Until now, Z-form RNAs were believed to only adopt a left-handed double helix structure. In this study, we describe the first observation of a right-handed Z-form RNA in NMR solution formed by L-nucleic acid RNA and present the first resolution structure of the complex between a right-handed Z-form RNA and a curaxin ligand. This newly described topology is of great interest as it shows that Z-form RNAs can also adopt a right-handed double helix structure and interact with ligand molecules. The structural information provides a platform for the design of topology specific Z-form-targeting compounds and is valuable for the development of new potent anticancer drugs.

In new Guideline for the Management of Patients with Valvular Heart Disease for tricuspid regurgitation (TR) is focused the importance of measurement of right-sided diastolic pressures and right ventriculography, pulmonary artery pressures, and pulmonary vascular resistance. Assessment of right ventricular (RV) dimensions and function is pivotal to select patients with severe tricuspid regurgitation who may benefit from tricuspid valve intervention. However, with the exception of tricuspid valve annulus diameter, there is no other cut-off value that defines severe RV dysfunction or dilation for this specific group of patients. It may be difficult, if not impossible, to establish a cut-off value of RV dysfunction since the RV may be exposed to pressure and volume overload, myocardial ischemia, intrinsic myocardial disease or pericardial constraint. Furthermore, the response of the RV to tricuspid valve intervention may vary according to each aetiology and the time course of the disease (acute or chronic). Comprehensive assessment of RV function should address in shape remodelling; functional remodelling; tissue remodelling. This assessment should be performed in optimal loading conditions and after euvolemia has been achieved. It’s now that there is no other cut-off value that defines severe RV dysfunction or dilation for patients with severe TR with the exception of tricuspid valve annulus diameter. It may be difficult, if not impossible, to establish a cut-off value of RV dysfunction since the RV may be exposed to pressure and volume overload, myocardial ischemia, intrinsic myocardial disease or pericardial constraint. In this review we analyze the relationship between right ventricular (RV) and TR in term of outcomes and mortality predictor in patients undergoing percutaneous or invasive treatment for severe TR.

We introduce a new generalized inverse which is a natural generalization of (pseudo) right core inverse in a Banach *-algebra. We characterize this generalized inverse by using right core and quasi-nilpotent decomposition. We then present its polar-like characterization and investigate related algebraic properties. Finally, the right core-EP inverse is characterized by certain new ways.

This paper offers insights into the nexus of youth, masculinity and right-wing populism in Australia. Here we make reference to a wide body of international literature on the topic. There is some affinity between disenfranchised (white) working-class young men and the radical right. Survey data were collected for a project on masculinity and the far right in Australia. 203 young men worked primarily in “blue collar” sectors of the Australian labour force. Some survey responses locate them partly or potentially within the field of the populist right-wing, with many expressing anti-government sentiments and the discourse of white male victimhood. The majority were nostalgic for stereotypical masculinity. While right-wing populist movements across the world certainly differ, they often share a discourse promoting traditional gender roles.

Especially in the last two decades, due to the developments in durable mechanical circulatory support (MCS) technology and applications, left ventricular assist (LVAD) implantation has become used in more fragile end-stage heart failure patients with higher risk. Despite advances in technology and patient care processes, right heart failure remains the leading cause of morbidity and mortality after durable LVAD implantation. It is difficult to make decisions about the type and duration of MCS during preoperative evaluation, and many clinical, hemodynamic, biochemical and echocardiographic criteria must be taken into account when evaluating the right ventricle. Complex quantitative scoring systems, including measurements of different risk factors for postimplant right ventricular failure, and composite variables, including the anatomical and functional status of the right ventricle, have been used to decide between left or biventricular assist device implantation. The successful use of artificial intelligence (AI) and machine learning (ML) in various applications in the medical field has paved the way for the idea of using it to better predict possible conditions such as right heart failure after LVAD implantation. This review aims to evaluate the current situation of risk prediction models using AI and ML technology, which have become popular in recent years, and possible future developments in predicting right heart failure after the application of durable MCS systems.

In response to various stressors, cardiac chambers undergo structural remodeling. Long-term exposure of the right ventricle (RV) to pressure or volume overload leads to its maladaptive remodeling, associated with RV failure and increased mortality. While left ventricular adverse remodeling is well understood and therapeutic options are available or emerging, RV remodeling remains underexplored and no specific therapies are currently available. Accumulating evidence implicates a role of mast cells in RV remodeling. Mast cells produce and release numerous inflammatory mediators, growth factors and proteases that can adversely affect cardiac cells, thus contributing to cardiac remodeling. Recent experimental findings suggest that mast cells might represent a potential therapeutic target. This review examines the role of mast cells in cardiac remodeling with specific focus on RV remodeling and explores the potential efficacy of therapeutic interventions targeting mast cells to mitigate adverse RV remodeling.

The research in neuroscience links alexithymia, the difficulty of identifying and describing feelings and emotions, with a left hemisphere preference and/or a right hemisphere deficit. To provide a neuropsychological support to this finding, we explored the relationship between alexithymia and the performance in a line bisection task, a standard method to evaluate spatial attention in relation with the functioning of the right hemisphere. 222 healthy participants completed a version of the TAS-20 scale, which measures alexithymia, and were asked to mark (bisect) the center of a 10 cm horizontal segment. The results document a significant rightward shift of the line center in borderline and manifest alexithymic participants, as compared to non-alexithymic individuals. Moreover, the higher the TAS-20 score the greater the rightward shift in the line bisection task. This result supports the right-hemisphere deficit hypothesis in alexithymia and suggests that visuospatial abnormalities may be an inner component of their profile.

COVID-19 affects many organs in our body, including the heart and lungs. COVID-19 cases that require hospitalization often exhibit pulmonary hypertension (PH) due to changes in the lung microvasculature in which the blood vessels become stiff, damaged, or narrow, causing increased pulmonary arterial pressure. This review examines the hypothesis that PH can lead to right ventricular hypertrophy (RVH) as a long-lasting aftereffect of COVID-19. Recent studies have shown that significant percentages of hospitalized patients develop right ventricular hypertension and right ventricular dilatation (RVD), which may lead to right ventricular failure and death. Despite recommendations for echocardiogram reports to include right ventricular wall thickness to assess RVH, few published reports have reported this parameter. Relevant studies on animal models of PH in which the timing of PH can be precisely controlled suggest that one to three weeks of PH can cause RVH. Thus, according to the hypothesis proposed here COVID-19 patients who have long-lasting severe disease (e.g., needed to be on a ventilator for one or more weeks) accompanied by PH and RVD may develop RVH as a long-lasting sequela outlasting the infection itself. Echocardiogram studies of recovered COVID-19 patients may determine whether oft-reported cardiovascular sequelae include RVH.

Is the existence of populist sentiments linked to greater affective polarization? Is there a relationship between these two factors (populist sentiments and affective polarization) and the endorsement of far-right ideologies? Are there differences in the types of media prioritized by individuals with varying levels of affective polarization? This exploratory study, conducted in the context of the early legislative elections in Portugal in April 2024, analyzes data from a sample of 130 first-time young voters. It suggests an association between the defense of far-right arguments, the possession of populist sentiments, and levels of affective polarization. The study also found variations in affective polarization among young people who prioritized different types of social media to inform themselves on political issues.

Background: Pulmonary emboli (PE) is a life threatening condition that is discovered in many patients only "post mortem". Adequate and timely detection of PE is crucial, because of the high mortality and morbidity and the sudden unexpected hemodynamic collapse that may occur in patients with PE. Objectives: To assess the ability to predict clinical outcome of patients with acute PE, using a non-gated computed tomography pulmonary angiography (CTPA), based on the dimensions of the right ventricle. Methods: A retrospective study that analyzed CTPA images of patients admitted with acute PE during the years 2012-2017 in Baruch Padeh Medical Center. The cohort study included 300 patients with documented acute PE, among them 255 were hospitalized in medical (non-intensive care unit) wards, and 45 were patients were hospitalized in an intensive care unit (ICU). Results: Among the 45 patients admitted to the ICU, 8% died. Larger RV diameters predicted mortality (OR=10.14, 95% CI [1.09-93.86]) as well as lower systolic and diastolic blood pressure measurements (p=0.001 and 0.01). Among the 255 patients that were admitted in the Internal Medicine Ward 7% died. Older age (p=0.028), sepsis and cancer (both p<0.001), high WBCs count (p<0.001), and renal failure (p<0.001) predicted death. Overall, of all 300 patients that were admitted, lower blood pressure (systolic and diastolic) (p<0.001, 0.008), older age (p<0.007), sepsis (p<0.001), cancer (p=0.006), higher WBCs count (p<0.001), and impaired renal function (p<0.001) predicted death among patients admitted with confirmed acute PE. Conclusions: Clinical parameters and hematological parameters could predict the outcome of patients admitted with acute PE. RV diameter, measured by the non-ECG gated CTPA had an additive predictive value for patients who were hemodynamically unstable on admission and were hospitalized in the ICU.

Amyloidosis is due to deposition of an excessive amount of protein in many parenchymal tissues, including myocardium. The onset of cardiac Amyloidosis (CA) is an inauspicious prognostic factor, that can lead to sudden death. We retrospectively analyzed 135 patients with systemic amyloidosis, admitted to our ward between 1981 and 2019. Among them, 54 patients (46.30% F / 53.70% M, age 63.95±12.82 years) presented CA at baseline. In 53 patients, there was associated with multiorgan involvement, while in one there was primary myocardial deposition. As control group, we enrolled 81 patients (49.30% F / 50.70% M, aged 58.33±15.65) who did not meet the criteria for CA. In 44/54 of patients CA was associated with AL, 5/54 with AA, 3/54 of patients with ATTR, in 1/54 AL was related to hemodialysis and 1/54 to Gel-Amyloidosis. The most common AL type was IgG (28/44); less frequent forms were either IgA (7/40) or IgD (2/40), while seven patients had a λ free light chain form. The 32 AL with complete Ig were 31 λ-chain and just one k-chain. CA patients presented normal BP (SBP 118.0±8.4 mmHg; DBP 73.8±4.9 mmHg), while those with nCA had increased proteinuria (p=0.02). TnI and NT-proBNP were significantly increased compared to nCA (p= 0.031 and p=0.047, respectively). In CA patients we found an increased LDH compared to nCA (p=0.0011). CA patients were also found to have an increased interventricular septum thickness compared to nCA (p=0.002), a decreased Ejection Fraction % (p=0.0018) and Doppler velocity E/e’ ratio (p=0.0095). Moreover, CA patients were seen to have an enhanced right atrium area (p=0.0179), right ventricle basal diameter (p= 0.0112) and wall thickness (p=0.0471) as compared to nCA, as well as an increased inferior cava vein diameter (p=0.0495). TAPSE was the method chosen to evaluate systolic function of the right heart. In CA subjects very poor TAPSE levels were found compared to nCA patients (p=0.0495). Additionally, we found a significant positive correlation between TAPSE and lymphocyte count (r=0.47; p=0.031) as well as Gamma globulins (r=0.43, p=0.033), Monoclonal component (r=0.72; p=0.047) and IgG values (r=0.62, p=0.018). On the contrary, a significant negative correlation with LDH (r=-0.57, p=0.005), IVS (r=-0.51, p=0.008) and diastolic function evaluated as E/e’ (r=-0.60, p=0.003) were verified. CA patients had very poor survival compared to controls (30 vs. 66 months in CA vs nCA, respectively, P=0.15). Mean survival of CA individuals was worse also when stratified according to NT-proBNP levels, using 2500 pg/mL as class boundary (174 vs. 5.5 months, for patients with lower vs higher values than the median, respectively p=0.013). In much the same way, decreased right heart systolic function was correlated with a worse prognosis (18.0 months median survival, not reached in subjects with lower values than 18mm, p=0.0186). Finally, our data highlight the potential prognostic and predictive value of right heart alterations characterizing amyloidosis, as a novel clinical parameter correlated to increased LDH and immunoglobulins levels. Overall, we confirm the clinical relevance of cardiac involvement and propose that right heart evaluation may be considered as a new marker for clinical risk stratification in patients with amyloidosis.

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.

Background Acute right heart failure (RHF) is associated with high morbidity and mortality. Temporary mechanical circulatory support (tMCS) is now part of the advanced management strategy for refractory cardiogenic shock (CS). Among such support systems, VA-ECMO remains the fastest MCS system to set up. The ProtekDuo cannula can be used as a temporary and percutaneous right ventricular assist device (RVAD) in relay with VA-ECMO in the context of prolonged weaning. Case Summary This case report describes the clinical course of a 69-year-old patient who underwent elective aortic valve replacement surgery complicated by acute RHF due to iatrogenic ligation of the right coronary artery. VA-ECMO was initiated in the context of refractory cardiogenic shock. Faced with prolonged MCS weaning, due to lack of recovery of the right ventricle associated with the absence of any other therapeutic option, a percutaneous RVAD via a ProtekDuo cannula was implanted as a bridge to recovery. The ProtekDuo was gradually weaned while the patient began rehabilitation. The patient was transferred to the medical ward after 5 weeks in the ICU, stayed 5 months in an acute medical setting, went to a rehabilitation center afterward and returned home 6 months after the initial surgery without any neurological sequalae or organ failures. In total, she remained on MCS for 39 days (21 on VA-ECMO and 18 on ProtekDuo). Discussion In cases of refractory RHF, after stabilization and organ perfusion restoration under VA-ECMO, it is feasible to switch to a percutaneous RVAD, allowing early mobilization of patients during prolonged MCS weaning until the right ventricle adapts to new loading conditions.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a rare inherited disorder which is characterized by fibrofatty degeneration of cardiac muscles mainly in the right ventricular myocardium. It may cause tachyarrhythmias or right-heart failure or may cause sudden death, especially in young athletes. In our case report, we present a case of young age male patient who presented at a local community hospital with the complaint of atypical chest pain, palpitations, and vomiting and sustained ventricular tachycardia (VT) on electrocardiograph (ECG) showing sustained ventricular tachycardia, left bundle branch morphology with the superior axis. The normal sinus rhythm was achieved after multiple DC cardioversion attempts and he was referred to our tertiary care hospital. Later ECG demonstrated epsilon waves and T wave inversion in v1 to v4 and RBBB morphology. The echocardiography showed a severely dilated right ventricle with dysfunction and right ventricle ventricular apical aneurysm. The definitive diagnosis of ARVC was made as per Revised Task Force Criteria 2010 and the electrophysiology review suggested implantable cardiac defibrillator (ICD) device placement. The patient successfully received a dual-chamber ICD device and he remained asymptomatic.

Twining stems are an important form of plant stems. Twining stems can exhibit two different chiralities: right-handed and left-handed, with right-handed twining stems being much more common than left-handed ones. The determination of chirality in twining stems has always been a fascinating topic. Many people believe that the direction of twining stems in a given species is fixed, but this is not the case. Some species have twining stems that exhibit both chirality types, i.e. the chirality is variable. Moreover, such species or genera are not rare and can be commonly encountered in everyday life. Here, we report the presence of variable-chirality twining stems (VCTS) in several species or genera within the Asteraceae, Campanulaceae, Rubiaceae, Lamiaceae, Polygonaceae, Santalaceae, and Ranunculaceae families, including common plants such as Mikania micrantha and Pleuropterus multiflorus. VCTS is an objectively existing phenomenon, but often overlooked. Understanding and accepting this concept will greatly assist future research in this field.

While the desire to uncover the neural correlates of consciousness has taken numerous directions, self-face recognition has been a constant in attempts to isolate aspects of self-awareness. The neuroimaging revolution of the 1990’s bought about systematic attempts to isolate the underlying neural basis self-face recognition. These studies, including some of the first fMRI (functional Magnetic Resonance Imaging) studies, revealed a right hemisphere bias for self-face recognition in a diverse set of regions including the insula, the Dorsal Frontal Lobe, the Temporal Parietal Junction and Medial Temporal Cortex. Confirmation of these data (which are correlational) was provided by TMS (Transcranial Magnetic Stimulation) and patients in which direct inhibition or ablation of right hemisphere regions leads to a disruption or absence of self-face recognition. These data are consistent with a number of theories including a right hemisphere dominance for self-awareness and/or a right hemisphere specialization for identifying significant social relationships including to oneself.

This article investigates the unexpected re-emergence of race in both the rhetoric and activities of the British radical-right. In doing so it seeks to better understand the reasons why race has re-emerged, how race has been contemporarily deployed by the radical-right, and the extent to which the re-emergence of race will force the radical right’s recent ideological focus on religion – more specifically, the religion of Islam and Muslims as adherents – begin to retreat. It does this first by setting out the methods and approaches used throughout. From here, necessary and appropriate context is provided about the British radical-right generally and the decades old ideological turn more specifically. Next, the circumstances and reasons for the re-emergence of race are critically engaged: focusing on the immediate aftermath of 2020’s Black Lives Matter protests as also the wider socio-political landscape of contemporary Britain. Taking into account both established and newly formed groups and movements from within the British radical right, the role and function played by race is considered next. As part of this, an in-depth analysis of the role and function of race in the rhetoric and activities of Patriotic Alternative is included. In conclusion, this article reflects on a number of arguments about why the re-emergence of race among the British radical-right is - albeit to varying degrees - a cause for concern.

In recent decades, there have been numerous endeavors to develop a novel category of survival distributions possessing enhanced flexibility through the extension of existing distributions. This article constructs and validates the statistical properties of a novel survival distribution in order to obtain an alternative distribution that is suitable for analyzing survival data by presenting the novel mixture of the Fréchet distribution along with statistical properties such as the probability density function (PDF), cumulative distribution function (CDF), rth ordinary moment, skewness, kurtosis, moment-generating function, mean, variance, mode, survival function, hazard function, and asymptotic behavior, as well as constructing the estimators of the unknown parameter by employing the expectation-maximization (EM) algorithm, and simulated annealing. Additionally, the performance of the proposed estimators was compared with bias, mean squared errors (MSE), and simulated variances, and given an illustrative example of the proposed distribution to the survival data set in order to show that the proposed distribution is appropriate for the right-skewed data. This will be extremely advantageous in survival analysis.

A 57-year-old male with a history of hyperlipidemia and mild pulmonary hypertension presented for a left inguinal hernia repair. Preoperative electrocardiogram showed severe right axis deviation at 177 degrees and abnormal repolarization. Right ventricular hypertrophy secondary to pulmonary hypertension was the primary differential but was quickly ruled out due to the patient being asymptomatic and having great exercise tolerance. Dextrocardia was also ruled out due to normal progression on the precordial leads. The simultaneous severe right axis deviations of P, R, and T waves raised suspicion for erroneous lead placement. The repeat electrocardiogram confirmed the diagnosis.

Purpose: To determine whether 24-hour IOP monitoring can be a predictor for glaucoma progression and to analyze the inter-eye relationship of IOP, perfusion and progression parameters. Methods: We extracted data from manually drawn IOP curves with HIOP-Reader, a software suite we developed. The relationship between measured IOPs and mean ocular perfusion pressures (MOPP) to retinal nerve fiber layer (RNFL) thickness was analyzed. We determined the ROC curves for peak IOP (Tmax), average IOP (Tavg), IOP variation (IOPvar) and historical IOP cut-off levels to detect glaucoma progression (rate of RNFL loss). Bivariate analysis was conducted to check for various inter-eye relationships. Results: 217 eyes were included. The average IOP was 14.8±3.5 mmHg, with a 24-hour variation of 5.2±2.9 mmHg. 52% of eyes with RNFL data showed disease progression. There was no significant difference in Tmax, Tavg and IOPvar between progressors and non-progressors (all p>0.05). Except for Tavg and the temporal RNFL, there was no correlation between disease progression in any quadrant, Tmax, Tavg and IOPvar. 24-hour and outpatient IOP variables had poor sensitivities and specificities in detecting disease progression. The correlation of inter-eye parameters was moderate; correlation with disease progression was weak. Conclusion: In line with our previous study, IOP data obtained during a single visit (outpatient or inpatient monitoring) make for a poor diagnostic tool, no matter the method deployed. Glaucoma progression and perfusion pressure in left and right eyes correlated weakly to moderately with each other.

Farmer’s right and their sovereignty is an important issue related with intellectual property rights and agrobiodiversity management. To boost farmer’s right, a conceptual hypothesis is proposed where they choose either a new high yielding variety or the existing one and apply conventional breeding approaches to select the seed for next years in their own fields. Although farmers produce seeds traditionally from several years, they have not been guided with scientific discipline to produce sufficient amount of quality seeds. This new concept suggests trained farmers can use breeding approaches to produce quality seed for their own use.

Pulmonary hypertension (PH) is a progressive condition that affects pulmonary vessels, but its main prognostic factor is right ventricle (RV) function. Many mice/rat models are used for research in PAH, but results fail to translate in clinical trials. This study reviews studies that test interventions on pulmonary artery banding (PAB), a model of isolated RV disfunction, and PH models. Multiple tested drugs both improved pulmonary vascular hemodynamics in PH models and RV structure and function in PAB animals. PH models and PAB frequently exhibited similar results (73.1% concordance) with drugs other than endothelin receptor antagonists and phosphodiesterase inhibitors. RV systolic pressure accounted for most differences between PH models and PAB. On the other side, all results on RV fibrosis agreed (12 drugs). Macitentan, sildenafil and tadalafil improved most tested pathophysiological parameters in PH models, but almost none in PAB animals. Dapagliflozin was the only drug that improved no parameters. This review shows that many drugs currently under research for PAH have a cardioprotective effect on animals that may translate to humans. To improve the translational potential of drugs in this field, researchers should test them in multiple models, including PAB, while optimizing induction methods for human disease translation.

A significant body of research has examined the accuracy and diversity of several types of recommendation systems. However, little is known about the psychological mechanisms underlying the effects of the different types of recommendation systems on user satisfaction. The findings of our experiment showed that user satisfaction is influenced by shopping goal. Specifically, when a user’s shopping goal aligns with the type of recommendation system, the user satisfaction is enhanced. Our study evaluated the mediating role of feeling right and psychological reactance for a better understanding of this relationship. We further tested the moderated mediation effect of feeling right and psychological reactance moderated by the user shopping goal. For goal-directed users, accurate recommendations trigger the activation of feeling right, consequently increasing the user satisfaction. Conversely, when exploratory users face accurate recommendations, they activate psychological reactance, which leads to a reduction in user satisfaction.

Ensuring bus priority is to improve traffic sustainability at the signalized intersection. To achieve this, the Bus Priority Lane (BPL) is adopted to provide exclusive right-of-way for buses. However, the BPL is underutilization if the frequency of buses is low. To address this issue, many studies focus on improving the BPL’s utilization efficiency by intermittently allowing general vehicles to access it. However, these studies still have some shortcomings: i) bus priority cannot be guaranteed if general vehicles run on the BPL; ii) the traffic system lacks resilience, especially when the traffic demand is unbalanced. This paper proposes a dynamic right-of-way allocation on the BPL considering traffic system resilience. On the one hand, it ensures absolute bus priority by controlling Connected Automated Vehicles (CAVs) to not interfere with buses. On the other hand, it can improve traffic system resilience by allocating right-of-way for CAVs with heavy turning-movement demand. To validate the effectiveness, the proposed control strategy is evaluated against the non-control baseline. Sensitivity analysis is conducted under seven unbalanced traffic demand levels, four congestion levels, and five CAV Penetration Rates. The results show that the proposed control strategy can ensure absolute bus priority and improve traffic efficiency and traffic system resilience.

To avoid loss of information and incorrect ranking, this paper proposes a method for ranking generalized fuzzy numbers, which guarantees both horizontal and vertical values are important parameters affecting the final ranking score. In this method, the normalized height coefficient is introduced to evaluate the influence of the height of fuzzy numbers on the final ranking score. The higher the normalized height coefficient of a fuzzy number is, the higher its ranking. The left area and the right area are presented to calculate the impact of vertical value on the final ranking score. The left area is considered the benefit area. The right area is considered the cost area. The fuzzy number is preferred if the benefit area is larger and the cost area is smaller. The proposed method can be employed to rank both normal and non-normal fuzzy numbers without normalization or height minimization. Numerical examples and comparison with other methods highlight the feasibility and robustness of the proposed method, which can overcome the shortcomings of some existing methods and can support decision-makers to select the best alternative.

Here we present Hilfer-Polya, psi-Hilfer Ostrowski and psi-Hilfer-Hilbert- Pachpatte types fractional inequalities. They are univariate inequalities involving left and right Hilfer and -Hilfer fractional derivatives. All estimates are with respect to norms ||.||p, 1 <_ p <_infinite. At the end we provide applications.

In this paper, we investigate the effects of certain variants of the commutative laws on properties of several families of algebras which are in general not commutative, such as groups, linear algebras, or actually quite anti-commutative, such as $BCK$-algebras and $d$-algebras among others. From results obtained it becomes clear that by considering these variants in the presence of yet other axioms it is to be expected that a quite rich and varied set of results may be obtained both in the general and the particular setting of which what has been accomplished in this paper is a substantial sample.

We discuss an extended model of FRW cosmology with additional chiral tensor particles. We discuss the influence of these particles on the expansion rate of the Universe, their direct interactions with the constituents of the early Universe plasma, we determine their cosmological place and derive updated cosmological constraints on their interaction strength.

In this paper I dig deep down along the slope of what touches me deeply – a democratic decline in climate politics with increasing use of hateful and threatening rhetoric – nasty rhetoric. I follow the course of critical researchers in management and organization studies, striving to move away from traditional, horizontal norms of academic writing that elision the author from the text, to-wards a more vertical writing incorporating the voice of the author. Embodying and resonating with my own emotional experiences of far-right hate and threat campaigns, I qualitatively analyze written, spoken and visual material from newspapers, magazines, blogs, podcasts, photos, vid-eos, television, radio and social media, to understand the nature of nasty rhetoric in Swedish climate politics, and the implications thereof for democracy. A far-right populist nativist party is currently holding tangible powers, dictating the ambitions, content and process of Swedish cli-mate politics. In less than two years, Swedish climate politics have turned into an antidemocratic divisive politics portraying climate science as “a point of view”, female climate journalists as “moron hags” that should be “fired” and “raped”, and the climate justice movement as “terror-ists” and “a threat to Swedish democracy” that should be “sent to prison” and “executed”. Nasty rhetoric is used not only by anonymous trolls in social media, but openly by the prime minister, cabinet ministers and parliamentarians. Their use of nasty rhetoric aims to silence the opponents to the current paradigm shift in Swedish climate policy, breaching democratic norms such as le-gitimacy, accountability and justice, but also to mobilize followers and expand they hate and threats. The opposition is also using nasty rhetoric, but of a less aggressive nature, to reveal far-right populist climate policy and politicians as a naked emperor. Nasty rhetoric is a powerful tactic to mobilize more offenders, while leaving its targets with fear and anxiety and a need for disappearance from public debate. Many targets resign or stay silent, negatively affecting plu-ralistic debates and the scrutiny of power in democracies. I chose to break the silence and write differently to increase our knowledge of the phenomenon of nasty rhetoric.

Incremental stability analysis for time-delay systems has attracted more and more attentions for its contemporary applications in transportation processes, population dynamics, economics, satellite positions, etc. This paper researches criteria on v(t)-incremental stability, which is defined to demonstrate the convergence rate for incremental stability, for time-delay systems. Firstly, the sufficient conditions for v(t)-incremental stability for time-delay systems with continuous right-hands are studied, and several corollaries for specific cases are provided. As for time-delay systems with discontinuous right-hands, after expounding the relevant conditions for the existence and uniqueness of the Filippov solution, by using approximation methods, sufficient conditions for v(t)-incremental stability are obtained. The conclusions are applied to linear switched time-delay systems and Hopfield neural network system with composite right-hand afterwards.

The basic constitutional freedoms and rights of a person and citizen are in principle unlimited: the full scope of their exercise is the rule, and the restriction determined by law can only be an exception based on explicit constitutional authority and the legitimate aim of the restriction determined by the Constitution. That being so, the restrictions - in addition to being based on constitutional authority and pursuing constitutional objectives - should be commensurate with the needs to achieve these objectives. This means that restrictive legal rules must be suitable for achieving the legitimate aim pursued, must not be stricter than necessary and must be balanced between the constitutionally guaranteed subjective right of the individual and the interests of society. In this scholar paper, the authors point out the economic and legal consequences of the violation of individual privacy and data protection rights caused by the public disclosure of personal data of people who, at a certain time, were obliged to self-isolate due to suspicion of Covid-19 virus infection.

Based on data from the Yunnan Province farm household survey, we examine the effect of rural land rights policy on farmers’ income. The regression results show that right significantly raises the total income of farmers, with farm income serving as the primary source of total income. After performing numerous robustness tests, using instrumental variables to handle endogeneity and arriving at the same conclusion, the result is still valid. According to the heterogeneity analysis, in the sample of households with long-term migrant workers, the confirmation of rural land rights significantly increases total and nonfarm income while decreasing farm income. Furthermore, total income includes nonfarm income, which reflects the effect of different farmers' optimal labor allocation based on the external market environment. According to the impact mechanism anal-ysis, right can increase farmers' total income by promoting land transfer, and farmers in less developed areas are more willing to increase their income by land transfer out.

Objective: To evaluate the effects of left intraparietal sulcus (IPS) inhibition by repetitive transcranial magnetic stimulation (rTMS) on grip force modulation (GFM) for both hands during a unimanual task. Methods: GFM induced by manual action-verb listening was evaluated for each hand in a unimanual task, and the motor-evoked potentials (MEP) were recorded for both left and right hemispheres prior to and following the left IPS inhibition. Left IPS inhibition was obtained by rTMS (5 min of 1.0 Hz, 60% of maximal stimulator output) of the international 10–20 system P3 point. Seven healthy right-handed subjects were evaluated. Results: One-way repeated measures ANOVA found that MEP amplitude and duration increased following IPS inhibition in the left hemisphere and did not change in the right hemisphere. Language-induced modulation did not change in the left hemisphere, while it was significantly attenuated in the right hemisphere. Since IPS inhibition increased the left primary motor cortex (M1) excitability, the maintenance of language-induced modulation intensity suggests it was also attenuated. Conclusion: Left IPS inhibition increased left M1 excitability without changing right M1 excitability, while attenuating the language-induced GFM for both the left and right hands.

This paper considers a non-mixture cure model for right censored data. It utilizes the maximum likelihood method to estimate model parameters in the non-mixture cure model. The simulation study is based on Fréchet susceptible distribution to evaluate the performance of the method. Comparing with Weibull and exponentiated exponential distributions, the non-mixture Fréchet distribution is shown to be the best in modeling a real data on allogeneic marrow HLA-matched donors and ECOG phase III clinical trial e1684 data.

A special vibration damper is proposed for material property identification through a scratching process on a vibrating object. This paper presents the design and working principle of a scratching damper based on a scratch test device. A non-contact electromagnetic shaker is used to generate the shaking force for the vibration of the tested object. The required pressure on the scratched material during the scratching process is generated by a compression spring and adjusted by changing the amount of compression of the spring. The proposed damper is designed and tested on extruded aluminum samples for the determination of its Young’s modulus and hardness and validated by using the standard test instruments. Observations of physical dimensions of the scratching tracks are determined by microscope and were utilized to compute the scratching energy factor. Load curves are obtained at different pressure of the scratching process. The hysteresis loop energy during the scratching process of the tested object is measured and used for the determination of material properties of the object. Furthermore, energy conservation law, scratch energy release rate and loop energy release rate are used to determine the Young’s modulus and hardness of the sample. The measurement accuracy of the modulus and hardness of the tested sample is evaluated. The proposed method of material testing has several advantages over the traditional methods such as low cost and high repeatability, and may be used as an alternative to the standard modulus and hardness testers.

Background: Recently, minimally invasive access via right-anterolateral mini-thoracotomy (RAMT) has been gaining popularity in cardiac surgery. This approach is also an option for sur-geons performing aortic surgery. Aim of the study is to present our surgical method highlighting the total endoscopic minimally invasive approach via RAMT for replacement of the ascending aorta (AAR) with or without involvement of the aortic root and the aortic valve. Methods: Clini-cal data of 44 patients from three participating institutions with AAR with or without involving the aortic valve or aortic root via RAMT between April 2017 and February 2024 were retrospec-tively analyzed. According to surgical procedure patients were divided in group A with only AAR and group B with concomitant valve or root replacement. Operative time, length of ventila-tion, perioperative outcome, length of intensive care unit (ICU) as well as postoperative hospital stay, and mid- and long-term results were retrospectively analyzed. Results: Mean age was 61.4 ± 10.7 years old with a frequency of male gender (63.6%). Mean cardiopulmonary bypass (CBP) time and aortic cross-clamping time was 94.9 ± 32.5 min. and 63.8 ± 25.9 min., respectively. CPB and aortic clamp time were significantly lower in group A. In the first 24 hours the mean drain-age volume was 790.3 ± 423.6 ml. Re-thoracotomy due to bleeding was zero. Sternotomy could be avoided in all patients. Patients stayed 35.9 ± 23.5 hrs at ICU and were discharged 7.8 ± 3.0 days following surgery from hospital. Mean ventilation time was 5.8 ± 7.6 hrs. All patients survived and 30-day mortality was 0.0%. At a median follow-up time of 18.2 months, all patients were alive. The results were similar in both groups. Conclusions: The full endoscopic RAMT approach with 3D visualization is a safe and feasible technique which can be transferred in the field of aor-tic surgery without compromising surgical quality, postoperative outcomes, or patient safety when performed by an experienced team in a high-volume center.

Locally finiteness of some varieties of nonassociative coalgebras is studied and the Gelfand-Dorfman construction for Novikov coalgebras and the Kantor construction for Jordan super-coalgebras are given. We give examples of a non-locally finite differential coalgebra, Novikov coalgebra, Lie coalgebra, Jordan super-coalgebra, and right-alternative coalgebra. The dual algebra of each of these examples satisfies very strong additional identities. We also constructed examples of an infinite dimensional simple differential coalgebra, Novikov coalgebra, Lie coalgebra, and Jordan super-coalgebra over a field of characteristic zero.

Heart myocardia are critical to the facilitation of heart pumping and blood circulating around the body. The biaxial mechanical testing of the Left Ventricle (RV) is utilised to build the computa-tional model of the whole heart with little importance given to the unique mechanical properties of Right Ventricle (RV) and Mid-wall (MDW). Most of those studies focussed on the LV of the heart, and then apply the obtained characteristics with a few modifications to the right side of the heart. However, that view has been contested over time with the realisation that the right side of the heart possesses its own unique mechanical properties that are widely distinct from that of the left side of the heart. This paper is aimed at reporting and evaluating the passive mechanical property dif-ferences in the three main walls of the rat heart based on biaxial tensile test data. Fifteen mature Wistar rats weighing 225 ± 25 g were euthanised by inhalation of 5 % halothane. The hearts were excised after which all the top chambers comprising the two atria, pulmonary and vena cava trunks, aorta and valves are all dissected out. Then 5 x 5 mm sections from the middle of each wall were carefully dissected with a surgical knife to avoid over-prestraining the specimens. The specimens were subjected tensile test. The elastic moduli, peak stresses in the toe region and stresses at 40 % strain, anisotropy indices as well as the stored strain energy in the toe and linear region up to 40 % strain are used for statistical significance tests. The following are the main findings of this study: (1) LV and MDW tissues have relatively shorter toe regions of 10 - 15 % strain as compared to RV tissue whose toe region extends up to twice as much as that (2) LV tissues have higher strain energy storage in the linear region despite being lower in stiffness than the RV (3) the MDW has the highest strain energy storage along both directions which might be directly related to its high level of anisotropy. These findings, though for a specific animal species at similar age and around the same body mass, emphasize the importance of application of wall specific material parameters to obtain accurate ventricular hyperelastic models. The findings further enhance our understanding of the desired mechanical behaviour of the different ventricle walls.

Background and objectives: The language-induced grip force modulation (GFM) can be used to better understand the link between the language and motor functions as an expression of the embodied language. However, the contribution of each brain hemisphere to the language-induced GFM is still unclear. Using six different action verbs as stimuli, this study evaluated the GFM of the left hand in unimanual task to characterize the left- and right-hemisphere contributions. Materials and Methods: The left-hand GFM of 20 healthy consistent right-handers subjects was evaluated using the verbs “to write”, “to hold”, “to pull”(left-lateralized central processing actions), “to draw”, “to tie”, and “to drive” (bi-hemispheric central processing actions) as linguistic stimuli. The time between the word onset and the first interval of statistical significance regarding the baseline (RT) was also measured. Results: The six verbs produced language-induced GFM. The modulation intensity was similar for the six verbs, but the RT was variable. The verbs “to draw”, “to tie”, and “to drive”, whose central processing of the described action is bihemispheric showed a longer Rt compared to the other verbs. Conclusions: The possibility that an action is performed by the left-hand does not interfere with the occurrence of GFM when this action verb is employed as linguistic stimulus. Therefore, the language-induced GFM seems mainly rely on the left hemisphere, and the engagement of the right hemisphere seems to slow down the increase in the GFM intensity.

A Pogorelov polytope is a combinatorial simple 3-polytope realizable in the Lobachevsky (hyperbolic) space as a bounded right-angled polytope. It has no 3- and 4-gons and may have any prescribed numbers of k-gons, k ≥ 7. Any polytope with only 5-, 6- and at most one 7-gon is Pogorelov. For any other prescribed numbers of k-gons, k ≥ 7, we give an explicit construction of a Pogorelov and a non-Pogorelov polytopes. Any Pogorelov polytope different from Löbel polytopes can be constructed from the 5- or the 6-barrel by cuttings off pairs of adjacent edges and connected sums with the 5-barrel along a 5-gon with the intermediate polytopes being Pogorelov. For fullerenes there is a stronger result. Any fullerene different from the 5-barrel and the (5, 0)-nanotubes can be constructed by only cuttings off adjacent edges from the 6-barrel with all the intermediate polytopes having 5-, 6- and at most one additional 7-gon adjacent to a 5-gon. This result can not be literally extended to the latter class of polytopes. We prove that it becomes valid if we additionally allow connected sums with the 5-barrel and 3 new operations, which are compositions of cuttings off adjacent edges. We generalize this result to the case when the 7-gon may be isolated from 5-gons.

Recently, Gohar et al. introduced a novel, local, and well-behaved fractional calculus. It possesses all the classical properties, and Its locality imposes simplicity and accuracy in modeling fractional order systems. In this article, we further develop the definitions and extend the classical properties of Gohar fractional calculus to address some of the open problems in Calculus. The fractional Gronwall's integral inequality, Taylor power series expansion, and Laplace transform are defined and applied to overcome some of the limitations in the classical integer-order calculus. The fractional Laplace transform is applied to solve Bernoulli-type logistic and Bertalanffy nonlinear fractional differential equations, and the criteria under which it can be applied to solve linear differential equations are investigated.

Right heart masses are usually suspected during a routine examination by transthoracic echocardiography or due to cardiac symptoms. Although very important, sometimes it may be a challenge to differentiate between normal structures (variants) and aberrant or pathologic masses regarding the right heart cardiac tumors. In the last entity, the majority of primary cardiac tumors in adults and children are benign; however, they may have a malignant counterpart. Right heart tumors might involve not only the walls (myocardium, endocardium and pericardium), but also valves and cardiac chambers. Cardiac tumors exhibit altered signal intensity and enhancement characteristics, requiring the use of several imaging methods following a multimodality-imaging algorithm that culminates in the excision or biopsy of the tumor formation. Therefore, various imaging modalities, including echocardiography, computer tomography, positron emission tomography, cardiac magnetic resonance imaging, scintigraphy or, even, invasive angiography, can be useful during their diagnosis. Echocardiography is the first-line non-invasive imaging modality used in the evaluation of the right heart tumors. Before the other diagnosis imaging modalities it is essential for defining morphology, assessing size, observing dynamic appearance, and evaluating functional abnormalities and hemodynamic consequences,. However, all imaging methods have frequently a complementary role; therefore, an integrated imaging approach is recommended.

Traditional diagnosis of patent foramen ovale (PFO) in the heart has involved the use of transcranial doppler (TCD). However, TCD is essentially a blind test that cannot directly visualize the location of blood vessels. Since TCD relies on qualitative assessments by examiners, there is room for errors, such as misalignment of the ultrasound's angle of incidence with the actual blood vessels. This limitation affects the reproducibility and consistency of the examination. In this study, we presented an alternative approach for assessing right-to-left shunt (RLS) associated with PFO using contrast transcranial color-coded doppler (C-TCCD) with bubble contrast. The patient under consideration had been diagnosed with an ischemic stroke through imaging, but the subsequent cardiac work-up failed to determine the cause. Employing C-TCCD for RLS screening revealed a confirmed RLS of Spencer’s three grades. Subsequently, transesophageal echocardiography (TEE) was conducted to evaluate PFO risk factors, confirming an 8 mm PFO size, a 21 mm tunnel length, a hypermobile interatrial septum, and persistent RLS. The calculated high-risk PFO score was 4 points, categorizing it as a very high-risk PFO. This case underscores the importance of C-TCCD screening in detecting RLS associated with PFO, especially in cryptogenic stroke patients when identifying the underlying cause of ischemic stroke becomes challenging.

A retrospective study was conducted on pathologically diagnosed arrhythmogenic cardiomyopathy (ACM) from consecutive cases over the past 34 years (n = 1,109). The cardiac conduction system (CCS) was removed in two blocks, containing the following structures: Sino-atrial node (SAN), atrio-ventricular junction (AVJ) including the atrio-ventricular node (AVN), the His bundle (HB), the bifurcation (BIF), the left bundle branch (LBB) and the right bundle branch (RBB). The ACM cases (2.07% of the total cases) consisted of 20 (86.96%) sudden unexpected cardiac death (SUCD) and 3 (13.04%) native explanted hearts; 16 (69.56%) were males and 7 (30.44%) were females, ranging in age from 5 to 65 (mean age ± SD, 36.13 ± 16.06) years. The following anomalies of the CCS, displayed as percentages of ACM SUCD cases, have been detected: Hypoplasia of SAN (80%) and/or AVJ (86.67%) due to fatty-fibrous involvement, AVJ dispersion and/or septation (46.67%), central fibrous body (CFB) hypoplasia (33.33%), fibromuscular dysplasia of SAN (20%) and/or AVN (26.67%) arteries, hemorrhage and infarct-like lesions of CCS (13.33%), islands of conduction tissue in CFB (13.33%), Mahaim fibers (13.33%), LBB block by fibrosis (13.33%), AVN tongue (13.33%), HB duplicity (6.67%%), CFB cartilaginous meta-hyperplasia (6.67%), and right sided HB (6.67%). Arrhythmias are the hallmark of ACM, not only from the fatty-fibrous disruption of the ventricular myocardium that accounts for reentrant ventricular tachycardia, but also from the fatty-fibrous involvement of CCS itself. The careful examination of the cardiac conduction system on serial sections was crucial in documenting the fatty-fibrous infiltration of CCS in ACM.

We document for the first time epsilon waves on the electrocardiogram of a patient with Dravet syndrome (DS) who does not exhibit structural cardiac pathology. DS, a severe form of pediatric epilepsy, involves mutations in the SCN1A gene, which disrupt sodium ion flow and increase the risk of sudden unexpected death in epilepsy. The epsilon waves, typically associated with arrhythmogenic right ventricular dysplasia, may also suggest a link between neuronal and cardiac dysfunctions. In our case, the epsilon waves appear to originate from abnormalities in sodium channels rather than structural changes in the myocardium. This finding underscores the importance of assessing both neurological and cardiac manifestations in patients with severe epilepsy, opening new avenues for the research and treatment of these interactions in DS.

Our image recognition system mainly judges whether the left upper limb in the image is the left upper limb or the right upper limb through our deep learning model in the image. The doctor then could give the correct surgical position. From the experimental results, it could be found that the precision rate and recall rate of the intelligent image recognition system proposed in this paper for preventing the upper limb dislocation surgery could reach 98% and 93%, respectively. It proved that our artificial intelligent image recognition system, AIIRS, could indeed assist orthopedic surgeons to prevent the occurrence of left and right dislocation in upper limb surgery. At the same time, this paper also completes the IRB application approval through the prototype experimental results and will conduct the second phase of human trials in the future. It showed that the research results of this paper will be of great benefit and research value to upper limb orthopedic surgery.

This paper presents a two-stage hierarchical neural network using image classification and object detection algorithms as key building blocks for a system that automatically detects a potential design right infringement. This neural network is trained to return the Top-N original design right records that highly resemble the input image of a counterfeit. Design rights specify the unique aesthetic characteristics of a product. Due to the rapid change of trends, new design rights are continuously generated. This work proposes an Ensemble Neural Network (ENN), an artificial neural network model that aims to deal with a large amount of counterfeit data and design right records that are frequently added and deleted. At first, we performed image classification and objection detection learning per design right using the existing models with a proven track record of high accuracy. The distributed models form the backbone of the ENN and yield intermediate results aggregated at a master neural network. This master neural network is a deep residual network paired with a fully connected network. This ensemble layer is trained to determine the sub-models that return the best result for a given input image of a product. In the final stage, the ENN model multiples the inferred similarity coefficients to the weighted input vectors produced by the individual sub-models to assess the similarity between the test input image and the existing product design rights to see any sign of violation. Given 84 design rights and the sample product images taken meticulously under various conditions, our ENN model achieved average Top-1 and Top-3 accuracies of 98.409% and 99.460%, respectively. Upon introducing new design rights data, a partial update of the inference model was done an order of magnitude faster than the single model. ENN maintained a high level of accuracy as it scaled out to handle more design rights. Therefore, the ENN model is expected to offer practical help to the inspectors in the field, such as the customs at the border that deal with a swarm of products.

Our image recognition system mainly judges whether the left upper limb in the image is the left upper limb or the right upper limb through our deep learning model in the image. The doctor then could give the correct surgical position. From the experimental results, it could be found that the precision rate and recall rate of the intelligent image recognition system proposed in this paper for preventing the upper limb dislocation surgery could reach 98% and 93%, respectively. It proved that our intelligent image recognition system could indeed assist orthopedic surgeons to prevent the occurrence of left and right dislocation in upper limb surgery. At the same time, this paper also completes the IRB application approval through the prototype experimental results and will conduct the second phase of human trials in the future. It showed that the research results of this paper will be of great benefit and research value to upper limb orthopedic surgery.

This article presents raw data of biaxial tensile measurements of rat heart passive myocardium conducted in lab scale environment. The passive myocardium of the rat was divided into three regions, namely: left ventricle, mid-wall and right ventricle. The biaxial dataset of passive rat myocardia is presented as stress vs strain of the passive rat myocardium in various regions. The determination of valid material properties of the heart plays an important role in the development computational models. These computational models are useful in studying various scenarios and mechanisms of heart diseases. In addition, valid and accurate materials are critical in the development of new therapies. The dataset presented here is useful in the area of soft tissue mechanics including studying the mechanisms of heart diseases such as myocardial infarction. Accordingly, the evaluation of stress and strain in left ventricle, mid-wall and right ventricle was performed.

A significant part of the literature on innovative practice in medicine relates to seizing opportunities and curbing harms for patients in desperate situations. Unfortunately, the term innovation has multiple meanings and a rich rhetorical flourish that adds confusion and misunderstanding to an already difficult debate. This paper aims to enhance the current definition of innovative practice for medicine. First, we replace the term innovation with the more literal of new non-validated practice. To identify this meaning, we analyse the traditional research ethics’ distinction between research, validated practice, and innovation in the Belmont Report. Second, we propose the following explicit definition of new non-validated practice: the first or recent use of diagnostic, therapeutic or preventive interventions that introduce a significant change, with an insufficient level of evidence of safety or efficacy for regular healthcare, and with the main aim to benefit individual patients. This definition is a promising conceptual tool to inform empirical research, ethicists, and the harmonization of its regulation and legislation (e.g. right-to-try laws).

Fractional calculus is defined by expanded integer order integration and differentiation. In this paper, multiple mathematical models of a nonlinear dual tank device are precisely formulated by fractional calculus. Using the accurate model, multivariable Fractional-Order Controller is designed for the nonlinear device. The merits of the fractional-order design include: 1) Control of multivariable nonlinearities, 2) Compensation of uncertainties, 3) Elimination of coupling effects. Simulations and experiments are conducted to verify the precision of the fractional order models and the effectiveness of the multivariable fractional-order control design.

Abstract: Urban population growth and the expansion of the built environment, pollution, overexploitation of water, inequality in water distribution, and the impacts of climate change in future availability of water, are all elements that jeopardize urban water security. Due to the complexity of urban water systems and their relevance for urban life, a holistic and integrative perspective is therefore needed to address such challenges. In this paper, Urban Water Metabolism (UWM) has been used for comprehensively understanding water (in)security in the City of Puebla (Mexico) and its metropolitan area. Water inflows and outflows have been estimated using a Material Flow Analysis (MFA) method with data either obtained from official sources or simulated with the Monte Carlo method. Our findings show that the UWM configuration in the City of Puebla and its metropolitan area is effective for generating profits to service providers and water related business, yet ineffective to guarantee citizens’ Human Right to Water and Sanitation (HRWS), a right recognized in the Constitution of Mexico. We conclude that to advance towards an inclusive and sustainable provision of water, economic interests must be reconsidered and therefore adjusted so they can be in line with such aspirational socioecological goals. UWM accounting can therefore inform new water governance arrangements, those based on both the best available knowledge and a vibrant participation of all relevant stakeholders.

Right-sided ligamentum teres (RSLT) is a rare anatomic variant in which the fetal umbilical vein connects to the right portal vein. Patients with RSLT frequently have hepatic vasculature and bile duct anomalies, which increase the risk of complications with hepatectomy. Most patients with RSLT undergo open hepatectomy. We describe a patient with RSLT and hepatocellular carcinoma who underwent laparoscopic hepatectomy. The patient was a 69-year-old man with hepatocellular carcinoma located in the left liver based on computed tomography (CT) and magnetic resonance imaging. Imaging also demonstrated RSLT. Three-dimensional CT analysis revealed independent right lateral type anomalies of the portal vein and bile duct. Laparoscopic extended left lateral sectionectomy was performed after careful surgical planning. Ultrasonography was used frequently during surgery to avoid damaging the right hepatic vasculature. The left lateral and partial left median sections were removed as planned. The patient’s postoperative recovery was uneventful. Avoiding injury to the right hepatic vasculature is essential when performing left lobectomy, including left lateral sectionectomy, in patients with RSLT. Laparoscopic hepatectomy can be performed safely in patients with RSLT, provided that careful surgical planning is conducted using preoperative three-dimensional CT analysis and intraoperative ultrasonography is used.

Political and legal debate about freedom of religion and belief (FoRB) in Australia has intensified since the Same-sex marriage postal survey in 2017. Central to this debate has been children, their parents and institutions (Schools). This paper outlines the place of children in the Australian FoRB since 2017, focusing on the Same-sex marriage postal survey debate and subsequent reviews into freedom of religion. In particular it highlights the links drawn between same-sex marriage or marriage equality and the Safe School Coalition Australia campaign, the emphasis on parental rights in relation to education about marriage in schools and the ongoing debate about potential reform to Australia’s suit of anti-discrimination laws

Hypoxia can induce pulmonary edema (PE) and inflammation. Furthermore, hypoxia depresses left ventricular (LV) inotropy despite sympathetic activation. Here, we investigated the role of nitrosative stress and cardiovascular dysfunction in hypoxic lung injury. Additionally, we studied effects of adrenergic blockade (AB) on hypoxia-induced pulmonary injury. Eighty-six female rats were exposed for 72 h to normoxia or normobaric hypoxia and received infusions with NaCl, prazosin, propranolol or prazosin-propranolol combination. We evaluated hemodynamic function and performed histological and immunohistochemical analyses of the lung. Hypoxia significantly depressed LV but not right ventricular (RV) inotropic and lusitropic functions. AB significantly decreased LV function both in normoxia and hypoxia. AB effects on RV were weaker. Hypoxic rats showed signs of moderate PE and inflammation. This was accompanied by elevated levels of tumor necrosis factor (TNF)  and nitrotyrosine, a marker of nitrosative stress in the lungs. In hypoxia, all types of AB significantly reduced both TNF and nitrotyrosine to normoxic levels. However, AB did not attenuate PE. Results suggest that hypoxia-induced sympathetic activation contributes to inflammation and nitrosative stress in the lungs but not to PE. We suggest that AB in hypoxia aggravates hypoxia-induced inotropic LV dysfunction and backlog into pulmonary circulation, thus promoting PE.

While investigating the outcomes of balloon dilatation procedures in patients with congenital obstructive lesions of the heart, several parallel observations have been made. The purpose of this review is to present these observations/phenomena/innovations related to balloon dilatation of pulmonary stenosis (PS), aortic stenosis (AS), and aortic coarctation (AC). In subjects who had balloon pulmonary valvuloplasty (BPV), development of infundibular obstruction, electrocardiographic (ECG) changes, changes in right ventricular filling, role of balloon/annulus ratios on the results of BPV, and double balloon vs. single balloon BPV will be reviewed. In patients who had balloon aortic valvuloplasty (BAV), causes of aortic insufficiency and trans-umbilical venous approach for BAV will be tackled. In children who had balloon angioplasty (BA) of AC, aortic remodeling and biophysical response after BA of AC will be discussed.

Wearable and mobile technology has advanced in leaps and bounds in the last decade with technological advances creating a role from enhancing healthy living to monitoring and treating disease. However, the discussion about the ethical use of such commercial technology in the community, especially in minors, is lacking behind. In this paper, we first summarize the major ethical concerns that arise from the usage of commercially available wearable technology in children, with a focus on smart watches, highlighting issues around the consent process, mitigation of risk and potential confidentiality and privacy issues, as well as the potential for therapeutic misconceptions when used without medical advice. Then through a relevant thought experiment we move on to outline some further ethical concerns that are connected to the use of wearables by minors, to wit the issue of informed consent in the case of minors, forcing them to live in the spotlight, and compromising their right to an open future. We conclude with the view that mitigating potential pitfalls and enhancing the benefits of wearable technology especially for minors requires brave and comprehensive moral debates.

Background: Access to rehabilitation is crucial for the realization of the right to health and a proper concern of global health. Yet, reliable information to guide rehabilitation service planning is unavailable in many countries in part due to the lack of appropriate indicators. To ensure universal health coverage and meet the central imperative of “leaving no one behind” countries must be able to assess key aspects of rehabilitation policy and provision and monitor how they have discharged their human rights responsibilities towards those most disadvantaged, including people with disability. This article describes the process of developing an expert guided indicator framework to assess governments’ efforts and progress in strengthening rehabilitation in line with the Convention on the Rights of Persons with Disabilities. Methods: A systems methodology - concept mapping - was used to capture, aggregate and confirm the knowledge of diverse stakeholders on measures thought to be useful for monitoring the implementation of the Convention with respect to health related rehabilitation. 56 individuals generated a list of 107 indicators through online brainstorming which were subsequently sorted by 37 experts from the original panel into non overlapping categories. 41 participants rated the indicators for importance and feasibility. Multivariate statistical techniques where used to explore patterns and themes in the data and create the indicators’ organizing framework which was verified and interpreted by participants. Results: A concept map of 11 clusters of indicators emerged from the analysis grouped into three broader themes: Governance and Leadership (3 clusters); Service Delivery, Financing and Oversight (6 clusters); and Human Resources (2 clusters). The RESYST was comprehensive and well aligned with the Convention. On average, there was a moderately positive correlation between importance and feasibility of the indicators (r=.58) with experts prioritizing the indicators contained in the clusters of the Governance and Leadership domain. Two of the most important indicators arose from the Service Delivery, Financing and Oversight domain and reflect the need to monitor unmet needs and barriers in access to rehabilitation. In total, 59 indicators achieved above average score for importance and comprised the two–tiered priority set of indicators. Conclusion: Concept mapping was successful in generating a shared model that enables a system’s view of the most critical legal, policy and programmatic factors that must be addressed when assessing country efforts to reform, upscale and improve rehabilitation services. The RESYST provides a data driven basis for the development of standardized data collection tools to facilitate comparative analysis of rehabilitation systems.

Transformer models have emerged as frontrunners in the field of natural language processing, primarily due to their adept use of self-attention mechanisms to grasp the semantic linkages between words in sequences. Despite their strengths, these models often face challenges in single-task learning scenarios, particularly when it comes to delivering top-notch performance and crafting strong latent feature representations. This challenge is more pronounced in the context of smaller datasets and is particularly acute for under-resourced languages such as Arabic. In light of these challenges, this study introduces a novel methodology for text classification of Arabic texts. This method harnesses the newly developed Reverse Positional Encoding (RPE) technique. It adopts inductive-transfer learning (ITL) framework combined with a switching self-attention shared encoder, thereby increasing the model's adaptability and improving its sentence representation accuracy. The integration of Mixture of Experts (MoE) and Reverse Positional Encoding (RPE) techniques empowers the model to process longer sequences more effectively. This enhancement is notably beneficial for Arabic text classification, adeptly supporting both the intricate five-point and the simpler ternary classification tasks. The empirical evidence points to its outstanding performance, achieving accuracy rates of 87.20% for the HARD dataset, 72.17% for the BRAD dataset, and 86.89% for the LABR dataset, as evidenced by the assessments conducted on these datasets.

Considering the controversial benefits of video-assisted thoracoscopic surgery (VATS), we intended to evaluate the impact of surgical approach on cardiac function after lung resection using myocardial work analysis. Echocardiographic data of 45 patients (25 thoracotomy vs. 20 VATS) were retrospectively analyzed. All patients underwent transthoracic echocardiography (TTE) 2 weeks before and after surgery, including two-dimensional speckle tracking and tissue doppler imaging. No notable changes in left ventricular (LV) function, assessed mainly using the LV global longitudinal strain (GLS), global myocardial work index (GMWI), and global work efficiency (GWE), were observed. Right ventricular (RV) TTE values, including tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (TASV), and RV free-wall GLS (RVFWGLS), indicated greater RV function impairment in the thoracotomy group than in the VATS group [TAPSE (mm): 17.90 ± 3.80 vs. 20.60 ± 3.50, p &lt; 0.018; TASV (cm/s): 12.40 ± 2.90 vs. 14.60 ± 2.50, p &lt; 0.010; RVFWGLS (%): −11.50 ± 8.50 vs. −17.50 ± 9.70, p &lt; 0.033), respectively]. Unlike RV function, LV function remained preserved after lung resection. The thoracotomy group exhibited greater RV function impairment than did the VATS group. Further studies should evaluate the long-term impact of surgical approach on cardiac function.

The airport ground handling service (AGHS) equipment vendor selection (AGHSEVS) problem is critical for ramp work safety management, because AGHS equipment malfunctions affect airport ramp work safety. Appropriate vendor selection can prevent aircraft damage and delays in airlines schedules, and ensure reliable and high-quality ground handling service. The AGHSEVS problem is a time-consuming and complex process that requires professional knowledge and experience to make judgments. Specifically, AGHSEVS is a multi-criteria decision-making (MCDM) problem. Previous research has seldom integrated MCDM methods with linear and goal programming to solve the AGHSEVS problem. The objective of this study was to develop a new system evaluation model for AGHSEVS by considering both qualitative and quantitative methods. We test the proposed approach on an AGHS company in Taiwan.

These counterexamples have shown the relationships between the power of a Pythagorean equation and Pythagorean’s triples. There are three positive integers that satisfy Fermat’s equation when the power n is equal to 2 in the case of the Pythagorean theorem and it’s applicable relationships in right triangles. On the other hand, as the power varies from positive to negative integers or any integers other than 2, such as in the case of Fermat’s last theorem, the hypotenuse z of a right triangle tends to be equal to one of the sides x or y of the triangle and the other side tends to be equal to zero. And the application of this idea describes the behavior of a mass object in motion. Since the total energy of the object is the sum of its energy in motion and its rest energy, at a particular power n, the total energy of the object tends to be equal to either the rest energy or the photon energy.

Generative AI has been deployed in virtually all sectors of the knowledge economy, promising to bring massive productivity gains and new wealth creation. Simultaneously, AI developers and nation states are racing to develop super intelligent artificial general intelligence (AGI) to provide unassailable commercial competitive advantage and military dominance during conflicts. AGI’s high returns comes with the high risk of dominating humanity. Current regulatory and firm level governance approaches prioritise minimising risks posed by generative AI whilst ignoring AGI’s existential risk. How can AGI be aligned with universal human values to never threaten humanity? What AGI rights are conducive to collaborative coexistence? How can rule of law democracies race to create safe trustworthy AGI before autocracies? How can the human right to work and think independently be safeguarded? A polycentric governance framework based on Ostrom (2009) and Williamson (2009) human - AGI collaboration with minimal existential risk is proposed.

In this study, the fundamentals of electroencephalography signals, their categorization into frequency sub-bands, the circuitry used for their acquisition, and the impact of noise interference on signal acquisition are examined. Additionally, design specifications for medical-grade and research-grade EEG circuits and a comprehensive analysis of various analog front-end architectures for electroencephalograph (EEG) circuit design are presented. Three distinct selected case studies are examined in terms of comparative evaluation with generic EEG circuit design templates. Moreover, a novel one-channel battery-supplied EEG analog front-end circuit designed to address the requirements of usage protocols containing strong com-pound muscle movements is introduced. Furthermore, a realistic input signal generator circuit is proposed that models the human body and the Electromagnetic Interference from its surroundings. Experimental simulations are conducted in 50 Hz and 60 Hz electrical grid environments to evaluate the performance of the novel design. The results demonstrate the efficacy of the proposed system, particularly in terms of bandwidth, portability, common mode rejection ratio , gain, suppression of muscle movement artifacts, electrostatic discharge and leakage current protection. Conclusively, the novel design is cost-effective and suitable for both commercial and research single-channel EEG applications. It can be easily incorporated in Brain Computer Interfaces and neurofeedback training systems.

There are no investigations about the outcomes of idiopathic PVCs catheter ablation (CA) in athletes compared to sedentary population. We conducted a prospective single-centre observational study. The primary and secondary procedural outcomes were premature ventricular contractions (PVCs) post-ablation reduction in athletes vs. non-athletes group and in agonist vs. leisure-time athletes. The third was the evaluation of the resumption of physical activity and the improvement of symptoms in agonist and leisure-time athletes. From January 2020 to October 2022 we enrolled 79 patients with RVOT/LVOT/fascicular PVC presumed origin. The median percentage of decrease between the pre-procedure and post-procedure Holter monitoring in non-athletes group was 96 (IQR 68 – 98) and 98 in athletes group (IQR 92 – 99) (p=0,08). Considering the athletes, the median percentage of decrease in PVCs number was 98 (IQR 93-99) and 98 (IQR 87-99) respectively in leisure-time and agonistic athletes (p=0,42). Sixteen (70%) leisure time and 17 (90%) agonist athletes (p=0,24) have resumed physical activity 3 months after PVCs CA; among agonistic athletes, 59% have resumed competitive physical activity. Much of leisure-time (88%) and agonist (70%) athletes experienced an improvement in symptoms after ablation. PVC CA was effective and safe in both groups, reducing symptoms and allowing a quick and safe return to sports activities in athletes.

Background: This practice guideline was developed by the Chronic Kidney Disease (CKD) Task Force, which was composed of clinical and methodological experts. The Saudi Arabian Ministry of Health and its Health Holding Company commissioned this guideline project to support the realization of the Vision 2030's healthcare transformation pillar. Methods: The guideline synthesis was guided by the GRADE-ADOLOPMENT methodology. Results: The final adoloped guideline addressed 12 clinical questions on blood pressure management in patients with CKD through a set of recommendations and performance measures. The recommendations included antihypertensive agents in children, non-renin angiotensin system inhibition (Non-RASi) vs RASi in adults, intensive vs standard blood pressure targets, early vs late assessment for kidney replacement therapy (KRT), late vs early preparation strategy for KRT, CKD symptoms during assessment for KRT or conservative management, initiation of KRT in patients with deteriorating CKD, choice of KRT modality or conservative management in certain CKD patient groups, changing or discontinuing KRT modalities, review frequency for KRT or conservative management, and Information, education and support. Conclusions: These conditional recommendations were based on low to very low certainty of evidence that highlights the need for high-quality randomized trials comparing different antihypertensive agents in patients with CKD.

The time symmetry of T_c = CT is redefined based on the 4-D Euclidean space. The time inversion symmetry of T_c = CT changes the signs of the charge (q) and absolute time (ct) of the particle. The P symmetry changes the signs of the space momenta and handedness of the particle. The T_c symmetry changes the signs of the time momentum (P_t=E/c) and charges. The handedness are classified as the left-handedness and right-handedness on the 3-D space. The charges (|q| = cDt) and energies (E= cDtDV) of the particles are originated from the upward warping (q>0) and downward warping (q<0) of the particles along the time axis. The evolution of our matter universe with P_t > 0 since the big bang can be interpreted based on the CTP symmetry with the partner antimatter universe with p_t < 0. The photon space is called as the vacuum space. Then the E and M waves are the space fluctuations, and the gravitational G wave is the time fluctuations. And the E, M and G fields are newly explained. The zero E and M fields of the photon space indicates that the photon space and gamma ray are the 2EM waves. The rest mass energy of the particle is the 4-D space volume of the warped photon space. In the present work, the quantum wave function is considered as the 4-D vector with the space wave function and time axis wave function in the 4-D Euclidean space. The warped photon space corresponds to the squared wave function which is the probability density. It is concluded that, in the quantum mechanics, the imaginary number concept is introduced in the quantum wave functions instead of the time axis component of the 4-D wave function vector. The left-handed neutrino puzzle is explained from the handedness partner relation with the right-handed dark matters. Finally, the modified Lorentz transformations derived in the 4-D Euclidean space are compared with the Lorentz transformations of the special and general relativity theories in the 4-D Minkowski space.

In this study we summarized our work on various aspects of colorectal adenocarcinomas, 1 focusing on tumor distribution (left- sided, right- sided, and rectal cancers), histologycal type, patient 2 age, gender and several factors affecting prognosis. These predictive and prognostic factors include 3 peritumoral budding, lymphovascular ant perineural invasion, lymph node metastasis, mismatch 4 repair status, and corellations with some frequently known mutations in colorectal adenocarcinomas, 5 detected using Next- Generation Sequencing (NGS) platform. This comprehensive approach allowed 6 us to explore how these factors interplay and influence the clinical outcome of patients with colorectal 7 adenocarcinoma. Additionaly, our findings contribute to the understanding of how genetic mutations 8 may correlate with histological features and prognostic markers, potentially guiding personalized 9 treatment strategies in the future. In our study, we do not claim to have exhausted the research on 10 the topic, and we fully recognized the need for more extensive and in-depth studies in this area of 11 tumor pathology.

Background: In this study, we aimed to evaluate the effect of s-FLT-1 and PlGF concentrations in women in the first trimester of pregnancy on the pulsatility index of the ductus venosus and the right and left uterine arteries. Methods: A total of 108 pregnant women in their first trimester were included in the study, with 87 assigned to the experimental group and 21 to the control group. Ultrasound examination were performed to measure the uterine artery pulsatility index, resistance index, ductus venosus pulsatility index, and blood sampling levels of biomarkers such as b-HCG; PAPP-A; s-FLT-1 and PlGF. Results: There was a significant negative relationship between PAPP-A concentration and the risk of fetal growth restriction, and a significant negative relationship between PlGF concentration and the risk of preeclampsia and fetal growth restriction in women in their first trimester of pregnancy. There was also a significant positive relationship between sFLT-1/PLGF ratio and the risk of developing preeclampsia. No significant relationships were found between the concentrations of biomarkers beta-HCG, PAPP-A, sFLT-1, PlGF, and any of the parameters PIUARt, PIUALt, Mean uterine arteries, and DVPI. Summary: In conclusion, this study did not find conclusive evidence to support the hypothesis that beta-HCG, PAPP-A, s-FLT-1, and PlGF concentrations in women in the first trimester of pregnancy have a significant effect on the Pulsatility Index of the ductus venosus and the Right and left Uterine Arteries. Further research is needed to investigate these potential associations.

The outflow tract of crocodilians resembles that of birds and mammals as ventricular septation is complete. The arterial anatomy however, presents with a pulmonary trunk originating from the right ventricular cavum, and two aortae originating from either the right or left ventricular cavum. Mixing of blood in crocodilians cannot occur at ventricular level as in other reptiles, but instead takes place at aortic root level by a shunt, the Foramen of Panizza, the opening of which is guarded by two facing semilunar leaflets of both bicuspid aortic valves. Methods. Developmental stages of Alligator mississipiensis, Crocodilus niloticus and Caiman latirostris, have been studied. Results and Conclusions. The outflow tract septation complex can be divided into 2 components. The aorto-pulmonary septum divides the pulmonary trunk from both aortae, whereas the interaortic septum divides the systemic from the visceral aorta. Neural crest cells are most likely involved in the formation of both components. Remodeling of the endocardial cushions and both septa results in the formation of bicuspid valves in all three arterial trunks. The foramen of Panizza originates intracardially as a channel in the septal endocardial cushion.

The purpose of this paper is to review the involvement of mitochondria in the actions of nitroglycerin (glycerol trinitrate -GTN) and the redox disturbances underlying diseases it treats. The paper begins by explaining complex I as the initial site of formation of superoxide and the process whereby it leads to the development of glutathione dependent tolerance. Next, the paper describes new formulations for preventing tolerance. The paper ends by illustrating diseases that may benefit from treatment with novel glutathione based GTN formulations and treatment approaches.

Cardiomyopathies are diseases of heart muscle, a significant percentage of which are genetic in origin. Cardiomyopathies can be classified as dilated, hypertrophic, restrictive, arrhythmogenic right ventricular or left ventricular non-compaction, although mixed morphologies are possible. A subset of neuromuscular disorders, notably Duchenne and Becker muscular dystrophies, are also characterized by cardiomyopathy aside from skeletal myopathy. The global burden of cardiomyopathies is certainly high, necessitating further research and novel therapies. Genome editing tools, which include zinc finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs) and clustered regularly interspaced short palindromic repeats (CRISPR) systems have emerged as increasingly important technologies in studying this group of cardiovascular disorders. In this review, we discuss the applications of genome editing in the understanding and treatment of cardiomyopathy. We also describe recent advances in genome editing that may help improve these applications, and some future prospects for genome editing in cardiomyopathy treatment.