Abstract: Purpose: This research intends to explore the relationships between digital risk management practices and the successful implementation of innovative banking services with moderation effect of digital capabilities and moderation effect of digital culture. Methodology Approach: In this study, the data was gathered using a quantitative approach and the cross-sectional survey method with responses from participants who were chosen as the unit of analysis of being investigated for the study. Islamic finance institutions in Jordan were used as the unit of analysis in this study. Responses of different Islamic finance institutions were surveyed in a structured manner to collect data. The current study then used a structural equation modeling using SmartPLS to investigate the relationship between the variables. Findings: The results show that utilizing digital risk management advanced analytics artificial intelligence and automated compliance systems is essential to fostering innovation while upholding Shariah compliance. The study also shows that efficient digital risk management boosts users confidence increases service effectiveness and facilitates the launch of cutting-edge Shariah-compliant products. The findings reveal meditation and moderation significant effect of digital capabilities and digital culture respectively among between digital risk management and innovative banking services. Originality: By investigating digital risk management in the particular context of Islamic innovative banking services, this study provides novel insight. In contrast to earlier research that focuses on innovation in Islamic finance or digital risk management in conventional banking independently this paper examines how digital risk management frameworks impact the creation governance and sustainability of innovative banking services that adhere to Shariah.

Abstract: The purpose of this paper is to investigate, collect, and analyze the different technologies that are being integrated into vehicle automation systems. These technologies can range from LIDAR/RADAR sensors, voice recognition, and AI models. With the continued push for the development of AI and au- tonomous vehicles in both the economy and among the populace, designers and engineers are more incentivized than ever to break new ground. As technology in the industry changes, so must the priorities of its developers. First, data and analysis on the safety of autonomous vehicles will be provided, providing context for the importance of the topic. Second, an overview of the research and development of the technology used to address the previous concerns is provided. Third, an examination of the successes and failures of the technology in regard to those concerns will be made. Lastly, this paper will explore the emerging breakthroughs and future advancements that will drive the mass adoption of autonomous vehicles, specifically those that can be scaled up to civilian automobiles.

Abstract: Introduction: Systemic inflammation is a key contributor to the pathophysiology of carotid plaque burden (CpB). Increasing evidence supports a link between periodontitis and systemic conditions, including endothelial dysfunction, and CpB. This study aimed to explore the relationship between periodontal status, inflammatory biomarkers, and CpB, as well as the potential impact of periodontal therapy. Methods: A pilot study was conducted on subjects presenting with both periodontitis and CpB. Of 87 initially screened participants, 10 met the inclusion criteria and completed the study. Periodontal parameters—probing pocket depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP)—were recorded. Systemic inflammatory biomarkers, including matrix metalloproteinase-8 (MMP-8), myeloperoxidase (MPO), lipoprotein-associated phospholipase A2 (Lp-PLA2), and soluble CD40 ligand (sCD40L), were analyzed. Results: Participants demonstrated severe periodontal disease, with mean PPD of 5.5 mm (maximum 8 mm), mean CAL of 6.46 mm (maximum 12 mm), and BOP of 67%. High serum Lp-PLA2 levels were associated with increased periodontal tissue destruction and inflammatory burden, supporting its role in both periodontitis and CpB pathophysiology. MMP-8 and MPO showed positive correlations with periodontal parameters, although these did not consistently reach statistical significance. Following periodontal therapy, a significant reduction in MMP-8 and Lp-PLA2 levels was observed, while MPO and sCD40L exhibited a decreasing trend without statistical significance. Conclusion: Inflammatory biomarkers may represent important mechanistic links between periodontitis and carotid artery disease. Within the limitations of this pilot study, non-surgical periodontal therapy was associated with reductions in selected systemic inflammatory biomarkers, supporting the feasibility of investigating the periodontitis–carotid plaque axis in larger translational cohorts. Larger studies are needed to validate these findings.

Abstract: Psoriasis and psoriatic arthritis (PsA) are systemic immune-mediated diseases, but the features that distinguish cutaneous-dominant psoriasis from musculoskeletal involvement remain unclear. We analyzed four core public cross-sectional datasets spanning whole-blood methylation, PBMC single-cell RNA sequencing summarized at the subject level, skin RNA sequencing, and purified CD4+ T-cell methylation, and used two additional public skin cohorts for external contextual checks to define an inflammatory disease axis (DIR) and a contrast-resolved systemic-state coordinate (CRS) representing additional systemic immune-state variation associated with PsA. In whole-blood methylation, DIR primarily separated healthy controls from psoriasis, whereas CRS separated psoriasis from PsA with minimal correlation to DIR. In PBMC single-cell data, CRS was higher in PsA and in the source-defined PSX subgroup (joint pain without CASPAR-classified PsA) than in PsO. Cell-type-resolved analyses localized CRS-related shifts to CD8 naive T cells, NK cells, CD14 monocytes, and regulatory T cells and identified multicompartment pathway-state remodeling along the CRS continuum. In contrast, skin RNA sequencing mainly captured lesional inflammatory burden and showed only limited additional PsA-related separation within the same tissue state. These findings support a model in which PsA is distinguished from psoriasis by an additional systemic immune-state axis rather than by skin inflammatory burden alone.

Abstract: Objective: To investigate the correlations of procalcitonin (PCT), interleukin-6 (IL-6), and lactate (Lac) with disease severity (assessed by APACHE II score) and organ dysfunction in patients with septic shock, and to compare their predictive values. Methods: We prospectively enrolled 320 patients with septic shock across four clinical centers from June 2023 to March 2025. Patients were divided into a Survival group (n = 248) and a Death group (n = 72) based on 28-day outcomes. Spearman correlation analysis was used to evaluate the relationships of PCT, IL-6, and Lac with APACHE II scores and organ function indicators (creatinine, platelet count, ALT). Results: Lactate showed the strongest correlation with APACHE II scores and was significantly associated with renal dysfunction and coagulopathy. Lactate (Lac) remained the most potent independent predictor of mortality (AUC = 0.884, 95% CI: 0.832-0.936). However, a tri-marker combined model (Lac + IL-6 + NGAL) achieved a superior AUC of 0.942, significantly outperforming any single biomarker (p < 0.001). Conclusion: lactate should be considered a core biomarker for assessing critical illness and prognosis in septic shock.

Abstract: This paper discusses a proposed operator-theoretic framework for the study of the Riemann zeta function's zeros within the critical strip. By defining a differential interaction operator $\Phi(s, \delta)$ on the Hilbert space $l^2(\mathbb{N})$, we explore the geometric behavior of the operator trace in regions where $Re(s) \neq 1/2$. Our approach utilizes a Master Inequality applied to the resulting phase torque $J(\delta, t)$, suggesting that a hyperbolic sine bias might provide a mechanism for establishing an analytical threshold against tail interference. Using Baker’s Theorem on Linear Forms in Logarithms, we examine how a primary interaction term may maintain signal dominance within the truncated Head. While preliminary, these results suggest a potential path for investigating the confinement of non-trivial zeros to the critical line through the lens of operator stability.

Abstract: Oxidative stress is a major contributor to neuronal apoptosis and subsequent neurofunctional deficits. This study investigates the dual role of the mitochondrial membrane-anchored protein NIX in PC12 cells, a model for mature neurons. We demonstrate that both overexpression and knockdown of NIX attenuate apoptosis under oxidative stress, albeit through distinct mechanisms. Overexpression of NIX promotes cell survival by activating NIX-mediated mitophagy, which clears damaged mitochondria and intracellular reactive oxygen species (ROS), thereby maintaining redox homeostasis. Conversely, knockdown of NIX reduces apoptosis primarily by diminishing the intrinsic pro-apoptotic function of the protein. Collectively, these findings reveal that NIX expression levels critically gate PC12 cell fate under oxidative stress by differentially activating pro-survival or anti-apoptotic pathways.

Abstract: Healthcare organizations face emerging challenges that threaten the safety of professionals and patients, as well as the performance and long-term sustainability of healthcare systems. Health problems such as work-related musculoskeletal disorders (WRMSD) are highly prevalent among nurses, not only due to the physical demands but also because of significant psychosocial stressors and mental health challenges inherent in healthcare environments. This study investigates the impact of psychosocial risks at work on the occurrence of WRMSD in nurses. A cross-sectional study was conducted, using a snowball recruitment method, from Octobre 2025 to March 2026, among 266 nurses. Data were collected using the Psychosocial Risk Factors scale (INSAT_ERPS) and The Depression, Anxiety and Stress Scale - 21 Items (DASS-21), and analyzed with descriptive and inferential statistics to analyze the predictive role of the psychosocial risk on burnout dimensions. This study analyzed the relationships between PSR, mental health and WRMSD. Key psychosocial determinants of WRMSDs include high psychological strain—manifesting as anxiety—compounded by psychosocial stressors such as low job control, role ambiguity, and barriers to professional development. The results highlight the importance of addressing PSR and mental health, to reduce the incidence of WRMSD among nurses. Interventions focused on improving working conditions and promoting mental health may be effective in preventing WRMSD.

Abstract: This study examines the relationship between insurance market development and economic growth in 33 OECD countries over the period 2011–2021, with particular emphasis on life insurance markets and structural characteristics. To capture the multidimensional nature of insurance development, the analysis distinguishes between insurance depth (density), size (penetration), and structure (retention and foreign participation). Using a two-way fixed effects panel framework with country and year effects and insurance-market controls, the results reveal a differentiated pattern. Insurance density—both total and life—is positively and statistically significantly associated with GDP per capita, indicating that the intensity of insurance usage remains economically relevant in advanced economies. In contrast, life insurance penetration is negatively associated with economic growth. Life insurance retention is also negatively associated with economic growth, highlighting the role of risk allocation in mature insurance systems. Foreign insurer participation does not exhibit a statistically significant effect. The findings suggest that in OECD countries, the economic contribution of insurance markets depends more on efficiency and structure than on scale.

Abstract: Background: Traditional cardiovascular risk models often overlook "residual risk" driven by psychopathological factors. This study investigates the independent and in-cremental predictive value of Type D personality (TDP) and specific symptomatic di-mensions on long-term all-cause mortality in patients with coronary artery disease (CAD). Methods: We prospectively evaluated 221 patients with confirmed CAD. An-atomical complexity was quantified via the SYNTAX Score (SS). Psychological profil-ing utilized the DS14 scale for TDP and the SCL-90 for granular symptoms (depression, anxiety, and hostility). Mortality was analyzed over a mean follow-up of 1,026 days using multivariate Cox proportional hazards models. Results: TDP prevalence was 33.0% and significantly correlated with higher anatomical complexity (SS: 26.21 vs. 15.49; p < 0.001). In the integrated psychological model, Anxiety emerged as a signifi-cant independent predictor of survival (HR = 0.941; p = 0.049). This suggests an "Anxi-ety Paradox," where heightened vigilance may improve outcomes. The psychological model demonstrated superior predictive accuracy (C-index = 0.624) compared to the clinical model (C-index = 0.527). Significant correlations were confirmed between SS and psychological distress (e.g., depression: r = 0.493). Conclusions: TDP and granular psychological symptoms are robust, independent determinants of mortality that transcend anatomical severity. TDP acts as a marker of biological vulnerability and accelerated vascular aging, while manageable anxiety may enhance treatment adher-ence. Integrating systematic psychological screening into routine CAD care is essential for refined risk stratification and improved long-term survival.

Abstract: Microplastic contamination in coral reef environments is increasingly recognized as a global concern; however, the extent to which polymer composition can resolve contamination sources and transport processes remains poorly understood. In this study, we assessed the abundance, composition, and diversity of microplastics (< 300 µm) across multiple reef systems in the Cuban archipelago using high-resolution spectroscopic analysis. Microplastic abundance varied substantially among sites, with a median concentration of 66 particles L⁻¹ (IQR: 45–115 particles L⁻¹), ranging from 8 to 218 particles L⁻¹. A total of 11 polymer types were identified, with polyethylene (PE), polypropylene (PP), and polyamide (PA) dominating the assemblages and accounting for approximately 77% of detected particles. While these polymers were consistently observed across all sites, indicating a pervasive regional background signal, highly impacted reefs exhibited more complex polymer profiles, including the enrichment of polyurethane (PU), polytetrafluoroethylene (PTFE), and polyvinyl chloride (PVC), reflecting localized anthropogenic inputs. Multivariate analysis revealed distinct compositional groupings associated with different contamination regimes. Notably, some sites exhibited elevated microplastic abundances while remaining dominated by common polymers, indicating a decoupling between contamination levels and source-specific signatures. This pattern suggests that regional transport and mixing processes, including circulation through the Caribbean basin and the Yucatán Channel, play a major role in shaping microplastic distributions in reef environments. These findings demonstrate that polymer composition provides critical information beyond abundance alone, enabling the differentiation between source-driven contamination and transport-driven accumulation. The integration of polymer-specific analysis with abundance and diversity metrics offers a robust framework for improving source apportionment and informing monitoring and management strategies in coral reef systems.

Abstract: The energy balance model (EBM) and its operational form, calories-in-calories-out (CICO), have dominated obesity research and clinical practice for decades. While these frameworks have yielded valuable public health insights, they rely on indirect conversions between mass and energy and rest on misconceptions about thermodynamic principles. This Perspective argues that a mass balance model (MBM) provides a conceptually simpler, mathematically consistent, and biologically more faithful paradigm. By tracking macronutrient mass directly – without intermediate energy-unit conversions or misapplications of thermodynamic laws – the MBM aligns analysis with physiological reality and better predicts body composition dynamics. Clarifying that the first law of thermodynamics concerns only energy (not mass), that calories cannot be eaten or oxidized, and that E=mc² has no relevance to human metabolism paves the way for more precise translational interventions in metabolic medicine.

Abstract: Background: Persistent high-risk human papillomavirus (hrHPV) infection causes over 99% of cervical precancers and cancers worldwide, with HPV genotype 16 (HPV16) responsible for 50% of the cases. Latvia ranks among the top EU countries for cervical cancer incidence and mortality. In the general Latvian population, 4.2% women are hrHPV-infected, mostly with HPV16. However, information on the circulating HPV16 isolates is missing. Objectives: To study the genomic variability of the Latvian HPV16 isolates, compare them with HPV16 in Europe and across the globe, reveal features associated with the severity of cervical disease and uncover eventual sequence changes due the national HPV vaccination. Methods: DNA was extracted from the formalin-fixed paraffin-embedded cervical tissues of women diagnosed with cervical intraepithelial neoplasia (CIN) stages I-III and squamous cell carcinoma (SCC) grades 1-3 collected between 2012 and 2024. Samples positive for HPV16 were subjected to whole genome sequencing (WGS) on the Illumina platform (n=16) or Sanger sequencing of the E6/E7 coding region (n=31). Consensus HPV16 sequence was generated, and single nucleotide polymorphisms (SNP) and eventual amino acid substitutions (AAS) were analysed. Results: Complete genomes of 16 HPV16 variants were reconstructed, 13 related to the European sublineage A1, and 3, to the sublineage A2 references. Sequences showed high conservation, still 93 non-redundant variants were identified. The highest variability was observed for the capsid protein L2, the lowest, for oncoprotein E7. Prevalence of SNPs and AAS in the Latvian HPV16 variants, specifically in capsid protein L1, did not increase with time, showing no effect of HPV vaccination. Associations between HPV16 sequence features and severity of cervical disease were limited to AAS E6:L90V which was significantly more common in SCC grade 2/3 than in CINII/III cases (p=0.015). Conclusions: Highly conserved HPV16 genomes circulating in Latvia harbour series of unique, as well as common nonsynonymous SNPs with respective AAS, with one, AAS E6:L90V, associating with disease severity. No HPV vaccine escape variants were detected. Deciphering complete genomes of HPV16 from CIN and SCC cases in Latvia informs public authorities performing HPV vaccination and is useful for management of HPV-associated cervical diseases.

Abstract: This paper describes the design and implementation of PolyUAnalog, a modular and open-source polyphonic analog synthesizer. The architecture utilizes the AS3397 analog voice chip, with each voice managed by a dedicated RP2040 microcontroller. System coordination, including MIDI processing and voice allocation, is handled by a central conductor board communicating over an I²C bus. Technical implementation details and associated measurements are provided regarding real-time DCO pitch stabilization via a PID feedback loop and the generation of high-resolution control voltages using filtered Pulse Width Modulation (PWM). The complete hardware schematics and C++ software stack are documented to facilitate replication, modification, and further development within the electronic musical instrument community.

Abstract: Electrochemical treatment of sulfide‑containing industrial effluents and gas emissions remains a pressing challenge for the development of clean technologies, whose solution requires anodes with low operating potential, stable performance, and facile, cost‑effective fabrication. The paper studies the influence of the substrate nature on the structural and electrochemical characteristics of lead dioxide anodes in sulfide-containing aqueous systems using the electrolysis of an aqueous solution of sodium sulfide Na₂S as an example. The substrates used were composite materials based on polylactic acid with the addition of 7 and 10 wt.% multiwalled carbon nanotubes, designated as PLA (7% mCNT)/PbO₂ and PLA (10% mCNT)/PbO₂, as well as a PLA (Graphite)/PbO₂ composite containing dispersed graphite as a conducting phase; PbO₂ coatings were applied to all of the above polymer substrates by electrochemical deposition. For comparison, a traditional Ti/PbO₂ anode and a graphite electrode without a lead dioxide coating, used as a standalone anode, were also considered. Cyclic voltammetry in a Na₂S solution was used to evaluate the anodic reaction overpotential, specific current densities, and current-voltage curve shapes on various substrates, as well as to analyze the influence of the conductive composite composition on the electrochemical behavior of the PbO₂ layer. It was shown that the PLA (7% mCNT)/ PbO₂, PLA (10% mCNT)/PbO₂, and especially PLA (Graphite)/PbO₂ anodes provide operating potentials, ohmic resistance, and cyclic stability comparable to or superior to those of the traditional Ti/PbO₂ anode in a sulfide-containing electrolyte, whereas the uncoated graphite electrode is inferior to the composite PbO₂ electrodes in terms of a combination of parameters. The obtained results allow us to conclude that the nature and composition of the substrate play a key role in the formation of the morphology, conductivity and electrochemical properties of PbO₂ anodes and confirm their high potential for use in electrochemical systems for treating sulfide-containing aqueous media and gas emissions.

Abstract: Background: Immunization programmes rely on cold-chain systems to protect vaccine quality, but these systems also generate waste streams that are not consistently addressed within conventional health-care waste frameworks. These include electronic temperature monitoring devices, data loggers, batteries, packaging materials, cooling accessories, damaged vaccine carriers, sensors, voltage stabilizers, obsolete parts, and decommissioned refrigerators and freezers. Methods: This review was conducted as a secondary evidence review with structured policy and guidance mapping. Peer-reviewed literature and guidance documents from global, technical, and national sources were reviewed to map cold-chain waste streams, assess policy and operational coverage, and identify relevant management pathways. Findings: Cold-chain waste is generated across vaccine shipment, storage, transport, outreach, maintenance, repair, replacement, and decommissioning. Existing guidance addresses some components, particularly obsolete refrigerators and freezers, but smaller items such as Q-tags, data loggers, batteries, sensors, packaging materials, ice packs, and broken accessories are covered indirectly, partially, or not as a unified programme-management issue. Relevant guidance is distributed across health-care waste management, e-waste regulation, procurement, asset management, vaccine logistics, and cold-chain equipment decommissioning documents. Interpretation: Cold-chain waste should not be treated as uniformly hazardous, but it should be recognized as a distinct operational category within immunization systems. A practical response requires risk-based classification, segregation, inventory, reuse or repair where appropriate, linkage with approved e-waste and disposal systems, stronger procurement clauses, and integration into EVM assessments, continuous improvement plans, vaccine-store SOPs, and national logistics working group processes. A concise global reference framework could help countries manage cold-chain waste through existing health, environmental, procurement, and asset-management systems.

Abstract: Physiotherapy is an evidence-based healthcare occupation aiming to collaborate in the diagnosis, prevention and treatment of myriad of diseases and clinical scenarios throughout all stages of human life. Its development has been accelerated over the last two decades. The scope of physiotherapy is continuously evolving. However, the accumulated evidence in the context of rare diseases is scarce. Remarkably, the opportunity for improvement and potential benefit for complex diseases with low prevalence is also very high, both as an isolated approach or within multidisciplinary specialized units. Systemic light-chain (AL) amyloidosis is a rare, chronic, complex, heterogeneous, incurable, and challenging disease, which may involve different organs and systems, including the heart, kidney, liver, peripheral nerves, lung, muscle, skin, and others. Heart is the most frequently involved organ leading to failure and arrhythmias. Peripheral neuropathy is a relatively frequent symptom. Renal, respiratory, and hepatic failure may also occur. The aim of this narrative review is summarizing, updating, and critically underlining potential new avenues of development on the role of physiotherapy in systemic light-chain (AL) amyloidosis, compared with its application on multiple myeloma, a closely related but not so rare entity.

Abstract: Kindergarten toilet design critically influences children's autonomy, hygiene behaviours, and psychological well-being. Yet comparative architectural evaluations in conflict-affected and developing regions remain scarce, particularly in Iraq, where facilities typically adhere only to minimum regulatory standards. This study develops and applies a structured evaluation framework to assess child-centred innovation in kindergarten toilet facilities, identifying design weaknesses and opportunities to inform architects, policymakers, and implementing institutions. The study evaluated ten kindergartens in Erbil using a literature-derived framework comprising four domains: Autonomy &amp; Functionality, Health &amp; Hygiene, Safety &amp; Comfort, and Aesthetics &amp; Sustainability, operationalised through 14 quantitative indicators and assessed via a five-point scoring rubric. Data sources included architectural drawings and systematic on-site observations. Overall innovation scores ranged from 3.1 to 4.3 (scale 1-5). While basic safety requirements were universally met, significant deficiencies emerged in inclusive design (accessible fixtures present in only 3/10 facilities, 30%), advanced hygiene technologies (sensor-activated fixtures in only 2/10, 20%), and aesthetic-environmental quality (mean score 2.4/5). Higher-performing facilities demonstrated closer classroom-toilet proximity (≤ 6m vs. &gt;15m), distributed rather than centralised layouts, and integrated child-scale fixtures. Current kindergarten toilet design in Erbil achieves functional adequacy but consistently fails to deliver inclusivity, technological innovation, and spatial quality. Policy revision beyond minimum compliance toward child-centred performance standards is urgently required.

Abstract: In classical mechanics, force is the physical entity mediating interactions between physical objects. Such objects consist of point masses, or appear as continuous bodies formed by a continuum of point masses. Force is defined as the sole entity capable of altering a point mass's state of motion (velocity) and is mathematically represented as a bound vector. However, this description of the physical world no longer holds at the atomic or subatomic level, where matter is discretized into quanta and interactions occur through the exchange of quanta of linear momentum and energy. While this dichotomy is currently accepted as the status quo, efforts to harmonize these frameworks into a more coherent formulation remain highly desirable. This paper investigates the extent to which interactions in classical mechanics can be reinterpreted as an exchange of linear momentum quanta. This investigation leads to a coherent reformulation of Newton’s laws, in which forces are treated as flow rates of these quanta. Therefore, classical mechanics admits a discretized description of the physical world even at the macroscopic level.

Abstract: Pancreatic cancer remains one of the most lethal malignancies worldwide, with pancreatic ductal adenocarcinoma accounting for the vast majority of cases and characterized by extensive desmoplasia, immune exclusion, and resistance to systemic therapies. Increasing evidence implicates lysosomal cathepsins as important regulators of these defining features of pancreatic tumor biology. Cathepsin-dependent proteolysis and lysosome-associated signaling pathways contribute to extracellular matrix remodeling, regulate immune cell trafficking, and influence antigen processing and presentation. Beyond their classical degradative functions, cathepsins participate in stress-adaptive cellular programs linked to autophagy, metabolic regulation, and proteostasis, supporting tumor cell survival under hypoxic, nutrient-limited, and therapy-induced stress conditions. Within the tumor microenvironment, dysregulated cathepsin activity promotes immune evasion by reshaping cytokine networks, impairing effective antigen presentation, and reinforcing physical and functional barriers to cytotoxic T-cell infiltration. Collectively, these mechanisms position the lysosome–cathepsin system as a central regulator of proteolytic remodeling, immune exclusion, and adaptive therapy resistance in pancreatic cancer, highlighting its potential relevance for emerging combinatorial therapeutic strategies.