapies. As the list of factors grows, and the dynamic interactions between these factors and the virus are elucidated, comprehensive and up-to-date summaries that recount the knowledge gathered after decades of research are beneficial to the field, displaying what is known so that researchers can build off the groundwork of others to investigate what is unknown. Herein, we aim to provide a review focusing on protein host factors, both well-known and relatively new, that impact HIV-1 replication in a positive or negative manner at each stage of the replication cycle, highlighting factors unique to HIV-1’s various target cell types where appropriate.

Introduction: Cleft lip with or without cleft palate (CL/P) is the most common congenital face anomaly in the world of multifactorial etiology. Objective: To determine the prevalence and characteristics of cleft palate. To identify associated risk factors to guide prevention and/or prenatal detection for early intervention and better health outcomes. To assess the rehabilitation protocols after operations in cleft palate. Design: Retrospective descriptive and clinical study. Patients: One hundred and three children with cleft palate treated in the Department of Head and Neck Surgery Clinic for Children and Young Adults, Department of Clinical Pediatrics, University of Warmia and Mazury, were included in the study. Methods: Records evaluation was conducted regarding sex, cleft type, mother occupation, parents education, histories of cleft in any of parents. The data were analyzed using R (R core team 2021) and the ordinal logistic regression analyses. Results: Children of stressed mothers during pregnancy had 9.4 times higher odds of having bilateral cleft. While there was no evidence that children sex, order of birth, and body mass as well as risk of maternal toxicity at work or reporting infections or drugs toxicity had a significant effect on the dependent variable. Conclusions: Children of parents with cleft history and having low educated mothers had higher probability of bilateral cleft palate. Children of stressed mothers during pregnancy had higher odds of having bilateral cleft. In literature, there is a lack of reports about rehabilitation in different operations methods in children with cleft palates.

Background: Experiential learning (EL) experiences are an important component of a university education, positively impacting career-related attitudes, knowledge, and skills. Students also require EL opportunities to gain experiences required for admission to competitive graduate and professional programs. Students with disabilities face barriers accessing and benefiting from such opportunities. Purpose: This study examined the degree to which demographic factors, type and severity of disability, dispositional factors, and overall adjustment and wellbeing are predictive of the quality of EL experiences among university students with disabilities. Methodology/approach: A survey was distributed to undergraduate students with disabilities who have participated in EL courses. Results were analyzed using multiple linear regression. Findings/conclusions: Dispositional and adjustment and wellbeing variables, including the environmental mastery dimension of their psychological wellbeing rather than demographic factors, such as gender or type and severity of disability, are significant predictors of the quality of EL experiences among students with disabilities. Implications: For students with disabilities to have academically and professionally successful EL experiences, post-secondary institutions must continue to provide appropriate accommodations and educate instructors about the diverse and complex needs of this student group. This must include an understanding of the uniqueness of each individual student’s needs.

To identify factors associated with interstitial lung disease (ILD) in patients with systemic sclerosis (SSc) and build an algorithm to better define this association, for a personalized application in clinical practice. Methods. 78 SSc patients underwent HRCT to assess ILD. Demographic, clinical and laboratory variables were collected, focusing on those associated either directly or indirectly with lung involvement. The discriminant value of each variable was determined using the operating characteristic curves (ROC) and included in a model to estimate the strength of ILD association in SSc. Results. Thirty-three (42.31%) patients showed ILD on HRCT. DLco, M-Borg, GERD-Q, and capillary density were significantly associated with the presence of ILD-SSc. A model including these variables had a coefficient of determination (R2) of 0.697. DLco had an AUC of 0.861 (p&lt;0.001) with a cut-off ≤72.3% (sensitivity 78.8%, specificity 91.1%, +LR 8.86). The m-Borg scale showed an AUC of 0.883 (p&lt;0.001) with a cut-off &gt;2 (sensitivity 84.8%, specificity 82.2%, +LR 4.77), GERD-Q had an AUC of 0.815 (p&lt;0.001) with a cut-off &gt;7 (sensitivity 72.7%, specificity 86.7%, +LR 5.45). The capillary density showed an AUC of 0.815 (p&lt;0.001) with a cut-off ≤4.78 (sensitivity 87.9%, specificity 68.9%, +LR 2.82). Based on the pre-test probability values, these four variables were applied to Fagan's nomogram to calculate the post-test probability of this association. Conclusions. Our study identified four associated clinical factors of ILD in SSc patients. Moreover, their inclusion in an algorithm for the post-test probability, tailored to the specific patients’ characteristics, significantly increases the ability to find out the presence of SSc-ILD.

Background and Objectives: Cancer as the second leading cause of death in the United States poses a huge healthcare burden. Barriers to access to advanced therapies influence the outcome of cancer treatment. In this study, we examined whether insurance types affect the quality of cancer clinical care regarding access to an important monoclonal antibody, ramucirumab. Materials and Methods: Data for 13,340 cancer patients with Purchased or Medicaid insurance from the All of Us Database were collected for this study. The Chi-square test of proportions was employed to determine the significance of patient cohort characteristics and ramucirumab usage between Purchased and Medicaid insurance groups. The independent t-test was utilized to assess the influences of other determinants on insurance types. Results: Cancer patients who are African American, with lower socioeconomic status, or with lower educational attainment are more likely to be insured by Medicaid. Analysis of survey questions demonstrated the relationship between income and education level with insurance type as Medicaid cancer patients were less likely to receive primary care and specialist physician access and more likely to request lower cost medications. In addition, those with Medicaid insurance were identified to have poorer access to expensive therapeutics like ramucirumab compared to those with Purchased insurance.  Conclusions: The inequities of the US healthcare system are observed for cancer patient care; access to physicians and therapeutics are highly varied and dependent on insurance types. Socioeconomic status determines insurance type, which unfortunately generates a significant impact on cancer treatment and disease outcome.

Aim To explore the impact of cardiovascular risk factors on the type and outcome of hypertensive crises. Additionally, to investigate the occurrence of new cardiovascular events in a six-month period for both types of hypertensive crises and to define possible risk factors that may influence this. Method The data from the hospital electronic medical records of patients who presented with hypertensive crises at the Emergency Medicine Clinic of the Clinical Center of the University of Sarajevo over a six-month period were retrospectively collected. Pregnant women were excluded. Patients who died before completing the diagnostic examination as well as patients with incomplete data were also excluded. Data collection encompassed blood pressure levels, age, sex, history of chronic hypertension, smoking status, and presence of diabetes mellitus as cardiovascular risk factors. Outcomes after initial admission and after 6 months follow up were recorded. Results The study included 243 patients: 66 (27.2%) with hypertensive emergencies and 177 (72.8%) with hypertensive urgencies. There was no significant difference between these groups in age, history of chronic hypertension, presence of dyslipidemia, smoking status, and presence of diabetes mellitus (p>0.05). Men predominated in HE, while women predominated in HU group (p<0.05). Diastolic blood pressure values were higher in HE patients (p<0.05). 98.3% of HU patients were discharged, while 92.4% of HE patients were hospitalized. Mortality after initial admission was 3%, all of whom were hypertensive emergencies. After a 6-month follow-up, there was no significant difference in the number of readmissions between these two groups (p>0.05), but mortality was significantly higher in hypertensive emergencies (15.15% vs 6.21%) (p<0.05). There was no significant difference in the investigated risk factors between patients without readmissions, with readmissions without fatal outcomes, and deceased patients (p>0.05) except for age, which was significantly higher in patients with fatal outcomes (p<0.05). Conclusion Male sex and higher diastolic blood pressure (DBP) are identified as risk factors for hypertensive emergency (HE), suggesting a higher likelihood of hospital treatment and increased intrahospital mortality. Patients with HE also exhibit a higher risk of a lethal outcome within six months. Advanced age is associated with an increased risk of six-month readmission and a lethal outcome.

Anxiety disorders, characterized by excessive fear and anxiety, are increasingly recognized as significant comorbidities in chronic diseases such as Chronic Obstructive Pulmonary Disease (COPD). This study aimed to evaluate the prevalence of anxiety in COPD patients referred from primary care centers to pulmonology services and identify predictive factors for anxiety. Conducted as a multicentric, observational, and prospective study, 293 COPD patients were recruited, undergoing comprehensive respiratory and smoking histories, spirometry, and anxiety assessments using the Hospital Anxiety and Depression Scale (HADS). These results show: a diagnosis of suspected anxiety in in 85 patients (29.0%): 17 possible and 68 with a strong suspicion. The study found significant associations between anxiety and factors such as gender (women showed a risk 3.5 times higher than men), weight, and body mass index (BMI). Disease severity, smoking status, and clinical manifestations did not significantly influence anxiety prevalence. The findings underscore the need for systematic psychological evaluations in COPD management, advocating for the use of simple diagnostic tools like the HADS to facilitate referrals to mental health services. Addressing anxiety in COPD patients could potentially improve their quality of life and disease outcomes. The study highlights the importance of a multidisciplinary approach involving family medicine, pulmonology, and psychiatry to optimize COPD patient care and suggests future research should focus on the impact of anxiety treatment on COPD progression. These insights call for integrating psychological assessments into routine clinical practice for comprehensive COPD management.

Food waste is a common issue arising from grinding of food by experimental animals, leading to excessive food scraps falling into cages. In the wild, animals grind food by gnawing vegetation and seeds, potentially damaging the ecological environment. However, limited ecology studies have focused on food grinding behavior since the last century, with even fewer on rodent food grinding, particularly recently. Although food grinding function is partially understood, biological purposes remain under-investigated and driving factors unclear. This review aims to explain potential causes of animal food grinding, identify influencing factors, and discuss contexts and limitations. Specifically, we emphasize recent progress on gut microbiota significance for food grinding. Moreover, we show abnormal food grinding is determined by degree of excess normal behavior, emphasizing food grinding is not meaningless. Findings from this review promote comprehensive research on the myriad factors, multifaceted roles, and intricate evolution underlying food grinding behavior, benefiting laboratory animal husbandry and ecological environment protection, and identifying potential physiological benefits yet undiscovered.

Graphene hybrid-filler polymer composites have emerged as prominent materials that revolutionize heavy industries. This study encapsulates the in-depth analysis of different influential factors such as filler/graphene type, aspect ratios, dispersion methods, filler-matrix compatibility, fiber orientation, synergistic effects, different processing techniques, and post-curing conditions that affect the processing, properties and determine the resultant applications of graphene hybrid polymer composites. Additionally, it discusses the substantial role of graphene collaboration with other fillers such as carbon nanotubes, silica, nano-clays and metal oxides to produce functionalized hybrid polymer composites with synergistically enhanced tailored properties to offer solutions for heavy industries like aerospace, automotive, electronics, and energy harvesting. The review concludes with some suggestions and outlook on the future of these composite materials by emphasizing the need for continued research to fully optimize their potential.

Sick leave is influenced by various modifiable lifestyle factors and sex differences. This study examines the impact of body mass index, fruit and vegetable consumption, physical activity, smoking, and alcohol consumption on sick leave among Serbia's working population, focusing on sex differences. Data from the 2019 National Health Survey of Serbia were analyzed, focusing on a representative sample of 4,652 individuals aged 18-65. Chi-square tests and logistic regression models assessed the relationships between lifestyle factors and sick leave, adjusting for sociodemographic, work-related, and health-related variables. Among respondents, 15.8% reported sick leave in the past 12 months, with higher rates among women in both, short-term (13.9% vs. 10.6%) and long-term sick leave (3.4% vs. 2.2%). For men, obesity (OR = 2.6), poor dietary habits (fruit OR = 2.1; vegetables OR = 2.8), smoking (OR = 1.9), and risky alcohol consumption (OR = 4.1) significantly increase the likelihood of sick leave. In women, smoking (OR = 1.8) and risky alcohol consumption (OR = 3.1) are major predictors, while BMI and physical activity show less impact. Fruit and vegetable consumption and physical activity have inconsistent effects on sick leave, indicating the need for further research. This study identifies obesity, poor dietary habits, smoking, and alcohol consumption as key predictors of sick leave in men. In women, smoking and risky alcohol consumption are major predictors. Smoking is a risk factor for both sexes, while risky alcohol consumption emerges as a prominent predictor and is a significant predictor overall. These findings highlight the need for targeted public health interventions to address these lifestyle factors and reduce sick leave rates. Further research is needed to clarify the roles of dietary habits and physical activity in influencing sick leave.

This research aims to explore and analyze the critical success factors (CSFs) that increase the likelihood of successful implementation of tourism PPP projects in China. As an important step toward developing such a protocol, this study identifies and examines 22 critical success factors for tourism PPPs based on a systematic research approach, which includes a rigorous literature review, and semi-structured interviews. A questionnaire survey was conducted to evaluate the relative importance of these 22 CSF. The results show that the top three critical success factors for China’s tourism PPPs are: adequate project evaluation and demonstration; political support and stability; clear and stable policy documents on PPP. Factor analysis indicated that the 22 CSFs could be grouped into five principal success factor groups. These insights are expected to profoundly influence the development of policies related to tourism PPPs, providing a structured framework to enhance the efficiency and success of these ventures.

Third and fourth-degree anal sphincter injuries are among the most severe traumas women can experience during childbirth, often leading to lifelong continence issues. Despite extensive research, current repair techniques are often inadequate, failing to provide long-term solutions. Women with previous severe injuries face a higher risk of recurrence in subsequent deliveries, making caesarean sections a safer option in many cases. The existing WHO classification system is outdated, as it doesn't account for injuries to muscles like the levator ani, which are crucial for continence. Effective repairs require skilled surgeons and often involve more than just fixing the sphincter. Smaller hospitals may not have the necessary expertise and resources for these complex repairs. Delaying repairs to allow specialists to perform them can be just as effective as immediate repairs. Comprehensive care that includes thorough anatomical knowledge and surgical skill is essential. As maternal age increases and birth rates decline, it's crucial for specialized centers to handle severe perineal injuries to ensure the best outcomes and long-term care for patients.

This retrospective study aimed to assess coronary artery calcium (CAC) progression in serial computed tomography measurements according to risk factor changes. In 448 asymptomatic adults who underwent CAC measurements with more than one-year intervals, CAC progression was assessed according to age, sex, variable traditional risk factors (diabetes mellitus, hypertension, hyperlipidemia, and smoking), and initial CAC score (0, 0.1–100, and &gt;100). Univariate and multivariate logistic regression analyses were assessed for independent predictors of rapid CAC progression (△CAC/year&gt;20). During the 3.5-year follow-up, coronary artery calcifications occurred in 43 (12.8%) of 336 individuals with an initial CAC score of zero. Of 112 individuals with initial CAC presence, 60 (53.6%) had △CAC/year&gt;20. Age, male sex, body mass index, and all risk factors were significantly associated with △CAC/year&gt;20, but recently diagnosed hypertension (odds ratio [OR], 11.3) and initial CAC score (OR, 1.05) were significant independent predictors in multivariate regression analyses. CAC progression was affected by demographic and traditional risk factors, but adjusting for these factors, recently diagnosed hypertension and initial CAC score were the most influential factors for rapid CAC progression. These findings suggest that patients with higher initial CAC scores may benefit from more frequent follow-up scans and checks regarding risk factor changes.

This study utilizes data from the fourth National Health Survey conducted in 2019. in the Republic of Serbia, aiming to contribute to a deeper understanding of the factors influencing the mobility of the elderly population. It examines the sociodemographic and psychosocial factors associated with functional limitations in older adults. By analyzing variables such as age, gender, marital status, education, income, social support, and mental health, the study seeks to explain their impact on the prevalence of walking limitations.Questionnaires were employed as a research instrument in line with the methodology of the European Health Survey (EHIS). The analysis is based on a sample of 3,705 participants aged 65 and above. Statistical significance between variables was assessed using the Chi-square test. Post-hoc comparisons were performed using pairwise z-tests. Univariate logistic regression was employed to identify predictors of walking difficulties. Additionally, multivariable logistic regression was conducted to further explore predictors while adjusting for potential confounding variables, with odds ratios and corresponding 95% confidence intervals estimated.Women exhibit significantly higher prevalence of walking difficulties compared to men (p < 0.001). There is a significant variation in the prevalence of walking difficulties among different age groups. Individuals aged 75-84 show the highest prevalence in all categories of walking difficulties, with particular significance in the categories of "no difficulty," "some difficulty," and "unable to walk at all" (p < 0.001). Higher levels of education generally correlate with lower prevalence of walking difficulties. Married or partnered individuals have 0.522 times lower odds of reporting difficulties in walking compared to singles (p < 0.05). Individuals with lower wealth index (1-Least affluent) have significantly higher prevalence of walking difficulties.This knowledge can inform targeted interventions to enhance mobility and improve the overall well-being of older individuals.

Background and objectives: Due to resistance and lack of treatment options, hospital-acquired Acinetobacter baumannii (A. baumannii) infections are associated with high mortality. The aim of this study was to identify the characteristics and outcomes of patients with infections caused by multidrug resistant A. baumannii in a tertiary-care teaching hospital and to determine the risk factors for in-hospital mortality. Materials and methods: A retrospective cohort study including 196 patients with A. baumannii strains isolated from different clinical specimens in the Hospital of the Lithuanian University of Health Sciences in 2016, 2017 and 2020, 2021 was conducted. Data on patients’ characteristics, comorbid diseases, treatment, length of hospital and ICU stay, outcome were collected. To determine risk factors for in-hospital mortality, logistic regression analysis was performed. Results: There were 60 (30.6%) women 136 (69.4%) men with a mean age of 61.7 ± 16.6 years (range, 52–74). More than three-fourths (76.5%, n = 150) of the patients had at least one comorbid disease. The highest number of A. baumannii strains were isolated from patients hospitalized in ICUs (43.4%, n = 85). A. baumannii strains producing three types of β-lactamases were more frequently isolated from women than men (77.8 % vs. 22.2%, p = 0.006). Infections caused by A. baumannii strains producing two types of β-lactamases were significantly more often treated with combination therapy than infections caused by strains producing one type of β-lactamase (78.9% vs. 60.0%, p = 0.019). Patients with A. baumannii strains producing two different types of β-lactamases (AmpC plus KPC, AmpC plus ESBL, or ESBL plus KPC) stayed significantly shorter at the ICU compared to patients with A. baumannii strains not producing β-lactamases (median of 9, IQR 2–18, vs. median of 26, IQR 7–38, p = 0.022). Death occurred in 58.7% (n = 115) of patients. Logistic regression analysis showed that combination therapy, length of hospital stay of < 10 days after A. baumannii infection, age of > 58 years, and absence of co-infection were independent predictors of in-hospital mortality. Conclusions: Patients with infection caused by A. baumannii strains producing two different types of β-lactamases were more frequently treated with combination therapy. Mortality of patients with multidrug resistant A. baumannii infection was high, and it was associated with patient’s age, length of hospital stay after the diagnosis of A. baumannii infection, absence of co-infection, and combination treatment.

Background and Objectives: Peripheral vertigo is one of the most common symptoms for which patients are seen by a neurologist in the emergency room. Symptoms of peripheral vertigo can range from lightheadedness to an illusion of spinning. On average, vertigo is diagnosed for older patients as its predicting factors from medical history are yet to be determined. The objective of the study was to predict peripheral vertigo based on medical history and risk factors. Materials and Methods: A prospective case-control study at the Neurology Department of Lithuanian University Hospital was conducted. 71 patients diagnosed with vertigo and 43 controls was included. They completed questionnaires and underwent evaluation by neurologists or otolaryngologists, with statistical analysis performed using IBM SPSS Statistics. Results: 58% of vertigo patients were diagnosed with peripheral vertigo, with significant predictors including age (&gt;60), motion sickness, height intolerance, gastroesophageal reflux disease and dyslipidemia, leading to the development of a risk assessment table for the peripheral vertigo prediction. Conclusions: This study suggest that early identification of these predictors could enhance peripheral vertigo management, while further research with larger cohorts is needed to validate and expand upon these findings, emphasizing the importance of considering medical history and risk factors for predicting peripheral vertigo and improving patient care.

Shiga toxin-producing Escherichia coli (STEC) is a significant public health threat due to its ability to cause severe gastrointestinal diseases in humans, ranging from diarrhea to life-threatening conditions such as hemorrhagic colitis and hemolytic uremic syndrome (HUS). As the primary reservoir of STEC, cattle play a crucial role in its transmission through contaminated food and water, posing a considerable risk to human health. This comprehensive review explores host-pathogen interactions during STEC colonization of the bovine gut, focusing on the role of gut microbiota in modulating these interactions and influencing disease outcomes. We integrated findings from published transcriptomics, proteomics, and genomics studies to provide a thorough understanding of how STEC adheres to and colonizes the bovine gastrointestinal tract. The insights from this review offer potential avenues for the development of novel preventative and therapeutic strategies aimed at controlling STEC colonization in cattle threby reducing the risk of zoonotic transmission.

Background and Aims: Sustained virologic response (SVR) lead to the decrease of portal hypertension, the regression of fibrosis, the improvement of the hepatic synthesis of procoagulant and anticoagulant factors. We aimed to assess the influence of SVR on coagulation parameters in HCV cirrhotic patients treated with DAAs. Methods: We performed a prospective study in the Institute of Gastroenterology and Hepatology Iasi, Romania, between January 2022 and February 2024. We included patients diagnosed with compensated and decompensated HCV-related liver cirrhosis, treated with direct antivirals (PrOD ± RBV or SOF/LED ± RBV) for 12/24 weeks. Blood samples for biochemical, immunological and coagulation tests were collected at baseline, EOT and SVR12/24. Results: We analyzed a group of 52 patients with HCV-related liver cirrhosis, predominantly female (68.0%), the degree of severity of cirrhosis placed the patients mainly in Child-Pugh classes B (40%) and C (36%). All patients achieved SVR. The MELD score decrease at EOT (13.48 ± 4.273; p =0.001), and SVR (9.88 ± 2.774; p = 0.000), compared to baseline (14.92 ± 4.707). Fibroscan values decreased at SVR (17.596 ± 3.7276; p = 0.000) compared to baseline (26.068 ± 7.0954). For all common coagulation parameters (platelets, INR, PT, fibrinogen, aPTT) there was a trend towards improvement during treatment, changes that were statistically significant for the majority of patients. Factor II low at baseline (75.40 ± 7.506), increases at EOT (87.40 ± 9.587), and later at SVR (99.12 ± 11.695; p = 0.000). FVIII values increased at baseline (175.52 ± 16.414) decrease at EOT (151.48 ± 13.703) and SVR (143.40 ± 13.937). FvW values decreased during treatment (146.84 ± 9.428 – baseline, 141.32 ± 9.690; p =0.000 – EOT, 126.68 ± 17.960 – SVR). In regards to the anticoagulant factors (PC, PS, ATIII), a significant improvement was brought on by SVR. Advanced stages of liver disease showed the most diminished FII activity, while at baseline and in Child-Pugh C patients we recorded the highest values of FVIII and FvW. Conclusions: Our study proved that the “reset” of the coagulopathy might be due to the improving of the liver function due to viral eradication secondary to AAD therapy.

Di(2-ethhylhexyl) phthalate (DEHP) is a common plastic rubberizer. DEHP leaches from plastic matrices and is under increasing scrutiny as numerous studies have linked it to negative human health manifestations. Coxsackievirus B3 (CVB) is a human pathogen that typically causes subclinical infections but can sometimes cause severe diseases such as pancreatitis, myocarditis, and meningoencephalitis. Though CVB infections are common, severe illness is relatively rare, and it is unclear what factors mediate severity of disease. Here we show that DEHP drastically increases CVB infection in a variety of human cell types. While not entirely clear what cellular processes underly DEHP’s proviral properties, we observe that DEHP may subvert CVB-induced interferon signaling and elevate levels of interferon-induced transmembrane proteins which appear to bolster CVB infection. We hypothesize that DEHP may represent a major environmental factor associated with the severity of CVB infection. Further understanding how DEHP exacerbates infection may better elucidate its potential role as a proviral environmental factor.

OBJECTIVE: To investigate the value of serum inflammatory factor levels in acute ischemic stroke patients after revascularization therapy in assessing acute prognosis. METHODS: 94 patients with acute ischemic stroke who underwent revascularization therapy admitted to our hospital from January 01, 2022 to January 01, 2024 were studied. The main evaluation index was modified Rankin Scale score (mRS) after 3 months, and patients with mRS score >2 were categorized into the poor prognosis group, and the rest were the good prognosis group. As well as the treatment of revascularization in all patients was used as a division into a thrombus extraction group and an intravenous thrombolysis group. Logistic regression analysis was applied to explore the independent risk factors for the prognosis of patients treated with recanalization for acute ischemic stroke. RESULTS: Two groups with good (59 cases) and poor (35 cases) prognosis were divided according to the mRS score. There were some differences in age, gender, emergency GLU, INR, whether they had diabetes or hypertension and other contents between the two groups, but the differences were not statistically significant. The NIHSS score, hospitalization days, previous cardiac history, hospitalization days, LDL, fasting glucose, IL-6, and TNF-a at the time of admission were lower than those in the poor prognosis group, and the difference was statistically significant. In the patients in the embolization group, there were some differences in age, gender, emergency GLU, INR, whether they had diabetes or hypertension and other contents between the two groups, but the differences were not statistically significant. The pre-hospital NHISS score, IL-6, and TNF-a of patients in the good prognosis group were lower than those in the poor prognosis group, and the difference was statistically significant. CONCLUSION: IL-6 and TNF-α may be used as predictors of prognosis after revascularization therapy for acute ischemic stroke, and this conclusion also applies to patients in the embolization group.

Gastrointestinal bleeding (GIB) after heart transplantation (HT) remains a significant clinical issue. The study aimed to explore its incidence, trends, outcomes and clinical predictors of GIB in HT patients. Adult patients who underwent HT between 2015 and 2021 at Union Hospital were recruited and divided into two groups based on the presence or absence of postoperative GIB. Primary outcomes were evaluated by follow-up. Independent predictors of GIB after HT were identified by logistic regression analysis. A nomogram prediction model was constructed according to these independent variables, and the accuracy of the model was assessed using the receiver operating characteristic (ROC) curve and the calibration curve. Among 461 patients, 40 (8.7%) developed GIB post-HT. HT patients with postoperative GIB exhibited higher in-hospital, 30-day, 90-day and 1-year mortality (all P < 0.05). Multivariate analysis identified age, preoperative warfarin, postoperative continuous renal replacement therapy and postoperative nasogastric tube as independent risk factors for GIB following HT. The nomogram prediction model was performed using the 4 variables. The area under the curve (AUC) of this model was 0.852(95% CI: 0.787-0.917, P < 0.001) and the calibration curve was close to the ideal diagonal line. GIB following HT is associated with a poor clinical prognosis. The constructed nomogram, incorporating its independent risk factors, demonstrated a favorable predictive value for GIB.

The most prevalent musculoskeletal disorder of childhood with unclear aetiology is Growing Pains (GPs). Anatomic deformities and factors that change bone turnover are implicated in GPs pathophysiology. Perinatal risk factors alter the bone metabolism affecting the bone mineral density and content. The aim of our study was to analyze the relationship between GPs, knock knees and perinatal factors. The examined population consisted of 276 children aged 3-7 years. Among them 10 pairs of dizygotic twins were evaluated. The data were collected by using a combination of semi-structured questionnaires, clinical examinations and medical charts of the children and the obstetric history of the mothers. 78 children presented GPs meeting Peterson’s criteria. Genu valgum severity was a significant factor for GPs manifestation and for their increased frequency and intensity. Subsequently, perinatal factors regarding gestational age, Apgar score, head circumference (lower than 33cm) and birth length or weight (smaller than 50 cm and 3000gr, respectively) made a remarkable contribution to the development of GPs. Conversely, antenatal corticosteroid treatment, increased maternal age and maternal smoking during pregnancy were not predictive for the disorder. Our data are potentially supportive for the “bone strength” theory and for the contribution of anatomical disturbances in GPs appearance.

We investigate regular damped oscillatory structures appearing in the "effective" form factor of various hadrons. The behavior of this form factor can be extracted from the experimental information on total cross sections, the processes $\sigma_{tot}(e^+e^- \to h \bar h)$, $h=\pi^{\pm}, K^{\pm}, K^0, p, n $ are examined. The apparent oscillations have been observed for the first time for the proton and we show, taking also other hadrons into the consideration, that they are an arbitrary artifact resulting from a very simplistic theoretical description based on an elementary three-parametric model. If the data are described by a more appropriate and well physically funded U\&A model, then the oscillations disappear. In addition, if the simple model is used to describe the data, one observes that the oscillations are opposite for particles which form an isospin dublet. We show, by using the U\&A model, that this feature is explained by the transformation properties of the corresponding states in the isotopic space.

Background: Metastatic triple-negative breast cancer (TNBC) is aggressive with a poor median overall survival (OS), ranging from 8 to 13 months. There exists considerable heterogeneity in the survival at the individual patient level. To better understand the survival heterogeneity and improve risk stratification, our study aims to identify the factors influencing survival utilizing a large patient sample in the National Cancer Database (NCDB). Methods: Women diagnosed with metastatic TNBC from 2010 to 2020 in the NCDB were included. Demographic, clinic-pathological, treatment data, and overall survival (OS) outcomes were collected. Kaplan-Meier curves were used to estimate OS. The log-rank test was used to identify OS differences between groups for each variable in the univariate analysis. For the multivariate analysis, the Cox proportional hazard model with backward elimination was used to identify factors affecting OS. Adjusted hazard ratios and 95% confidence intervals are presented. Results: 2,273 women had a median overall survival of 13.6 months. Factors associated with statistically significantly worse OS included older age, higher comorbidity scores, specific histologies, higher number of metastatic sites, presence of liver or other site metastases in those with only one metastatic site (excluding brain metastases), presence of cranial and extra-cranial metastases, lack of chemotherapy, lack of immunotherapy, lack of surgery to distant sites, lack of radiation to distant sites, and receipt of palliative treatment to alleviate symptoms. In the multivariate analysis, comorbidity score, histology, number of metastatic sites, immunotherapy, and chemotherapy had a statistically significant effect on the OS. Conclusions: Through NCDB analysis, we have identified prognostic factors for metastatic TNBC. These findings will help improve prognostication at diagnosis, optimize treatment strategies, and facilitate patient stratification in future clinical trials.

Climate change poses a serious threat to the ancient Magnoliaceae family, particularly for the endangered Yulania trees. Until now, little is known about the suitable geographical range of Yulania zenii, and about how it responds to past and future climate scenarios. Here, we first employed ten models from Biomod2 to preliminarily simulate its potential distribution in China and selected MaxEnt for final modeling. The results showed that among the key environmental factors influencing its distribution, the top three factors were Bio2 (Mean diurnal range), Bio15 (Precipitation seasonality of variation coefficient) and Elevation. Its current suitable distribution were primarily concentrated in southern Anhui, central Hubei, eastern Hunan, southern Jiangsu, northern Jiangxi, and northern Zhejiang. The total suitable area of Yulania zenii was 14.68 × 104 km2, only taking 1.53% of China's total territory, which is larger than known. During the Last Interglacial and Middle Holocene, its suitable habitats were larger than currently, exhibiting a relatively continuous distribution. Under various future climate scenarios, its suitable habitats may averagely decrease by 20.26% compared with the current, and these habitats become more fragmented. Collectively, the centroid of Yulania zenii is expected to migrate towards the southeast in the future. Therefore, our findings demonstrate, for the first time, that climate change takes an adverse effect on this species in distribution from the past to current till future. Our study can contribute to the conservation and management of Yulania zenii in China, and can provide reference for other endangered Yulania species of this country under the condition of climate change.

Climate change has significant impacts on the distribution of orchids. The endemic and endan-gered orchids are more susceptible to climate change than widely distributed orchids. To date, lit-tle is known concerning the response of endangered Changnienia amoena, endemic to China, to different climate scenarios. Here, we chose RF, MaxEnt, and GBM to build an ensemble model af-ter using ten models from Biomod2 to project its potential distribution in China. The outcomes showed that the four key environmental factors influencing its distribution were mean diurnal temperature range, minimum temperature of the coldest month, temperature seasonality, and precipitation of the warmest quarter. This orchid was mainly distributed in western Hubei, the junction between Shaanxi and Sichuan, eastern Guizhou, northwestern Hunan, and the junction among Anhui, Henan, and Hubei provinces in the current. The total suitable area of C. amoena was 58.33 × 104 km2, only accounting for 6.08% of China's total territory, which is larger than known. However, only 4.48% of the suitable area is located within national nature reserves, and 3.33% within provincial nature reserves, respectively. During the Last Inter Glacial and mid-Holocene, its suitable areas were larger than the current. Under six future climate scenarios, its suitable areas may averagely decrease by 2.26% relative to the current, with severe habitat fragmentation. Col-lectively, the centroid of C. amoena is expected to migrate towards the southeast in the future. Therefore, our findings demonstrate that climate change takes an adverse effect on its potential distribution. We recommend expanding protected areas or establishing new conservation sites for C. amoena. Furthermore, our study can help to inform the development of conservation manage-ment strategies for other endangered orchids in China under climate change.

We assessed the impact of social determinants of health (SDOH) and psychosocial factors on screening behavior in a nationally representative sample of women in the US. A retrospective population-level cross-sectional sample was extracted from the 2022 Health Information National Trends Survey. Descriptive statistics were conducted for demographic characteristics and covariates. Population-based estimates with 95% confidence intervals (95% CI) were produced for Pap testing behaviors across study years. We used logistic regression models to assess Pap testing differences based on SDOH and psychosocial factors, adjusting for covariates, with a significance level of 0.05 for hypothesis testing. Women (n=2,224) with a mean age of 46.96 participated in the study. Our study found that 90% of women were interested in cervical cancer screening, with an 80% actual screening rate. Screening rates differed by age group and rurality. SDOH and psychosocial factors were associated with participants’ interest in screening and in actual screening behavior. The impacts of SDOH and psychosocial factors on screening behavior were 3% and 1%, respectively. The SDOH and psychosocial factors are associated with the uptake of cervical cancer screening among women in the United States. Policies must be directed at bridging the gap created by these SDOHs.

This paper presents a theoretical framework aimed at improving IoT network cybersecurity by AI-driven anomaly detection in the context of rapid urbanization and the development of smart cities. The framework draws upon the Complex Adaptive Systems Theory, Theory of Planned Behavior, the Technology Acceptance Model, and the Socio-Technical Systems Theory, and intri-cately examines how AI might be integrated into the intricate ecosystem of smart cities to detect and mitigate cyber threats. It emphasizes AI-driven anomaly detection methods as pivotal in-struments that impact cybersecurity enhancement in smart city infrastructures. The proposed framework also highlights the crucial role that human-related factors, including user behavior and adoption, play in determining how effective AI applications are in enhancing cybersecurity in smart cities. It also recognizes the important moderating roles played by outside factors like legislative frameworks, environmental contexts, and technological breakthroughs in the relationship between AI-enabled anomaly detection and enhanced cybersecurity. The goal of this research is to shed light on the interactions between technology and socio-technical dynamics by offering a thorough theoretical understanding of AI's potential in smart city cybersecurity. It highlights the significance of taking into account a variety of contextual aspects when employing AI to strengthen the digital security of urban areas, and provides a strategic direction for future research and practical implementation.

Parkinson's disease (PD) is a common neurodegenerative disorder characterized by the loss of dopaminergic neurons and the buildup of misfolded alpha-synuclein proteins. While its exact cause remains unknown, several factors may influence its development. This review examines how factors like chronic constipation, head injuries, cholesterol and uric acid levels, pesticide exposure, smoking, NSAIDs, and caffeine intake may affect PD risk. Chronic constipation appears to be linked to a higher risk of PD, potentially serving as an early warning sign. Head injuries, especially mild-to-moderate ones, may also play a role in increasing PD risk. Surprisingly, higher levels of cholesterol seem to protect against PD, while lower levels of uric acid might increase the risk in the presence of some differences according to gender type. Exposure to certain pesticides is associated with a higher PD risk. NSAIDs, on the other hand, may or may not have a protective effect, with conflicting evidence. Interestingly, caffeine and tobacco smoking appear to lower the PD risk. Further studies are needed to fully understand the complex interplay between these factors and PD. It's also important to remember that these are just general trends, and individual risk factors will vary depending on a person's unique genetic makeup, medical history, and overall health.

With the Sendai Framework (2015-2030) and the Paris Agreement (2015), the UN has been promoting at a global level, the priority objectives to protect the life and well-being of people, these documents of global consensus have scheduled in several countries, an extensive list of actions of responsibilities and commitments to the environment, to address natural disasters among those of greatest impact earthquakes and floods and among earthquakes (seismic activity). The materialization of the disaster is a natural or human-induced event, it manifests itself in permanent changes in society and by its origin it is classified as natural, anthropogenic (anthropogenic) and mixed, creating a worldwide problematic situation of immediate reaction. The attention and alert in the scientific community have been adding efforts, but in a disorganized way, with limited human and material resources and with globalized strategies still to be improved. The literature review of disaster risk management due to seismic activity, from 2008 to 2023, allows us to have updated information to identify the factors and deepen them, with the understanding, comprehension, and multidisciplinary knowledge. The selected researches that mention the factors (elements) that influence risk management of natural disasters due to seismic activity (RMNDDSA) allow us to know the advances and spaces to approach them, which constitutes the motivation to study the twenty-four (24) factors present in this type of disasters. The selected research articles indicate important advances that associate disaster risk management (DRM) and communication technology (ICTs). The technological means mentioned are well received and accepted by society, capable of detecting and communicating in real time seismic activity worldwide, with the help of social mobile networks, technological platforms, Twitter, Facebook, and others.

Objective: This study aimed to explore potential interventions or preventive measures to reduce the incidence of falls among the elderly in the Madinah region, and to provide recommendations for healthcare professionals, policymakers, and community stakeholders to enhance fall prevention strategies and improve the overall well-being of the elderly population in this area. Methods: The study adopted a cross-sectional study design, and was carried out in the Madinah region using convenient physical assignment among of Saudi and non-Saudi local residents aged 65 years and over. Questionnaire surveys were circulated and demographic characteristics were collected, including participants’ fall experience and health status data over the past year, in order to assess the incidence of falls among the elderly population. This design allows for the collection of data at a single point in time, aiming to evaluate the prevalence, risk factors, and consequences of falls among the target population. Results: A total of 189 participants were recruited to the study, and the data indicated that the prevalence of falls among those aged 65 years and older in the past year was 41.5%. We found that 73% of the participants had experienced falls and post-fall injuries within the past 12 months. There were minimal differences in terms of physical handicapped cases found between those with and without a fall history. Logistic regression analysis revealed a significant link between fall experience and maximum bite force. Conclusion: There is a high prevalence of falls in the elderly population in the Madinah region. Our study reveals that 50.79% of our elderly participants had experienced more than one fall during the preceding year. Some preventable risk factors were identified in an analysis of their daily routines. The impacts of these risk factors have potential consequences for their healthy lives.

Background: Colorectal cancer (CRC) patients experienced multiple chemotoxicity affecting treatment compliance, survival, and quality of life (QOL). Prior research shows clinician-reported chemotoxicity (i.e., grading scales or diagnostic codes) predicts rehospitalization and cancer survival. However, a comprehensive synthesis of clinician-reported chemotoxicity is still lacking. Objectives: We conducted a systematic review and meta-analysis to determine the chemotoxicity's prevalence and risk factors in CRC. Methods: A systematic search from 2009 to 2024 yielded 30 studies for review, with 25 included in the meta-analysis. Results: Pooled prevalences of overall, non-hematological, and hematological moderate-to-severe toxicities were 45.7%, 39.2%, and 25.3%, respectively. The most common clinician-reported chemotoxicities were gastrointestinal (GI) toxicity (22.9%) and neuropathy or neutropenia (17.9%). Significant risk factors at baseline were malnutritional status, frailty, impaired immune or hepato-renal functions, short telomere lengths, low gut lactobacillus levels, age, female sex, aggressive chemotherapy, and low QOL. Age was associated with neutropenia (β: -1.44) and GI toxicity (β:1.85) (Ps 65 y.o.) had higher prevalences of overall (OR: 1.14) and GI (OR: 1.65) toxicities, but a lower prevalence of neutropenia (OR: 0.65) than younger adults (Ps

Background/Objectives: RAS is associated with coronary artery disease (CAD), exacerbation of arterial hypertension and progression to heart failure, but remains frequently unrecognised in clinical practice. Methods: We conducted a systematic review and meta-analysis of studies by pooling data of patients undergoing CAG due to suspected or stable CAD that received a bilateral renal artery angiography; Results: A total of 31 studies with 31,689 patients were included (mean age 63.2±8.7 years, 20.9% were female). Overall, 13.4% (95%CI 10.5-16.7%) of patients undergoing coronary angiography had significant RAS, with 6.5% (95% CI 4.5-8.9%) and 3.7% (95%CI 2.5-5.2%) having severe and bilateral RAS. The mean weighted proportion of patients with 3-vessel coronary disease (3VD) was 25.1 (95%CI 19.6-30.9%) while 4.2% (95%CI 2.6-6.2%) had leftmain (LM) coronary disease. Patients with RAS compared to those without RAS were significantly older (mean difference - MD 4.2 years, (95%CI 3.8-4.6). The relative risk of RAS was greater for the female sex (risk ratio, 95%CI; RR 1.3, 1.03-1.57), presence of diabetes (RR 1.2, 1.10-1.36), arterial hypertension (RR 1.3, 1.21-1.46), dyslipidemia (RR 1.1, 1.06-1.14), peripheral artery disease-PAD (RR 2.1, 1.40-3.16), chronic kidney disease-CKD (RR 2.6, 2.04-3.37), 3VD (RR 1.6, 1.30-1.87), and LM disease (RR 1.8, 1.28-2.47). Smoking had a neutral effect on the risk of RAS occurrence (RR 1.0, 0.94-1.06); Conclusions: RAS is common in patients undergoing coronary angiography. CKD, PAD, older age, and severe CAD were among the strongest predictors for the presence of significant RAS.

Background Eating disorders are complex illnesses with serious long-term consequences. They are linked to negative outcomes such as miscarriage, low birth weight, and other obstetric and postpartum difficulties. Our study in Muscat, Oman, examines the eating habits of pregnant women who consult primary care physicians. We aim to understand how eating disorders affect pregnant women and inform more effective interventions. Method We used the Eating Disorder Examination Questionnaire to assess the potential for the presence of eating disorders. Chi-Square and Fisher's Exact tests were used to analyze relationships between improper eating behavior and independent variables. Results The study showed that 1.6% of participants had a potential diagnosis of an eating disorder, with the most common inappropriate behavior being binge-eating at a prevalence of 18.8%. A pre- gestational low Body Mass Index (BMI) was associated with a higher prevalence of binge eating during pregnancy. Additionally, we found that pregnant women who were working were more prone to self-induced vomiting. High BMI before pregnancy was significantly associated with various inappropriate eating behaviors such as restraint behavior (p = 0.000), shape concern (p = 0.000), weight concern (p = 0.040), eating (p = 0.045), laxative use (p = 0.020), and excessive exercise (p = 0.043). Conclusion The study reveals a high prevalence of eating disorders in pregnancy. Less educated women exhibit higher laxative use, while working women show more instances of binge eating and self-induced vomiting. These findings emphasize the critical need to prioritize targeted interventions and support for vulnerable pregnant women.

Background and Objectives. Prevalence of GERD is increased among individuals with obesity and RYGB is considered as the most effective procedure to control GERD and obesity. However, some patients continue to have GERD after RYGB. The aim of the study was to investigate the prevalence and the risk factors of GERD after RYGB. Material and Methods. This prospective study included 180 patients operated with RYGB and followed for on average of 12.2 (0.6) years. 126 (70%) patients agreed to participate in online consultations and provided data on weight, GERD symptoms, filled GERD-HRQL, TFEQ-18 and GSRS questionnaires. Results. The average age before surgery was 42.7 (10.5) years and BMI was 45.2 (6.4) kg/m2. 128 (71.1%) were females and preoperative GERD was diagnosed in 74 (41.1%) patients. At 12 years follow-up the mean %EBMIL and %TWL were 60.37 and 25.73, respectively. The median %WR was 18.0 (39.0). The GERD was present in 30 (23.8%) patients, of whom 12 (40%) continued to have GERD symptoms and 18 (60%) developed de novo GERD. The GERD-HRQL score significantly decreased from 3.0 (8.0) at baseline to 2.0 (5.0) (p=0.028) at 12 years. GSRS Diarrhea and Indigestion median scores increased significantly, from 1.33 (0.67) to 1.5 (2.42) (p 3.2.

Extra virgin olive oil (EVOO) is recognized for its numerous health benefits attributed to its rich phenolic components. NMR has emerged as a prevalent technique for precisely identifying these compounds. Among Mediterranean countries, Greece stands as the third-largest producer of olives, with the Epirus region notably advancing in olive cultivation, contributing significantly to the dynamic growth of the region. In this study, an NMR method was employed based on the acquisition of an 1H NMR spectrum along with the multiple resonant suppression in order to increase the sensitivity. Using the above method, 198 samples of extra virgin olive oil, primarily sourced from the Epirus region were analyzed and both the qualitative and quantitative aspects of phenolic compounds were acquired. In addition, we examined the effect of various factors, such as, variety, harvest month and region origin on the phenolic compounds’ concentration. The results revealed an average total phenolic content of 246 mg/kg, closely approaching the EU health claim limit of 250 mg/kg. Approximately 15% of the samples were confidently characterized as high-phenolic olive oil. The highest concentrations were observed in Thesprotia samples, with several Lianolia variety exceeding the total phenolic content of 400 mg/kg. Statistical tests demonstrated a significant influence of the olive variety and the month of fruit harvest on phenolic component concentration, followed by the region of origin. A very strong correlation was noted between the total phenolics content and the levels of oleocanthal and oleacein, with a correlation coefficient (r) of 0.924. Upon optimization of all factors affecting olive oil quality, the majority of EVOO from the Epirus region have the potential to be characterized as high in phenolic content.

Users with Autism Spectrum Disorder may find human-computer interaction (HCI) challenging due to a number of symptoms experienced, one of which is difficulty coping with change. Through capturing, comparing and statistically analysing the reactions of autistic and neurotypical users to seven individual design changes, it has been possible to identify the changes that cause significant difficulty in autistic users. These difficulty points were then used to form heuristics that can followed by HCI practitioners in the industry to reduce the negative impact of software interface design change on autistic users, hence making software updates more accessible.

Aim: To analysis the relationship between healthy adults right ventricular diameter (RVD) and geographical factors. Location: China’s 22 provinces, municipalities and autonomous regions. Methods: Using correlation analysis the relationship between RVD and nine geographic factors, build predictive models by factor analysis. Results: There is significant correlation between RVD and geographical factors, and the annual average temperature is most relevant geographical factors, a predictive model was built by factor analysis: Ŷ = 19.46 + 0.0007072X1 + 0.001034X2 -0.05412X3 -0.001405X4 -0.0006351X5 + 0.02903X6 + 0.01243X7 -0.01033X8 + 0.03816X9 ± 0.63. Then using Kriging interpolation interpolate the geographical distribution of Chinese healthy adult right ventricular diameter reference value in ArcGIS software. Main Conclusion: If geographic factors can be derived in anywhere of China, RVD can be calculated by the model, you can also get RVD from geographical distribution.

Summary: Hypertension is a public health problem with serious social, economic, and health consequences. The World Health Organisation (WHO) estimates that 1 in 3 adults worldwide suffers from hypertension. In Cameroon, the prevalence of hypertension is estimated at 35%, with nearly 17,000 deaths recorded each year. This study aimed to determine the factors associated with the occurrence and complications of hypertension at the Sangmélima Referral Hospital (HRS). A total of 528 patients treated in the cardiology department of the HRS were identified between January and December 2023. The data were analyzed using SPSS 28 software. Binary logistic regression determined the odds ratios and 95% confidence intervals associated with each variable. Differences were statistically significant for a p-value &lt; 0.05. At the HRS, the annual incidence of hypertension was 16.13%. Hypertension was present in 78.8% of patients. The factors associated with the occurrence and complications of hypertension were age (OR=1.028; p=0.003 ), level of education (OR=15.49; p=0.023), marital status (OR=3.859; p=0.04), hypercholesterolemia (OR=2.856; p=0.01), monthly income (OR=0.882; p=0.026), number of dependents (OR=1.231; p=0.025), food security (OR=16.666; p&lt;0.001), tobacco consumption (OR=8.592; p=0.041), fruit and vegetable consumption (OR=0.027; p=0.031), salt/sugar consumption (OR=8.129; p&lt;0.001), place of residence (OR=4.794; p=0.005), access to essential technologies (OR=8.851; p=0.002), and use of traditional care (OR=3.137; np=0.032). HTA at the HRS is associated with several factors. In order to limit the impact of hypertension, it is crucial to emphasize improving socioeconomic and health conditions.

This study aimed to investigate the prevalence of cardiovascular disease (CVD) risk factors among Algerian aircrew, a population exposed to unique environmental and occupational stressors. By comparing these rates to the general population, we sought to identify specific health challenges faced by aircrew. Methods: A cross-sectional study was conducted on 154 Algerian aircrew participants. Prevalence rates for current smoking, hypertension, diabetes, and dyslipidemia were compared between the aircrew and a general population control group. Results: Our findings revealed significantly higher rates of current smoking among aircrew compared to the general population. Additionally, smoking, dyslipidemia, hypertension, and diabetes emerged as the most prevalent risk factors within the aircrew population. Conclusions: Despite the rigorous selection process for aircrew recruitment, our study confirms findings from previous literature, highlighting the high rate of normal qualifying examinations. The substantial sample size and homogeneous nature of the aircrew population enhance the reliability and generalizability of our conclusions. These findings underscore the importance of targeted interventions to mitigate CVD risk factors within this specific population, given the unique environmental and occupational factors associated with aircrew.

This paper provides a comprehensive review of the current understanding of non-alcoholic fatty liver disease (NAFLD) and its progression to non-alcoholic steatohepatitis (NASH), focusing on key factors influencing its pathogenesis and emerging therapeutic strategies. The background highlights the growing prevalence of NAFLD and NASH, emphasizing their multifactorial nature. The methods section outlines the various contributors to NAFLD development, including genetic, dietary, and environmental factors. The results highlight the intricate interplay between these factors and their impact on hepatic lipid metabolism, inflammation, and insulin resistance. Genetic predisposition, dietary fat intake, and excessive fructose consumption are discussed as significant contributors to NAFLD progression. The conclusions emphasize the lack of a single therapeutic approach and underscore the need for combination strategies. Lifestyle interventions, particularly weight loss through diet and exercise, remain crucial, while pharmacological options like GLP-1 receptor agonists, obeticholic acid, lanifibranor, and resmetirom show promise but require further validation. Bariatric surgery and emerging endoscopic procedures offer potential in eligible patients. In sum, this review underscores the complexity of NAFLD and NASH, advocating for a multifaceted approach to address this increasingly prevalent and clinically relevant condition.

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.

In recent years, Ethiopia's number of returnee entrepreneurs has increased dramatically, significantly contributing to personal financial achievement and the nation's economic development and transformation. However, their businesses are typically smaller and less profitable than non-migrant entrepreneurs. This study explores factors affecting the success of these returnee migrant entrepreneurs, including individual characteristics, entrepreneurial skills, and experience, financial resources, as well as the mediating role of government policies and institutional support. Data was collected from 390 returnee migrants who started their businesses and analyzed using a robust theoretical foundation and PLS-SEM to understand the impact of success factors. The results show that entrepreneurial skills, experience, and financial resources positively and significantly influence the success of returnee migrant entrepreneurs. Furthermore, social networks, while not directly significantly influencing the entrepreneurial success of returnee migrants are mediated by government policies and institutional support. Professional guidance and counseling provided by experts and mentors of the accelerator program were found to be essential for entrepreneurial success but did not improve the effectiveness of the policy. Financial resources, although crucial, did not significantly impact policy efficacy. These findings underscore the need for tailored policy interventions addressing the challenges faced by returnee migrants, including economic self-sufficiency, socio-psychological support, and effective social networks to boost the success of returnee migrants. Experienced returnee entrepreneurs play a key role in developing a vigorous and supportive entrepreneurial ecosystem through community engagement and policy advocacy. Additionally, personal traits are crucial for entrepreneurial success, while practical experience influences government policies for substantiated policy development in returnee migrant entrepreneurship and its benefits.

Epilepsy is a brain disease characterized by a persistent predisposition to epileptic seizures. The current issue is the development of new methods of epilepsy therapy, In particular, using gene therapy methods. Promising areas of research in this field are the modulation of the expression of a number of neuropeptides, ion channels, transcription factors, neurotrophic factors, etc., as well as the use of antisense oligonucleotides. One of the optimal vectors for the delivery of therapeutic transgenes is the adenoassociated virus (AAV), which is most often used in the gene therapy of neurological disorders due to the high transduction ability of neuronal tissues and low immunogenicity/cytotoxicity. In this study, we analyze the existing achievements in the use of AAV vectors in the treatment of epilepsy of various etiologies.

Measuring the impact of land use regulation on the land market involves identifying and classifying relevant impact factors related to the land market. The objective of this study was to identify land market impact factors in the context of the introduction of land use regulation in Nepal. A desktop review was carried out to identify preliminary set of impact factors, which were reclassified through intuitive analysis based on the degree of thematic closeness. Perspective-based impact factors were identified through the qualitative analysis of primary data collected through semi-structured interviews with the Nepalese land market stakeholders. These independently derived impact factors were compared with the desktop literature review impact factors resulting in fourteen land market impact factors across four dimensions, including transaction cost, valuation, mortgage availability, taxation, and compensation across the economic dimension; lot size, subdivision restrictions, and coordination across the institutional dimension; awareness, expectation and proximity across the social dimension; and risk reduction, quality of residential land, and suitability of zoning classification across the environmental dimension. There was significant overlap and commonality across factors identified from both the literature review and semi-structured interviews. The land market impact factors determined in the study may be adapted and generalized across other countries and could be utilized to better understand the impacts of land policy decisions on urban planning and development. Further research is recommended on the process to operationalize the use of these factors to quantify the impact of land use regulation on different land markets.

This study aimed to examine the effects of the input factor allocation on tangerine production in Selayar Islands Regency, South Sulawesi Province. Binary logistic regression was the data analysis method utilized to achieve the research objective. Based on the findings, it was found that the factors of length of education, farmer group membership, farm distance, labor, pesticides, herbicides, urea fertilizer, manure, and NPK fertilizer all had a significant impact on the output of tangerines in farming. Factors such as education duration, participation in farmer groups, labor availability, and the use of herbicides, urea fertilizer, NPK fertilizer, and manure all positively and significantly impact tangerine farm production. However, the distance between farms and insecticide application imposes a substantial negative effect on tangerine yields. These results suggest that the tangerine farmers at the research site should increase their production by learning farming management, joining farmer groups, cultivating additional land, and using more urea, NPK, and manure. Pesticide application optimization can also boost tangerine production. In addition, farmers need a mix of conventional and organic fertilizers and limited pesticide use to stay productive.

Background: Long COVID, characterized by a persistent symptom spectrum following SARS-CoV-2 infection, poses significant health, social, and economic challenges. This review aims to consolidate knowledge on its epidemiology, clinical features, and underlying mechanisms to guide global responses; Methods: We conducted a systematic literature review, analyzing peer-reviewed articles and reports to gather comprehensive data on long COVID’s epidemiology, symptomatology, and management approaches; Results: Our analysis revealed a wide array of long COVID symptoms and risk factors, with notable demographic variability. The current understanding of its pathophysiology suggests a multifactorial origin yet remains partially understood. Emerging diagnostic criteria and potential therapeutic strategies were identified, highlighting advancements in long COVID management.; Conclusion: This review highlights the multifaceted nature of long COVID, revealing a broad spectrum of symptoms, diverse risk factors, and the complex interplay of physiological mechanisms underpinning the condition. Long COVID symptoms and disorders will continue to weigh on healthcare systems in years to come. Ad-dressing long COVID requires a holistic management strategy that integrates clinical care, social support, and policy initiatives. The findings underscore the need for increased international cooperation in research and health planning to address the complex challenges of long COVID. There is a call for continued refinement of diagnostic and treatment modalities, emphasizing a multidisciplinary approach to manage the ongoing and evolving impacts of the condition.

Conclusion: This review provides evidence that major foodborne pathogens, such as E. coli O157:H7, Salmonella spp., L. monocytogenes, and hepatitis A virus, can persist on food for prolonged periods to cause harm. These insights underscore the importance of implementing appropriate control measures to contribute to a safer and more secure food supply chain.

BACKGROUND AND AIMS: Cardiovascular disease and colorectal cancer (CRC) are significant health problems and share some risk factors. The aim of our study was to develop and validate a predictive score for advanced colorectal neoplasia (CRN) based on risk factors for cardiovascular disease and CRC. MATERIALS AND METHODS: A cross-sectional study comprising a derivation cohort and an external validation cohort of 1049 and 308 patients respectively. A prediction score for advanced CRN (CRNAS: Colorectal Neoplasia Advanced Score) was developed from a logistic regression model, comprising sex, age, first-degree family history for CRC, systolic and diastolic blood pressure, total cholesterol, HDL-cholesterol, body mass index, diabetes, smoking, and antihypertensive treatment. Other cardiovascular risk scores (Framingham-Wilson, REGICOR, SCORE and FRESCO) were also used to predict the risk of advanced CRN. The discriminatory capacity of each score was evaluated using the area under the curve (AUC). RESULTS: CRN were found in 379 subjects from the derivation cohort (36%) including 228 patients (22%) with an advanced CRN. Male sex, age, diabetes, and smoking were identified as independent risk factors for advanced CRN. The newly created score (CRNAS), showed an AUC of 0.68 (95% CI: 0.64-0.73) for advanced CRN, which was better than cardiovascular risk scores (p

Critical phases in socio-technical systems (STS) design are the definition of functional requirements for automated or software supported human activities while also addressing social and human interaction issues. To define automation support for human operations, STS designers need to ensure that specifications will satisfy not only non-functional requirements (NFR) of the system but also of its human actors such as human reliability/workload. However, such human factors aspects are not addressed sufficiently with traditional STS design approaches which could lead to systems failure or rejection. This paper proposes a new STS design method that addresses this problem and introduces a novel type of requirements namely Task Support Requirements (TSR) that assists in specifying the functionality that the system should have to support human agents in undertaking their tasks by addressing human limitations. The proposed method synthesizes a requirements/software engineering approach to STS design with functional allocation and an HCI perspective which facilitate application of human factors knowledge in conceptual models and evaluation through VR simulation. A case study methodology is employed in this work that allows in-depth, multi-faceted explorations of the complex issues that characterize STS.

Osteoarthritis and chronic pancreatitis comorbidity are insufficiently studied, and the reciprocal impact of these conditions remains poorly understood. This study aimed to investigate potential predictors for the development of osteoarthritis and chronic pancreatitis comorbidity, as well as complications associated with this comorbidity. A cohort of 150 patients was categorized into three groups: a control group (n=30), patients with osteoarthritis (n=68), and patients with comorbid osteoarthritis and chronic pancreatitis (n=52). Potential predictors for comorbidity development and associated complications were explored. The study revealed that concurrent osteoarthritis and chronic pancreatitis exacerbate each other's progression and contribute to malnutrition. Body Mass Index (BMI) emerged as a potential predictor for chronic pancreatitis development in osteoarthritis patients. In osteoarthritis patients, fecal elastase-1 levels were identified as potential predictors for exocrine pancreatic insufficiency. Factors such as WOMAC total score, fecal elastase-1, C-reactive protein (CRP), ferritin, retinol, tocopherol, 25-hydroxy vitamin D3, and BMI were found to influence comorbidity development between osteoarthritis and chronic pancreatitis. Additionally, Gastrointestinal Symptom Rating Scale-Diarrhea Syndrome (GSRS-DS), Gastrointestinal Symptom Rating Scale-Constipation syndrome (GSRS-CS), Qualitative Assessment of the Symptoms and Impact of Pancreatic Exocrine Insufficiency domain A (PEI-Q-A), retinol, tocopherol, and iron were identified as potential predictors for exocrine pancreatic insufficiency in osteoarthritis patients. In conclusion, the comorbidity of osteoarthritis and chronic pancreatitis exacerbates disease progression and complications, necessitating further investigation.

Despite the high quality of soybean protein, raw soybeans and soybean meal cannot be directly included into animal feed mixtures due to the presence of Kunitz (KTi) and Bowman Birk protease inhibitors (BBi) which reduces animal performance. Heat treatment can substantially inactivate trypsin and chymotrypsin inhibitors (BBi) but such treatment is energy intensive, adds expense, and negatively impact the quality of seed proteins. As an alternative approach we have employed CRISPR/Cas9 gene editing to create mutations in BBi genes to drastically lower the protease inhibitor content in soybean seed. Agrobacterium-mediated transformation was used to generate several stable transgenic soybean events. These independent CRISPR/Cas9 events were examined in comparison to wild type plants using Sanger sequencing, proteomic analysis, trypsin/chymotrypsin inhibitor activity assays and q15RT-PCR. Collectively, our results demonstrate the creation of an allelic series of loss of function mutations affecting the major BBi gene in soybean. Mutations in two of the highly expressed seed specific BBi genes lead to substantial reductions in both trypsin and chymotrypsin inhibitor activities.

In Kenya, reports of Rift Valley fever (RVF), one of the worst climate-sensitive zoonosis, have been common. Despite the fact that several empirical studies have demonstrated that Machine learning techniques perform better than time series models in forecasting time series data, there is little evidence of their use in predicting disease outbreaks in Africa. Recently, the literature has mentioned a number of other uses of machine learning to support intelligent decision-making in the healthcare industry and public health but there is limited knowledge on the use of the XGBoost model in the prediction of disease outbreaks. Among the Kenyan provinces, Rift valley fever cases were more pronounced in Rift valley (26.80%) and Eastern (20.60%) regions. The study explored the relationship be-tween RVF incidence and various climatic factors, such as humidity, clay content, elevation, slope, and rainfall. The strongest correlation, a meager 0.02903 for rainfall, was found in the correlation matrix, which showed weak linear relationships between various climatic factors and RVF cases. These climate variables were used to train the XGBoost model, which showed remark-able performance with an AUC of 0.8908, accuracy of 99.74%, precision of 99.75%, and recall of 99.99%. Rainfall was found to be the most important predictor in the feature importance analysis. These findings are consistent with other research showing how important weather conditions are to RVF outbreaks. According to the study's findings, the use of sophisticated machine learning models that take a variety of climatic factors into account can greatly improve RVF outbreak prediction and control.

Abstract: Aim: The aim in this study was to conduct a prospective survey regarding the socio-demographics and lifestyle risk factors for cancer of a population of Caribbean immigrants living in the U.S. Materials and Methods: The data were processed and analysed using SPSS software 27 and Excel. Crosstabulations were performed. The chi-square test was used to evaluate differ-ent hypotheses. Statistical significance was defined as p < 0.05. Results: Statistically significant differences in the country of birth of the Caribbean immigrants were found for sex (p = 0.038) and the cleanness of their neighbourhoods (p = 0.045). We found differences in occupations between men and women (p = 0.001). Men were less unemployed than women (p = 0.011). Sex also showed statistically significant differences in how easily the immigrants balanced their work and per-sonal life (p = 0.044). Age groups depicted differences in the physical health of the immigrants (p = 0.001). The use of alcohol and tobacco was not an important risk factor among participants (p = 0.529). Conclusions: These findings suggest that the sociodemographics risk factors for cancer among a population of Caribbean immigrants were significantly different between the sexes. However, the use of tobacco and alcohol showed insignificant differences among the immigrants.

Background/Objectives: Resources to cope for maternity and women’s participation are essential modulators of maternal well-being. Therefore, it is relevant that the psychosocial factors of woman will be monitored during maternity to promote adequately healthcare. This study consisted in the design and the validation of two new tools that identify women's knowledge of obstetric healthcare rights (MatCODE) and perception of resource scarcity (MatER) during pregnancy, labor and early postpartum; Methods: The content validity was carried out using the Aiken's V coefficient and the content validity index (CVI-i) based on 5 experts. In addition, for the face validity of the pilot cohort was considered the INFLESZ scale. Finally, the questionnaires were applied to 185 women, which allowed to assess the construct validation by factorial and Rasch analysis. The divergent validity was also studied with validated psychological questionnaires; Results: MatCODE and MatER questionnaires received CVI-i and Aiken's V&gt;0.80 values, also the INFLESZ demonstrates acceptable semantic understanding. The analysis confirms the unidimensional of the questionnaires with fit values for MatCODE of RMSEA=0.113 [0.105; 0.122] and MatER of RMSEA=0.067 [0.063; 0.072]. The divergent validity showed significative and consistent correlations with the constructs assessed. In MatCODE was =0.95 and =0.94 and in MatER was =0.79 and =0.78; Conclusions: MatCODE and MatER are new useful tools monitoring maternal healthcare, with adequate psychometric characteristics in Spanish context.

The signaling complex around voltage-gated sodium (Nav) channels includes accessory proteins and kinases crucial for regulating neuronal firing. Previous studies showed that one such kinase, WEE1—critical to the cell cycle—selectively modulates Nav1.2 channel activity through the accessory protein fibroblast growth factor 14 (FGF14). Here, we tested whether WEE1 exhibits crosstalk with the AKT/GSK3 pathway for coordinated regulation of FGF14/Nav1.2 channel complex assembly and function. Using the in-cell split luciferase complementation assay (LCA), we found that the WEE1 inhibitor II and GSK3 inhibitor XIII reduce FGF14/Nav1.2 complex formation, while the AKT inhibitor triciribine increases it. However, combining WEE1 inhibitor II with either one of the other two inhibitors abolished its effect on FGF14/Nav1.2 complex formation. Whole-cell voltage-clamp recordings of sodium currents (INa) in HEK293 cells co-expressing Nav1.2 channels and FGF14-GFP showed that WEE1 inhibitor II significantly suppresses peak INa density, both alone and in the presence of triciribine or GSK3 inhibitor XIII, despite the latter inhibitors’ opposite effects on INa. Additionally, WEE1 inhibitor II slowed the tau of fast inactivation, and caused depolarizing shifts in the voltage dependence of activation and inactivation. These phenotypes either prevailed or were additive when combined with triciribine but were outcompeted when both WEE1 inhibitor II and GSK3 inhibitor XIII were present. Concerted regulation by WEE1 inhibitor II, triciribine and GSK3 inhibitor XIII were also observed on long-term inactivation and use-dependence of Nav1.2 currents. Overall, these findings suggest a complex role for WEE1 kinase—in concert with the AKT/GSK3 pathway—in regulating the Nav1.2 channelosome.

Procrastination among students in higher education is a widely recognized problem, with significant effects on academic performance and personal well-being. This descriptive study aims to assess the level of procrastination among nursing students in Bengaluru and determine the association between procrastination and selected demographic variables, such as age, gender, and parental education. A total of 100 nursing students from Sneha College of Nursing participated in the study. Data were collected using a structured questionnaire and a 16-item procrastination scale. The results revealed that 55% of the students had low levels of procrastination, while 45% exhibited high levels. However, no significant association was found between procrastination and demographic variables like age, gender, religion, year of study, or parental education. The findings suggest that while procrastination is a common issue among nursing students, demographic variables may not be reliable predictors of procrastination behavior. These results call for interventions to improve time management and reduce procrastination among nursing students to enhance their academic outcomes.

Purpose: This study aimed to identify the risk factors for acute pancreatitis (AP) and its impact on outcomes in Polish children treated for ALL. Methods: The study group included 2303 children who received intensive chemotherapy for ALL. The group was subdivided into patients with at least one episode of AP and those who did not develop AP following treatment for ALL. Results: The cumulative incidence of AP in the study group was 4.08%. Older age was an independent risk factor for AP development (OR 1.05; 95%CI: 1.006 – 1.098; p=0.03). The overall mortality related to AP was 2.13%. The probabilities of disease-free survival (p-DFS) and event-free survival (p-EFS) were 0.84 vs. 0.86, log-rank: p=0.65 and 0.75 vs. 0.80, log-rank: p=0.12, respectively in both subgroups. A total of 22 out of 94 patients (23.4%) with AP were re-exposed to asparaginase (ASP) during the subsequent phases of the treatment. Only one re-exposed to ASP patient (4.5%) developed a second episode of AP. There were no significant differences in p-DFS and p-EFS between patients re-exposed and not re-exposed to asparaginase (0.78 vs. 0.86, log-rank p=0.27 and 0.63 vs. 0.79, log-rank p=0.09 respectively). Conclusions: The incidence of AP in children with ALL is low and related to the patient’s age. AP development doesn’t seem to impact p-DFS and p-EFS in children with ALL. The recurrence of AP following re-exposure to asparaginase in patients with ALL and a history of AP is low (4.5%). Re-exposure to asparaginase after the first episode of AP doesn’t improve either p-DFS or p-EFS in children with ALL.

Oncolytic virotherapy is a promising immunotherapy approach for cancer treatment, utilizing viruses to preferentially infect and eliminate cancer cells while stimulating immune responses. In this review we synthesize current literature on the molecular circuits of immune sensing and response to oncolytic virotherapy; focusing on viral DNA or RNA sensing by infected cells, cytokine and danger-associated signal sensing by neighboring cells, and subsequent downstream activation of immune pathways. The sequential sense-and-response mechanisms involve the triggering of molecular sensors by viruses or infected cells to activate transcription factors and related genes for a breadth of immune responses. We describe how molecular signals induced in the tumor upon virotherapy can trigger diverse immune signaling pathways, activating both antigen-presenting cell-based innate and T cell-based adaptive immune responses. Insights into these complex mechanisms provide valuable knowledge for enhancing oncolytic virotherapy strategies.

Obesity has increasingly become a worldwide epidemic, as demonstrated by epidemiological and clinical studies. Obesity may lead to development of a broad spectrum of cardiovascular diseases (CVDs), such as coronary heart disease (CHD), hypertension, heart failure (HF), cerebrovascular disease, atrial fibrillation (AF), ventricular arrhythmias, and sudden cardiac death (SCD). In addition to hypertension, there are other cardiometabolic risk factors (CRFs) such as visceral adiposity, dyslipidemia, insulin resistance, diabetes, elevated levels of fibrinogen, and C-reactive protein and others, all of which increase the risk of CVD events. Mechanisms involved between obesity and CVD mainly include insulin resistance, oxidative stress, inflammation, and adipokines dysregulation, which cause maladaptive structural and functional alterations of the heart, particularly left ventricular (LV) remodeling and diastolic dysfunction. Natural products of plants, provide a diversity of nutrients and different bioactive compounds, including phenolics, flavonoids, terpenoids, carotenoids, anthocyanins, vitamins, minerals, fibers, and others, which possess a wide range of biological activities including antihypertensive, antilipidemic, antidiabetic, and other activities, thus conferring cardiometabolic benefits. In this review, we discussed the main therapeutic interventions using extracts from herbs and plants in preclinical and clinical trials with protective properties targeting CRFs. Molecular mechanisms and therapeutic targets of herbs and plants extracts for the prevention and treatment of CRFs are also reviewed.

Cardiovascular diseases (CVDs) and their risk factors are a major cause of illness and death worldwide, especially in low- and middle-income countries like Cameroon. Physiotherapist-led health promotion (PLHP) has proven effective in improving health and reducing CVD risks. Understanding patient perspectives is crucial for designing effective, context-specific PLHP interventions. This study explored patients' views, experiences, perceived usefulness, acceptability, and preferred methods of PLHP through a sequential explanatory mixed-methods approach. The quantitative data highlights a significant burden of CVD conditions and risk factors among patients seen in physiotherapy services. Qualitatively, three themes were identified and included: 1) perspectives and experiences of people at risk or with CVDs (pwCVDs) on PLHP; 2) Perceived usefulness and acceptability of PLHP; 3) Preferred delivery methods of PLHP. Participants reported positive feedback on PLHP and physiotherapy services. Barriers to effective PLHP included high workloads for physiotherapists, limited service access in rural areas, and prohibitive costs. Despite these challenges, participants expressed strong confidence in physiotherapists' competence, though they also called for improved regulation and ongoing professional development. PLHP components, especially physical treatment and dietary advice, were deemed highly useful and acceptable. Patients suggested various delivery methods, including peer support groups, home visits, and mass media interventions. This study highlights the need to improve the scope of practice, competence of physiotherapists and accessibility of physiotherapy services in Cameroon for pwCVDs. It is necessary to adopt multidisciplinary approaches to achieve better outcomes for risk factors like diabetes and hypertension in context.

Myasthenia gravis (MG) is a disease characterized by typical clinical and immunopathogenic pe-culiarities, which correlate with age and sex/gender. Accordingly, MG patients show thymic al-terations and auto-antibodies productions, that can be the expression of a different pathogenetic mechanism related to age and gender. This determines, in relation to age at and sex/gender, a dif-ferent MG onset, prognosis, and outcome. Therefore, diverse MG forms can be identified, classi-fied, and characterized in relation to their different features, and precisely there are early onset and late-onset forms of MG. It has been hypothesized that the cause of appearance the two diverse forms of MG can be ascribed mainly to the diverse genetic and epigenetic factors. In this narrative review, we will analyze and discuss about the interplay of age- and sex-related factors (i.e. genet-ic and epigenetic factors) related to two different MG forms and how they contribute to their di-verse pathogenesis.

Background/Objectives: This study aimed to identify various risk factors associated with breast cancer and explore different treatment strategies based on socio-economic, hormonal, and clinical perspectives.; Methods: We analyzed socio-economic, hormonal, genetic, and clinical variables using data from 356 questionnaires obtained from breast cancer patients at Hassan II Regional Hospital in Agadir, Morocco ; Results:The study reveals that the average age of breast cancer patients is 50 ± 10.72 years, with a mode of 47 years and an age range from 29 to 94 years. Notably, women aged 38 are most frequently diagnosed with triple-negative breast cancer. Significant socio-economic trends were observed among the participants, with the majority being housewives (91%) and nearly half residing in rural areas (48.60%). High rates of illiteracy (74.72%) and financial difficulties (54.2%) pose challenges in accessing healthcare services. Psychological distress is prevalent, with 40.7% experiencing anxiety and 30.1% experiencing sadness. The use of oral contraceptives varies, with implications for breast cancer risk. Additionally, statistics on menarche and menopause suggest hormonal influences on breast cancer development. Histological analysis indicates a predominance of grade II invasive ductal carcinoma and left breast localization. Metastases are present in nearly 38.20% of cases. Notably, surgery as the primary treatment effectively treats medium-sized tumors while limiting metastasis. Furthermore, a comparison of treatment strategies reveals a preference for letrozole among postmenopausal patients and tamoxifen among premenopausal patients; Conclusions:These findings highlight the complexity of breast cancer risk factors and therapeutic approaches, emphasizing the importance of personalized care and targeted interventions.

Breast cancer mortality rates vary across ethnic groups in Israel, where protective factors such as high fertility and breastfeeding rates may be moderated by socioeconomic factors and mammography rates. We aim to investigate disparities in breast cancer mortality between Jewish and Muslim Arab women in Israel and examine how sociodemographic variables and number of children are associated with mortality. Our retrospective follow-up study uses data from the Israeli Central Bureau of Statistics and multivariable Cox regression models, adjusting for age, number of children, country of origin, locality size, and socioeconomic status. Compared to Jewish women, Muslim Arab women exhibited lower breast cancer mortality rates. However, after adjusting for multiple sociodemographic variables, no significant differences persisted between Jewish and Muslim Arab women. Having more than three children was associated with lower mortality among Muslim Arab women, but not among Jewish women. European/American origin, larger localities, and medium socioeconomic status were associated with higher mortality. Sociodemographic factors may therefore explain the disparities in breast cancer mortality between Jewish and Muslim Arab women in Israel. Targeted intervention programs considering unique characteristics and risk factors of different ethnic groups are needed to reduce disparities and improve outcomes.

Environmental genetics-related modern methods are shown as important indicators of various cyanotoxins syntheses, and their knowledge and use are critically analyzed. Microcystins and other cyanotoxins loads and syntheses are related to different drivers, like various chemical elements and compounds (especially nutrients, such as nitrogen and phosphorus, and their ratio), then to the light, conductivity, temperature, and other climatical and hydrological factors, to which spatial and geographical features (such as the surface of the water bodies) have to be added. The biotic relationships include different specific and supraspecific, uni- and bilateral links between the cyanobacteria, and subsequently their synthesized toxins, and protozoans (or protoctists), chromists, macrophytes, different systematical and ecological groups of zooplankton, and others. The importance of, but also the gaps in, the knowledge and the scarcity of studies involving ectocrines mediated interactions between different groups of algae and plants are highlighted. The paper ends with an interesting classification of lakes' trophicity, illustrated with conceptual diagrams, based on possible scenarios of cyanobacteria behavior.

Abstract: Background/Objectives: Schizophrenia (SZ) is a severe psychiatric disorder characterized by a complex interplay of genetic, developmental, and environmental factors that significantly increase the risk of suicidal ideation (SI) and suicide attempts (SAs). This systematic review synthesizes current research on the developmental predictors of SI in individuals with SZ, aiming to delineate the multifactorial etiology of suicide within this population. Methods: A comprehensive search across Medline, PsycINFO, and EMBASE databases identified 23 eligible studies, emphasizing the varied methodological approaches and the global distribution of research efforts. Results: These studies demonstrate a robust association between early life adversities, particularly childhood trauma such as physical neglect, emotional abuse, and sexual abuse, and the increased prevalence of SI and SAs in SZ. This review also highlights the significant genetic factors associated with development of suicidality in SZ, suggesting that polymorphisms in inflammation-related genes and neurodevelopmental abnormalities may influence susceptibility to SI. Notably, family history of psychiatric conditions may exacerbate the risk of SI through both hereditary and environmental mechanisms. Environmental factors, including socioeconomic status and social support, are also implicated, underscoring the role of broader socio-environmental conditions influencing outcomes. Conclusions: This review supports the integration of biopsychosocial models in understanding SI in SZ, advocating for interventions addressing the complex interplay of risk factors and the need for longitudinal studies to elucidate the dynamic interactions between risk factors over time. This comprehensive understanding is crucial for developing targeted preventative strategies and enhancing the clinical management of SZ, aiming to reduce suicidality in this vulnerable population.

By repeated unloading and loading of the excavation dynamic and static loads, repeated train dynamic and static loads of multi-factors, the underpass tunnel, cross tunnel engineering influence area rock layer, the existing tunnel structure of the three constitutes a multifaceted structure, multi-factor interaction system. Existing tunnels into the prediction theory model of the new tunnel excavation process of dynamic and static loads, dynamic and static loads of existing tunnels are mostly analyzed individually, the results of synergistic analysis needs to be improved. Based on the theory of the current layer method, the paper comprehensively considers the stiffness of the existing tunnel, the stiffness of the new tunnel, the excavation method load and the existing tunnel load, coupled with Peck's empirical formula, the theoretical model of deformation prediction for excavation of a two-lane highway tunnel under the tunnel through the existing railroad is proposed, and verified and optimized by numerical calculations and monitoring data, which proves the applicability and reliability of the theoretical model in the similar strata and the project promotion.

Oncomelania Hupensis is the exclusive intermediary host of Schistosoma japonicum in China. The alteration of its habitat and population distribution directly affects the safety of millions of individuals residing in the Yangtze River Economic Belt (YREB), and the ecological stability. Therefore, it is crucial to analyse the influence of climate change on the distribution of O. Hupensis in order to achieve accurate control over its population. This study utilised the MaxENT model to forecast possible snail habitats by utilising snail distribution data obtained from historical literature. The subsequent outcomes were achieved: The primary ecological factors influencing the distribution of O. Hupensis are elevation, minimum temperature of coldest month, and precipitation of wettest month; Furthermore, future climate scenarios indicate a decrease in the distribution area and a northward shift of the distribution centre for O. hupensis; Specifically, those in the upstream will move northeast, while those in the midstream and downstream will move northwest; These changes in suitable habitat area, the average migration distance of distribution centers across different climate scenarios, time periods, and sub-basins within the YREB, resulting in uncertainty. This study offers theoretical justification for the prevention and control of O. hupensis along the YREB.

The use of energy resources is essential to the survival and development of human civilization. However, inefficient energy use not only has an impact on the economy, but it also has a significant impact on climate change. Studying and analyzing the factors that increase energy consumption is crucial for improving energy management. The aim of this study is to analyze the factors influencing energy savings in a building taken as a study model under two different climatic conditions. Measurements of the building's energy performance were carried out using the EnergyPlus calculation engine, which enabled us to analyze the strengths of building parameters such as the number of lights, the equipment used, occupancy, temperature and the relationships between the factors influenced. EnergyPlus is an important software tool in the field of building energy efficiency, enabling the precise simulation of building energy consumption. Simulation scenarios based on actual consumption data carried out by researchers have made it possible to develop energy management strategies in buildings in order to optimize energy efficiency, and in particular to promote the thermal performance of these buildings. In the present work, EnergyPlus building energy simulation software is used to simulate the energy consumption of the building of the Faculty of Electrical Engineering at the "Gheorghe Asachi" Technical University in Iasi, in order to determine the factors influencing building energy consumption. It has been shown that occupancy and heating and cooling systems are the key factors influencing energy consumption in buildings. The advantage of this study is that it can be used to model the most influential factors in predicting future energy consumption in buildings.

Substance use is a growing problem among young people in sub-Saharan Africa; tobacco use is the dominant one among these practices. The aim was to analyse prevalence rates and determinants for cigarette smoking of school-attending adolescents in the capital, Bissau, Guinea-Bissau. In June 2017, a survey questionnaire was implemented in 16 schools among adolescents aged 14–19 (52% girls). The Chi-square (p&lt;0.05) and odds ratios (OR) were calculated with 95% confidence intervals (CI). Potential explanatory variables for the dependent variables were introduced into a multinomial logistic regression model, and p-values were transformed to LogWorth values. The prevalence of lifetime smoking experience among 1,845 participants was 14.8%; 6.5% were current users, and 2.2% were daily smokers. The most significant determinants for cigarette smoking included having friends who smoke, being a boy, attending a private school, smoking initiation at a young age, other substance use and violent behaviour. It is imperative to initiate preventive actions against smoking and other use of tobacco in Guinea-Bissau. Considering the significant impact of the peer group, policymakers need to engage young people in developing primary prevention strategies to curb the use of tobacco and other substances.

This qualitative research explores negotiation dynamics within procurement, focusing on strategies, challenges, and outcomes in contemporary business environments. Negotiation in procurement plays a crucial role in shaping organizational strategies, supplier relationships, and operational efficiencies. In a globalized economy characterized by rapid technological advancements and market uncertainties, effective negotiation practices are essential for organizations seeking competitive advantage and sustainable growth. Through semi-structured interviews with procurement professionals, supply chain executives, and industry experts, this study examines the nuanced strategies employed in negotiation processes. Thematic analysis of the data reveals key themes including negotiation strategies (e.g., preparation, flexibility), challenges (e.g., price volatility, regulatory constraints), and outcomes (e.g., cost savings, innovation incentives). Relationship management emerges as pivotal, highlighting the importance of trust, transparency, and mutual respect in fostering collaborative supplier partnerships. The study also explores contextual factors (e.g., organizational culture, industry dynamics) and emotional dimensions (e.g., emotional intelligence, interpersonal dynamics) that influence negotiation effectiveness.

Monitoring the status and dynamics of desertification is one of the most important parts of combating desertification. In this study, 30m high-resolution information on land desertification and restoration in the HRB was extracted from the land cover database. The results indicate that land desertification coexists with land restoration in the HRB. At different periods, the area of land restoration is much larger than the area of land desertification in the HRB, and the HRB has been in a process of land restoration. Upstream of the HRB, there is a continuing trend of increasing land desertification associated with overgrazing in a context where climate change favors desertification reversal. In the middle and lower reaches, although both climate variability and human activities favor land desertification, the process of land desertification in the middle and lower reaches is still being reversed and land restoration dominates. The implementation of the Eco-Environmental Protection Project and desertification control measures, especially the EWDP, is contributing to the reversal of desertification in the middle and lower reaches of the HRB. However, the EWDP has indirectly led to the lowering of the water table in the middle reaches, resulting in local vegetation degradation. Therefore, there is therefore an urgent need to transform the economic structure of the middle reaches to cope with water scarcity and land desertification.

(1) Background: The prediction of cervical lesions evolution is a challenge for clinicians. The prospective study aimed to determine and compare the predictive accuracy of cytology, HPV genotyping, and p16/Ki67 dual staining alone or in combination with personal risk factors for the prediction of progression, regression or persistence of cervical lesions in human papillomavirus (HPV)-infected patients; (2) Methods: This prospective study included HPV-positive patients with or without cervical lesions that underwent follow-up. Descriptive statistics and sensitivity analysis for individual or combined index tests were used for data analysis; (3) Results: The highest predictive performance for the progression of cervical lesions was achieved by a model that comprised a Pap smear suggestive of high-grade squamous intraepithelial lesion (HSIL), the presence of 16/18 HPV strains, a positive p16/Ki67 dual staining result along with the presence of at least 3 clinical risk factors, which had a sensitivity (Se) of 74.42%, a specificity of 97.92%, an area under the receiver operating curve (AUC) of 0.961, and an accuracy of 90.65%. The prediction of cervical lesions regression or persistence was modest; (4) Conclusions: Multiple testing or new biomarkers should be used to improve HPV-positive patient surveillance, especially for cervical lesion regression or persistence prediction.

Background: Research has consistently shown increased drug use among lesbian, gay, bisexual, transgender, intersex, queer/questioning, and asexual (LGBTQIA+) individuals. This is particularly the case among LGBTQIA+ adolescents. Substance use within this vulnerable community can propagate mental health issues leading to psychiatric disorders, self-harm and even suicide. Therefore, the objective of this scoping review was to evaluate the determinants of drug use among LGBTQIA+ adolescents. Methods: A comprehensive search of mainly primary research was conducted using several databases. Peer-reviewed articles published between 2018 and 2023 were included. The scoping review was conducted using the framework outlined by Joanna Briggs Institute (JBI) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses- Extension for Scoping Reviews (PRISMA-ScR) statement. Results: A total of 29 articles (including 400194 participants) were included in the analysis. The articles reported that the main determinants of drug use among LGBTQIA+ adolescents include homelessness, peer-peer interactions, mental health, and protective factors. The articles reported that mental health issues, which are mainly triggered by rejection, were the main determinants of drug use among LGBTOIA+ adolescents. Conclusion: Findings from this scoping review provide relatively reliable evidence that homelessness, mental health, peer-peer interactions, and protective factors are the main determinants of illicit drug use among LGBTQ+ adolescents. Rigorous studies that include large sample sizes, and systematic reviews are needed to further confirm these findings and assist in developing interventions to combat the unusually high level of drug use among this group.

Background: Despite their generally favorable prognosis, hepatic fibrosis remains a possible complication for hepatitis B virus (HBV) inactive carriers. This study aimed to estimate the prevalence of significant fibrosis and associated risk factors among Omani HBV inactive carriers. Methods: A retrospective study was conducted of 200 Omani HBV inactive carriers visiting a tertiary hospital in Muscat, Oman, between January 2017 and December 2018. Significant fibrosis (stage F2 or higher) was identified using two-dimensional shear-wave elastography. Baseline clinical, laboratory, and radiological data were analyzed to determine associations. Results: Of the total sample, 106 patients (53%) were male, and the mean age was 44.6 ± 9.3 years. The prevalence of significant fibrosis was 20% (n = 40). Male gender (p = 0.007), age ≥60 years (p = 0.024), and fatty changes in liver ultrasound (p = 0.044) were found to be independent factors for significant fibrosis. Conclusion: the prevalence of significant fibrosis was relatively high among a sample of Omani HBV inactive carriers, with several sociodemographic and clinical risk factors identified. Periodic assessment of liver function is needed for patients with these risk factors; moreover, routine biochemical parameters could be useful predictors of disease prognosis. Further research is recommended to substantiate these findings.

The study is based on information as the property of matter and its evolution from chemical to digital information. Consequences of these forms of information include molecular, modular, cel-lular, non-human, and human individual interactions, as well as human-machine interaction, and the formation of corresponding modules through self-organizing selective processes. The function of modular structures is decision-making and is analogous to the behavior of an intelligent agent. The evolutionary modular model is proposed based on the interaction of evolutionary factors (matter, energy, information, self-organization, natural selection, and heritability) among themselves and with the arrow of time. In conclusion, we realize that the essence of the evolution of living organ-isms is modular evolution. Modules through which the survival and reproduction of living organ-isms is ensured, are formed by two basic molecular processes, which are molecular recognition or information and modular self-organization.

With the increased global attention to environmental protection, social responsibility and corporate governance (ESG) standards, integrating ESG into supply chain management (SCM) is becoming a strategic requirement for companies to achieve competitiveness and sustainable development. This study reviews the impact factors of ESG practices on supply chain competitiveness, and empirically examines the mechanism of ESG performance on supply chains through a questionnaire survey with a sample of Chinese SMEs. It was found that normative pressure, coercive pressure and imitative pressure in SMEs have a significant positive effect on cognition and attitude and perceived behavioral control; good corporate cognition and attitude, perceived behavioral control and corporate pressure also enhance the level of ESG practices. Further analysis shows that cognition and attitude and perceived behavioral control play a mediating role in the impact of ESG practices, and ESG performance promotes sustainable development of SMEs. The article puts forward the following suggestions: (1) close supply chain partnerships to enhance green innovation; (2) the government should give more resource support to ESG-invested enterprises and support the development of advantageous enterprises; (3) improve the corporate disclosure mechanism and strengthen the supervision; and (4) strengthen the training of professionals in supply chain ESG management.

The subway station operation is susceptible to safety accidents when high-pressure gas pipeline overlaying, and analyzing the correlations between the safety influencing factors (SIFs) under this operation situation can provide paths to reduce safety accidents. Thus, this paper investigated the coupling correlations between the SIFs. We firstly identified the SIFs during subway station operation under high-pressure pipeline (SSOUHP) based on the literature review and experts’ discussion. Then, the analytic hierarchy process (AHP) and coupling degree analysis (CDA) were combined to assess the coupling correlations between the SIFs. And Y subway station was selected to test the proposed hybrid coupling analysis approach. Research results show that (a) 23 second-level SIFs were identified and these SIFs can be summed up into 5 first-level SIFs, namely, human-related SIFs, pipeline-related SIFs, station-related SIFs, environment-related SIFs, and management-related SIFs; (b) the proposed hybrid approach can be used to evaluate the coupling correlations between SIFs; (c) of the coupling situations during Y subway station operation, the internal coupling correlations among environment-related SIFs, the coupling correlations between pipe-related SIFs and environment-related SIFs, and the coupling correlations among human-related SIFs, pipe-related SIFs and environment-related SIFs are with higher safety risk; (d) the overall coupling correlation among all SIFs during Y subway station operation is with lower safety risk. The research can enrich the knowledge in the safety evaluation area, and provide reference for onsite safety management.

Background/Objectives: The global push to eliminate tuberculosis (TB) as a public health threat is in-creasingly urgent, particularly in high-burden areas like O.R. Tambo District Municipality, South Africa. Drug-resistant TB (DR-TB) poses a significant challenge to TB control efforts and is a leading cause of TB-related deaths. This study aimed to assess DR-TB transmission patterns and predict future cases using geospatial and predictive modeling techniques. Methods: A retrospective cohort study was conducted across five decentralized DR-TB facilities in O.R. Tambo District Municipality from January 2018 to De-cember 2020. Data were obtained from Statistics South Africa, and patient GPS coordinates were used to identify clusters of DR-TB cases via DBSCAN clustering. Hot Spot Analysis (Getis-Ord Gi) was performed, and two predictive models (Linear Regression and Random Forest) were developed to estimate future DR-TB cases. Analyses were conducted using Python 3.8 and R 4.1.1, with significance set at p < 0.05. Results: A total of 456 DR-TB patients were enrolled, with 56.1% males and 43.9% females. The mean age was 37.5 (±14.9) years. The incidence of DR-TB was 11.89 cases per 100,000 population, with males dispropor-tionately affected. Key risk factors included poverty, lack of education, and occupational exposure. DR-TB types included RR-TB (60%), MDR-TB (30%), Pre-XDR-TB (5%), XDR-TB (3%), and INHR-TB (2%). Spatial analysis revealed significant clustering in socioeconomically disadvantaged areas. A major cluster was identified, along with a distinct outlier. Predictive models indicated differing trends, with the Random Forest model predicting stabilization at 30 cases per year by 2022, while the Linear Regression model projected a decline to zero by 2026. Conclusions: The study highlights the need for targeted interventions in vulnerable populations to curb DR-TB transmission and improve treatment outcomes.

The present study aims to find out the financial risk tolerance scores of the rural residents of Ludhiana district. Also, how drivers such as socio-demographic factors, namely, gender, age, education, annual income, existence of loan, occupation, employment status and psychological factors, namely, deliberative thinking, optimism and personality type A/ B impact financial risk tolerance of rural residents. The study is important for financial policy makers as they will become aware about scenario of rural residents and frame policies accordingly. Stepwise regression analysis was carried on. The result was found out that optimism positively and deliberative thinking negatively impacted financial risk tolerance, but personality type A/B did not have a significant impact on financial risk tolerance. Socio-demographic factors such as existence of loan, full-time salaried individuals, marital status significantly impacted financial risk tolerance. Other factors failed to have impact on financial risk tolerance of rural residents in the current study.

Vagueira Beach on the Central Portuguese coast, is known as one of the places in Europe most affected by coastal erosion. The area has suffered more than 156 meters of coastline retreat over the period 1958 to 2001. With the aim to evaluate the influence of local factors on coastal erosion, this paper assesses the anthropogenic and natural factors that are related with the retreat of the coastline, by adopting statistical correlation and regression analyses. Through the Pearson's correlation coefficient (r) it was observed that local factors such as annual dredging at the Aveiro Port entrance (r = 0.93), the total length of groins in the Espinho-Vagueira section (r = 0.89), and storm events (r = 0.52) are directly related to coastline retreat in the area. A multiple linear regression model was developed in which coastline retreat is explained by these same factors over the period 1980 to 2006. With a coefficient of determination of R² = 0.91, it was observed that length of groins (significant at the 1% level), dredging of the port entrance (significant at the 5% level) and precipitation (as a proxy for storm events; significant at the 10% level) are significantly correlated with coastline retreat. Hence, it is shown that anthropogenic factors are the main drivers of coastline retreat in Vagueira Beach. This study provides an innovative approach for the assessment of coastal erosion, resulting in important information that can be used for decision-making related to coastal zone management as it allows to understand in greater detail the main drivers of coastal erosion.