In the present work we consider two modified Chevallier-Polarski-Linder (CPL) models in the background of homogeneous and isotropic FLRW space-time, namely (i) the generalized CPL model (Model I) and (ii) the logarithmic form of the the equation of state for the dark energy. From the observational data sets ((Pantheon+)+BAO+HST), we find that at the present epoch (redshift $z=0$), the equation of state for the dark energy converges almost at the same value $\omega_{fld}\approx -0.86$ and the variation of $\omega_{fld}(z)$ with respect to the redshift parameter is very small for both models. we also find that the present value of the Hubble parameter $H_0$ is almost same for both the models. Finally, we compare the models in the light of Akaike, Bayesian Information Criterion (BIC) and Bayesian Evidence. However, we find that Model II is better compared to the Model I from the estimated value of the deceleration parameter.

$\phi$CDM models provide an alternative to the standard $\Lambda$CDM paradigm, while being physically better motivated. These models lead to a time-dependent speed of sound for dark energy that is difficult to replicate by $w$CDM parametrizations. We review the most up-to-date status of observational evidence for the $\phi$CDM models in this paper. We start with an overview of the motivation behind these classes of models, the basic mathematical formalism, and the different classes of models. We then present a compilation of recent results of applying different observational probes to constraining $\phi$CDM model parameters. Over the last twenty years, the precision of observational data has increased immensely, leading to ever tighter constraints. A combination of the recent measurements favors the spatially flat $\Lambda$CDM model, but a large class of $\phi$CDM models is still not ruled out.

This research paper examines a cosmological model in flat space-time via $f(R,G)$ gravity where $R$ and $G$ are respectively the Ricci scalar and Gauss-Bonnet invariant. Our model assumes that $f(R,G)$ is an exponential function of $G$ combined with a linear combination of $R$. We scrutinize the observational limitations under a power law cosmology that relies on two parameters - $H_0$, the Hubble constant, and $q$, the deceleration parameter, utilizing the 57-point $H(z)$ data, 8-point BAO data, 1048-point Pantheon data, joint data of $H(z)$ + Pantheon, and joint data of $H(z)$ + BAO + Pantheon. The outcomes for $H_0$ and $q$ are realistic within observational ranges. We have also addressed Energy Conditions, $Om(z)$ analysis and cosmographical parameters like Jerk, Lerk and Snap. Our estimate of $H_0$ is remarkably consistent with various recent Planck Collaboration studies that utilize the $\Lambda$CDM model. According to our study, the power law cosmology within the context of $f(R,G)$ gravity provides the most comprehensive explanation for the important aspects of cosmic evolution.

The present analysis deals with the study of the $f(Q, T )$ theory of gravity which was recently considered by many cosmologists. In this theory of gravity, the action is taken as an arbitrary function $f(Q, T )$ where $Q$ is non-metricity and $T$ is the trace of energy-momentum tensor for matter fluid. In this study, we have taken three different forms of the function $f(Q, T )$ as $f(Q,T)=a_1Q+a_2 T$ and $f(Q,T)=a_3 Q^2+a_4 T$ and discussed some physical properties of the same. Also, we have obtained the various cosmological parameters towards Friedmann-Lemaitre-Robertson-walker (FLRW) Universe by defining the transit form of scale factor which yields the Hubble parameter in redshift form as $H(z)=\frac{H_{0}}{(\lambda+1)} \left(\lambda+ (1+z)^{\delta}\right)$. %We have obtained the approx best-fit values of model parameters using the least square method for observational constraints on available datasets like Hubble dataset $H(z)$, Supernova dataset SNe-Ia, etc., by applying the Root Mean Squared Error formula (RMSE). By applying the Root Mean Squared Error formula (RMSE), we were able to determine the approximate best-fit values of model parameters using the least square approach for observational constraints on the datasets Hubble dataset $H(z)$, Supernova dataset SNe-Ia, etc. We have observed that the deceleration parameter $q(z)$ exhibits a signature-flipping (transition) point within the range $0.623 \le z_{0} \le 1.668$ through which it changes its phase from the decelerated to the accelerated expanding universe with $\omega = -1$ at $z=-1$ for the approximate best-fit values of the model parameters. %For obtained approx best-fit values of model parameters we have observed that the deceleration parameter $q(z)$ shows a signature-flipping (transition) point within the range $0.623 \le z_{0} \le 1.668$ through which it changes its phase from decelerated to the accelerated expanding universe with $\omega = -1$ at $z=-1$.

This review explores methodological considerations for maximizing the precision and accuracy of observational cohort studies assessing the risk profiles of tobacco and nicotine products. These considerations, informed by the ROBINS framework for minimizing statistical bias, are anchored in a comprehensive characterization of exposure to all tobacco products currently or formerly used, with corroboration of dose-response relationships. Best-practice considerations for non-randomized observational studies of exposure are enumerated, to most precisely and accurately inform future waves of databases, studies and meta-analyses. These principles are then considered within the context of a recent comprehensive meta-analysis, representing 107 observational studies, which evaluated the health effects of using electronic cigarettes (EC) compared to non-use, use of combusted cigarettes (CC) and dual-use of both products (DU). The meta-analysis had previously reported the relative risk from all-sources, including tobacco use and non-tobacco use. We now report the magnitude of risk reduction associated with displacing CC use with EC use indicated from the primary references, along with considerations regarding the precision of characterization of dose, duration, and timing of CC and EC use in the cited studies.

Preventive behavior is one of the main strategies to contain the spread of the coronavirus, understand the factors that influence adherence or hesitation to protective measures and the way the population behaves during a health crisis is of great importance. Aim: To analyze the factors associated with adherence to protection measures against Covid-19 in Brazil. Method: cross-sectional study, survey type online, between the period of August 2020 and February 2021. The population included in the study were Brazilians, aged 18 years or older. Non-probabilistic sampling was used to obtain the sample. The data was stored on the "Redcap" platform and analyzed in a descriptive and inferential approach. Results: The sample consisted of 1,516 people, women adopted 10% more protective measures than men, people with higher education level and higher income, within the age group between 40-59 years, were those who most adhered to the measures imposed by health agencies. Carrier of Asthma, Diabetes Mellitus, Systemic Arterial Hypertension, Obesity and smoking were factors that increased the adherence of protective measures in the fight against COVID-19. Conclusion: Being female, aged between 40 and 59 years, higher education, smoking, not having a religion, having health insurance, and being a carrier of chronic diseases were associated with greater adherence to protective measures against COVID-19.

Taxanes have been shown to be the most effective treatment for recurrent or metastatic breast cancer. However, for patients pretreated with taxanes, more active and possibly less toxic drugs are needed. In this retrospective study, we investigated on the effectiveness and safety of eribulin mesylate in 91 taxane-refractory subjects, extracted from the ESEMPIO database, which included 497 metastatic breast cancer patients treated with eribulin allover the Italy. This analysis included only those patients who have shown disease progression while receiving taxane therapy (primary refractory), or those who achieved a response followed by progression while still on therapy (taxane failure). Overall, 41/91 patients (45.2%) showed a clinical benefit; 1 complete response (2.2%) and 16 partial responses (17.6%) were observed. The median progression free survival was 3.1 months (95% CI: 2.8–3.5) and the median overall survival was 11.6 months (95% CI: 8.7–16.7). With regard to toxicity, 53 patients (58%) experienced asthenia/fatigue, 23 (25%) showed peripheral neurotoxicity, 18 (20%) alopecia, 12 (13%) mild constipation and 27 (30%) neutropenia. The toxicity related to the treatment led to eribulin dose reduction in 19 (21%) and discontinuation in 9 (10%) patients, respectively. In conclusion, this study suggests that eribulin is effective and well tolerated also in taxane-refractory patient.

As network systems become larger and more complex, there is an increasing focus on how to verify the security of systems that are at risk of being attacked. Automated penetration testing is one of the effective ways to do this. Uncertainty caused by adversarial relationships and the "fog of war" is an unavoidable problem in penetration testing research. However, related methods have largely focused on the uncertainty of state transitions in the penetration testing process, and have generally ignored the uncertainty caused by partially observable conditions. To address this new uncertainty introduced by partially observable conditions, we model the penetration testing process as a partially observable Markov decision process (POMDP), and propose an intelligent penetration testing decision method compatible with it. We experimentally validate the impact of partially observable conditions on penetration testing. The experimental results show that our method can effectively mitigate the negative impact of partially observable conditions on penetration testing decision. It also exhibits good scalability as the size of the target network increases.

Background. Implementing mammogram screening means that clinicians are seeing many breast cancers that will never develop metastases. The purpose of this study was to identify subgroups of breast cancer patients who did not present events related to long-term breast cancer mortality, taking into account diagnosis at breast screening, absence of palpability and axillary involvement, and genomic analysis with PAM50. Patients and Methods. To identify them, a retrospective observational study was carried out selecting patients without palpable tumour, without axillary involvement, and a genomic analysis was performed with PAM50. Results. The probability of distant metastasis-free interval (DMFI) of 337 patients was 0.92 (95% CI, 0.90-0.93) at 20 years and 0.96 (95% CI, 0.92-1.00) in 95 patients (28%) with available PAM50 tests. In 22 (23.15%) luminal A tumours and in 9 (9.47%) luminal B tumours smaller than 1 cm and in HER2 and basal type tumours there were no metastatic events (20-year DMFI of 1.00). Conclusion. Patients with nonpalpable breast cancer found at screening with negative nodes are at very low risk. It is possible to identify subgroups without metastatic events by determining the intrinsic subtype and tumour size less than 1 cm. De-escalation of treatment should be considered.

Taekwondo masters and coaches believe that they have a kind of “eagle eye” and that is why they feel comfortable to analyze athletes’ skills without using essential tools. The aim of this study was to analyze the athletes’ technical indicators during performance of the Miluh-chagi kick. To analyze the reliability and precision of the cycle of ten kicks (n = 120), performed by 5 women and 7 men senior athletes, we used an expert panel and a previously published observational tool. The coefficient of variation was calculated to verify precision. The intraclass correlation coefficient was calculated to confirm the reliability among the evaluators. Student’s t-test was used for group-to-group analysis. Correlation analyses were accessed using Spearman’s rho. The data quality sample reliability results, for group, intra- and inter-rater were excellent and good re-spectively. Statistically significant differences, with a large effect size, were found in the foot take-off, knee up and start leg flexion observational moments. The values showed a small and negative to moderate correlation between the conducts and aggregates criteria. Perfect correlation values were found between support leg foot and contact leg position. These findings meet the measurement requirements of athletes’ technical indicators to analyze motor behavior, develop-ment and performance of this technique.

Background: Asthma is the most common chronic disease affecting children and altering their quality of life. The severity of asthma is often modulated by immunoglobulin E (IgE)-mediated allergen sensitization and is associated with comorbid allergic dis-eases. Omalizumab is a humanized monoclonal antibody anti-IgE, the first biological therapy approved to treat patients aged ≥6 years with severe allergic asthma. The primary objective of our study was to investigate the efficacy and safety of Omali-zumab in Romanian paediatric patients with severe allergic asthma. Methods: In this observational real-life study, 12 children aged 6 to 18 years, (mean age 12.4 years ) with severe allergic asthma received Omalizumab as an add-on treatment. The levels of asthma control, exacerbations, lung function and adverse events were evaluated at baseline and after the first year of treatment. Results: We noticed general improvements in total asthma symptom scores and the rate of exacerbation of severe asthma. Omalizumab increased the initial variables of lung function, and no serious adverse reactions were reported. FEV1 improved statistically significant after one year of treatment with Omalizumab, [ΔFEV1 (% pred.) =18.3, and similarly, ΔMEF50 (%) = 25.8]. The mean severe exacerbation rates due to asthma decreased from 4.1 (2.8 SD) to 1.15 (0.78 SD) during the treatment year (p<0.0001) with Omalizumab. Conclusions: Treatment with Omalizumab can be an effective and safe therapeutic option for Romanian children with severe allergic asthma, providing clinically relevant in-formation on asthma control and exacerbation rate in children and adolescents. The results highlighted the effect of Omalizumab in young patients, starting from the first year of treatment.

Objectives: This study aims to identify, report, and analyze registered and published clinical trials and observational studies for the pharmacological treatment of COVID-19 conducted in China. Methods: A strategic search was conducted via the Chinese Clinical Trial Registry to identify and extract clinical trials and observational studies registered and conducted in China for the pharmacological treatment of COVID-2019 between January 1^st, 2020 and March 21^st, 2020. This was further supplemented by searches conducted via the China National Knowledge Infrastructure (CNKI) database, the MEDLINE database, the World Health Organization (WHO) database, and MedRxiv and BioRxiv electronic platforms for preprint articles, published up until April 8^th, 2020. Studies available in Chinese and English were included in the searches and extracted. A primary descriptive analysis was performed for registered clinical trials and observational studies identified in the Chinese Clinical Trial Registry based on the extraction of the following clinical study information: trial ID, planned date of enrollment, recruitment status, study design, population, sample size, intervention/exposure group, control /reference group, dosage, and primary outcomes. A secondary descriptive analysis was performed for published clinical trials and observational studies identified from the supplementary databases based on the extraction of the following published clinical study information: study design, population, intervention/exposure group, control /reference group and main results as appropriate. Results: A total of 221 clinical trials and observational studies were included from all databases searched. From the Chinese Clinical Trial Registry, 195 registered clinical studies including 170 clinical trials and 25 observational studies were identified and included for primary analysis. From the supplementary databases, 26 published clinical studies including 8 clinical trials and 18 observational studies were included for secondary analysis. Of these 26 published clinical studies, 18 studies, including 3 clinical trials and 15 observational studies were identified from CNKI, 2 studies including 1 clinical trial and 1 observational study from MEDLINE, 2 including 1 clinical trials and 1 observational studies from the WHO database, and 4 including 3 clinical trials and 1 observational studies from MedRxiv and BioRxiv platforms. In the primary analysis, among the 170 clinical trials included from the Chinese Clinical Trial Registry, 101 investigated western medicines (WMs), while 15 investigated Traditional Chinese Medicines (TCMs), and 54 investigated a combination of TCMs and WMs. Among the 25 included observational studies from the Chinese Clinical Trial Registry, 2 investigated WMs, 2 investigated TCMs, and 21 investigated a combination of TCMs and WMs. The total number of exposed patients in all 195 clinical studies from the Chinese Clinical Trial Registry amounted to 24,500. In the secondary analysis, treatment with Lopinavir-ritonavir and treatment with Hydroxychloroquine was not associated with a difference from standard of care in the rate of RT-PCR negativity; treatment with a combination of Lopinavir-ritonavir, interferon α, and Lian-Hua-Qing-Wen capsule was found to significantly improve the effective rate of treatment compared with Interferon α combined with Lian-Hua-Qing-Wen capsule. Conclusions: China is generating a massive source of evidence that is critical for defeating the COVID-19 pandemic. Not only the clinical experience, but also the scientific evidence should be shared with the global scientific community.

Abdominal aortic aneurysm (AAA) represents an important public health problem with a prevalence between 1.3% and 12.5%. Several population-based randomized trials have evaluated ultrasound screening for AAA providing evidence of a reduction in aneurysm-related mortality in the screened population. The aim of our study was to perform a systematic review and meta-analysis of the risk factors for AAA. We conducted a systematic review of observational studies and we performed a meta-analysis that evaluated the following risk factors: gender, smoking habits, hypertension, diabetes mellitus, Coronary Artery Disease and family history of AAA. Abdominal aortic aneurysm prevalence is higher in smokers and in males. It is important to underline that all countries, where AAA screening was set up, had high income level and the majority belong to Western Europe (United Kingdom, Sweden, Italy, Poland, Spain and Belgium). Abdominal aortic aneurysm screening is fundamental for public health. It would avoid deaths, ruptures, and emergency surgical interventions if abdominal aortic aneurysm was diagnosed early in the population target for screening.

Cloud-induced atmospheric extinction and occlusion have a major effect on the effectiveness and quality of telescope observations. Real-time cloud cover distribution and long-term statistical data are essential for astronomical siting and telescope operations. At ground-based astronomical telescope sites, cloud cover distribution is currently analyzed using manual observation methods. However, the main disadvantages of manual observation methods are human subjective, heavy workloads and poor real-time performance. Therefore, a real-time automatic cloud images classification method is desperately needed. This paper presents a new cloud identification method, which is named PSO+XGBoost model by combining eXtreme Gradient Boosting (XGBoost) and Particle Swarm Optimization (PSO). The entire cloud image is divided into 37 sub-regions in order to more precisely identify the distribution of the clouds. 19 features are then extracted, including the sky background, star density, lighting conditions, and subregion grayscale values. The experimental results have shown that the overall classification accuracy of 96.91% and our model is able to outperform several state-of-the-art baseline methods. Our approach achieves high accuracy in comparison with the manual observation methods. Moreover, this method meets telescope real-time scheduling requirements.

Long COVID–19 syndrome is another vicious feature of COVID-19 infection, the mechanism remains unidentified. Several observational studies suggest that vaccinations might have protective and therapeutic effect on long COVID-19 and our study aimed to assess the influence of vaccination on COVID-19 patients. We performed an observational cohort study from October 2020 to July 2022, which included 503 patients (291 males and 212 females) with a median age of 65. They were hospitalized due to COVID-19 pneumonia and had persistent symptoms (after 1 month of COVID-19 infection. The clinical and demographic data including vaccination status collected during hospitalization and regular visits at the Community Healthcare Center dr. Adolf Drolc Maribor were analyzed. More non-vaccinated patients acquired long COVID-19 than vaccinated. Patients with type 2 diabetes suffered from long COVID-19 in a smaller percentage than patients without diabetes. Gender, inhalational therapy due to chronic pulmonary disease and the number of complications have significantly influenced long COVID-19 development and the mostly vaccinated patients were older and with asthma/COPD. Our study confirmed that vaccination is a safe and effective measure to prevent the severe progression of acute disease and to lower the incidence of developing long COVID.

Here we use the flat Friedmann-Lemaitre-Robertson-Walker metric describing a spatially homogeneous and isotropic universe to derive the cosmological redshift distance in a way which differs from that which can be found in the astrophysical literature. We use the co-moving coordinate r_e (the subscript e indicates emission) for the place of a galaxy which is emitting photons and r_a (the subscript a indicates absorption) for the place of an observer within a different galaxy on which the photons - which were traveling thru the universe - are absorbed. Therefore the real physical distance - the way of light - is calculated by D = a(t₀) r_a - a(t_e) r_e. Here means a(t₀) the today’s (t₀) scale parameter and a(t_e) the scale parameter at the time of emission (t_e) of the photons. Nobody can doubt this real travel way of light: The photons are emitted on the co-moving coordinate place r_e and are than traveling to the co-moving coordinate place r_a. During this traveling the time is moving from t_e to t₀ (t_e ≤ t₀) and therefore the scale parameter is changing in the meantime from a(t_e) to a(t₀). Using this right way of light we calculate some relevant classical cosmological equations (effects) and compare these theoretical results with some measurements of astrophysics. As one result we get e.g. the today’s Hubble parameter H_0a ≈ 62.34 km/(s Mpc). This value is smaller than the Hubble parameter H_0,Planck ≈ 67.66 km/(s Mpc) resulting from Planck 2018 data [12] which is discussed in the literature.

In the aftermath of the COVID pandemic, post-COVID-19 syndrome (PCS) remains a challenge and may continue to represent a major health problem in the future. Moreover, the influence of type 2 diabetes and being overweight on PCS remains unclear. This study aimed to assess this influence. We performed an observational study from October 2020 to July 2022, which included 466 patients (269 males and 197 females) with a median age of 65. They were hospitalized due to COVID-19 pneumonia and had persistent symptoms after 1 month of COVID-19 infection. The patients were divided into four groups according to the study objectives: patients with type 2 diabetes, overweight patients, overweight patients with type 2 diabetes, and normal-weight patients without type 2 diabetes. The clinical and demographic data collected during hospitalization and regular visits at the Community Healthcare Center dr. Adolf Drolc Maribor were analyzed. Our results showed that type 2 diabetes patients had a more difficult course of treatment and longer hospitalization. Moreover, more type 2 diabetes patients underwent rehabilitation than the other study groups. The prevailing symptoms in our patients with PCS were dyspnea and fatigue, mostly in female patients with type 2 diabetes. Our study also showed that more women with type 2 diabetes and more overweight women with type 2 diabetes suffered from secondary infections. Further, more overweight patients were treated in the intensive care unit compared to the other groups. However, our study showed an interesting result that patients with type 2 diabetes had the shortest PCS durations. Type 2 diabetes and being overweight are risk factors for PCS onset and prolonged duration. Therefore, our data that revealed a shorter duration of PCS in type 2 diabetes patients compared to the other investigated groups was unexpected. We believe that answering this question regarding the results will enable us to improve PCS treatment in general.

The aim of this study was to identify gender differences in technical-tactical behaviour in football. To this end 68 matches of the first division of the Spanish men’s and women´s league, corresponding to 2016/17 season were analyzed. A comparison of medians was carried out using the Mann-Whitney U-test were conducted as post hoc test and a grouping of the variables through the clustering bootstrapping technique in both groups. We have detected statistically significant differences regarding all accurate passes, in favour of men, as well as a greater number of yellow cards. In female football, a greater number of picking up free balls, interceptions, lost balls, recoveries, challenges and attacks, both positional and counterattacks, are produced. The clustering analysis also allowed that in male football, the circumstance of receiving a red card is closely related to the number of goals conceded and most of the shots on goal are achieved by positional attacks. In women's football, ball possession on own half is closely related to the number of losses. These results could be useful for gender-specific training information for optimal preparation. However, more research is warranted to establish the main gender differences and characterize women's football.

Results from the phase III Keynote-024 clinical trial have established Pembrolizumab monotherapy as the first-line standard of care for patients with metastatic NSCLC who have PD-L1 expression ≥ 50%, EGFR and ALK wild-type. However, given the differences between patients treated in routine clinical practice and within a clinical trial, real-world data are needed to confirm the treatment benefit in standard practice. Given the lack of data on large cohorts of patients with long follow-up, we designed a retrospective observational study of patients with NSCLC who were treated with Pembrolizumab, starting from its reimbursement eligibility until December 2020. The primary endpoints were to assess PFS and OS using the Kaplan-Meier method, treatment response and safety. We followed 880 patients (median follow-up: 35.1 months) until February 2022. Median PFS and OS were 8.6 months (95% CI: 7.6-10.0) and 25.5 months (95% CI: 21.8-31.6), respectively. We also found that ECOG PS, PD-L1 expression and smoking habit were prognostic factors for PFS, while age, sex, ECOG PS, smoking habit and histology had an impact on OS. Multivariable analysis confirms prognostic role of PD-L1 for PFS and ECOG for both PFS and OS. 39.9% of patients reported an adverse event, but only 6.3% of patients discontinued therapy due to toxicity. Our results suggest a long-term benefit of Pembrolizumab in the first-line setting as well as a safety profile consistent with the results of Keynote-042. Many collected variables appear to influence clinical outcome, but results from these exploratory unadjusted analyses should be interpreted with caution.

We constrain two dynamical dark energy models that are parametrized by the logarithm form of $w(z)=w_{0}+w_{1}\left(\frac{\ln (2+z)}{1+z}-\ln 2\right)$ and the oscillating form of $w(z)=w_{0}+w_{1}\left(\frac{\sin(1+z)}{1+z}-\sin(1)\right)$. Comparing with the Chevallier-Polarski-Linder (CPL) model, the two parametrizations for dark energy can explore the whole evolution history of the universe properly. Using the current mainstream observational data including the cosmic microwave background data and the baryon acoustic oscillation data as well as the type Ia supernovae data, we perform the $\chi^2$ statistic analysis to global fit these models, finding that the logarithm parametrization and the oscillating parametrization are almost as well as the CPL scenario in fitting these data. We make a comparison for the impacts of the dynamical dark energy on the cosmological constraints on the total mass of active neutrinos. We find that the dark energy properties could significantly change the fitting results of neutrino mass. Looser constraints on $\sum m_{\nu}$ are obtained in the logarithm and oscillating models than those derived in the CPL model. Consideration of the possible mass ordering of neutrinos reveals that the most stringent constraint on $\sum m_{\nu}$ appears in the degenerate hierarchy case.

Since the beginning of the mass immunization with COVID-19 vaccines of patients with multiple sclerosis, many data on the efficacy and safety of these vaccines have been produced. Considering that MS is an autoimmune disease whose pathology can be explained by an altered immune system and that some DMTs seem to be able to decrease the antibody response against COVID-19 vaccines, we carried out this retrospective study with the aim to evaluate the safety in terms of AEFIs occurrence and the antibody response after the third dose of COVID-19 vaccines in people with MS. Third doses were administered from October 2021 to January 2022. Two hundred and ten patients (64.8% female; mean age: 46 years) received the third dose of the mRNA-based COVID-19 vaccine and were included in the study. The majority of patients (n=193) were diagnosed with RRMS and EDSS values were ≤3.0 in 72.4% of them. DMTs most commonly used by included patients were interferon Beta 1-a, dimethyl fumarate, natalizumab and fingolimod. Overall, 160 patients (68.8% female) experienced 294 AEFIs, of which about 90% were classified as short-term, while 9.2% were classified as long-term. The most commonly reported following the booster dose were pain at the injection site, flu-like symptoms, headache, fever and fatigue. Regarding the immune response, consistently with literature data, we found that patients receiving ocrelizumab and fingolimod had lower IgG titer than patients receiving other DMTs.

Despite the extensive literature on missing data theory and cautionary articles emphasizing the importance of realistic analysis for healthcare data, a critical gap persists in incorporating domain knowledge into missing data problem formulation, assumption specification, and method development. In this paper, we highlight the gap particularly for observational data from healthcare facilities. We address this gap by identifying ten fundamental missingness scenarios arising during data measurement, recording, and pre-processing in observational health data, influenced by physicians, patients, healthcare facilities, and data scientists. We analyze the effect of scenarios on estimand formulation, missing data identification, estimation, and sensitivity analysis. To emphasize how domain-informed analysis can improve method reliability, we conduct simulation studies under the influence of various missingness scenarios. We compare the results of three common methods in medical data analysis (complete-case analysis, Missforest imputation, and inverse probability weighting estimation) for two estimands (variable mean estimation and classification accuracy). We advocate for our analysis approach as a reference for the analysis of observational health data. Furthermore, we posit that the proposed analysis framework is applicable to other medical domains, including medical wearable data analysis.

Iron overnutrition has been implicated with higher risk of developing metabolic and cardiovascular diseases, including metabolic syndrome (MetS), while iron deficiency anemia exacerbates many underlying chronic conditions. Hemoglobin (Hb) concentration in the blood, which reflects a major functional iron (i.e., heme iron) in the body, may serve as a surrogate of iron nutrition status. We conducted sex-specific observational association studies where we carefully titrated the association between Hb deciles and MetS and its components among the Taiwanese Han Chinese (HC) from the Taiwan Biobank and Europeans of White ancestry from the UK Biobank, representing two large ethnicities. Our data show that at higher-than-normal levels of Hb, increasing deciles of Hb concentration were significantly associated with MetS across all sex subgroups in both ethnicities, with the highest deciles resulting in up to three times greater risks than the reference group [Taiwanese HC: OR=3.17 (95% CI, 2.75-3.67) for Hb >16.5 g/dL in men, OR=3.11 (2.78-3.47) for Hb >14.5 g/dL in women; European Whites: OR=1.89 (1.80-1.98) for Hb >16.24 g/dL in men, OR=2.35 (2.24-2.47) for Hb >14.68 g/dL in women]. The association between stronger risks and increasing Hb deciles was similarly observed with all metabolic components except diabetes. Here we found that both the highest Hb decile groups and contrarily the lowest ones, with respect to the reference, were associated with higher odds of diabetes in both ethnic groups [e.g., Taiwanese HC men: OR=1.64 (1.33-2.02) for Hb >16.5 g/dL, OR=1.71 (1.39-2.10) for Hb <13.5 g/dL; European Whites women: OR=1.39 (1.26-1.45) for Hb >14.68 g/dL, OR=1.81 (1.63-2.01) for Hb <12.39 g/dL]. These findings confirm that elevated Hb concentrations, a potential indicator of iron overnutrition, may play a role in the pathophysiology of MetS and metabolic components.

In this part of the two-part series of essays, we first derive some equations for further physical redshift distances. We then analyze a catalog with 132,975 quasars, for which both the apparent magnitude m and the redshift z are given, in order to find the today’s value of the parameter β₀ of the theory presented. We then use this value to determine the today’s value of the radius R_0a of the Friedmann sphere using a magnitude redshift diagram of 19 SNIa. With the help of the known values of R_0a and β₀, statements about astrophysical data from the black hole in the galaxy M87 can be made. In addition, the today’s Hubble parameter H₀ results from both parameters. Furthermore, we calculate the values of the further physical redshift distances for the black hole in M87 and all 19 SNIa. The resulting parameter values are: β₀ ≈ 0.731, R_0a ≈ 2,712.48 Mpc and H₀ ≈ 65.638 km / (s ∙ Mpc). The today’s mass density of the Friedmann sphere is ρ₀ ≈ 4.843 x 10^-27 g / cm 3. For the mass of the Friedmann sphere we find M_FK ≈ 1.206 x 10⁵⁶ g. Annotation: Knowledge of the first part [1] of the series of articles is a prerequisite for understanding this article.

Globally, increasing rates of obesity are one of the most important health issues. The association between breakfast skipping and body weight is contradictory between cross-sectional and interventional studies. The systematic review and meta-analyses aim to summarize this association based on observational longitudinal studies. We included prospective studies on breakfast skipping and overweight/obesity or weight change in adults. Literature was searched until September 2020 in PubMed and Web of Science. Summary RRs with a 95% CI were estimated in pairwise meta-analyses by applying a random-effects model. In total, 9 studies were included in the systematic review and 6 of them were included in the meta-analyses. The meta-analysis indicated an 13% increased RR for overweight/obesity when breakfast was skipped on ≥ 3 days per week compared to ≤ 2 days per week (95% CI: 1.06, 1.21, n=3 studies). The meta-analysis on weight change displays a 21% increased RR for weight gain for breakfast skippers compared to breakfast eaters (95% CI: 1.05, 1.40, n=2 studies). The meta-analysis on BMI change displayed no difference between breakfast skipping and eating (RR=1.02, 95% CI: 0.99, 1.05, n=2 studies). This study provides low meta-evidence for an increased risk for overweight/obesity and weight gain for breakfast skipping.

The Universe has a gravitational horizon with a radius R_h = c/H coincident with that of the Hubble sphere. This surface separates null geodesics approaching us from those receding, and as free-falling observers within the Friedmann-Lemaitre-Robertson-Walker spacetime, we see it retreating at proper speed c, giving rise to the eponymously named cosmological model R_h = ct. As of today, this cosmology has passed over 20 observational tests, often better than LCDM. The gravitational radius R_h therefore appears to be highly relevant to cosmological theory, and in this paper we begin to explore its impact on fundamental physics. We calculate the binding energy of a mass m within the horizon and demonstrate that it is equal to mc². This energy is stored when the particle is at rest near the observer, transitioning to a purely kinetic form equal to the particle's escape energy when it approaches R_h. In other words, a particle's gravitational coupling to that portion of the Universe with which it is causally connected appears to be the origin of rest-mass energy.

M87 is a giant elliptical galaxy in the Virgo cluster of galaxies. The radio source has a core which coincides with the nucleus of the galaxy and a jet of emission which is detected from radio to X-ray bands. A supermassive black hole is assumed to be at the centre of M87 which sends out relativistic particles in the form jets along its axis of rotation. Relativistic particles accelerated in a magnetic field, give out synchrotron radiation. The centre is surrounded by an accretion disc, which is the closest that we can probe into a black hole. High resolution observations are needed to examine the nature of the radio emission closest to the centre of M87. An array of millimetre-band telescopes across the globe were used as an interferometer, called the Event Horizon Telescope, (EHT) to probe the nuclear region. The angular resolution of this interferometer array is 25 microarc sec, at a wavelength of 1.3mm and the data was carefully calibrated and imaged. The resulting image shows an asymmetric ring which is consistent with the predictions of strong gravitational lensing of synchrotron emission from hot plasma near the event horizon. In this paper, we review the results of the observations of the radio galaxy, M87, using the Event Horizon Telescope

(1) Background: Most patients with mycosis fungoides (MF), a form of cutaneous T-cell lym-phoma (CTCL), develop relapsed/refractory (R/R) disease following front-line systemic therapy. This report describes treatment patterns and outcomes from the subpopulation with R/R MF. (2) Methods: This observational, retrospective, cohort study analysed patient records (1984–2016) from 27 clinical sites in Eurpe. Outcomes included treatments received, response to first-, second- and third-line treatment, overall survival (OS), and progression-free survival (PFS). (3) Results: Of 104 patients with MF, 100 received second-line and 61 received third-line therapy. Median (range) times from start of first-line therapy to first R/R MF and from first to second R/R MF were 11.2 (0.3–166.5) and 13.5 (0.0–174.6) months, respectively. Second-and third-line treatment options varied and comprised systemic therapies (85% and 79% of patients, respectively), radio-therapy (32% and 34%, respectively) and topical therapies (48% and 36%, respectively). Median (95% confidence interval [CI]) OS from the diagnosis of first R/R MF was 11.5 (6.5–not reached [NR]) years and was higher with non-chemotherapy (NR) versus chemotherapy (6.5 years); es-timated median PFS (95% CI) from the time of first R/R MF was 1.3 (1.0–2.1) years. (4) Conclu-sion: High rates of R/R disease were observed after second- and third-line treatments in this re-al-world cohort, with longer median OS in patients receiving non-chemotherapy versus chemo-therapy. Following the standard management of MF and using recently approved targeted therapies can help improve patient outcomes in advanced-stage MF.

In New Orleans, Louisiana the population’s poor baseline health led to its establishment as an early epicenter for severe acute COVID-19. Antici-pating future outbreaks of COVID-19 and other respiratory viruses, we need to identify correlates of outcome, from real clinical experience. 89 patients were recruited into the ClinSeqSer acute COVID-19 longitudinal observational study, from the beginning of the outbreak in March to July 2020. Patients admitted for acute COVID-19 were enrolled in person. The cohort is unique as it is 68% Black, 53% female, of average age of early 60s, and prevalence of obesity and hypertension respectively of 55% and 83%. The outcomes are: 53% severe (20% fatal, 33% non-fatal) and 47% non-severe, with severe defined as death or requiring mechanical ventila-tion or high flow oxygen. Obesity and admit systolic blood pressure (SBP) >140mmHg are each associated with severe outcome and, despite respective sensitivity of 71% and 76%, specificity ~66% for both, and ac-curacy of 60% and 70% by ROC analysis, would likely provide useful predictors of outcome in critically stressed health care systems. We discuss pathophysiologic hypotheses to explain why high admit SBP is observed only in half of patients with pre-COVID hypertension and is associated with severe outcome.

The lightcone gauge is a set of what are called the observational coordinates adapted to our past lightcone. We develop this gauge by producing a perturbed spacetime metric that describes the geometry of our past lightcone where observations are usually obtained. We connect the produced observational metric to the perturbed Friedmann-Lema\^itre-Robertson-Walker metric in the standard general gauge or what is the so-called 1+3 gauge. We derive the relations between these perturbations of spacetime in the observational coordinates and those perturbations in the standard metric approach, as well as the dynamical equations for the perturbations in observational coordinates. We also calculate the observables in the lightcone gauge and re-derive them in terms of Bardeen potentials to first order. A verification is made of the observables in the perturbed lightcone gauge with those in the standard gauge. The advantage of the method developed is that the observable relations are simpler than in the standard formalism, and they are expressed in terms of the metric components which in principle are measurable. We use the perturbed lightcone gauge in galaxy surveys and the calculations of galaxy number density contrast. The significance of the new gauge is that by considering the null-like light propagations the calculations are much simpler due to the non-consideration of the angular deviations.

The main foundations of the standard $\Lambda $CDM model of cosmology are that: 1) The redshifts of the galaxies are due to the expansion of the Universe plus peculiar motions; 2) The cosmic microwave background radiation and its anisotropies derive from the high energy primordial Universe when matter and radiation became decoupled; 3) The abundance pattern of the light elements is explained in terms of primordial nucleosynthesis; and 4) The formation and evolution of galaxies can be explained only in terms of gravitation within a inflation+dark matter+dark energy scenario. Numerous tests have been carried out on these ideas and, although the standard model works pretty well in fitting many observations, there are also many data that present apparent caveats to be understood with it. In this paper, I offer a review of these tests and problems, as well as some examples of alternative models.

This paper examines the fundamental distinctions and complementary relationships between generative and descriptive methods in research and analysis. Through a systematic review of their applications across various fields, we explore how descriptive methods excel in capturing and characterizing existing phenomena, while generative methods enable the creation of new instances based on learned patterns. The analysis reveals that while these approaches serve different primary purposes, their integration often leads to more robust and comprehensive research outcomes. Our findings suggest that understanding the strengths and limitations of both methodologies is crucial for researchers and practitioners in choosing appropriate approaches for their specific contexts.

We conducted a monocentric observational study aimed at evaluating the pharmaceutical service provided at a Community Pharmacy (C.PH.) during pandemia in our Puglia Region in the period from 29.12.2021 to 12.03.2022 on 550 patients of various ages, sexes, and with concomitant diseases. We collected anamnestic data and any post-vaccination adverse reactions. Interviews with the integrated EQ5 method on evaluating the quality of the service offered and any therapy preference were also performed. As expected, the vaccines were reactogenic after the first dose in the patients with mild-moderate reactions with younger age and female gender as risk factors. Immune-allergic reactions of moderate-severe degree were observed in adult females. In the elderly, the vaccination procedure was well tolerated. Comirnaty showed a favorable O.R.<;1 vs other vaccines. No myocarditis and thromboembolic events in our population were observed. All treatments in May 2023 were correlated with a viremia trend, Paxlovid was prescribed in 3% of the patients in our center and in 1.46% in the Puglia Region with no effects in the hospitalization. It was distributed/dispensed by a novel on behalf of third parties distribution/dispensation (D.P.C.) protocol by the C.PH. The C.PH. resulted in a safe vaccination center providing appropriate patient inclusion during vaccination.

The world is in the grips of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increase concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D [25(OH)D] concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome, and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D₃ for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40–60 ng/ml (100–150 nmol/l). For treatment of people who become infected with COVID-19, higher vitamin D₃ doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.

With reference to Planck scale Hubble parameter, super luminal expansion speeds, super luminal rotation speeds, Mach’s principle and Holographic principle, we review the current cosmological observations with eight simple assumptions. By understanding Yuri N. Obukhov and V.A. Korotky proposed cosmic rotational effects of polarization of radiation due to massive bodies, to some extent cosmic rotation can be deep-rooted in an observational approach and the ratio of current angular velocity and Hubble parameter can be estimated. It is possible to show that, at H₀ =70 km/sec/Mpc, current cosmic temperature, age, radius, mass, mass density are 2.721 K, 4.41x10¹⁷ sec, 90 billion light years, 1.14654x10⁵⁴ kg, 0.0482 times the current critical density respectively. Clearly speaking, current universe seems to constitute 267 Hubble spheres. Important point to be noted is that, current rotational kinetic energy is 0.6667 times the current critical energy. Based on the estimated current mass density and current rotational kinetic energy, current cosmic dark matter density can be shown to be 0.2851 times the current critical density. These numerical coincidences cast serious doubt on the on the real existence of currently believed ‘dark energy’. Initial and current expansion speeds are 3x10⁸ m/sec and 3.56x10⁹ m/sec respectively. With increasing cosmic age and increasing cosmic expansion speed, current universe is expanding with a speed of 11.885c. By knowing the time to time future cosmic temperatures, future Hubble parameters and corresponding future cosmic expansion speeds can be estimated and thus future expansion speed can be understood. Starting from ‘speed of light’, our model assumes a continuous increase in expansion speed and attains a current radius of 90 billion light years (without inflationary concepts) and casts a serious doubt on the actuality of currently believed ‘inflation’.