Volunteering has many social, emotional and health benefits and could be an option for people with younger/early onset dementia to engage in stage and age-appropriate, personally meaningful activities within their local communities. This study explored how people with young onset dementia volunteer in the UK, the benefits and barriers, and how we can improve access to volunteering opportunities. Audio data of people with young onset dementia discussing their experiences of volunteering were taken from the Dementia Diaries audio and video diary project (https://dementiadiaries.org/). The data were co-analysed by a co-production team, (X), made up of six researchers living with young onset dementia and two facilitators. The findings suggest that stigma is the overarching concept (or net) which influences people’s experiences of volunteering with dementia. Within the stigma net, three themes were developed that employed a lifespan approach to challenging said stigma: 1) Valuing the past, 2) Valuing the present and 3) Valuing the future, each with additional subthemes. This research contributes to the limited pool of literature that highlights the clear benefits of volunteering for people with young onset dementia, while also considering how dementia stigma can create practical and institutional barriers to accessing volunteering. Guidance is provided for how to deliver meaningful and accessible volunteering opportunities.

Recent epidemiologic studies have revealed an upward trend in young-onset colorectal cancer (YOCRC) overall, whereas specific data on young-onset colorectal neuroendocrine neoplasms (YONEN) remain limited. This study investigates demographic characteristics and survival trends in YONEN and compares these with those of young-onset colorectal adenocarcinoma (YOADC), the most common histologic subtype of YOCRC. A retrospective analysis was conducted from 2000 to 2019 using the Surveillance, Epidemiology, and End Results (SEER) database. Survival outcomes were assessed using univariate and multivariable Cox proportional models, with demographic differences evaluated via Wilcoxon Rank Sum and Chi-square tests. Out of 61,705 patients aged 20-49 with colorectal cancer, 8% had NEN, and 92% had adenocarcinoma. The YONEN cohort had a higher proportion of Black patients and a lower proportion of White patients than the YOADC cohort (21% vs. 13% and 44% vs. 57%, respectively). NEN was more commonly found in the rectum (79%), and adenocarcinoma was mostly colonic (57%) in origin. YONEN patients had better survival than YOADC patients. Multivariate analysis in YONEN patients revealed that Hispanic patients had better overall survival compared to White patients (HR 0.67, 95% CI 0.47-0.95, p=0.024). Racial disparities should be investigated further to aid in policymaking and targeted interventions.

(1) Background: Patients with type 2 diabetes mellitus (T2DM) are at higher risk of cancer but how these two diseases associate is still debated. The goal was the assessment of the overall incidence of cancer among patients with newly diagnosed T2DM in Hungary. Summarizing, incident T2DM is associated with a significantly higher overall risk of incident cancer, with a reverse correlation of age. Newly registered T2DM patients were suggested to be screened for cancer within 6 months. (2) Methods: A nationwide, retrospective, longitudinal study was performed using a Hungarian database. The incident T2DM and diabetes free Hungarian population were included in the study. The primary endpoints were the overall and site-specific incidence and annual percentage change of the incidence of cancer in both populations. (3) Results: The overall incidence of cancer in patients amounted to 29.4/1000 and 6.6/1000 with or without T2DM, respectively, and the OR (95%CI) of cancer of the T2DM group was 4.32 (4.14-4.53), p<0.0001. The risk of having cancer was age-dependent, having the highest odd in the age group 18-39. The incidence of cancer was declining in the non-diabetic but was unchanged in T2DM population. The average lag time of diagnosing a cancer after the detection of T2DM was 3.86 months.; (4) Conclusions: Iincident T2DM is associated with a significantly higher overall risk of incident cancer, with a reverse correlation of age. Newly registered T2DM patients were suggested to be screened for cancer within 6 months.

Introduction: Maturity-onset diabetes of the young (MODY) represents the most frequent form of monogenic diabetes mellitus (DM), currently classified in 14 distinct subtypes according to single gene mutations involved in the differentiation and function of pancreatic β-cells. Case report: The female patient at the age of 16 years old was diagnosed with non-autoimmune DM with glycated haemoglobin (HbA1c) value of 6.5%. After 6 years of dietary and lifestyle interventions due to the worsening of the glycometabolic profile, oral hypoglicemic therapy was initiated including at first only metformin, and subsequently also sulfonylureas and DPP-IV inhibitor. 11 years after diagnosis glargine insulin was started, associated 3 years later with Lispro insulin because of the worsening of the post-prandial glycaemia. According to the genetic testing a compound heterozygosis of two novel variants of uncertain/unknown clinical significance of BLK and RFX6 genes, respectively c.1013T>C (Ile338Thr) and c.1072G>A (Val358Ile), was identified. The RFX6 variant was also detected in the patient’s mother genome, while the BLK variant in her father’s. Discussion: Up to 11% of MODY has unknown etiology, suggesting that the genetic landscape is still to be explored. Recently, novel causal genes, involved in the differentiation and function of β-cells, have been identified such as RFX6, NKX2.2, NKX6.1, WFS1 and PCBD1. Genetic and clinical features of MODY variants remain highly heterogeneous, with no direct genotype-phenotype correlation especially in the low-penetrant subtypes. Thus, the aim of our paper is to present additionally to such rare case of a compound heterozygosity BLK/RFX6 underlying MODY, also a brief review of literature focused on the rare and reduced-penetrant variants, as well as on some controversies regarding this subtype of monogenic diabetes. Conclusions: Due to the limited data available, the assessment of MODY related-genes pathogenicity remains challenging especially in the setting of rare and low-penetrant subtypes. In consideration of the crucial importance of an accurate diagnosis, prognosis and management of MODY, more studies are warranted to further investigate its genetic landscape, the genotype-phenotype correlation, as well as the pathogenetic contribution of the non-genetic modifiers in this cohort of patients.

This is growing recognition of early onset gastrointestinal (GI) malignancies in young adults

Chilling injury (CI), which causes seed browning in pepper, may arise following long-term cold storage, and is a major cause of postharvest losses. To explore potential strategies of minimizing the associated postharvest losses, the present study investigated the optimal pepper harvest time that could reduce levels of seed browning, in addition to the relationship between fruit maturity and seed browning. Fruit harvested 15 days after flowering (DAF) were sensitive to cold storage at 4°C and exhibited 100% seed browning (CI index, 4.0); in contrast, the seed browning rate of fruit harvested 35 DAF was 10% (CI index, 0.4) within 7 d of cold storage. Seed antioxidant activity was higher in seeds harvested at early stages (15 DAF to 20 DAF) than in seeds harvested at later stages (40 DAF to 50 DAF) at the beginning of storage. Pericarps of fruit harvested at 50 DAF exhibited the highest antioxidant activity. Lipoxygenase, catalase, and peroxidase activity, and the expression levels of cell wall-related genes, pectin methylesterase-like protein, and endo-β-1,4-glucanase were higher in seeds of immature fruit harvested 15 DAF than in seeds of mature fruit harvested 35 DAF. The endosperm separated from the seed coat in fruit harvested 35 DAF and the seeds did not brown under low-temperature storage. The lack of seed browning observed in mature fruit under low-temperature storage could be attributed to physical protection provided by the seed coat rather than cold stress resistance conferred by antioxidants.

Young dementia carers (YDCs) rarely receive appropriate training and support. Their visibility and identification remain dangerously low and as a consequence, support initiatives being developed are failing to reach them. This study explored the success (or failure) of YDCs identification pathways as well as the barriers and enablers to their implementation. An explorative qualitative approach was followed drawing on the experiences of parents of YDCs, dementia researchers, professionals in the field of dementia/young carers and young adult carers. Data collection involved semi-structured interviews (n=17) and a participatory 2-hour workshop to discuss and critique preliminary themes as well as explore strategies to increase the visibility and identification of YDCs. Five themes were identified: A ‘whole family approach’ (as a pathway to identification); ‘Not a carer’ (self/family identification); A postcode lottery (high variability of support services); Tailored support that is ‘fit for purpose’ and the ‘power’ of peer support. Recommendations on potential initiatives and actions that can help raise awareness and increase identification success of YDCs are proposed. Our findings support the need for a broad and holistic approach to the identification of YDCs that runs alongside the development of support initiatives that are accessible and relatable. The support itself will play a role in improving subsequent identification or hindering it if not ‘fit for purpose’.

Cardiovascular diseases are one of the leading causes of death in the world. The capability to direct the differentiation of human pluripotent stem cells (hPSCs) into functional cardiomyocytes (CMs) provides excellent opportunities for disease modeling and novel cell-based cardiac therapies. However, current hPSC-derived cardiomyocytes (hPSC-CMs) remain largely immature, limiting experimental and clinical uses. New insights into the maturation process of adult-like hPSC-CMs are critical. In this paper, we developed a data-driven pipeline to quantify cell maturity, based on gene expression input spanning different stages of cardiac development. First, we determined that culture time can serve as a proxy of the maturity level of hPSC-CMs. Second, we selected key heart-related genes whose expression varies with culture time, based on machine learning algorithms that are applied to accurately predict culture time. Our results demonstrate that the average discrepancy between the predicted culture time and the observed culture time can be reduced to 4.461 days. Furthermore, Gene CASQ2 (Calsequestrin 2), whose protein plays a role in the storage and transportation of calcium ions, has been identified as the most important cardiac gene that correlates with the culture duration.

Young women with breast cancer represent 15% of cancer cases in Latin America. Genomic studies have found that early-onset breast-cancer cases exhibit a higher genetic susceptibility and a specific genomic signature as compared to their older counterparts. The aim of this study was to describe clinically relevant germline mutations in a cohort of young women with breast cancer. To achieve this, we analyzed hereditary-cancer genes from whole-exome sequencing data in 108 unrelated women with an extreme phenotype of breast cancer (≤40 years of age), diagnosed and treated at the National Cancer Institute of Mexico; 11% of the patients carried a pathogenic variant. BRCA2 comprised 46% of the mutations, followed by BRCA1 with 23%; PALB2 with 15%; and TP53 and RAD51C with 8 % each. This article describes a novel pathogenic mutation in RAD51C c.519dupT. The median age at diagnosis was 35 years overall; however, it was six years younger in patients with mutations. Age at diagnosis (OR=0.82, CI 95% 0.71-0.94; P= 0.008) and first-degree family history of cancer (OR=8.26, CI95% 1.35-50; P= 0.022) were the only epidemiological variables associated with mutational status. We found no differences in disease-free survival (p=0.403) or overall survival (p=0.735) among mutational status subgroups.

The landscape of business intelligence (BI) is marked by rapid growth, extensive research, and practical implementations, reflecting its sustained relevance in modern business strategies. This paper delves into the dynamics of BI, particularly focusing on the interplay between maturity and agility. While BI maturity emphasizes optimization and predefined goals, BI agility prioritizes adaptability and response to change. The paper highlights the contradictions between these concepts, emphasizing the need for a balanced approach in BI strategy formulation.The role of organizational culture in fostering BI agility is explored through literature review and interviews with BI professionals. Key insights include the necessity of an open culture for effective BI utilization, clear strategic vision, decision delegation, information sharing, business-IT cooperation, and a learning-oriented mindset. These cultural factors contribute significantly to BI effectiveness and the ability to navigate dynamic business landscapes. The paper proposes pillars of agile maturity supported by an open organizational culture, including efficient communication, information integration, creative problem-solving, and close collaboration between business and IT. These pillars underscore the importance of a flexible and open mindset in navigating BI challenges and ensuring sustained value. Empirical validation and further research are suggested to deepen our understanding of the impact of organizational culture on BI agility and effectiveness.

Background: Neonatal sepsis associated with severe morbidity and mortality defines the systemic condition arising from the bacterial, viral, fungal origin associated with hemodynamic and clinical alterations. Symptomatology can be different, from subclinical to severe, focal or systemic disease. The causal agent comes from maternal flora or can be of community/hospital origin. Material and method: Our retrospective study evaluated 121 newborns (both preterm and term), divided into three groups: early onset sepsis (35), late onset sepsis (39), and control group (47), from 0 to 28 days old. Blood samples and cultures were collected at admission, after 24 hours, and 72 hours. Results: The two-sample Wilcoxon signed rank test revealed a statistically significant difference between the initial and final measures of lactate dehydrogenase (LDH) and ferritin within the early onset sepsis (EOS) and late onset sepsis (LOS) groups. No significant differences were observed for those two variables within the control group. There were significant differences for first and last measurements of C-Reactive Protein (CRP) (p = 0.029), leukocyte count (p = 0.002), and platelets (TR) (p = 0.00001). Conclusions: Ferritin is a potential biomarker that can be associated with systemic response and sepsis in both cases of early and late onset sepsis.

The present research project entitled "Development of a method for predicting the optimal maturity level of avocado using machine learning" aims to establish an accurate and efficient approach to assess the maturity of avocados using machine learning methodologies. This research specifically focuses on identifying the relevant physical and chemical characteristics of avocados, creating a dataset containing categorized images of maturity levels, and creating machine learning models capable of accurately predicting fruit maturity. The studies reveal that the application of machine learning, in particular convolutional neural networks and multisensor models, has the potential to transform the prediction of avocado maturity and thus improve product quality and customer satisfaction. The findings indicate that the proposed techniques achieve an accuracy rate of over 90%, demonstrating their viability for integration into mobile applications that can benefit growers and suppliers in their decision-making processes.

This paper examines the use of business maturity models as a tool for achieving business maturity and improving organizational performance in a rapidly changing business environment. Specifi-cally, the paper evaluates existing maturity models and methodologies, analyzes their effective-ness, and develops a novel and enhanced model tailored to the oil and gas sector. The authors highlight the importance of considering fundamental factors that underlie the implementation of maturity models and the need to evaluate their fit with organizational goals and values. The pa-per concludes by emphasizing the ongoing nature of business maturity and the effectiveness of theproposed Business Maturity Framework (BMF) model in enhancing operational excellence, competitiveness, and sustainable growth in the oil and gas industry. The paper makes a notable contribution to the specialized literature precisely through the differ-ent approaches to the business maturity process and through the proposed business maturity model itself as a base of strategy formulation, which includes a new dimension. This dimension analyzes whether the market and customers are ready for the level of digitization that the com-pany wants to achieve in a future state.

Early-onset colorectal cancer (EOCRC) is defined as a diagnosis of colorectal cancer (CRC) in individuals younger than 50 years of age. While overall CRC rates in the United States (US) decreased between 2001 and 2018, EOCRC rates have increased. This research project aims to evaluate the feasibility and acceptability of Time-Restricted Eating (TRE), Mindfulness, or TRE combined with Mindfulness among young to middle-aged adults at risk of EOCRC. Forty-eight participants will be randomly assigned to one of four groups: TRE, Mindfulness, TRE & Mindfulness, or Control. Data on feasibility, adherence, and acceptability will be collected. Measures assessed at baseline and post-intervention will include body weight, body composition, dietary intake, physical activity, sleep behavior, circulating biomarkers, hair cortisol, and gut microbiome. Effects of the intervention on the following will be examined: 1) acceptability and feasibility; 2) body weight, body composition, and adherence to TRE; 3) circulating metabolic, inflammation, and oxidative stress biomarkers; 4) intestinal inflammation; and 5) the gut microbiome. TRE combined with Mindfulness holds promise for stress reduction and weight management among individuals at risk of EOCRC. The results of this pilot study will inform the design and development of larger trials aimed at preventing risk factors associated with EOCRC.

The company strategic procurement function makes a significant contribution to overall corporate success, and yet remains under-researched in terms of digitalisation and digital maturity. This research adopts an inductive case study approach, using qualitative data from in-depth inter-views with industry practitioners, to develop and apply a digital maturity model for the deployment of strategic procurement analytics. The research presents a snapshot of the digital maturity of the strategic procurement function of a global aircraft manufacturer, and finds that current exploitation of analytics remains constrained by a range of factors, including the need for close compliance with regulatory norms. Thematic analysis of the interview material provides the basis for the development of the maturity model, which - although geared to a specific industry context - is nevertheless of relevance in other business environments. The research thus con-tributes to the existing literature in this field, and will also be of interest to procurement professionals. However, the research clearly has its limitations, not least in that it is based on just one industry case, and cross-industry generalisations from the findings must therefore be treated with caution.

Approximately 20% of patients with colorectal cancer (CRC) are diagnosed with a mucinous subtype of this tumor, have a worse prognosis, and often show resistance to available therapies. Molecules from the mucin family are involved in the regulation of epithelial-mesenchymal transition (EMT), which significantly determines the cancer aggressiveness. This study aimed to examine the diagnostic and prognostic significance of mucinous histology and EMT markers in patients with early-onset CRC and their association with disease severity and tumor characteristics. The study included tumor tissue samples from 106 patients diagnosed with CRC before the age of 45, 53 with mucinous and 53 with non-mucinous tumors. The EMT status was determined by immunohistochemical analysis of E-cadherin and Vimentin in tissue sections. Mucinous tumors had a significantly higher cytoplasmic E-cadherin score (P=0.043), they were significantly less differentiated (P=0.007), more advanced (P=0.005), and predominately affected right colon (P=0.030) in comparison to non-mucinous tumors. Epithelial tumors were significantly better differentiated (P=0.034) and with less prominent tumor budding (P < 0.001) than mesenchymal tumors. The process of EMT appears to be more prominent in tumors of younger patients regardless of mucinous histology. EMT status may represent a useful prognostic tool in early-onset CRC.

The aim of this study was to determine the potential of early inflammatory markers to diagnose late-onset neonatal sepsis - procalcitonin (PCT), interleukin 6 (IL-6), interleukin 8 (IL-8) and endocan (ESM-1), and to compare them with routinely used markers. A prospective (January, 2022 – January, 2023) clinical-epidemiological study was conducted in a third level NICU in Pleven, Bulgaria. Patients with suspected nosocomial infection and healthy controls were tested. A sandwich ELISA method was used to measure the serum concentrations. Sixty newborns with an average gestational age of 29.75 ± 3.61 gestational weeks were included, of which 35 % were symptomatic and infected, 33.3 % were symptomatic but uninfected, and 31.7 % were asymptomatic controls. The mean values of PCT, IL-6, I:T index and PLT differ significantly in the three groups. For ESM-1, IL-8 and CRP, the difference was statistically insignificant. The best sensitivity (78%) and negative predictive value (84%) was found for IL-6. The combination of PCT + IL-6 + I:T+ PLT demonstrated high precision (78%) and best sensitivity (94%) and negative predictive value (95%). The introduction into routine practice of indicators such as PCT and IL-6 may provide an opportunity to promptly optimize the diagnostic and therapeutic approach to LOS.

The fishery biology of the invasive Atlantic blue crab Callinectes sapidus in the Mediterranean Sea outside the eastern sectors of the basin has been only recently investigated. Here we studied the population of C. sapidus in the Lesina Lagoon (Adriatic Sea, SE Italy). In total, 838 crabs were captured monthly between February 2021 and January 2022 using fyke nets. Abundances varied seasonally with catches per unit effort ranging between 0 and 1.76 crabs fyke nets-1 d-1 in winter and summer. Spatial abundances estimated in summer by a Carle-Strub procedure ranged between 0.06 and 0.64 crabs m-2. Sex ratio (♂/♀) was close to 1:1; males prevailed only in August and September; ovigerous females occurred from April to August. Males’ size at morphological maturity was smaller than females (110.6-112.3 mm vs. 122.1-123.1 mm). Seasonal von Bertalanffy growth parameters indicated that, compared with males, females showed a shorter maximum lifespan (5 vs. 8 years), a higher growth coefficient K (0.6 vs. 0.4 y-1) and growth performance index ' (4.6 vs. 4.3), while maximum sizes CW∞ (237.8 vs. 232.6 mm) and seasonality indices C (0.62 vs. 0.57) were similar. Furthermore, females showed higher natural and fishing mortalities and exploitation rate. We discussed the results of the present study in the context of the available literature to provide a valuable basis for the implementation of standardised Mediterranean-scale management plans, matching exploitation of C. sapidus with sustainable conservation of coastal ecosystems.

The purpose of this study was to compare players anthropometric (AP) and body composition (BC) characteristics between different maturity bands (pre-PHV, circa-PHV, post-PHV)) in youth elite football. This study considered 320 male football players (mean age 13.8 y.) from U14 (n=157) and U15 (n=163) age-groups. The Khamis-Roche method was used for calculating the percentage of predicted adult height (PAH) at the time of observation based on which the players were further divided into maturity bands (pre-PHV ≤ 87%, circa-PHV = 88-95%, post-PHV > 95%). Height and weight were measured, body mass index (BMI), fat free mass (FFM), total body water (TBW), body fat mass (BFM), percentage of body fat (%BF), skeletal muscle mass (SMM), FFM of both upper limbs and lower limbs and FFM of trunk were estimated according to In-body 270. All observed AP and BC characteristics differed between maturity bands (F= 139.344 – 7.925; p< 0.001; large effect sizes) except the BFM (F= 2.998; p=0.051; small effect size). Current somatic maturity stage of athletes should be considered while evaluating BC results, otherwise there is a risk of misinterpretation.

Coronavirus disease 2019 (COVID-19), an infectious disease pandemic, affected millions of people globally, resulting in high morbidity and mortality. Causing further concern, significant proportions of COVID-19 survivors suffer from the lingering health effects of severe acute respiratory syndrome virus 2 (SARS-CoV-2), the pathogen that causes COVID-19. One of the diseases manifesting as a post-acute sequela of COVID-19 is new-onset diabetes. This systematic review and meta-analysis will perform a comprehensive and systematic literature search to estimate the burden of new-onset diabetes after COVID-19. Specifically, this study will estimate the magnitude of the incidence, risk, and population-attributable fraction of new-onset diabetes. The study will also explore and summarize the data on the natural history or clinical course of the new-onset diabetes cases. Five bibliographic databases, including PubMed, MEDLINE, Embase, Scopus, and Web of Science, will be searched for eligible studies. The World Health Organization COVID-19 Research Database, preprint servers, and conference abstracts will also be searched. Cohort studies of COVID-19 patients of all ages providing data on new cases of diabetes in the post-acute phase of the illness will be included. The comparators to estimate the pooled risk ratio will be those with no diagnosis of COVID-19 or those infected with other respiratory tract infections. The findings of this study will likely inform clinical practice, public health guidelines, and policies for early detection and treatment of new-onset diabetes cases in the long-COVID phase. This protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO: No.CRD42020200432).

This prospective single-center study was designed to assess the clinical utility of the FilmArray® blood culture identification (BCID) panel for improving the diagnostic accuracy in neonatal sepsis. Results obtained using the FilmArray® BCID panel were correlated with results of blood culture in all consecutive neonates with suspicion of early-onset (EOS) and late-onset sepsis (LOS) attended in our service over a 2-year period. A total of 102 blood cultures from 92 neonates were included, 69 (67.5%) in cases of EOS and 33 (32.3%) in LOS. The FilmArray® BCID panel was performed in negative culture bottles at a median of 10 hours of blood culture incubation (range 7.5-20 hours), without differences by the type of sepsis. The FilmArray® BCID panel showed a 66.7% sensitivity, 100% specificity, 100% positive predictive value, and 95.7% negative predictive value. There were four false-negative cases, three of which of Streptococcus epidermidis in neonates with LOS and one case of Granulicatella adiacens in one neonate with EOS. We conclude that the use of the FilmArray® BCID panel in negative blood cultures from neonates with clinical suspicion of sepsis is useful in decision-making of starting or early withdrawal of empirical antimicrobials because of the high specificity and negative predictive values of this assay.

Green ICT has received significant attention in organizations to reduce global warming since last decade. Several maturity models have been proposed for tracking green ICT practices in organizations. Current literature shows that SMEs around the world try to follow some common strategies such as virtualization, consolidation of devices, energy efficiency and disposal of ICT equipment for greening ICT. The increasing interest for green ICT practices in organizations is not only due to the desire to attain environment-friendly atmosphere but mainly because of sustaining business goals such as cost reduction, competitive advantages and stakeholders’ pressure. Nevertheless, due to the lack of green ICT knowledge, organizations, specially SMEs, tend to ignore those practices. Therefore, this research proposes a framework that provides combination of existing green and sustainable ICT maturity models by mapping them with the strategies the businesses are already following. Out of this framework, a web application has been developed that provides questionnaire for SMEs to identify their present situation of green ICT practices and guidelines for improvement. The results have been analyzed by testing the application in some SMEs of Finland and Bangladesh. Finally, a survey has been conducted to attain SMEs’ perception about the possibility of sustainable development of businesses through this application.

The research investigates the role the environmental manager plays to ensure a successful (or not) implementation of environmental performance within an organization. It is based on interviews of 5-7 actors per company within a sample of 7 companies (42 interviews). We build upon bias of perception of the various actors interviewed within each company to define 4 paradoxes related to the roles and mission of the environmental manager that hinder proper efficiency of environmental management at company level. Paradox 1 is that no one takes ownership of environmental performance within the organization. Paradox 2 is that the environmental manager is in an awkward situation vis-à-vis his boss. Paradox 3 is that the role of the environmental manager is ambiguous vis-à-vis employees. Paradox 4 is that corporate and product approaches are decoupled. We suggest that these paradoxes interact and form a vicious cycle that may in part be responsible for the environmental decoupling phenomenon – the fact that companies often adopt a sustainability policy symbolically without implementing it substantively. Our research suggests that, by leveraging the leadership of the environmental manager through organizational and motivational measures, the vicious cycle can be transformed into a virtuous cycle and the human motivation can become a driver for green change within corporations. We proposed the SEA (Shaping Environmental Action) model based of 4 pillars: information, motivation, organization and strategy.

One widely used method to predict concrete strength development based on temperature variations during curing is the equivalent maturity time (te) method. This method uses the activation energy (Ea) as its key parameter, which reflects the cement’s sensitivity to temperature. However, research shows that the Ea value varies depending on factors such as cement type, water-cement ratio, temperature, and additives. The permanent subject of discussion is the question of what value of the Ea parameter should be assumed. In this paper, a new approach is proposed by using a neural network analysis method to develop a strength-temperature-time history model. It was assumed that the ANN-fc% model would have 4 inputs including hydration heat (Q), activation energy (Ea), temperature (T) and time (t). A data set was collected and research was carried out on mortars using: 6 cements, curing temperatures 5-35°C, strength within 90 days. The results showed that the ANN analysis method allows for estimating the relative compressive strength with sufficient accuracy. Input nodes analysis showed that Q influences early strength gain, while Ea affects later strength development. The method of using the ANN model to calculate strength depending on the temperature change during maturation was shown.

In the early stage of new vehicle development, the requirements of maximum performance of the air conditioning (AC) system are obtained through Amesim software simulation, but the calibration control of the AC system is usually carried out in the prototype-build vehicle test stage, and the test time is spanned up to 10 months after spring (autumn), summer and winter, of which up to 2 months are for environment chamber tests. Due to the long calibration cycle of AC control in the road test, which seriously affects the vehicle launch time, virtual calibration technology of air conditioning system is developed to shorten the calibration cycle of AC systems and ensure the quality of vehicles. In the project development stage, the calibration control of the vehicle AC system can be realized to carry out the functional test of the AC system in advance. In that, the grade of maturity for the AC system control can be improved, the on-road calibration test cycle can be shortened, and the development cost can be saved.

Diagnosis of neonatal sepsis is difficult as signs and symptoms are nonspecific. Interleukin-6 (IL-6) is a promising marker for neonatal sepsis. We aimed to test the accuracy of IL-6 in term and preterm infants after 72 hours of life (late-onset sepsis-LOS). We searched for IL-6 diagnostic accuracy studies between 1990 and 2020 using the PubMed database. Study selection was performed. The range of reported IL-6 sensitivities and specificities was 68% to 100% and 28% to 100%, respectively, the median values were 85.7% and 82% from 15 studies including 1306 infants. Subgroup analysis was performed. Sensitivity (87% vs 82%), but not specificity (both 86%), was better in preterm infants than in preterm and term infants. Early sample collection had the highest sensitivity (84%), but the lowest specificity (86%). To assess quality we used a STARD checklist adapted for septic neonates. Limitation of this review include the heterogeneous group of studies on the one side and the small number of studies on the other side that analyzed different combinations of biomarker. We concluded that IL-6 had a good performance especially in the preterm infant population and best results are achieved by measurements at the time of LOS suspicion.

Studies have shown that COVID-19 patients with prediabetes frequently present with high plasma glucose levels on hospital admission. However, whether the glycemic abnormalities are temporary or persist after recovery from the illness is unclear. We conducted a prospective cohort study of 69 COVID-19 patients with prediabetes (HbA1c 5.7-6.4%) who were admitted to a tertiary care hospital in Chennai, India, from May to October 2020 and were discharged alive. Over a mean follow-up of 146.6 (SD: 72.5) days, the mean fasting plasma glucose rose by 16.8 mg/dl (from 119.3-136.1 mg/dl), 2-hr post-prandial glucose by 61.0 mg/dl (from 176.2-237.2 mg/dl), and HbA1c by 0.6% (5.9-6.5%). Of the 49 (84.5%) patients who were discharged with glucose-lowering medications, 40 (81.6%) continued taking them at the first follow-up visit (mean of 50.1 days from admission), and 39 (79.6%) continued taking them at the second follow-up visit (mean of 114.3 days from first the follow-up visit). In addition, 12.1% of patients developed new-onset diabetes after recovery from the illness. Continuous monitoring of glycemia and detecting new-onset diabetes in COVID-19 patients with prediabetes after recovery are essential, as the metabolic effects of SARS-CoV-2 persist for several months.

A field study was conducted at the Eastern Mediterranean Agricultural Research Institute, Adana, Turkey, during the 2022/23 cropping seasons to examine the impact of Mepiquat chloride dosage applied at different intervals to optimize growth, yield characteristics enhancement and improve fiber quality attributes of cotton. The study employed a split-split plot design with three replications. The results revealed that differences among treatments were not statistically significant for most parameters investigated. The observed discrepancies indicated that all treatments tested in 2012 delayed cotton development, whereas in 2023, they led to premium fibers. In 2023, the fiber percentage was highest in the control treatment, and in 2022, it was highest at 400 mL·ha-1. Across all years, the Selin variety exhibited the highest fiber percentage when Mepiquat chloride was applied at the bolling stage. The shoot-root ratio was highest at 400 mL·ha-1 during harvest in 2022 and at 0 mL·ha-1 during the reproductive stage in 2023. Overall, the results demonstrated that the application of Mepiquat chloride altered the physiological characteristics of the cotton plants, leading to bottom-up effects on cotton performance. This implies that the effectiveness of Mepiquat chloride in cotton production to alleviate drought stress is influenced by weather-related conditions.

The morphology and maturation process of gonads of 70 Burmeister´s porpoises, with body lengths ranging 135–183 cm (n= 34 females) and 64.5-182 cm (n= 36 males) were described. Samples were collected in six ports of central and northern Peru in 1987-1999. In the field, females were classified as immature, mature (resting, lactating, pregnant) and males as immature, pubescent and mature based on, respectively, the presence of ovarian corpora and the relative quantity of semen in cut epididymides. The ovaries of P. spinipinnis are ovoid or bean-shaped and flattened, with corpora modifying surface appearance. In the laboratory, ovaries were examined macro- and microscopically, measured, weighed and sliced in 1-3 mm sections. The number of corpora ovarica (lutea, albicantia, atretica) found in each ovary as well as their macroscopic and microscopic characteristics were documented in some detail. The follicles, their oocytes and nucleus were measured. Follicular development in P. spinipinnis is predominantly left-sided, but occurs in both ovaries in 16.3% of females, mainly in those with numerous corpora. Macroscopically, several corpora atretica with luteinization had characteristics similar to those of corpora albicantia, making microscopic determination essential. Inconclusive evidence of recent ovulation was found in January. Two of three immature females showed good follicular development in March and April. The body length at 50% sexual maturity in females was estimated at 152.7 cm. There was no evidence of reproductive senescence. The testes of P. spinipinnis are elongated and cylindrical. Of the 36 males examined macroscopically, 7 were immature, 5 pubescent and 24 mature. The histological analysis determining the presence and abundance of Sertoli cells, spermatogonia, spermatocytes, spermatids and spermatozoa, the relative amount of interstitial tissue, the elongation and mean diameter of the seminiferous tubules and the relative size of the lumen allowed to confidently determine sexual maturity status. The field evaluation of maturity based on the presence of sperm in the epididymides is a useful but, in 8.3% of cases, not exact method. For males the body length at 50% sexual maturity was estimated at 157 cm. No histological evidence of male reproductive seasonality was found. Spermatogenesis was perceptible year-round and tubule diameters had non-specific variations for each month.

The maturity of tomato fruit is normally characterized by external color and it is often difficult to know when fruit have achieved commercial maturity or become over-mature. The internal structure of tomato fruit change during development and this study investigates the utility of nondestructive measurement of tomato fruit structure as a function of maturity using magnetic resonance imaging (MRI). The objective of this work is to use analysis of internal tomato fruit structural measurements to characterize maturity. Intact cherry tomato fruit were harvested at six different maturity stages. At each stage of maturity, the internal structure of the fruit was measured using a series of 2D magnetic resonance (MR) images. Qualitative and quantitative image analyses were performed to correlate internal fruit structure with maturity. Internal structural changes observed in the pericarp region of the tomato fruit are highly correlated with fruit maturity. MR image information combined with classical analysis techniques provides a more complete understanding of structure and physicochemical changes in tomato fruit during maturation. This study demonstrates that MRI is a useful analytical tool to characterize internal changes in agricultural produce as the produce matures. This technique can be applied to almost any agricultural produce to monitor internal physical changes due to external impact, maturity stage, variation in climate, storage time and condition or other factor impacting quality.

Introduction: Unlike cigarette smoking, secondhand smoke (SHS) has not been as well described as an environmental risk for Multiple sclerosis (MS) nor as a risk factor for disease progression. We systematically reviewed the association between SHS and the risk of onset and/or progression of MS.Methods: We systematically screened MEDLINE/PUBMED, Science Direct, LILACs, and SCIELO searching for publications between January 1st , 2010, and July 5, 2021 with the following keywords: “multiple sclerosis and smoking”; “multiple sclerosis and passive smoking”; “multiple sclerosis and secondhand smoking”. An 11-year filter was applied from 2010 to 2021. Results: Fifteen articles were included in this review, which consisted of systematic reviews with meta-analysis (N = 2), systematic reviews (N = 2), and observational studies (N = 11). Both meta-analyses reported an impact of SHS on MS onset among secondhand smokers. One of the systematic reviews selected two observational studies showing the association between SHS and MS development, and one study that did not find a significant association between SHS and the risk of MS development. The other systematic review identified selected eight articles showing a relationship between SHS and MS. Seven observational studies reported higher odds of MS onset when associated with SHS. Four observational studies did not show a relationship between SHS and MS onset or progression.Discussion: Most articles showed a positive association between SHS exposure and the risk of developing MS. On the other hand, an association between SHS and a higher risk for MS progression could not be established.

The COVID-19 pandemic in Indonesia makes a significant impact both physically and psychologically. One month after the President of the Republic of Indonesia announced about the COVID-19 patient cases, the Indonesian Child Protection Commission data during April 2020, depicted that 76.7% of children were not happy to participate in distance learning because 81.8% were only given assignments by the teacher and 73.2% felt they had a heavy task and had a short period of time to complete. This reaction is an indicator of the children’s anxiety about distance learning. The anxiety that occurs in these students is assumed to depend on their social support and emotional maturity. When students get optimal family support and are able to control their emotions in the face of a pandemic, they can reduce anxiety in facing online learning. The subjects of this study were 202 junior high and high school students. The results showed that social support and emotional maturity simultaneously affect anxiety in online learning (Freg = 45.066, p = 0.00 <0.01). These results can be used as a basis for providing psycho-education to increase family support and emotional maturity to reduce anxiety in online learning.

Objectives: To develop a multivariate model for risk factors specific to early onset preeclampsia (EOP) and late onset preeclampsia (LOP) in our entire population (singleton and twin pregnancies). Material and methods: 20 year-observational population-based historical cohort study (2001-2020). All consecutive births delivered at the Centre Hospitalier Universitaire Hospitalier Sud Reunion’s maternity. A standardized validated epidemiological perinatal data base. Results: During the 20-year period, there were 81,834 pregnancies and 83,555 infants born, 1232 dichorionic and 350 monochorionic twin pregnancies. There were 2120 cases of preeclampsia, of which 2001preeclamptic singleton pregnancies and 119 twin pregnancies (incidence 7.5% in twin pregnancies vs 2.5% singletons, OR 3.0, p<0.001). Independent risk factors for EOP and LOP in a multivariate model (controlling for the two major confounders: namely maternal ages -both risks for EOP and LOP- and maternal pre-pregnancy BMI – specific risk factor for LOP) were: history of preeclampsia (aOR 11.7 for EOP, 7.8 for LOP, p < 0.0001), chronic hypertension (aOR 7.3 for EOP, 3.9 for LOP, p < 0.0001), history of perinatal death (aOR 2.2 for EOP, p < 0.0001 and 1.48 for LOP, p= 0.007), primipaternity (aOR 3.0 for EOP and 3.6 for LOP, p = 0.001), dizygotic twin pregnancies (aOR 3.7 for EOP, p < 0.0001 and 2.1 for LOP, p = 0.003), monozygotic twin pregnancies (aOR 3.98 for EOP, p = 0.003 and NS for LOP), ovulation induction (aOR 5.6 for EOP, p = 0.004 and NS for LOP), and in vitro fertilization (aOR 2.8 for EOP, p = 0.05 and NS for LOP). Specific to LOP and NS for EOP: renal diseases (aOR for LOP 2.9, p= 0.007) and gestational diabetes mellitus (aOR 1.2, p= 0.04). Conclusions: Maternal ages over 35 years, chronic hypertension , history of preeclampsia, ovulation induction, in vitro fertilizations, history of perinatal deaths and twin pregnancy (in our experience, especially mono zygotic twin pregnancies) are significant risk factors for EOP. New paternity is an independent factor for both EOP and LOP.

The Societal Patterns Evolution Model (SPEM) (Gakh, 2023a) has been developed to apply to socio-technical systems. It contains patterns representing stages of societal development. Mapping of these patterns to the development of Information and Communication Technologies (ICTs) and Information Systems was presented at FedCSIS 2022 conference (Gakh, 2022c). This paper discusses the application of SPEM to model the development of three pillars of sustainability: economic, social, and environmental (Purvis, et al., 2019; United Nations, 2023).

Currently, many manufacturing industries use machine learning, artificial intelligence, robotics, and blockchain technologies as process-streamlining instruments of industry 4.0. Before implementing industry 4.0 tools in any process of a manufacturing industry's supply chain, it is essential to evaluate their adaptability. In this paper, the adaptability of industry 4.0 procurement tools to an oil and gas-related manufacturing company's procurement process is evaluated to determine the company's level of maturity. The active participation of participants is evaluated to determine the level of maturity of the main procurement process areas. The results identified the areas of the procurement process that can be improved by implementing the suggested industry 4.0 tools and techniques.

Many clinical trials end uninformatively. Informativeness, in the context of clinical trials, defines whether a study’s results definitively answer its research questions with meaningful next steps. One subset of these trials are those focused on global health set in low-resource settings. Global health clinical trials benefitting people in low-resource settings are funded primarily by a limited number of large foundations, pharmaceutical firms (“industry”), and national governments. While clinical trial protocols are required to go through reviews in regulatory and ethical domains, outside of industry-funded trials, funders rarely require focused scientific design reviews. There are no documented standards and processes, or even best practices, for funders to perform scientific reviews after the funding commitment. Considering the investment in and standardization of ethical and regulatory reviews, and the prevalence of studies ending without clarity or never finishing, it may be that scientific reviews of trial designs with a focus on informativeness offer the best chance for improved outcomes and return on investments in clinical trials. A maturity model is a helpful tool for knowledge transfer to help grow capabilities in a new area, or for those looking to perform a self-assessment in an existing area. Such a model is offered for scientific design reviews of clinical trial protocols: a valuable and often-neglected governance step for funders or sponsors, among others. This maturity model includes 11 process areas and 5 maturity levels. Each of the 55 process area levels is populated with descriptions on a continuum toward an optimal state to improve trial protocols in the area of risk of failure. This tool allows for prescriptive guidance on next investments to improve attributes of post-funding reviews of trials, with a focus on informativeness.

There are different Maturity, Motivation, and Development models. The models can be applied to the development of organizations, businesses, information technology infrastructure, human resources, and so on. This paper discusses society patterns that can be used in modeling society and team development. The model discussed has many advantages over existing ones. It assumes the Age of Creativity and the Creative Society Pattern as the upmost level of development. The patterns are juxtaposed with the 16 levels Simple Learning Motivation Hierarchy Model that allow modeling of dynamic processes with Expansion and Totality as the upmost levels. This approach eliminates the limitations of existing models and allows detailed modeling and planning. Explanation of the future development of humanity (up to the Age of Creativity) is one of the advantages of the model. The paper contains the description of the main peculiarities of society patterns and creates a basis for practical implementation of the model for society and team development. Organizations and teams can benefit from this model through its implementation in consulting and coaching processes. The model can be used in regional/organizational development and investment planning.

The study assessed the changes in the quality and physical and chemical parameters of apples of four cultivars (‘Gala’, ‘Idared’, ‘Topaz’, ‘Red Prince’) subjected to mechanical vibrations during transport under model conditions and after storage (shelf-life). Quality changes in apples were evaluated based on skin and flesh colour, total soluble solids, dry matter, firmness, titratable acidity, pH value, total polyphenol content and antioxidant capacity. The applied vibrations at a frequency of 28 Hz caused changes in the above parameters, which were visible also after storage and depended on cultivar, but did not show any clear trend or direction. Skin colour varied whereas flesh colour remained stable. Vibrations resulted in a decrease in firmness. The greatest stability of quality parameters, the highest content of bioactive compounds and the highest antioxidant capacity were observed for ‘Red Prince’ and ‘Topaz’ apples – this refers to the control and treated samples before and after storage. However, total polyphenol content and antioxidant capacity increased in all studied cultivars as a result of vibrations and storage, which suggests that 28 Hz mechanical vibrations and short-term cold storage did not reduce the health promoting potential of the apples.

The reproductive biology of the invasive blue crab Callinectes sapidus was studied in the Thermaikos Gulf (Northwest Aegean Sea, Eastern Mediterranean). In the two-year survey 5,698 (2,897♂/ 2,801♀) crabs were caught with the use of fyke nets. Total sex ratio (♂/♀) reached equality (1.03:1). The female blue crab exhibited a protracted reproductive period. Mature and ovigerous females exhibit short migratory movements from estuarine and inshore waters, where the population mostly congregates (0-3 m), and move to slightly deeper waters (1-3 m) up to 9 m for spawning. A total of 340 ovigerous females were caught. Their number varied both spatially and temporally; they were observed for a 7-month period (April to October) with a clear peak in July - August and at a 3 m depth gradient corresponding to ≈60% of the total number of ovigerous females caught in both years. Size at first sexual maturity (CW50) was estimated at 113.1 mm CW. Average fecundity was ≈790,000 eggs. Experimental trawling showed that inshore waters (<1 m) in the estuaries serve as nursery areas for juveniles. Defining the spatiotemporal and bathymetrical distribution of ovigerous females in any invaded coastal habitat could be considered key information for the implementation of a management policy for the species.

Background: Older adults with bipolar disorder (OABD) are individuals aged 50 years and older with bipolar disorder (BD). People with BD may have fewer coping strategies or resilience. A long course of the disease, such as in OABD, could impact the development of resilience strategies, but this remains under-researched in OABD. Therefore, this study aims to assess resilience levels within the OABD and explore associated factors, hypothesizing that resilience could improve psychosocial functioning, wellbeing and quality of life of OABD patients. Methods: This study sampled 33 OABD patients from the OABD cohort at the Bipolar and Depressive Disorders Unit of Hospital Clinic of Barcelona. This was an observational, descriptive and cross-sectional study. Demographic and clinical variables as well as psychosocial functioning, resilience and cognitive reserve were analyzed. Resilience was measured using the CD-RISC-10. Non-parametric tests were used for statistical analysis. Results: The average CD-RISC-10 score was 25.67 points (SD 7.87). Resilience negatively correlated with the total number of episodes (p = 0.034), depressive episodes (p = 0.001), and the FAST (p < 0.001). Participants with normal resilience had a lower FAST (p = 0.046), a higher CRASH (p = 0.026), and more EOBD (p = 0.037) compared to those with low resilience. Conclusions: OABD individuals may exhibit lower resilience levels which correlate with more psychiatric episodes, particularly the number of depressions and worse psychosocial functioning and cognitive reserve. Better understanding and characterization of resilience could aid in early identification of patients requiring additional support to foster resilience and enhance OABD management.

Digital transformation has become the top priority for 80% of sports companies worldwide, but statistics show that between 70% and 95% of all digital transformation projects fail due to signif-icant and varied challenges that sports companies face during the process of digital transfor-mation. This is because strategy, not digital technology, drives digital transformation, and suc-cess is unlikely without a mature digital transformation model. Moreover, the digital transfor-mation model of developing and emerging markets is not the same and cannot be adopted as a blueprint. Therefore, the aim of this research was to propose a framework for the digital trans-formation maturity of esports businesses in developing and emerging markets. Semi-structured interviews were conducted with a sample of 15 stakeholders of esports businesses in Iran. Thematic analysis was used to analyze the interviews, and three main perspectives were identified: (1) enablers, (2) digital resilience and capabilities, and (3) digital transformation ma-turity stages. The enablers were formed by six sub-themes, including governance and leader-ship, strategy, culture and skills, innovation, technology, and data. Digital resilience and capa-bilities were formed by four sub-themes, including business model and ecosystem, digital cus-tomer experience, digital employee experience, and digital processes. Additionally, it was found that digital transformation maturity stages are based on four stages of digital beginners, digital followers, digital conservatives, and digital leaders. The findings indicate that moving towards digital transformation and achieving digital resilience in esports businesses will be impossible without synergy between enablers and digital resilience and capabilities. This framework can be useful for esports businesses to evaluate their current digital status and effectively guide them towards a desirable digital status. Furthermore, esports businesses can prioritize their efforts and resources for digital transformation by focusing on targeted capabilities and enablers and ensure more effective and efficient allocation of resources towards digital transformation.

The microvessel neurovascular unit with its brain endothelial cell (BEC) and blood-brain barrier remodeling is important in the development of impaired cognition in sporadic or late-onset Alzheimer’s disease (LOAD) and vascular dementia or vascular cognitive impairment and dementia including cerebral amyloid angiopathy in neurodegeneration. LOAD is considered to be the number one cause of dementia globally; however, when one considers the role of mixed dementia (MD) (the combination of both the amyloid cascade hypothesis and the vascular hypothesis of LOAD), it becomes apparent that MD is the number one cause. The microvessel BECs are the first cells in the brain to be exposed to the peripheral neurotoxins of the systemic circulation and are therefore the brain cells at the highest risk for early and chronic injury. Therefore, it is not surprising that microvessel BECs are the first cells to undergo injury and the response to injury wound healing mechanism and remodeling that is excessive and recurrent in the aging process plus other age-related diseases such as cerebro-cardiovascular disease, hypertension, type 2 diabetes mellitus, Parkinson’s disease, plus others. This narrative review explores the intricate relationship between microvessel remodeling, cerebral small vessel disease (SVD), and neurodegeneration as occurs in LOAD. Further, it discusses the current understanding of how microvessel dysfunction, disruption, and pathology contribute to the pathogenesis of LOAD and thus, highlights potential avenues for therapeutic interventions.

Schizophrenia patients with an earlier age of onset have been found to have more serious negative symptoms and cognitive deficits. Oxidative stress is thought to be implicated in cognitive impair-ment in schizophrenia. Total antioxidant capacity (TAOC) is an essential indicator of oxidative stress. However, the association between age of onset, TAOC, and cognitive performance in schizophrenia is still unexplored. In this study, 201 patients (age: 26.5±9.6 years, male: 53.2%) with drug naïve schizophrenia were recruited. Clinical symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS). Cognitive functioning was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Plasma TAOC levels were an-alyzed using established procedures. Results showed that early-onset (EO) patients had higher TAOC levels, more severe negative symptoms and performed worse on Visuospatial/Constructional, Language and RBANS total score compared with non-EO patients. After Bonferroni correction, only non-EO patients showed a significant inverse relationship between TAOC levels and RBANS language, attention, and total scores. Our findings suggest that early /late age of onset may be correlated with psychopathological symptoms, cognitive impairment and oxidative responses in schizophrenia. Furthermore, the age of onset may moderate the relationship between TAOC and cognitive function in patients with schizophrenia. These findings suggest that improving oxidative stress status in non-EO schizophrenia patients may enhance their cognitive function.

Owing to its unique position within multiple monsoon regimes, latitudinal extent, and complex topography, Vietnam is divided into seven agroclimatic zones, each with distinct rainy season characteristics. Variation in the dominant rainfall system across zones affects the rainfall climatology, the primary water resource for regional crops. This study explores the creation of an agronomic rainy season onset based on high-resolution rainfall data for each agroclimatic zone for applications in an agricultural context. Onset information has huge practical importance for both agriculture and the economy. The spatiotemporal characteristics of zonal onset date are analyzed using integrated approaches of spatial and interannual variability, temporal changes, and estimation of predictability using teleconnection with Niño 3.4 sea surface temperature anomalies (SSTA) for 1980 to 2010. Results suggest that northern and southern zones experience regional onset dates in May, while the central zones experience rainy season onset in late August. The regional variability of rainy season onset is lower in a single dominant monsoon regime (northern and southern zones) and higher in latitudinally extended zones on the border of monsoon regimes (central zones). The interannual variation in rainy season onset date is found to be approximately 2 weeks across all agroclimatic zones. The significant negative trend in rainy season onset date is found for Central Coast and South Central Coast zones, suggesting that the onset date shifted earlier for the entire period. In the decadal scale, the zonal mean onset date shifted later in the Northwest and earlier in the Central Highlands. Out of the seven climate zones, a significant positive correlation is only noticed in the Central Highlands and South zones between zonal mean onset date and Niño 3.4 SSTA for Dec-Jan-Feb, suggesting the potential of seasonal scale predictability of rainy season onset date with respect to preceding El Niño-Southern Oscillation (ENSO) events.

The onset of embryonic heart beating may be regarded as the defining feature for the beginning of personal human life. Clarifying the timing of the 1^st human heartbeat, therefore, has religious, philosophical, ethical, and medicolegal implications. This article reviews the historical and contemporary sources of knowledge on the beginning of human heart activity. Special attention is given to the problem of the determination of the true age of human embryos and to the problem of visualization of the human embryonic heart activity. It is shown that historical and current textbook statements about the onset of blood circulation in man do not derive from observations on living human embryos but derive from the extrapolation of observations on animal embryos to the human species. This fact does not preclude the existence of documented observations on human embryonic heart activity: Modern diagnostic (ultrasound) and therapeutic (IVF) procedures facilitate the visualization of early embryonic heart activity in precisely dated pregnancies. Such studies showed that the human heart started its pumping action during the 4^th post-fertilization week. A small number of direct observations on the heart activity of aborted human embryos were reported since the 19^th century but did not receive much recognition by embryologists.

Acute exposure to cannabis has been associated with an array of cognitive alterations, increased risk for neuropsychiatric illness, and other neuropsychiatric sequelae including the emergence of acute psychotic symptoms. However, the brain alterations associating cannabis use and these behavioral and clinical phenotypes remains disputed. To this end, neuroimaging can be a powerful technique to non-invasively study the impact of cannabis exposure on brain structure and function in both humans and animal models. While chronic exposure studies provide insight into how use may be related to long-term outcomes, acute exposure may reveal interesting information regarding the immediate impact of use and abuse on brain circuits. Understanding these alterations could reveal the connection with symptom dimensions in neuropsychiatric disorders and, more specifically with psychosis. The purpose of the present review is to: 1) provide an update on the findings of pharmacological neuroimaging studies examining the effects of administered cannabinoids and 2) focus the discussion on studies that examine the sensitive window for the emergence of psychosis. Current literature indicates that cannabis exposure has varied effects on the brain, with the principal compounds in cannabis (delta-9-tetrahydrocannabinol and cannabidiol) altering activity across different brain regions. Importantly, we also discorvered critical gaps in the literature, particularly regarding sex-dependent responses and long-term effects of chronic exposure. Certain networks often characterized as dysregulated in psychosis, like the default mode network and limbic system, were also impacted by THC exposure, identifying areas of particular interest for future work investigating the potential relationship between the two.

Many countries have been facing the problem of bank insolvency across the globe. Asset deterioration is one of the main reasons for insolvency of banks. The objective of the paper is to ascertain the determinants of nonperforming loans (NPLs) in the banking sector of Pakistan for the period 2006-16. Other than the bank specific and macro variables proposed by the literature, the roles of weighted maturity and output gap are for the first time examined. We find significant impact of output gap on NPLs however weighted maturity has insignificant role in shaping the future NPLs. Bank specific drivers of NPLs include bank size and capital adequacy ratio.

Background and Aims: Screening and assessment of cognitive changes in adults with Intellectual Disabilities, mainly Down Syndrome (DS), is crucial to offer appropriate services to their needs. We present a systematic review of the existing instruments assessing dementia, aiming to support researchers and clinicians’ best practice. Methods: Searches were carried out in the databases Web of Science; PubMed; PsycINFO in March 2019 and updated in May 2020. Studies were selected and examined if they: (1) focused on assessing age-related cognitive changes in person with ID; (2) included adults and/or older adults; (3) included scales and batteries for cognitive assessment. Results: Forty-eight cross-sectional studies and twenty-six longitudinal studies were selected representing a total sample of 5,851 participants (4,089 DS and 1,801 with other ID). In those studies, we found 38 scales, questionnaires, and inventories, and 14 batteries for assessing cognitive and behavioural changes in adults with DS and other ID. Conclusion: The most used instrument completed by an informant or carer was the Dementia Questionnaire for Learning Disabilities (DLD), and its previous versions. We discuss the strengths and limitations of the instruments and outline recommendations for future use.

A joint analysis of solar wind, geomagnetic field, and earthquake catalog data showed that before the catastrophic M7.8 and M7.5 Kahramanmaras earthquake sequence on February 6, 2023, the closed strong magnetic storm occurred on November 7, 2022, SYM/H=-117 nT. Storm started at 08:04 UT. At this time, the high latitudinal part of Turkey's longitudinal region of future epicenters was located under the polar cusp, where the solar wind plasma would directly access the Earth's environment. The time delay between storm onset and earthquake occurrence was ~91 days. We analyzed all seven strong (M7+) earthquakes from 1967 to 2020 to verify the initial findings. A similar pattern has been revealed for all events. The time delay between magnetic storm onset and earthquake occurrence varies from some days to some months. To continue these investigations, a retrospective analysis of seismic and other geophysical parameters just after preceded geomagnetic storms in the epicenter areas is desirable.

A 35-year-old man with a late-onset combined immunodeficiency (LOCID) variant of common variable immunodeficiency, severe plaque psoriasis, psoriatic arthritis, and Crohn's disease attended Regional Hospital of Presidente Prudente and HC-FMUSP, São Paulo, Brazil. Anti-IL-12/IL-23 (ustekinumab) monoclonal antibody was prescribed due to failure of other treatments (phototherapy, oral acitretin) for psoriasis and Psoriasis Area Severity Index &lt;10. We evaluated the impact of ustekinumab, a potent immunosuppressor, on the risk of infectious diseases in this patient followed for 8 years. Four quarterly doses of ustekinumab 90 mg and human immunoglobulin replacement (10,000 mg at 28-day intervals) were administered. Immunophenotyping, culture of lymphocytes, genetic sequencing, and whole exome sequencing were performed to investigate the primary immunodeficiency. Normal lymphocyte proliferation, absence of pathogenic variants in the genes analyzed and no clinically significant variants were detected in the whole exome. The main infections included chronic sinusitis, tonsillitis, fungal and bacterial otitis, gastroenteritis, and community-acquired pneumonia. The patient was infected with COVID-19, dengue (twice), and influenza and was hospitalized three times for intravenous antibiotic therapy. Ustekinumab did not influence susceptibility to severe infections and significantly improved psoriasis, psoriatic arthritis, and Crohn's disease in a patient with LOCID.

Telomeres are structures at the ends of eukaryotic chromosomes that help maintain genomic stability. During aging, telomere length gradually shortens, producing short telomeres, which are considered markers of premature cellular senescence. This is believed to contribute to age-related diseases, including Alzheimer's disease (AD) and based on this, several studies have hypothesized that telomere shortening may characterize AD. Current research, however, has been inconclusive regarding the direction of the association between leukocyte telomere length (LTL) and disease risk. We assessed the association between LTL and AD in a retrospective case-control study of a sample of 255 unrelated patients with late-onset AD (LOAD), including 120 sporadic cases and 135 with positive family history for LOAD, and a group of 279 cognitively healthy unrelated controls, which were all from Calabria, a region from south Italy. Following regression analysis, telomeres were found to be significantly shorter in LOAD cases than in controls (p<0.001 for both sporadic and familial cases). Interestingly, LTL were associated to disease risk independently of the presence of conventional risk factors (e.g., age, sex, MMSE scores, presence of the APOE-ε4 allele). Altogether, our findings lend support to the notion that LTL shortening may be an indicator of the patho-genesis of LOAD.

Explosive boiling is a fast phase transition from an ultra-thin liquid film to vapor under an extremely high heat flux, which typically has been studied using molecular dynamics simulation (MDS) method. The present MDS study investigated the explosive boiling of a liquid argon nanofilm over different solid copper surfaces with different nanowall patterns including parallel and cross nanowalls. For each surface, atomic motion trajectories, number of liquid and vapor argon atoms, heat flux, and, mainly, onset time of explosive boiling were investigated. The simulation results indicated that explosive boiling occurs earlier on parallel and cross nanowall surfaces than on an ideally smooth surface, regardless of the topology and configuration of nanowalls. Moreover, the results revealed that by using the cross nanowall surfaces, the onset time of explosive boiling decreased by 0.7–4% compared to the parallel nanowall surfaces. In addition, it was found that the onset time of explosive boiling strongly depends on the potential energy barrier and the movement space between nanowalls for both parallel and cross nanowall surfaces. Furthermore, simulation findings showed that even though increasing the height of cross nanowalls increases heat flux and temperature of the fluid argon domain, it does not necessarily result in a shorter onset time of explosive boiling. These findings demonstrate the capability of cross nanowall surfaces for explosive boiling, thereby could be utilized in future surface design for thermal management applications.

Early diagnosis of paroxysmal atrial fibrillation (PAF) could suggest patients to receive timely interventions in clinical practice. Various PAF onset prediction algorithms might benefit from accurate heart rate variability (HRV) analysis and machine learning classification but to be challenged in real-time monitoring scenarios. The aim of this study is to present an end-to-end deep learning based PAFNet model that integrates a sliding window technique on raw R-R interval of electrocardiogram (ECG) segments to achieve a real-time prediction of PAF onsets. This integration enable the deep convolutional neural network (CNN) to be customized as a light-weight architecture that accommodates the size of sliding windows simply by altering the input layer, specifically its effectiveness in making a new prediction with each new heartbeat. Catering to potential influence of input sizes, three CNN models were trained using 50, 100, and 200 R-R intervals, respectively. For each model, the performance of automated algorithms was evaluated for PAF prediction using a ten-fold cross-validation. As a results, a total of 56,381 PAFN-type and 56,900 N-type R-R interval segments was collected from publicly accessible ECG databases, and a promising prediction performance of the automated algorithm with a 100 R-R intervals was achieved in terms of the sensitivity of 97.12%, the specificity of 97.77%, and the accuracy of 97.45%, respectively. Importantly, the automated algorithm with a sliding windows step of 1 could process one sample in only 23.1 milliseconds and identify the onset of PAF at least 45 minutes in advance. The present results suggest that the sliding window technique on raw R-R interval sequences along by deep learning based algorithms may offers the possibility of providing an accurate, real-time, and end-to-end clinical tool for mass monitoring of PAF.

This study analyses uncertainties associated with the main features of the annual cycle of West African rainfall (amplitude, timing, duration) in 15 CMIP5 simulations over the Sahelian and Guinean regions with satellite daily precipitation estimates. The annual cycle of indices based on daily rainfall such as the frequency and the intensity of wet days, the consecutive dry (CDD) and wet days (CWD), the 95th percentile of daily rainfall (R95) have been assessed. Over both regions, satellite datasets provide more consistent results on the annual cycle of monthly precipitation than on higher-frequency rainfall indices, especially over the Guinean region. CMIP5 simulations display much higher uncertainties in both the mean precipitation climatology and higher-frequency indices. Over both regions, most of them overestimate the frequency of wet days. Over the Guinean region, the difficulty of models to represent the bimodality of the annual cycle of precipitation involves systematic biases the frequency of wet days. Likewise, we found strong uncertainties in the simulation of the CWD and the CDD over both areas. Finally, models generally provide too early (late) onset dates over the Sahel (the Guinean region) and overestimate rainfall during the early and late monsoon phases. These errors are strongly coupled errors in the latitudinal position of the ITCZ and do not compensate at the annual scale nor when considering West Africa as a whole. wet days. We found strong uncertainties in the simulation of the CWD and he CDD over both areas. Conversely for R95p and R95PTOT, the ncertainties in CMIP5 models appear somewhat weaker, but the magnitude f R95 is largely underestimated in most models.

This study analyses uncertainties associated with the annual cycle of West African rainfall characteristics in 15 simulations of the Coupled Model Intercomparison Project phase 5 (CMIP5) over the Sahel and Guinean regions. Indices based on daily rainfall such as the frequency and the ntensity of wet days, the consecutive dry days (CDD) and wet days (CWD), the 95th percentile of daily rainfall (R95) and its contribution to the umulative monsoon rainfall (R95PTOT) have been assessed. Over both regions, TRMM, GPCP and CHIRPS observational datasets provide very consistent results on the annual cycle of precipitation but less so on the frequency of wet days. Conversely, higher uncertainties are noted on the intensity of wet days over both study areas, particularly over the Guinean region. Overall, CMIP5 simulations present much higher uncertainties in the representation of the mean precipitation climatology, often provide too early (late) onset dates over the Sahel (the Guinean region) and overestimate rainfall during the early and late monsoon phases. These errors do not compensate at the annual scale nor when considering West Africa as a hole. Results also reveal that over the Guinean region, the difficulty of models to represent the annual structure of the mean precipitation strongly involves biases in the representation of the annual cycle of the frequency of wet days. We found strong uncertainties in the simulation of the CWD and he CDD over both areas. Conversely for R95 and R95PTOT, the ncertainties in CMIP5 models appear somewhat weaker, but the magnitude of R95 is largely underestimated in most models.

Background: This paper investigates the statistical relationship between bilingualism and the Onset Age (OA) of AD and MCI across a clinical sample, consisting of 580 Alzheimer's Disease (AD) subjects and 1264 Mild Cognitive Impairment (MCI) subjects, via a statistical analysis conducted on the sample retrieved from the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset. Method: To investigate whether bilingualism has any correlation with the OAs of AD or MCI subjects, our study leverages the full potential of the ADNI dataset, a dataset that covers both the OA and the bilingualism status of both the AD and MCI subjects. Prior to performing any meaningful statistical analysis, a regression model and a probabilistic model were developed in parallel to fill in the missing OA and bilingualism values. A simple least-square regression model that consists of an independent variable of registered age for Mini-Mental State Examination (MMSE) score was used to estimate the OA of the AD and MCI subjects in the ADNI dataset. After filling in the missing OA values, the number of subjects relevant for the statistical analysis increased from 816 (AD: 371, MCI: 445) to 1844 (AD: 580, MCI: 1264), which greatly enlarged the representation of the AD and MCI sample in the ADNI population. With increased sample size, a novel probabilistic classification model was introduced to infer an ADNI subject’s bilingualism when relevant demographic information and deterministic outcome were not readily available from the ADNI dataset. The weighted average OA for the bilinguals and the monolinguals was then computed, where the weights for the probabilistic labels were assigned based on the percentage of bilingualism in the general US population. Finally, a statistical analysis was performed to test whether any statistically significant correlation exists between the OA and the bilingualism of the AD and MCI subjects within the ADNI dataset. Findings: Our preliminary study demonstrates no significant statistical difference between the OA of the bilinguals and the monolinguals within the ADNI dataset. Thus, the monolingual speakers within the ADNI dataset do not statistically manifest earlier onset, as compared to the bilingual speakers, which is slightly inconsistent with some earlier statistical findings that bilingual speakers enjoy certain distinctive advantages, such as late onset of AD, as compared to monolingual counterparts.

Anderson – Fabry disease (AFD) is a rare, X-linked lysosomal storage disorder caused by a mutation in the α-Galactosidase A gene resulting in α-Galactosidase A enzyme (α-Gal A) deficiency. The metabolic defect leads to progressive accumulation of glycosphingolipids and structural and functional impairment of affected organs. Due to the inheritance pattern, male patients are hemizygous with more severe manifestations of the disease as compared to females who in most cases are heterozygous with delayed and variable clinical presentation caused by uneven X – chromosome inactivation. Fabry disease cases are often identified by targeted screening programs in high-risk groups, such as in patients with end-stage renal disease, premature stroke or unexplained cardiomyopathy. Here we describe a unique case of homozygous female patient identified by a nationwide screening program in hypertrophic cardiomyopathy patients. Before the systematic screening, the patient had a diagnosis of hypertrophic obstructive cardiomyopathy and was treated accordingly including alcohol septal ablation to reduce the obstructive gradient. The confirmation of Fabry disease has led to discovery of the same variant in several members of her family. The identified variant was c.644A>G, p.Asn215Ser (N2015S) known to cause predominant cardiac involvement with late onset of the disease. The variant is amenable for an oral therapy by the small molecular chaperone migalastat which was started, then interrupted for recurrence of patient´s migraine and then re-initiated again after two years. During this period the patient received enzyme replacement therapy by agalsidase beta but developed a progressively worsening venous access. Our case illustrates the importance of systematic screening of patients with clinical evidence of hypertrophic cardiomyopathy in whom routine diagnostic process fails to discover Fabry disease, in particular variants with late onset cardiac manifestations. Many of the late onset variants are amenable for orally active therapy by migalastat which significantly improves the comfort of the treatment. Its long term results are analysed by a large international “Follow-me” registry which was designed to verify the validity of pivotal trials with migalastat in Fabry disease.

Background: Clozapine (CLZ) use is precarious due to its neurological, cardiovascular, and hematological side effects; however, it is the gold standard in therapy-resistant schizophrenia (TRS) in adults and is underused. Objective: to examine the most recent CLZ data on (a) side effects concerning (b) recent pharmacological mechanisms, (c) therapy benefits, and (d) the particularities of the COVID-19 pandemic. Data sources: a search was performed in two databases (PubMed and Web of Science) using the specific keywords "clozapine" and "schizophrenia," "side effects," "agranulocytosis," "TRS," or "bipolar affective disorder (BAF)" for the last ten years. Study eligibility criteria: clinical trials on adults with acute symptoms of schizophrenia or related disorders. Results: We selected 37 studies, randomized controlled trials (RCTs), and clinical case series (CCS), centered on six main topics in the search area: (a) CLZ in schizophrenia, (b) CLZ in bipolar disorder, (c) side effects during the clozapine therapy, (d) CLZ in pregnancy, (e) CLZ in early-onset schizophrenia, and (f) CLZ therapy and COVID-19 infection. Limitations: We considered RCTs and CCS from two databases, limited to the search topics. Conclusions and implications of key findings: (a) Clozapine doses should be personalized for each patient based on pharmacogenetics testing when available; the genetic vulnerability postulates predictors of adverse reactions' severity; patients with a lower genetic risk could have less frequent hematological monitoring; (b) CLZ-associated risk of pulmonary embolism imposes prophylactic measures for venous thromboembolism; (c) convulsive episodes are not an indication for stopping treatment; the plasma concentration of clozapine is a better side effect predictor than the dosage; (d) COVID-19 infection may enhance clozapine toxicity, generating an increased risk of pneumonia. Therapy must be continued with proper monitoring of the white blood count, and the clozapine dose decreased by half until three days after the fever breaks; psychiatrists and healthcare providers must act together. Background: Clozapine (CLZ) use is precarious due to its neurological, cardiovascular, and hematological side effects; however, it is the gold standard in therapy-resistant schizophrenia (TRS) in adults and is underused. Objective: to examine the most recent CLZ data on (a) side effects concerning (b) recent pharmacological mechanisms, (c) therapy benefits, and (d) the particularities of the COVID-19 pandemic. Data sources: a search was performed in two databases (PubMed and Web of Science) using the specific keywords "clozapine" and "schizophrenia," "side effects," "agranulocytosis," "TRS," or "bipolar affective disorder (BAF)" for the last ten years. Study eligibility criteria: clinical trials on adults with acute symptoms of schizophrenia or related disorders. Results: We selected 37 studies, randomized controlled trials (RCTs), and clinical case series (CCS), centered on six main topics in the search area: (a) CLZ in schizophrenia, (b) CLZ in bipolar disorder, (c) side effects during the clozapine therapy, (d) CLZ in pregnancy, (e) CLZ in early-onset schizophrenia, and (f) CLZ therapy and COVID-19 infection. Limitations: We considered RCTs and CCS from two databases, limited to the search topics. Conclusions and implications of key findings: (a) Clozapine doses should be personalized for each patient based on pharmacogenetics testing when available; the genetic vulnerability postulates predictors of adverse reactions' severity; patients with a lower genetic risk could have less frequent hematological monitoring; (b) CLZ-associated risk of pulmonary embolism imposes prophylactic measures for venous thromboembolism; (c) convulsive episodes are not an indication for stopping treatment; the plasma concentration of clozapine is a better side effect predictor than the dosage; (d) COVID-19 infection may enhance clozapine toxicity, generating an increased risk of pneumonia. Therapy must be continued with proper monitoring of the white blood count, and the clozapine dose decreased by half until three days after the fever breaks; psychiatrists and healthcare providers must act together.

Introduction: Pediatric-Onset Multiple Sclerosis (POMS) is characterized by high inflammatory disease activ-ity. Our aim was to describe the treatment sequencing and report the impact Highly Effective Disease Modifying Treatment (HET) had on disease activity. Materials and Methods: 2/5 consecutive POMS were administered HET as initial therapy after diagnosis. Data on treatment sequencing, relapses and MRIs were collected during the follow-up. Results: Our patients had an average age of 13.8 years (range 9-17) at di-agnosis and 13.4 years (range 9-16) at disease onset, 2/5 (40%) POMS were female. The pre-treatment aver-age annualized relapse rate was 1.6 (range 0.8-2.8) and the average follow-up length was 5 years (range 3-7). A total of 2/5 (40%) patients were stable on HET at initial therapy, 3/5 (60%) required an escalation to more aggressive treatment, even if two of them had been put on HET as initial treatment. Four out of five patients (80%) had No Evidence of Disease Activity-3 status (NEDA-3) at an average follow-up of 3 years (range 2-5). Conclusion: it has been observed that in a recent time period all the cases had prompt diagnosis, early HET or escalation to HET with a good outcome in 80% of the cases.

Coconut is an important multipurpose crop wherein different stages of its maturity are used for different products. Traditional approach of its classification use sound formed by tapping the fruit, and the tapper will base its judgment through the sound he heard. The procedure was highly subjective and attempts had been made by other researchers to automate and classify the adulthood of the coconut objectively. Nowadays, deep learning techniques are being utilized to solve classification problems. One such method is Convolutional Neural Network (CNN) that takes raw pixel data, learns to extract features, and ultimately classifies the input. In this study, a portable device was developed that takes audio signals generated from tapping the fruit mechanically. This audio clip was converted to spectrogram and was used as input to a LeNet CNN architecture. We argue that CNN classifier has improved accuracy compared to the non-deep learning system. Our evaluation confirmed that the use of CNN had improved the accuracy of classifying coconut by about 15%.

(1) Background: Neonatal early-onset sepsis (EOS) is associated with important mortality and morbidity. The aims of this study were to evaluate the association between serum biomarkers with early onset neonatal sepsis in a cohort of patients with prolonged rupture of membranes (PROM), and to calculate their diagnostic accuracy. (2) Methods: A retrospective cohort study was conducted on 1355 newborns with PROM admitted between January 2017 and March 2020, who were divided in two groups: group A, with PROM ≥ 18 hours and group B, with PROM < 18 hours. Both groups were further split into subgroups: proven sepsis, probable sepsis and no sepsis. Descriptive statistics, ANOVA analysis, and a Random Effects Generalized Least Squares (GLS) regression were used to evaluate the data. (3) Results: The statistically significant predictors of neonatal sepsis were the high white blood cells count from the first (p = 0.005) and third day (p = 0.028), and high CRP values from the first day (p = 0.004). Procalcitonin (area under the curve - AUC = 0.78) and CRP (AUC = 0.76) measured on the first day had the best predictive performance for early onset neonatal sepsis. (4) Conclusions: Further studies are needed to explore other bi-omarkers of sepsis in both pregnant women and newborns to better predict EOS.

The increasing demand for sustainable products and services has become a constant requirement by the different stakeholders in an organization. Higher Education Institutions (HEI) have a crucial role in training conscious and competent professionals to lead these changes. Chemical analyses laboratories bring together the proper mix, where the adoption of mature and efficient management systems proves to be crucial not only to better train the institutions´ human resources but also to cooperate in recruiting research projects and other services to benefit society. Maturity models assist in the needed stages for sustainable growth to take place. This paper proposes a Maturity Model based on standardized norms to guide adjustments related to quality, risks, safety, and environment of chemical analyses laboratories in public higher education institutions. This research was done in four stages: theoretical research about Maturity Models, sustainability, and integrated management systems; survey with laboratories; case study at a chemical analyses laboratory of an HEI; and structuring and validating a maturity model. As a result of this, the model includes eight dimensions (Strategy, Leadership, Management, Operations, Continuous Improvement, Sustainability, Culture, and Integration), 31 subdimensions, and 204 management practices to assess and guide chemical analyses laboratories to sustainable maturity levels.

It’s well known that existing horizontal well drilling and hydraulic fracturing technology that is used to achieve large-scale cost-effective production from immature to low-moderate maturity continental shale in China, where the organic matter mainly exists in the solid form is fairly ineffective. To overcome the obstacles, in-situ conversion technology seems feasible, while implementing it in the target layer along with estimating the amount of expected recoverable hydrocarbon in such shale formations seems difficult. This is because there is no guideline to choose the most appropriate method and select relevant key parameters for this purpose. Hence, based on thermal simulation experiments during the in-situ conversion of crude oil from the Triassic Chang 73 Formation in the Ordos Basin and the Cretaceous Nenjiang Formation in the Songliao Basin, this deficiency in knowledge was addressed. First, relationships between the in-situ converted total organic carbon (TOC) content and the vitrinite reflectance (Ro) of the shales and between the residual oil volume and the hydrocarbon yield was established. Second, the yields of residual oil and in-situ converted hydrocarbon were measured, revealing their sensitivity to fluid pressure and crude oil density. In addition, a model was proposed to estimate the amount of in-situ converted hydrocarbon based on the TOC, hydrocarbon generation potential, Ro, residual oil volume, fluid pressure, and crude oil density. Finally, a method was established to determine key parameters on the final hydrocarbon yield from immature to low-moderate maturity organic material during in-situ conversion in shales. Following the procedure outlined in this paper, estimated recoverable in-situ converted oil in the shales of the Nenjiang Formation in the Songliao Basin was estimated to be approximately 292×108 tons, along with 18.5×1012 cubic meters of natural gas, in an area of approximately 8×104 square kilometers. Collectively, the method developed in this study is independent from the organic matter type and other geological and/or petrophysical properties of the formation and can be applied to other areas globally where there isn’t any available in-situ conversion thermal simulation experimental data.

This paper presents the results of a study aimed at understanding how technology maturity level influences the incidence of university technology transfer to the private sector. The study examined the topic from the perspective of private sector organizations. It used data from a random sample of patent applications filed with the United States Patent and Trademark Office and a theoretically guided sampling of multiple cases of private sector organizations that contemplated obtaining and assimilating technologies created at universities in the United States. The patent application data were analyzed using nonparametric statistical techniques and the case data were analyzed using qualitative comparative analysis (QCA). The findings of the study suggest that the typical maturity level of technologies created at U.S. universities is a TRL-5 or lower on as scale adapted from the NASA technology readiness level (TRL) scale. A technology maturity level of TRL-6 or higher is likely an insufficient but necessary part of at least one unnecessary but sufficient configuration of conditions that tends to result in the occurrence of university technology transfer. However, under certain circumstances, a technology maturity level of at least TRL-6 could be a sufficient but unnecessary condition for the occurrence of university technology transfer. These findings have several important implications. First, they provide support for the notion that university technology transfer is subject to causal complexity. Moreover, it may be possible to increase the incidence of university technology transfer in the United States by implementing public policy and practices that explicitly take technology maturity level into consideration.

The main aim of this paper is to explore the issue of big data and to propose a conceptual framework for big data, based on the temporal dimension. The Temporal Big Data Maturity Model (TBDMM) is a means for assessing organization’s readiness to fully profit from big data analysis. It allows the measurement of the current state of the organization’s big data assets and analytical tools, and to plan their future development. The framework explicitly incorporates a time dimension, providing a complete means for assessing also the readiness to process temporal data and/or knowledge that can be found in modern sources, such as big data ones. Temporality in the proposed framework extends and enhances the already existing maturity models for big data. This research paper is based on a critical analysis of literature, as well as creative thinking, and on the case-study approach involving multiple cases. The literature-based research has shown that the existing maturity models for big data do not treat the temporal dimension as the basic one. At the same time, dynamic analytics is crucial for a sustainable competitive advantage. This conceptual framework was well received among practitioners, to whom it has been presented during interviews. The participants in the consultations often expressed their need of temporal big data analytics, and hence the temporal approach of the maturity model was widely welcomed.

Background: Differential diagnosis between polymyalgia rheumatica (PMR) and seronegative elderly-onset rheumatoid arthritis (SEORA) is not easy, to the point that in the past they were considered the same entity. In these patients, sleep disorders have been scarcely assessed, and considered as expression of mood disorders such as depression and anxiety. Methods: In 38 Caucasian elderly patients (median age: 73.9 ± 8.06 years) consecutively referred to two outpatient clinics from January to May 2018 with diagnosis of PMR and SEORA, sleep impairment was assessed using the Medical Outcomes Study-Sleep scale (MOS-SS). Depression and anxiety were assessed using the Neuropsychiatric Inventory (NPI) score, with point 0 for absent and point 3 for severe. Comorbidities were assessed using the Cumulative Illness Rating Scale (CIRS). Patients taking medications used to treat sleep disturbance or that could favor sleep disturbances were excluded. The study was approved by the local ethics committee and carried out in accordance with the Helsinki Declaration, revised 2013. Every patient signed an informed consent form at the time of the first visit. Results: MOS-SS total point in PMR patients was significantly higher than in SEORA patients (47.60 ± 8.4 vs 28.26 ± 12.4; P = 0.000). After six-month therapy with prednisone (12.5–15 mg/day, followed after 4 weeks by gradual tapering), MOS-SS total point improved in the two groups of patients, with no significant difference (17.0 ± 6.2 vs 17.8 ± 4.2; P = 0.644). No correlation was found between MOS-SS and comorbidities, and between MOS-SS, anxiety or depression. Conclusions: Our data suggest that the assessment of sleep impairment could be very useful in the differential diagnosis between PMR and SEORA. Up today, the reasons why patients with PMR have—at the time of diagnosis—a sleep impairment higher than SEORA are speculative. Further ad hoc complementary studies in multicenter cohorts are needed.

The primary purpose of this article is to present a maturity model dealing with environmental manufacturing processes in a company. First, a theoretical approach is presented where evolution from the first industrial revolution to the present (Industry 4.0.) is outlined with a need to implement environmental initiatives. Chapter two contains a detailed literature review, which resulted in the creation of our own maturity model presented in the next chapter. According to some authors, Industry 4.0 is based on characteristics that have already been the focus of “lean and green” concepts. The practical part of the article is a case study that shows which areas of the manufacturing process have “environmental” potential. The goal was to move from resource consumption, pollutant emissions and more extensive manufacturing towards environmentally responsible manufacturing (ERM). Using environmental materials and methods reduces energy consumption, which generates cost savings and higher profits. Here, VSM (Value Stream Mapping) was applied to identify core processes with environmental potential. The final part of the article summarizes the work and presents future possibilities. This paper provides an understanding of the role of environmental manufacturing in the era of the 4th industrial revolution.

Forestry workers play a crucial role in implementing forest management programs, but their outdoor work exposes them to rising temperatures caused by global climate change, which poses potential health risks related to heat. This study focuses on Indonesian forestry workers and examines the relationship between their knowledge of heat-related issues, risk perception, and precautionary behavior in dealing with increasing workplace heat exposure. Developing effective precautionary behavior is essential for preventing heat-related health disorders and promoting health protection programs. To facilitate a comprehensive comparison of the three variables, interviews were conducted with two groups of outdoor workers, comprising 210 forestry workers and 215 paddy farmers. The findings indicate that increasing knowledge about heat-related issues promotes precautionary behavior, and risk perception acts as a mediator between knowledge and behavior. Additionally, the study highlights that the emotion of "dread" intensifies perceived risk and predicts positive behavior change. To enhance heat-related knowledge, exploring the potential use of a "fear" tone is important. In conclusion, comprehensive strategies need to be implemented to promote precautionary behavior among vulnerable forestry workers, particularly manual laborers.

Growth-preserving instrumentation techniques are utilized in early-onset scoliosis (EOS) cases requiring surgical intervention. Shilla technique corrects the deformity and may reduce the need for surgical treatment with its growth-directing effect. As with other techniques, various prob-lems can be encountered following the administration of the Shilla technique. The aim of this study was to examine the effect of complications encountered with Shilla treatment on correction and growth. Sixteen patients with a follow-up period of at least 1 year who received Shilla growth guidance for EOS were included in the study. No complications occurred in 50% cases and no unplanned surgery was required. Of the remaining 8 patients with postoperative im-plant-related complications (50%), 6 (37.5%) required unplanned surgery; this consequently caused implant failure in the proximal region in 5 cases (31.25%) and deep tissue infection around the implant in 1 case (6.25%). Deformity correction, spine length, and quality-of-life scores significantly improved in EOS through Shilla growth guidance. Although implant-related com-plications were observed and related unplanned surgeries were required with Shilla growth guidance in our patients, these complications did not have a significant negative effect on correc-tion and spine growth.

Early onset neonatal sepsis is a significant contributor to neonatal morbidity and mortality. Although blood cultures remain the diagnostic gold standard, they detect pathogens in only a minority of suspected cases. This study compared the accuracy of blood cultures with a rapid multiplex PCR test. Newborns at risk for neonatal sepsis were prospectively screened as recommended per national guidelines. Evaluations included laboratory parameters (CrP, IL6, differential blood count), blood culture, and a molecular multiplex PCR test (ROCHE LightCycler SeptiFast) identifying 20 common microbial agents. Blood samples were taken simultaneously from umbilical cord or venous sources on the first day of life. Of 229 infants included, 69% were born preterm. Blood culture and multiplex PCR sensitivity were 7.4% and 11.1% respectively. Specificity, negative and positive predictive values between methods showed no significant variance, though multiplex PCR had more false positives due to contamination. The limited sensitivity of blood cultures for early onset neonatal sepsis is concerning. Despite quicker results, multiplex PCR does not enhance diagnostic accuracy or antibiotic therapy guidance, thus it can not be recommended for this indication.

A ~3-kb deletion-type DNA copy-number variation (CNV, esv3587290) located at intron 7 of the VANGL1 gene (1p13.1, MIM*610132) has been proposed as a genetic factor for developing lupus nephritis (LN) in adult systemic lupus erythematosus (SLE) patients across European-descent populations, but its replication in other ethnicities has been inconsistent and its association with LN in childhood-onset SLE (cSLE) remains unknown. Here, we performed an exploratory association study in a sample of 66 unrelated cSLE Mexican patients (11 males, 55 females; ages 7.8 to 18.6 years). Two stratified groups were compared: cSLE patients with (N=39) or without (N=27) LN, as diagnosed by renal biopsy (N=17), proteinuria (N=33), urinary protein:creatinine ratio >0.2 (N=34), and erythrocyturia and/or granular casts in urinary sediment (N=16). For esv3587290 CNV genotyping, we performed an end-point PCR assay with breakpoint confirmation by Sanger sequencing. We also determined the allelic frequencies of the esv3587290 CNV in 181 deidentified ethnically-matched individuals (reference group). The obtained genotypes were tested for Hardy-Weinberg equilibrium (HWE) by c2 test. Associations between LN and esv3587290 CNV were tested by calculating the Odds Ratio (OR) and using Pearson's c² tests with a 95% confidence interval and P≤0.05. The esv3587290 CNV allele (OR 0.108, 95% CI 0.034-0.33, P=0.00003) and the heterozygous genotype (OR 0.04, 95% CI 0.119-0.9811, P=0.002) showed a significant protective effect against LN development. Finally, we characterized the precise breakpoint of the esv3587290 CNV as NG_016548.1(NM_138959.3):c.1314+1339_1315-897del (https://databases.lovd.nl/shared/variants/0000918418#00025811) in our population. This report supports the notion that a broad genetic heterogeneity underlies the susceptibility for developing LN.

(1) Background: Investigating the characteristics of photosynthetic physiological changes of leaves in Mangifera indica L. cv. 'GuIfei' under enhanced UV-B radiation, natural light exposed trees were regarded as control, and 96 kJ·m-2·d-1enhanced UV-B radiation was artificially simulated in the field; (2) Methods: The changes of fruit maturity and fruit quality, leaf net photosynthetic rate (Pn), photosynthetic pigments contents, photochemical reaction, activities of photosynthetic enzymes and their genes expressions were determined; (3) Results: Compared with CK, the percentage of mature fruits of the treatment was significantly increased, and fruit quality was better. The net photosynthetic rate (Pn), the contents of photosynthetic pigment, Hill reaction activity and photochemical quenching coefficient (qP) of the treatment leaves showed a significantly higher trend than CK. The activities of Rubisco and RCA, and the expression of Rubisco genes rbcL and rbcS were significantly increased; (4) Conclusions: 96 kJ·m-2·d-1 enhanced UV-B radiation treatment improved Rubisco activity through increasing the expression of Rubisco genes rbcL and rbcS, thereby enhancing the CO2-fixing capacity and dark reaction capacity of leaves. Based on this, it raised the net photosynthetic rate of leaves, which promoted the early maturity of 'Guifei' mango by the fast accumulating photosynthetic products.

This research was conducted to understand changes of physicochemical properties of fruits of three apple cultivars as influenced by stage of maturity and packaging types over storage period of three weeks. The research was designed to replicate practices by the producers and along the value chains and to assess the fruit quality under the conditions of the major markets in the region. All the measured physicochemical parameters significantly varied with the cultivars, maturity stage at harvest and packaging types. Higher firmness was recorded for the samples harvested about two weeks before the optimal maturity, usually practiced by significant number of producers to gain market advantage. Lower total soluble solids corresponded to the early harvested samples regardless of cultivars and packaging types. The firmness was observed decreasing over the storage periods whereas the total soluble solids increased, which is associated to improving sensorial quality for the early harvested cultivars as the soluble solids are mainly sugars. The early harvesting resulted in fruits of inferior desirability including extreme hardness, firmness and low total soluble solids that may have high sourness and less sweet taste. Awareness creation for the producers on the quality and advantages of harvesting their produces at optimal maturity and practicing good postharvest management is required.

Nowadays, frameworks and models are critical to enabling organizations to identify their current sustainability integration into business and to follow up on these initiatives over time. In this context, the maturity models offer a structured way of analyzing how a supply chain meets specific sustainability requirements and which areas demand attention to reach maturity levels. This study proposes a five-level maturity model to help supply chains identify their level of engagement with sustainability practices combining three perspectives: intra and inter-organizational sustainability practices, triple-bottom-line approach and critical areas for sustainability. All the steps followed in constructing the maturity model were based on a literature review, and case studies supported its improvement, application, and testing. The proposed model presents many advantages, such as being used as a self-assessment tool, a roadmap for sustainability behaviour improvement, and a benchmarking tool to evaluate and compare standards and best practices among organizations and supply chains.

The seeds of cultivated peanut, Arachis hypogaea, are an agronomically important crop produced for human nutrition, oilseed and feed stock. Peanut seed is the single most expensive variable input cost and thus producers require seed with excellence performance in terms of germination efficiency. During the maturation process, triglycerides are stored in oil bodies as an energy resource during germination and seedling development. The stability of oil body membranes is essential for nutrient mobilization during germination. This study focused on evaluating the phytosterol composition in seed components including the kernel, embryo (heart), and seed coat or skin. Samples of different maturity classes were analyzed for macronutrient and phytosterol content. The three most abundant phytosterols, β-sitosterol, campesterol, and stigmasterol, comprised 82.29%, 86.39%, and 94.25% of seed hearts, kernels, and seed coats, respectively. Stigmasterol concentration was highest in the seed kernel providing an excellent source of this sterol known to have beneficial effects on human health. Peanut hearts contained the highest concentration of sterols by mass potentially providing protection and resources for the developing seedling. The amount of α-tocopherol increases in peanut hearts during the maturation process providing protection from temperature stress and stability required for seedling vigor. These results suggest that phytosterols may play a significant role in the performance of seeds and provides a possible explanation for the poor germination efficiency of immature seeds.

Proposed study aims to investigate the digital transformation of Greek small and medium enterprises (SMEs), with a particular focus on their digital maturity and the strategic and organizational factors contributing to digital transformation. The research issue of digital transformation is attracting considerable interest among academics and business practicians since COVID-19 accelerated the procedure of implementing Industry’s 4.0 principles all over global economies. Quantitative research on 147 Greek SMEs revealed most important issues on how these businesses implement digital transformation, factors accelerating or decelerating the process, barriers and expected outcomes. Research enlights how SMEs face the transition to digital business and reveals the factors that can facilitate the whole process. Results can be valuable for stakeholders enabled to digital transformation process from both business and academic point of view, while there exist aspects that can contribute to policy makers / motivation developers in state’s level as well.

Objective: To analyze the clinical and economic impact of community-onset urinary tract infections (UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae requiring hospitalization. Methods: A retrospective cohort study included all adults with UTI caused by K. pneumoniae admitted to a tertiary care hospital in Barcelona, Spain, between 2011 and 2015. Demographic, clinical and economic data were analyzed. Results: One hundred and seventy-three episodes of UTI caused by K. pneumoniae were studied; 112 were non-ESBL-producing and 61 ESBL-producing. Multivariate analysis identified ESBL production, acute confusional state associated with UTI, shock, and time to adequate treatment as risk factors for clinical failure during the first 7 days. Economic analysis showed differences between ESBL-producing and non-ESBL-producing K. pneumoniae for the total cost of hospitalization per episode (mean 6,718 € vs 3,688 € respectively). Multivariate analysis of the higher costs of UTI episodes found statistically significant differences for ESBL production and time to adequate treatment. Conclusion: UTI caused by ESBL-producing K. pneumoniae requiring hospitalization, and time to adequate antimicrobial therapy are associated with worse clinical and economic outcomes.

Background: Postoperative atrial fibrillation (POAF) is the most common arrhythmia after cardiac surgery in conventional extracorporeal circulation (CECC), with an incidence of 15-50%. The POAF pathophysiology is not known, and no blood biomarkers exist. However, an association between increased ferritin levels and increased AF risk, has been demonstrated. Based on such evidence, here, we evaluated the effectiveness of ferritin and other haemato-chemical parameters as a POAF onset biomarker in subjected to cardiac surgery. Materials and Methods: We enrolled 90 patients (mean age= 66.9±2.8 years; 40 men and 20 females) with diverse heart pathologies and subjected to cardiothoracic surgery. Their blood samples were collected and used to determine haemato-chemical parameters. The tree test approach was used to detect the best data-driven ferritin cuff-off value (=141 ng/ml) to predict POAF risk. Results: The data obtained demonstrated significant higher concentrations, absolute values, and percentages, of ferritin, RDW, PLTs, in POAF patients. However, the ferritin resulted to be the independent factor associated with the onset POAF risk. Thus, we detected the ferritin cut-off value, which, when ≥ 141 ng/ml identifies the subjects at the highest POAF risk. Conclusions: Ferritin values≥ 141 ng/ml might be used as predictive POAF biomarker.

This study examines the role of using algorithmic HRM to make strategic decisions pertaining to HR activities in organizations. The study develops a scale to measure algorithmic HRM usage in its first phase, and in the second phase, it finds that algorithmic HRM having significant impact on the strategic HR decision making that helps and enables organization in creating the competitive advantage. Utilizing the author’s LinkedIn profile, 234 final participants considered for this research. Collected data analyzed by applying PLS SEM. It evaluates the mediation role of the HR strategic decision making, and the HR digital maturity as a moderator in seeing the impact of algorithmic HRM on the competitive advantage of the firm. The study finds a strong relationship between the algorithmic HRM usage and competitive advantage, a significant relationship between algorithmic HRM usage and the strategic HR decision making, and lastly, a significant relationship between strategic HR decision making and the competitive advantage. The moderating role of HR digital maturity was found to be insignificant in this research which paves the way for further research. This research, the model, and its findings contribute to the theory and implicate the practicality of algorithmic HRM. It's one of few papers that address the algorithmic HRM usage in the transitioning economy like Saudi Arabia.

Soybean maturity is a trait of critical importance for the development of new soybean cultivars, nevertheless, its characterization based on visual ratings has many challenges. Unmanned aerial vehicles (UAVs) imagery-based high-throughput phenotyping methodologies have been proposed as an alternative to the traditional visual ratings of pod senescence. However, the lack of scalable and accurate methods to extract the desired information from the images remains a significant bottleneck in breeding programs. The objective of this study was to develop an image-based high-throughput phenotyping system for evaluating soybean maturity in breeding programs. Images were acquired twice a week, starting when the earlier lines began maturation until the latest ones were mature. Two complementary convolutional neural networks (CNN) were developed to predict the maturity date. The first using a single date and the second using the five best image dates identified by the first model. The proposed CNN architecture was validated using more than 15,000 ground truth observations from five trials, including data from three growing seasons and two countries. The trained model showed good generalization capability with a root mean squared error lower than two days in four out of five trials. Four methods of estimating prediction uncertainty showed potential at identifying different sources of errors in the maturity date predictions. The architecture used solves limitations of previous research and can be used at scale in commercial breeding programs.

With the continuous development of digital transformation and upgrading of Chinese construction enterprises, it is becoming increasingly important to measure their digital level, find the problems in the enterprise transformation process, and identify the key factors of enterprise digital capacity enhancement. This paper constructs a construction enterprise digital transformation maturity evaluation model from six first-level indicators and 20 second-level indicators, including digital strategy, digital business application, digital technology capability, data capability, digital organization capability, and change management. Digital maturity is divided into five levels: business management, process operation, intelligent construction, intelligent scene application, and industrial ecological collaboration. A detailed process of digital maturity evaluation based on the method of Analytic Hierarchy Process (AHP)-Decision Testing and Evaluation Laboratory (DEMATEL) is then developed. A questionnaire survey of 25 experts is used to weight the various parameters in the model, which is then demonstrated with an example construction enterprise. The model comprehensively reflects digital levels under the background of the digital economy. Its application will help understand the advantages and disadvantages enterprises face in their digital transformation to enable targeted measures to improve their digital transformation capabilities and efficiency, enhance their core competitiveness of enterprises, and promote the development of digital transformation in the construction industry.

Background. This study aimed to establish a prognostic nomogram for predicting overall survival (OS) and cancer-specific survival (CSS) of patients with early-onset endometrial cancer (EOEC). Methods. Patients diagnosed with EOEC during 2004-2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox regression analyses were performed to ascertain the independent factors impacting the prognosis of EOEC patients, while a prognostic nomogram was established. Its performance was verified by the receiver operating characteristic (ROC) curves, and calibration plots. The prediction accuracy and clinical net benefit between the model, TNM stage and SEER stage were further compared by the concordance index (C-index) and decision curve analysis (DCA). Results. A total of 4415 eligible patients with EOEC were identified and enrolled in this study. Independent prognostic factors for OS and CSS were confirmed by multivariate Cox regression, which were further incorporated to constructed a nomogram. ROC curves and calibration curves indicated an optimal accuracy of the nomogram. Meanwhile, the C-index and DCA showed the predictive capability and the clinical applicability of the nomogram was superior over the TNM stage and SEER stage. Conclusions. Nomogram based on risk factors was developed as an individualized tool to predict OS and CSS for EOEC patients. The novel tool will assist in patient counseling and selection of appropriate therapeutic regimens.

This study investigates the spatio-temporal variability of the onset, offset, and Length of the rainy season in Senegal over the 1981-2018 period. The onset, offset dates, and length of the rainy season are crucial parameters for agricultural planning in West Africa, which exhibits high interannual and spatial variability in rainfall. The objective is to detect and spatially classify these phenological parameters across Senegal using different approaches. Daily precipitation data from the Climate Hazards group InfraRed Precipitation with Stations (CHIRPS) dataset over the study period and ERA5 reanalysis were used. The method of was applied to detect the onset, offset dates, and length of the rainy season. The Kohonen algorithm was then used to spatially classify these parameters on topological maps. A hierarchical ascendant classification was also performed to reduce the number of classes obtained. Finally, a composite analysis of moisture transport before the onset and end of the 1984 and 2007 seasons was conducted with ERA5 data. The results show a meridional gradient of the start of the season, progressively later from southeast to northwest, while the end follows a north-south gradient. The duration of the rainy season ranges from 45 days in northern Senegal to 150 days in the south. The maximum number of dry days also decreases from north to south. The Kohonen self-organizing maps allow spatial prediction of the onset, end date, and duration of the rainy season across Senegal. The dynamics analysis reveals that early onset years are associated with stronger and earlier northward moisture transport over West Africa, underscoring the role of this parameter in triggering the rainy season. These promising results can provide an early warning to policymakers and farmers on the start and end dates of the season in each area of Senegal.

Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder. Diagnosis can take a long time, especially in the presence of confounding factors, and it is, at least in part, of exclusion. AOSD is generally mild, however a small percentage of patients can develop a fearsome as well potentially fatal complication, the macrophage activation syndrome (MAS), which is also referred to as hemophagocytic lymphohistocytosis (HLH). This condition is correlated with a cytokine storm production and monocyte/macrophage overactivation, and typically occurs with rash, pyrexia, pancytopenia, hepatosplenomegaly and systemic involvement. Exitus occurs in approximately 10% of cases. The Histiocyte Society, which is a nonprofit organization committed to improving the lives of patients with histiocytic disorders, currently suggests etoposide in combination with dexamethasone for the treatment of HLH/MAS, although a multidisciplinary collaboration using the resources and expertise of several specialists (e.g. rheumatologist, infectiologist, critical care medicine specialist) is always recommended. Hereby we propose the detailed description of the clinical case of a previously healthy young woman in which MAS was the dramatic onset manifestation of AOSD and whose diagnosis posed a real clinical challenge.

Pediatric onset multiple sclerosis (POMS), characterized by the onset of multiple sclerosis before the age of 18, is gaining increased recognition. Approximately 5 percent of MS cases manifest before the age of 18, with less than 1 percent occurring before the age of 10. Despite its rarity, pediatric MS exhibits distinct characteristics, with an association between younger age at onset and a comparatively slower disease progression. Despite this slower progression, individuals with POMS historically reach disability milestones at earlier ages than those with adult-onset multiple sclerosis. While various immunomodulatory agents demonstrate significant benefits in MS treatment, such as reduced relapse rates and slower accumulation of brain lesions on magnetic resonance imaging (MRI), the majority of disease-modifying therapies (DMTs) commonly used in adult MS lack evaluation through pediatric clinical trials. Current evidence is predominantly derived from observational studies. This comprehensive review aims to consolidate existing knowledge on the mechanisms of action, efficacy, safety profiles, and recommended dosages of available DMTs specifically in the context of pediatric MS. Furthermore, the review outlines recent advancements and explores potential medications still in developmental stages, providing a thorough overview of the current landscape and future prospects for treating POMS.

Recently considered modifications to public policy and trends in technology transfer practices have underscored the need for validated instruments to assess the maturity of technologies. This paper details a study that aimed to develop and present a generalized technology readiness level (GTRL) scale that a variety of professionals and researchers could use to assess the maturity of technologies in a range of contexts. Of particular interest is developing and validating an instrument that technology transfer professionals in federal laboratories, universities, and the private sector in the United States of America can use to assess the maturity of technologies to facilitate their technology transfer efforts. The primary goal of the research study was to highlight the need for validated measurement instruments for assessing the maturity of technologies in these contexts, test methods for validating the GTRL scale and other readiness level scales, and fill the knowledge gap regarding methods for properly validating such instruments. This included producing insights to inform future efforts to validate the GTRL scale as well as efforts to develop and validate other instruments to measure technology maturity. The study provides specific recommendations relevant to determining the face validity, content validity, inter-rater reliability, and intra-rater reliability of the GTRL scale and other such instruments for assessing technology maturity.

Ascending aorta aneurysm (AsAA) is a complex disease, currently defined an inflammatory disease. In the sporadic form, AsAA has, indeed, a complex physiopathology with a strong inflammatory basis, significantly modulated by genetic variants in innate/inflammatory genes, acting as independent risk factors and as largely evidenced in our recent studies performed during the last 10 years. Based on these premises, here, we want to revise the impact of reactive oxygen species (ROS) and oxidative stress on AsAA pathophysiology and consequently on the onset and progression of sporadic AsAA. This might consent to add other important pieces in the intricate puzzle of the pathophysiology of this disease with the translational aim to identify biomarkers and targets to apply in the complex management of AsAA, by facilitating the AsAA diagnosis currently based only on imaging evaluations, and the treatment exclusively founded on surgery approaches.

Successful implementation of antibiotic stewardship programs (ASP) requires a well-structured approach involving all stakeholders. Despite embracing key responsibilities, nurses’ role remains poorly defined, preventing consistent engagement. We conducted a scoping survey to assess knowledge, attitude and perception of nurses towards nurse-led initial sepsis risk evaluation using the sepsis risk calculator (SRC) of newborns admitted to the mother-baby unit. Single-center, cross-sectional study. Study link was sent to all full-time nurses in mother-baby unit. Survey centered around knowledge of unit’s ASP and attitude and perception towards nurse-led initial sepsis risk evaluation. 89% response rate. 100% agreed that SRC reduced antibiotic use and 66% felt nurse-led sepsis risk evaluation will enhance nurse involvement, but this was offset by extra burden of work (66%) and low confidence in differentiating stable from clinically unstable infants (46%). Other facilitating factors included greater nurse/patient ratio (100%), targeted education (89%) and incorporation of the SRC into EMR (78%). Only 11% were willing to serve as champions for it. There was no significant correlation to age or experience however, greater number of fresh grads were interested in championing this effort. Our study identifies a need for strong foundation of knowledge and greater nurse/patient ratio as two main factors for improving nurse-led use of the SRC. Multi-site studies scoping barriers to nursing involvement for successful implementation of ASPs are necessary.

Patients with sAID are a population at high risk of severe COVID outcomes but evidence on the efficacy of SARS-CoV-2 vaccination in this group of patients is scarce. To investigate the efficacy of SARS-CoV-2 vaccination in patients with systemic autoinflammatory diseases (sAID) receiving interleukin-1 inhibition is important. Vaccination responses from 100 sAID patients most of whom were treated with IL-1inhibitors (N=96) and 100 healthy controls (HC) were ana-lyzed. After 2nd SARS-CoV-2 vaccination, sAID patients showed similar anti-SARS-CoV-2 anti-body responses (mean (SD): 6.7 (2.7)) compared to HC (5.7 (2.4)) as well as similar neutralizing antibodies (85.1 ±22.9% vs. 82.5 ±19.7%). Anti-SARS-CoV-2 antibody responses and neutralizing antibodies were similar in sAID patients after SARS-CoV-2 infection and double vaccination. Furthermore, while antibodies increased after 1st and 2nd vaccination in sAID patients they did not further increase after 3rd and 4th vaccination. No difference was found in antibody responses between anakinra and anti-IL-1 antibody treatments and also the additional use of colchicine or other drugs did not impair vaccination responses. Primary and booster SARS-CoV-2 vaccination lead to protective antibody responses in sAID patients, which are at the same level of vaccination responses in HC and in sAID patients after SARS-CoV-2 infection. Immunomodulatory treatments used in sAID do not seem to affect antibody responses to the SARS-CoV-2 vaccine.

Plums are primarily marketed for fresh consumption, canning, freezing, jam and jelly. Unfortunately, plum consumption has remained steady or declined. Consumers complain about a lack of flavor quality but are willing to pay for higher quality. Thus, lack of flavor and cold storage disorders are the main barriers to consumption. Plum cultivars are susceptible to gel breakdown, flesh browning and ‘off flavors’. Consumer acceptance and postharvest life are highly dependent on genotype, quality attributes, harvest date and proper postharvest handling. A consumer quality index (CQI) based on soluble solids concentration (SSC) and minimum firmness is proposed to maximize flavor and postharvest life. In most cases, late harvest increases quality attributes. Our work and industry experience demonstrated that using critical bruising thresholds (CBT) based on minimum firmness measured at harvest acts as a reliable predictor of how late to harvest safely for maximum visual and sensory quality. Plums are well adapted to late harvest because of their low susceptibility to bruising damage, but proper postharvest temperature management and marketing within the potential market life are necessary to maintain flavor and avoid the onset of storage disorders. Thus, to maximize flavor and postharvest life, a CQI based on SSC and minimum firmness measured at consumption is proposed. This article provides guidance on using this CQI, combined with proper postharvest handling techniques such as correct harvest date determination and temperature management, to maintain quality and increase consumption.

Dysferlinopathies comprise a spectrum of muscular dystrophies characterized by progressive muscle weakness and degeneration due to mutations in the DYSF gene, which encodes the dysferlin protein critical for muscle membrane repair. This review delves into the clinical spectra of dysferlinopathies, their molecular mechanisms, and the spectrum of emerging therapeutic strategies. We explore the phenotypic heterogeneity of dysferlinopathies, highlight the incomplete understanding of genotype-phenotype correlations, and discuss the implications of various DYSF mutations. Furthermore, we examine the utility of animal models in elucidating disease mechanisms and the potential of symptomatic, pharmacological, molecular, and genetic therapies in mitigating the disease's progression. We also consider the roles of diet and metabolism in managing dysferlinopathies, as well as the impact of clinical trials on treatment paradigms. By culminating the complexities inherent in dysferlinopathies, this article emphasizes the need for multidisciplinary approaches, precision medicine, and extensive collaboration in research and clinical trial design to advance our understanding and treatment of these challenging disorders.

This study investigated co-constructed research poetry as a way to understand the lived experiences of people affected by rarer dementia and as a means to use poetry to convey those experiences to healthcare professionals. Using mixed-methods, 71 people living with rarer dementia and care-partners (stakeholders) contributed to co-constructing 27 poems with professional poets; stakeholders’ verbatim words were analysed with descriptive qualitative analysis. Stakeholders were also surveyed and interviewed about their participation. Healthcare professionals (n = 93) were surveyed to elicit their responses to learning through poetry and its acceptability as a learning tool. Poems conveyed a shared narrative of different aspects of lived experience, often owing to atypical symptoms, misunderstandings by professionals, lack of support pathways, and a continuous struggle to adapt. Stakeholder surveys indicated it was a valuable experience to both co-create and respond to the poems, whilst group interviews revealed people’s experiences of the research poetry were characterised by reflection on lived experience, curiosity and exploration. Healthcare professionals’ responses reinforced the poetry’s capacity to stimulate cognitive and affective learning specific to rare dementia support and prompt both empathy and critical thinking in practice. As the largest poetry-based study that we are aware of, this novel accessible approach of creating group poems yielded substantial information about the experiences and needs of those affected by rarer dementia and how poetry can contribute to healthcare education and training.

The development of mineral resources in China has gradually entered the stage of deep mining. Rock burst, collapse and other ground pressure disasters caused by deep high stress have become major hidden dangers restricting mine safety production. Microseismic monitoring technology is an important means of ground pressure risk prediction. In this paper, the wavelet coefficient threshold denoising method in time-frequency domain, STA/LTA method, AIC method, Skew and Kurtosis method are studied, and the automatic P-phase onset time picking model based on noise reduction and multiple detection indexes is established. Through the effect analysis of microseismic signals collected by microseismic monitoring system of coral Tungsten Mine in Guangxi, automatic P-phase onset time picking is realized. the reliability of the P-phase onset time picking method proposed in this paper based on noise reduction and multiple detection indexes is verified. The picking accuracy can still be guaranteed under the severe signal interference of background noise, power frequency interference and manual activity underground mine, Which is of great significance to the data processing and analysis of microseismic monitoring.

The results of physico-chemical studies of individual fruit parts, including crusts, partitions, juice and seeds themselves, extracted from immature (green), unripe and mature fruits of three harvest periods are presented: 20.VII, 01.IX and 15.X. The analyses were carried out in 2019-20 during the period of active growth and ripening of fruits in the varieties Spring, Iridanaly, Guleisha pink and wild pomegranate from the Geokchay region (Azerbaijan) using standard and generally accepted physico-chemical methods. The ripe fruit (130-288 g) consisted of 60-113% of the peel (peel together with partitions), 53-140% of the juice and 17-85% of the seeds themselves. The edible part of the ripened fruits (53.85-73.2 of the total weight of the fruit) consisted of 58.54-78.65% juice and 21.35 -41.46% seeds, fresh juice contained 15.7-17.7% solids, including 12.04-13.84% sugar, 0.17-0.30% protein, 0.15—0.23% pectin, 0.30-0.40% ash and 0.26-0.57% total polyphenols. The concentrations of solids, protein, ash and total polyphenols in the seeds themselves, remaining after the extraction of juice from the grains of ripe fruits, were 50.0-58.2, 4.13-5.75, 0.60-1.0 and 0.08-0.32%, respectively. There were fewer total polyphenols, flavonoids, chlorogenic acids, catechins and leucoanthocyanins in ripe fruits, and more ascorbic acid, anthocyanins and proanthocyanidins than in unripe ones. The period from the second half of July to the beginning of September is the time of a real “boom” of common polyphenols.

A genome-wide association study (GWAS) was performed on a set of 260 lines which belong to three different bi-parental flax mapping populations. These lines were sequenced to an averaged genome coverage of 19× using the Illumina Hi-Seq platform. Phenotypic data for 11 seed yield and oil quality traits were collected in eight year/location environments. A total of 17,288 single nucleotide polymorphisms were identified, which explained more than 80% of the phenotypic variation for days to maturity (DTM), iodine value (IOD), palmitic (PAL), stearic, linoleic (LIO) and linolenic (LIN) acid contents. Twenty-three unique genomic regions associated with 33 QTL for the studied traits were detected, thereby validating four genomic regions previously identified. The 33 QTL explained 48-73% of the phenotypic variation for oil content, IOD, PAL, LIO and LIN but only 8-14% for plant height, DTM and seed yield. A genome-wide selective sweep scan for selection signatures detected 114 genomic regions that accounted for 7.82% of the flax pseudomolecule and overlapped with the 11 GWAS-detected genomic regions associated with 18 QTL for 11 traits. The results demonstrate the utility of GWAS combined with selection signatures for dissection of the genetic structure of traits and for pinpointing genomic regions for breeding improvement.

Clinical and histological similarities between sarcoidosis and tuberculosis have driven repeated investigations looking for a mycobacterial cause of sarcoidosis. Over 50 years ago “anonymous mycobacteria” were suggested to have a role in the etiology of sarcoidosis. Both tuberculosis and sarcoidosis have a predilection for lung involvement though each can be found in any area of the body. A key histopathologic feature of both sarcoidosis and tuberculosis is the granuloma – while the tuberculous caseating granuloma has an area of caseous necrosis with a cheesy consistency; the non-caseating granuloma of sarcoidosis does not have this feature. This article reviews and reiterates the complicity of the infectious agent, Mycobacterium avium ss. paratuberculosis (MAP) as a cause of sarcoidosis. MAP is involved in a parallel story as the putative cause of Crohn’s disease, another disease featuring noncaseating granulomas. MAP is a zoonotic agent infecting ruminant animals and is found in dairy products and in environmental contamination of water and air. Despite increasing evidence tying MAP to several human diseases, there is a continued resistance to embracing its pleiotropic roles. "Who Moved My Cheese" is a simple yet powerful book that explores the ways in which individuals react to change. Extending the metaphor, the “non-cheesy” granuloma of sarcoidosis actually contains the difficult-to-detect “cheese”, MAP; MAP did not move, it was there all along.