Global climate change, particularly rising sea surface temperatures, profoundly impacts coral ecosystems, disrupting reproduction synchrony, symbiotic relationships with algae from the Symbiodiniceae family, and causing widespread bleaching and mortality among coral populations.  Oculina patagonica, a temperate scleractinian coral dominant in Mediterranean coastal waters, tolerates an annual temperature range of 10- 31°C. Moreover, in the past three decades, sea surface temperatures have rapidly risen in the Eastern Mediterranean Sea. O. patagonica offers insight into evolutionary adaptation to rapid environmental changes. This study investigated the effects of temperature changes on O. patagonica reproductive development, synchrony, and thermal sensitivity. Monthly monitoring of O. patagonica colonies for a year reveals no disruption in gonad development compared to previous studies, suggesting an unaffected sexual reproduction capacity. Thermal performance

A new model for international bed numbers is applied to local area populations for English Clinical Commissioning Groups (CCGs) where the Age Standardized Mortality Rate (ASMR) is used as a measure of population health and hence for total occupied hospital bed demand (elective plus emergency admission types, including acute, rehabilitation, mental health, and maternity), rather than simple bed availability. A 100-unit increase in ASMR (European Standard population) leads to a 15.3 – 30.7 (feasible range) unit increase in occupied beds per 1,000 deaths. ASMR shows why the Australian states of the Northern Territory and Tasmania have an intrinsic higher bed demand than the other states – although in both cases the bed planning methodologies failed to indicate this need and both states show a large bed deficit. Due to the high volatility in bed demand the average bed demand for 2019 was determined by a linear trend using data for 2014/15 to 2019/20 — as the pre-COVID-19 baseline. The slope of the relationship between occupied beds per 1,000 deaths and deaths per 1,000 population shows a power law function. As is to be expected there is scatter around the trend line which will partly arise from uncertainty in the expected occupied beds in 2019, fluctuations in both ASMR and deaths per 1,000 population from one year to another, changes in the number of persons on the elective, outpatient and diagnostic waiting lists, and local area variation in births and consequently upon maternity, neonatal and pediatric bed demand. Additional variation in bed demand will arise from differences in the level of funding for social care, especially elderly care, and to a lesser extent upon patients using private health care, and charitable hospices for palliative care. However, after including the change in bed demand arising from ASMR the model is sufficiently accurate to identify gross differences in bed demand as a prelude to further investigation. The model requires further extension to cover specialty-level demand, and perhaps segregation between elective and emergency types of inpatient demand. A method for benchmarking the whole hospital’s average bed occupancy is given which enables them to run at optimum efficiency and safety. Using this method English hospitals can be shown to operate at highly disruptive and unsafe levels of bed occupancy leading to deleterious ‘turn-away’. Turn-away implies bed unavailability for the next arriving patient. The problems associated with crafting effective bed planning are illustrated using the English NHS as an example.

Silicon carbide single crystal (SiC) has been widely used in the field of power devices, while it is difficult to fabricate ultra-flat surface by traditional manufacturing technologies due to its difficult-to-machine property. This paper investigates the interaction process during femtosecond laser ablation of crystalline silicon carbide based on the two-temperature model simulation and experimental study. The findings reveal that parameters such as laser pulse energy, scanning interval, and defocus amount exert significant influence on ablation depth, roughness, and surface morphology. The femtosecond laser proves effective in removing surface defects from cut SiC substrates, albeit resulting in increased surface roughness. However, subsequent polishing treatment of the laser-ablated silicon carbide surface can mitigate this roughness, underscoring the feasibility of laser surface ablation for silicon carbide single crystals.

Microplastic pollution (MP) in marine environments around the globe is severe and enough precautions have not been taken so far for its prevention. The focus of this study is to quantify MPs from beach sediment and seawater samples and to identify their distribution and types along the western coast of Sri Lanka from the Kelani River estuary to the Mahaoya estuary. Nine sites along this 42 km stretch were selected and random sampling was employed to collect a minimum of 8 sediment samples from each site between October and December 2021. Water samples were also collected, parallel to the sediments, from the ocean surface. FTIR analysis revealed that most of the MPs found were polyethylene(PE), polypropylene(PP), polystyrene(PS), polyethylene terephthalate(PET), and phenol formaldehyde resin. The mean abundance of MPs varied from 2.0 ± 0.6 items/L to 161.0 ± 15.7 items/L in water samples and, from 3.0 ± 0.3 items/m2 to 656.0 ± 34.5 items/m2 in sediment samples. The MPs found were identified in different shapes as fragments (80.2%), pellets (14.9%), fibers (2.7%) and foams (2.5%). Analysis revealed that the beach sediments were contaminated with PS, phenol formaldehyde resin, PET, PP and PE, while surface seawater is dominated by phenol formaldehyde resin, PS, PP and PE.

Cardiovascular disease (CVD) and obesity are prevalent public health concerns with grave implications for morbidity and mortality, necessitating tailored interventions. This research explores the utility of fuzzy c-means clustering paired with principal component analysis (PCA) in detecting at-risk groups and personalizing health strategies for these conditions. Fuzzy c-means clustering allows for the dynamic classification of individuals into groups based on unique risk factors and intervention outcomes, while PCA aids in distilling complex data sets to uncover underlying patterns. The conjoined use of these methods has shown promise in identifying diverse risk profiles and in forecasting intervention success rates. The study acknowledges limitations, including possible biases stemming from data set composition and analytical parameter selection. Future research aims to refine these tools for clinical application. The results support implementing fuzzy c-means clustering and PCA for delineating specific target populations for health interventions, emphasizing careful use of these analytical approaches. Subsequent studies should focus on correlating these techniques with concrete clinical results to enhance public health measures.

(1) Background: Intravesical Chemotherapy is standard of care in intermediate risk non-muscle-invasive bladder cancer (NMIBC). Different agents are used across the world based on availability, cost and practice patterns. Epirubicin (EPI), one of these agents is used by many centers over many decades. However, its true differential efficacy compared to other agents and its tolerability is still poorly reported. We aimed to assess the differential efficacy and safety of intravesical EPI in NMIBC patients. (2) Methods: A systematic search of PUBMED, Webofscience, clinicaltrials.gov, and Google Scholar databases was performed on December 31, 2023. We reviewed 28 studies that included patients treated EPI after TURBT (transurethral resection of bladder tumors) for NMIBC and who compared oncological outcomes such as recurrence and progression to other adjuvant treatment such as Mitomycin C (MMC), Gemcitabine (GEM) and BCG. Further, we looked at the safety profile of EPI at room temperature under hyperthermia intravesically and at the oncological outcomes when administrated with hyperthermia; (3) Results: When compared to other chemotherapeutics (MMC/GEM), EPI seemed to be equally effective; however, EPI seems less effective in preventing disease management recurrence compared to BCG intravesical. The most common adverse events of EPI include cystitis, dysuria, and pollakiuria. (4) Conclusions: EPI exhibits similar oncological performances to Gemcitabine and Mitomycin C currently used for adjuvant therapy in NMIBC. Novel delivery mechanisms such as hyperthermia are promising newcomers.

To elucidate the function of the cold resistance regulatory gene FmNAC1 from Fraxinus mandshurica, this study identified the role that the overexpression of the FmNAC1 gene plays in tobacco growth and cold stress regulation. The cloned FmNAC1 gene from F. mandshurica is 891 bp in length and encodes 296 amino acids. Our subcellular localization analysis confirmed that FmNAC1 is primarily located in the nucleus and functions as a transcription factor. FmNAC1 is responsive to cold and NaCl stress, as well as to the induction of IAA, GA, and ABA hormone signals. To further elucidate its function in cold resistance, four transgenic tobacco lines of FmNAC1 overexpression（FmNAC1-OE）were generated through tissue culture after the agrobacterium-mediated transformation of wild-type (WT) tobacco. These FmNAC1-OE plants exhibited accelerated growth after transplantation. When exposed to low-temperature conditions at -5°C for 24 hours, the rates of wilting and yellowing of the FmNAC1-OE plants were significantly lower than those of the WT tobacco plants. Additionally, the membrane integrity, osmotic regulation, and reactive oxygen species (ROS)-scavenging abilities of the FmNAC1-OE tobacco lines were better than those of the WT plants, indicating the potential of the FmNAC1 gene to improve plant cold resistance. The gene expression results further revealed that the FmNAC1 transcription factor exhibits regulatory interactions with growth-related genes such as IAA and AUX1; cold resistance-related genes such as ICE, DREB, and CBF1; and genes involved in the clearance of reactive oxygen species (ROS), such as CAT and SOD. All of this evidence shows that the FmNAC1 transcription factor from F. mandshurica plays a key role in contributing to the enhancement of growth, cold resistance, and ROS clearance in transgenic tobacco plants.

ABSTRACT The work is focused on determining the energy transfer from EV’s to grid for different operating conditions. The study has been simulated on a scaled model and later validated through experimental tests on batteries of 20 kWh, 40 kWh, 60 kWh and 80 kWh for EV’s energy rates from 130 Wh/km to 180 Wh/km. Tests have been developed to evaluate the energy transfer from driving distance between 0 and 50 km. Results have proved there is a linear dependence between energy transfer and energy rate. Experimental and simulated values have been correlated showing a 99.6% accuracy. The ratio of energy transfer to battery energy capacity depends not only on this latter parameter, but also on the energy rate of the electric vehicle. Experimental tests have shown a variation from a minimum transfer ratio of 54.1% for the highest electric vehicle energy rate and lowest battery energy capacity and power transfer to grid rate to a maximum of 88.6% for the highest power transfer to grid rate and battery energy capacity and lowest electric vehicle energy rate.

The early 2-factor (E2F) family of transcription factors, including E2F1-8, plays a critical role in apoptosis, metabolism, proliferation, and angiogenesis within glioblastoma (GBM). However, the specific functions of E2F transcription factors (E2Fs) and their impact on the malignancy of Bevacizumab (BVZ)-responsive GBM subtypes remain unclear. This study used data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) to explore the impact of eight E2F family members on the clinical characteristics of BVZ-responsive GBM subtypes and possible mechanisms of recurrence after BVZ treatment.To predict the possibility of GBM patient survival and progression, we classified and comparedthe expression of E2Fs according to BVZ-responsive subtypes and employed a machine learning method-TreeBagger, one random forest algorithm. Multiple bioinformatics analyses have shown that the significant increased E2F8 post BVZ treatment may enhance the function of angiogenesis and stem cell proliferation, indicating one of the mechanisms of GBM recurrence after treatment. In addition, BVZ treatment in unresponsive GBM patients may potentially worsen disease progression. Our findings suggest that E2F family members play important roles in GBM malignancy and BVZ treatment response, highlighting their potential as prognostic biomarkers and therapeutic targets and recommending precise BVZ treatment for GBM patients.

This study investigated the effects of fish oil (FO) treatment, particularly enriched with eicosapentaenoic acid (EPA), on obesity induced by a high-fat diet (HFD) in mice. The investigation focused on elucidating the impact of FO on epigenetic modifications in white adipose tissue (WAT) and the involvement of adipose-derived stem cells (ASCs). C57BL/6j mice were submitted to a control diet or a HFD for 16 weeks, treated (or not) with FO for the last 8 weeks. WAT was removed for RNA and protein extraction, while ASCs were isolated, cultured, and treated with Leptin. All samples were analyzed using functional genomics tools, including PCR-array, RT-PCR and Western Blot assays. Mice receiving HFD displayed increased body mass, fat accumulation, and altered gene expression associated with WAT inflammation and dysfunction. FO supplementation attenuated these effects, a potential protective role against HFD-induced obesity. Analysis of H3K27 revealed HFD-induced changes in histone, which were partially reversed by FO treatment. The study further explored leptin signaling in ASCs, suggesting a potential mechanism for ASC dysfunction in the leptin-rich environment of obese WAT. Overall, FO supplementation demonstrated efficacy in mitigating HFD-induced obesity, influencing epigenetic and molecular pathways, and shedding light on the role of ASCs and leptin signaling in WAT dysfunction associated with obesity.

Sweden has long been hailed as a role model in climate policy. But the new right-wing government supported by a far-right populist party is undertaking a paradigm shift in Swedish climate policy and governance. This paper critically analyses this paradigm shift and its impacts on legitimacy, accountability and justice. These are democratic norms important in the analysis of a just transition to climate neutrality. Severe democratic deficits of the policy process and the policies proposed and adopted are identified, suggesting ‘nasty politics’ characterised by populist, divisive, and contentious rhetoric that entrenches polarization and us/them narratives. Climate scientists and the climate justice movement are discriminated in the policy process, the latter also being accused of terrorism and seen as a threat to democracy by the government. The deficits are partly explained by the neo-corporatist political system of Sweden and the dominance of the (neo)liberal discourse of ecological modernization in Swedish environmental policy, but primarily with the ongoing process of autocratization driven by anti-democratic far-right populist parties throughout Europe. The anti-democratic climate policy reforms in Sweden are foreboding an unwelcome development in the EU given the boost of far-right populist parties in the upcoming elections to the European Parliament in June 2024.

This study examines the attitudes and practices of dentists and dental students towards envi-ronmental issues within their professional context. Data was selected based on their responses on a Google Forms e-questionnaire, designed specifically for the study. The sample consisted of 78 professional dentists and 75 dental students in Greece and their attitudes towards environmental protection, awareness of the environmental impact of dental practices, and factors influencing the adoption of environmentally friendly practices were assessed. Results reveal generally positive attitudes towards environmental protection, with students demonstrating higher levels of proper waste management practices. Dentists express awareness of their environmental impact but ex-hibit varying levels of engagement in eco-friendly practices. Factors such as moral consciousness and believing in the severity of climate change significantly influence environmental awareness in dental practice. Notably, dental students exhibit greater environmental awareness compared to practicing dentists. These findings emphasize the importance of integrating environmental edu-cation into dental curricula and continuing education programs to foster sustainable practices in dental care. Future research could explore interventions to enhance environmental consciousness among practicing dentists and assess the long-term impact of environmental education initiatives on dental care sustainability.

Abstract: Background: Nurses worldwide are acknowledged for their role in health education across various settings. However, doubts often arise regarding their competence in this domain. This study aims to validate the Nurse Health Education Competence Instrument (NHECI) linguis-tically and culturally for the Italian context. Methods: Following Beaton et al.’s (2000) guidelines, we conducted cross-cultural adaptation to develop the Italian version of the questionnaire. Results: The Italian version demonstrates good internal consistency and stability, making it suita-ble for assessing nursing students during clinical internships and practicing nurses. Availability of Italian tools promotes research in healthcare, ensuring patient-centric care. Conclusions: The validity and reliability of the Italian version of the instrument for assessing health education competencies, essential for self-assessment among health education nurses, are established.

In air quality management, at urban and regional levels, road transport remains the cornerstone of residential, commercial, and industrial activities, and the vehicle exhaust emissions maintain the position of one of the key contributing sources. In Indian cities, big and small, vehicle exhaust emissions and dust from vehicle movement on the roads, contribute to as much as 50% of particulate matter pollution in a year. So, having access to a vehicle exhaust emissions inventory that is reliable and replicable is critical for air quality management and this exercise starts with access to vehicle stock numbers. These numbers are typically obtained from vehicle registration databases, traffic surveys, and other governmental records, and often require time consuming data cleaning protocols before they can used for emissions and pollution baseline analysis. This paper provides a cleaned and open-access vehicle stock database, as registered and in-use fleet, for the period covering 1993 and 2018, for all India and states, along with an estimate of age-mix of the vehicles using survival functions.

In this study, a new diphosphate compound, Ag0.2Na0.6FeP2O7, was synthesized using a solid-state reaction method and extensively studied using various techniques. The compound's structure was confirmed through X-ray diffraction analysis, revealing a single-phase monoclinic structure with the P21/C space group. The electrical behavior of the compound was investigated, and its conductivity followed Jonscher's universal law. The correlated barrier hopping (CBH) model explained the temperature-dependent ac conductivity and parameter "s" well. The study also explored the contribution of single-polaron and bipolaron hopping to the a.c. conductivity and discussed the ionic conductivity in relation to the structural characteristics of the sample. Overall, this investigation significantly enhances our comprehension of the distinctive electrical properties of Ag0.2Na0.6FeP2O7 and its potential practical applications.

Among earth’s microbial populations are the genes, functional capacities, generational memory and sentient cognition that enable microorganisms to adapt and thrive in the full range of ecological conditions found on planet earth. In prior sequential publications, we considered fundamental properties (e.g., use of and responses to sound, light, vibrations) and features of microorganisms that cause them to be critical co-partners of human and other holobionts as well as the potential benefits for humanity that can be gained by fully applying quantum-related and novel capacities of microbial life. In this narrative review we: 1) discuss key concepts concerning a microbially-enhanced and sustainable future, and 2) focus on electric- and magnetic- based features of microorganisms that make them pivotal for myriad benefits ranging from beyond pharma-based health and wellness to free- and/or renewable energy and restorative agriculture to improved human networking. While the benefits are many, the risks posed by hazardous electric or magnetic field exposures to both holobionts and microbial communities are significant. This review concludes that microbes and their remarkable capacities offer both humanity and the planet a much brighter future if we reverse the demonization of microbes and wanton microbiome degradation that has predominated much of the past century.

Based on the need for real-time sag monitoring of Overhead Power Lines (OPL) for electricity transmission, this article presents the implementation of a hardware and software system for online monitoring of OPL cables and cable sag determination. The mathematical model based on differential equations and the methods of algorithmic calculation of OPL cable sag are presented. Considering that, based on the mathematical model presented, the calculation of OPL cable sag can be done in different ways depending on the sensors used, and the presented application uses a variety of sensors. Therefore, a direct calculation is made using one of the different methods. Subsequently, the verification relations are highlighted directly and, respectively, the calculation by the alternative method, which uses another group of sensors, to generate both a verification of the calculation and the functionality of the sensors, thus obtaining a defect observer of the sensors. The hardware architecture of the OPL cable online monitoring application is presented, together with the main characteristics of the sensors and communication equipment used. The configurations required to transmit data using the ModBUS and ZigBee protocols are also presented. The main software modules of the OPL cable condition monitoring application are described, which ensure the monitoring of the main parameters of the power line and the visualisation of the results both on the electricity provider's intranet using a web server and MySQL database, and on the Internet using an Internet of Things (IoT) server. This categorisation of the data visualisation mode is done in such a way as to ensure a high level of cyber security. Starting from the mathematical model of the OPL cable sag calculation, it goes through the stages of creating such a monitoring system, from the numerical simulations carried out using Matlab to the real-time implementation of this monitoring application. The main modules of the application software are: the software module for reading quantities from the sensor network through a ModBUS Input/Output (I/O) server, the software module for real-time calculation of the OPL cable sag, the software module for read/write operations based on MySQL type data, the software module for transferring data to the user's intranet through a web server, and the software module for viewing data by authorised users based on user and password through an IoT server. The development software environments used are Matlab and Laboratory Virtual Instrument Engineering Workbench (LabVIEW).

Bistatic radar experiments have been used to study surface characteristics of extra-terrestrial bodies in the Solar System, including the Moon, Venus, Mars, and Titan. This paper proposes a 3D model to characterize the scattered field of a Gaussian rough surface on an extra-terrestrial body for an orbital bistatic radar configuration. Specifically, this model will investigate how the variability of surface roughness impacts the spectral broadening of the received signal using physical optics approximations and ray tracing on a surface model using a facet approach with Gaussian properties. A linear relationship between spectral broadening of the signal and surface roughness was found. This relationship is in line with results obtained by commonly used analytical models for bistatic radar on planetary surfaces.

Skin inflammation associated with chronic diseases has the direct action of keratinocytes in its immunopathogenesis, leading to a series of immune responses. However, there are still no highly targeted treatments, and the development of more specific therapies is highly desirable. In the present work, nanocapsules containing quinizarin (QZ/NC) were developed, evaluating their act in a model of the keratinocytes inflammatory process in vitro with the action of Photodynamic Therapy, analyzing the permeation in a 3D skin model. Physicochemical, stability, cytotoxicity and permeation analyses of the nanomaterials were carried out. The nanocapsules showed desirable physicochemical characteristics and were stable during the analysis period, without spectroscopic modifications. The cell viability test carried out showed no cytotoxicity at the lowest QZ/NC concentrations. The permeation and cellular uptake studies showed the permeation of QZ/NC in 3D skin models and the intracellular incorporation and internalization of the drug, enhancing its action in the drug delivery technique. Promising results were presented using the model developed to induce the inflammatory process in vitro and applying the synthesized nanomaterial in conjunction with PDT, where a decrease in the levels of cytokines analyzed was observed, representing a possible new therapeutic approach for inflammatory skin diseases.

Background/Objectives: The aim of this study was to investigate feasibility and safety of neuromuscular electrical stimulation (NMES) in patients on extracorporeal membrane oxygenation (ECMO) and assess thoroughly any potential adverse events. Methods: We conducted a safety and feasibility study including 16 ICU patients on ECMO support who were admitted to the cardiac surgery ICU from January 2022 to December 2023. Patients underwent a 45-minute NMES session, still on ECMO support, that included a warm up phase of 5 minutes, a main phase of 35 minutes and a recovery phase of 5 minutes. NMES was implemented on vastus lateralis, vastus medialis, gastrocnemius and peroneus longus muscle of both lower extremities. Two stimulators delivered biphasic, symmetric impulses of 75 Hz, with 400 μsec pulse duration, 5 sec on (1,6 sec ramp up and 0,8 sec ramp down) and 21 sec off. The intensity levels aimed to cause visible contractions and be well tolerated. Primary outcomes of the study were feasibility and safety, evaluated by whether the NMES sessions were successfully achieved, and by any adverse events and complications. Secondary outcomes included indices of rhabdomyolysis from biochemical blood test, 24 hours after the application of NMES. Results: All patients successfully completed their 45-minute NMES session, without presenting hemodynamic deterioration, adverse events or signs of rhabdomyolysis. The majority of patients achieved type 4 and 5 quality of muscle contraction. Conclusions: NMES is a safe and feasible exercise methodology in patients supported with ECMO.

Dark energy and dark matter are described as different manifestations of vacuum energy in a new cyclic universe framework of Extra Dimensional Symmetry (EDS) that doubles large spatial dimensions with microscopic partners. In this testable framework, vacuum energy, constrained by a Planck density constraint, exists in a gravitationally dark state where actual gravitational constant G_o = 0G. While a small repulsive component is constrained by an asymptotically evolving asymmetry to the active state where G_o = 2G, some components in the inert state are enabled to gravitationally attract by neutrino induced gravitational constant with light and shear activated heavy components. Observational and experimental tests are briefly discussed.

The insufficient of fish meal has been become a prominent problem with the development of the aquaculture industry. Therefore, it is great significance that replacement fish meal using other protein sources for the sustainable development of aquaculture industry. In this study, fermented cottonseed meal (FCM) and fermented rapeseed meal (FRM) were used to replace fish meal in Chinese mitten crab. The ratio of FCM and FRM were set according to 1:2, 1:1, and 2:1, and were supplemented into 25% fish meal (FM-25) and 15% fish meal (FM-15) diets, respectively, to formulated 6 kinds of experimental diets. The feeding duration was 8 weeks. The results showed that the weight gain (WG) and specific growth rate (SGR) of crabs fed the diets containing 25% fish meal were significantly higher than crabs fed 15% fish meal diets. At 25% fish meal level, the WG and SGR of crabs fed the diet with 1FCM:1FRM were significantly higher than those fed the 1FCM:2FRM and 2FCM:1FRM diets. At 25% fish meal level, the crude lipid (CL) content of crabs fed the diet with 1FCM:2FRM were significantly higher than those fed the 2FCM:1FRM and 1FCM:1FRM. At 25% fish meal level, the activities of glutathione peroxidase (GPX) and peroxidase (POD) of crabs fed the diet with 1FCM:2FRM were significantly higher than those fed the 2FCM:1FRM and 1FCM:1FRM. At 25% fish meal level, the relative expression of peroxiredoxin (PRX) of crabs fed the diet with 1FCM:1FRM were significantly higher than those fed the 2FCM:1FRM and 1FCM:2FRM. In summary, diets supplemented with a mixture of fermented cotton meal and fermented rapeseed meal (1:1) can significantly improve the growth and antioxidant capacity of Chinese mitten crab.

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

The study of coherent vortices remains an urgent field of singular optics of vortex beams. In this paper, coherent properties of partially coherent vortex Bessel—Gaussian optical beams propagating through a uniform medium (free space) or a turbulent atmosphere are examined theoretically. The consideration is based on analytical solution of the equation for the transverse second-order mutual coherence function of the field of a partially coherent optical radiation in a turbulent atmosphere. For the partially coherent Bessel—Gaussian beam, the second-order mutual coherence function of the source field is taken as a Gaussian Shell-model. In this approximation, we analyze the behavior of the coherence degree and the integral coherence scale of these beams as a function of the propagation pathlength, propagation conditions, and beam parameters, such as the radius of the Gauss factor of the beam, parameter of the Bessel factor of the beam, topological charge, and correlation width of the source field of partially coherent radiation. In addition, the integral coherence scale of the partially coherent vortex Bessel—Gaussian beam is compared with that of the partially coherent Gaussian beam. It is found that as a partially coherent vortex Bessel—Gaussian beam propagates through a turbulent atmosphere, there appear not two (as might be expected: one due to atmospheric turbulence and another due to partial coherence of the source field), but only one ring dislocation of the coherence degree (due to the simultaneous effect of both these factors on the optical radiation). In addition, it is shown that the dislocation of the coherence degree that affects significantly the beam coherence level is formed only for beams, for which the coherence width of the source field is larger than the diameter of the first Fresnel zone.

This study, serving as Part-2 of the research titled "Comparative Analysis of Length Deformation in Classical and Relativistic Mechanics," investigates the behaviour of matter within gravitationally bound systems. Through meticulous examination of projected length alterations, the research highlights differences between classical and relativistic mechanics frameworks, emphasizing the necessity of considering relativistic effects beyond velocity alone. Additionally, the study underscores the crucial role of gravitational effects on the effective mass of moving objects, which emerges as a critical factor in predicting length deformation across scientific disciplines. The incomplete treatment of relativistic effects within Relativistic Mechanics, including acceleration and material stiffness, emphasizes the importance of comprehensively understanding gravitational influences on effective mass. This is evident in gravitational equations, where the gravitational force depends not only on the object's mass but also on its effective mass, influenced by kinetic energy. Thus, incorporating the gravitational effect on effective mass enhances the understanding of length deformation phenomena within gravitationally bound systems, enriching scientific discourse.

Reduced-order electrothermal models play a key role in the design and control of lithium- ion cell stacks, calling for accurate model parameter calibration. This paper presents a complete electrical and thermal experimental characterization procedure for coupled modeling of cylindrical lithium-ion cells in order to implement them in a prototype Formula SAE hybrid racing car. The main 4goal of the tests is to determine cell capacity variations with temperatures and discharge currents, to predict the open circuit voltage of the cell and its entropic component. A simple approach for the characterization of the battery equivalent electrical circuit and a two-steps thermal characterization method are also shown. The investigations are carried out on four commercial 18650 NMC lithium cells. The model demonstrated to predict the battery voltage at a RMS error lower than 20mV and the temperature to a RMS error equal to 0.5 ◦C. The authors hope that this manuscript can contribute to the development of standardized characterization techniques for such cells, while offering experimental data and validated models that can be used by researchers and BMS designers in different applications.

Boutique hotels emerged in the late 1970s since then the product has become more mainstream. The draw of boutique hotels is more personalized services. When marketing and providing services to a niche market it is smart to be able to differentiate potential guests to best meet their needs. The generational cohort theory states that a population may be divided into segments based on their generation. This research focuses on Generation X to find out what they are seeking in a boutique hotel product. Based upon how they chose their travel destination there were significant differences between culinary experience, attractions/activities, and cost/budget.

During the last decade, Bangladesh has been experienced a significant climatic anomalies which lead to an increase in magnitude and frequency of various climate relate extreme events. Climate scientists substantiate that global temperature and precipitation pattern is expected to change, which may result in consequential impact on agriculture, livelihood, and ecosystem. Bangladesh is therefore likely to face substantial challenges in the coming decades. In order to adequately understand this complex, dynamic phenomena, Analyzing historical Climate change scenarios as well as projecting its future trends is a great concern for researcher. This study aims to analyzes/ historical climatic data from (1901-2020), and predict future temperature and precipitation patterns in Bangladesh using CMIP6 data. Data used in this study (Observed data is from CRU TS 4.05 and future data is from CMIP6) have been acquired from WorldClim v2.1. Various methods including correlation, regression, standard deviation, correlation matrix, percentiles, cell statistics, and IDW interpolation were performed to analyze the trends, variability and spatial patterns of temperature and rainfall. This study revealed that Over the historical study period (1901-2020) Bangladesh has been experienced a significant warming trend with an average increase in temperature 2°C and with annual decline of the total precipitation 607.26 mm along with a shift towards drier conditions despite weak correlation with hotter years. Projected climate models represents that Bangladesh minimum temperature is expected to increase from 1°C to 4.4°C as well as maximum temperatures from 1°C to 4.1°C by 2100. Moreover, projected precipitation is expected to increase by 480.38 mm, with the biggest rises during monsoon months. Regional variations in temperature and precipitation are again expected, with the Southeast (SE) likely experiencing the most significant warming and the Northeast (NE) seeing the most substantial increase in precipitation.

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

Many farms are replacing the lighting with light emitting diode (LED) bulbs because of the technological modernization. We aimed to investigate the effects of incandescent light (IL) and LED lighting on Cobb500 broiler chickens for six weeks. Production parameters (body weight, feed consumption, feed conversion ratio), calculated slaughter values (yield%, relative breast%, thigh%) and breast meat quality parameters (pH at 45 min and 24 h postmortem, color, drip loss, kitchen equipment losses, shear force, meat composition) were recorded. Non-stop recordings were used to analyze the behavior of the birds in several periods of the rearing. LED group was significantly better in body weigh parameter between week 1-5 and feed conversion ratio between week 2-3. The most significant difference in behavior was observed in the middle of the rearing period. The chickens in the LED group spent more eating time, drinking time, interacting, and resting less. There was no difference in the meat quality parameters, only shear force was significantly lower in the LED group (1781.95±0.33 g/s vs. 2098.82±0.42 g/s). Based on our results, LED lighting can bring positive changes in animal production efficiency, behavior, and important characteristics for meat consumers.

In a business environment that is constantly changing, intellectual capital stands out as the most valuable asset for companies. Those who invest in developing their employees, especially their Chief Financial Officers (CFOs), tend to outperform their competitors. This study explores the relationship between the intellectual Capital of CFOs and the financial performance of companies listed on B3. The 100 companies with the largest capitalization listed on B3 in 2022 were analyzed, with available data on the CFO. A statistical model was applied in a cross-section analysis, considering two of the three subdivisions of Intellectual Capital: Human Capital ( experience, education, and certifications) and Relational/Social Capital ( network and reputation of the CFO). The results indicated a statistically significant relationship between CFOs' Human Capital level and the performance of the companies they manage, measured by EPS, ROA, and ROE. However, no statistical significance was found for Relational/Social Capital. This study contributes to the literature on intellectual capital and corporate finance in the Brazilian context, providing new evidence on the importance of CFOs' intellectual capital for company performance. It was observed that there are few equivalent studies in Brazil on the topic, especially about the Intellectual Capital of CFOs of companies listed on the stock exchange (BOVESPA).

To address the requirements of sonar imaging, such as high receiving sensitivity, wide bandwidth, wide receiving angle, an AlN PMUT with an optimized ratio of 0.6 for the piezoelectric layer diameter to backside cavity diameter is proposed in this paper. A sample AlN PMUT is designed and fabricated with SOI substrate-based bulk MEMS process. The characterization test result of the sample demonstrates a -6 dB bandwidth of approximately 500 kHz and a measured receiving sensitivity per unit area of at 1.37 V/μPa/mm2, which significantly surpasses the performance of previously reported PMUTs. The -6 dB horizontal angles of the AlN PMUT at 300 kHz and 500 kHz are measured 68.30° and 54.24°, respectively. To achieve an accurate prediction of its characteristics when being packaged and assembled in a receive array, numerical simulations with the consideration of film stress are conducted. The numerical result shows a maximum deviation of ±7% in the underwater receiving sensitivity across the frequency range of 200 kHz to 1000 kHz and a deviation of about 0.33% in the peak of underwater receiving sensitivity comparing to the experimental data. By such good agreement, the simulation method reveals its capability of providing theoretical foundation for enhancing the uniformity of the AlN PMUTs in future studies.

The study examines projected changes in dry- and wet-spell probabilities in West Africa using a Markov chain approach. Four simulations of regional climate models from the CORDEX-Africa program were used to analyze projected changes in intraseasonal variability. The results show an increase in the probability of having a dry day, a dry day preceding a wet day and a dry day preceding a dry day, and a decrease in the probability of wet days in the Sahel region under anthropogenic forcing scenarios RCP4.5 and RCP8.5. The decrease in wet days is stronger in the far future and under the RCP8.5 scenario (up to -30%). The study also finds that the probability of consecutive dry days (lasting at least 7 days and 10 days) is expected to increase in the Western Sahel, the Central Sahel, and the Sudanian Area under both scenarios, with stronger increases in the RCP8.5 scenario. In contrast, the decrease is expected over the Guinea Coast, with the changes more important under the RCP4.5. These changes in dry- and wet-spell probabilities are important for water management decisions and risk reduction in the energy and agricultural sectors. The study also highlights the need for decision-makers to implement mitigation and adaptation policies to minimize the adverse effects of climate change.

Effective waste elimination is critical for the success of construction projects. Although several studies have focused on various aspects of construction waste, limited efforts have investigated the dynamic effect of Making-Do (MD) practices on productivity, rework, defects, and materials wastage. From a lean construction perspective, this study aims to address MD waste using the Last Planner System (LPS) and BIM. First, the casual structure that can cause MD in construction projects was expressed in a casual loop diagram (CLD), and thematic analysis uncovered the strategies of LPS-BIM to eliminate MD identified by reviewing the literature. Secondly, twenty-five strategies from the LPS and BIM strategies to address MD using Structural Equation Modeling (SEM) were assessed. Subsequently, a system dynamics model (SDM) for investigating LPS-BIM strategies on MD decisions in a construction project was formulated based on the underlying causal loop diagrams and the mathematical relations among the variables. Finally, the model was applied to three projects, and simulations for four LPS-BIM scenarios were carried out. The findings show that dynamic interactions among diverse production planning and control factors are critical in evaluating MD impacts on a construction project. The results demonstrate that the LPS-BIM approach resulted in an average 43.8% reduction in the tasks performed with MD, 45.3% of constraints, 66.5% of construction waste, increasing 13.7% completion rate, and 29.3% cost reduction, demonstrating that LPS-BIM as a more efficient solution for MD mitigation and construction planning.

Abstract Incretin mimetics, also known as glucagon-like peptide-1 (GLP-1) receptor agonists, are a class of medications used to treat type 2 diabetes by mimicking the actions of incretin hormones in the body. These hormones are responsible for promoting insulin release from the pancreas in response to nutrient intake, as well as decreasing glucagon secretion, slowing gastric emptying, and promoting satiety. By imitating these actions, incretin mimetics help to regulate blood sugar levels in individuals with diabetes and glucose intolerance. One of the key benefits of incretin mimetics is its ability to lower blood sugar levels without causing hypoglycemia. This is especially important for individuals with diabetes who may experience dangerous drops in blood sugar levels when using other medications. Additionally, incretin mimetics have been shown to promote weight loss in some individuals, making them a valuable option for those struggling with obesity in addition to diabetes. Incretin mimetics are administered by injection, once or twice daily, depending on the specific medication. They are often combined with other diabetes medications, such as metformin or insulin, for optimal blood sugar control. These medications are generally well-tolerated, with common side effects including nausea, vomiting, and diarrhea, which usually diminish over time as the body adjusts to the medication. Studies have shown that incretin mimetics can help improve cardiovascular outcomes in individuals with diabetes, including reducing the risk of heart attacks and strokes. This is particularly significant given the increased risk of cardiovascular disease in individuals with diabetes. Incretin mimetics also have been shown to preserve pancreatic beta-cell function, which is responsible for producing insulin. This can help slow the progression of diabetes and reduce the need for higher insulin doses over time. Despite their many benefits, incretin mimetics are not without limitations. They can be expensive compared to other diabetes medications, which may make them less accessible for some individuals. Additionally, there have been concerns about the potential risk of pancreatitis and pancreatic cancer associated with the use of these medications. However, more research is needed to fully understand these risks. It is important for healthcare providers to carefully assess each individual's unique needs and medical history when considering the use of incretin mimetics. They may not be appropriate for everyone, particularly those with a history of pancreatitis or pancreatic cancer. Patients should also be educated about these medications' proper administration and potential side effects to ensure their safety and efficacy. Overall, incretin mimetics have emerged as an important therapeutic option for individuals with type 2 diabetes, offering a unique mechanism of action that can help improve blood sugar control, promote weight loss, and reduce cardiovascular risk. With ongoing research and development in this field, incretin mimetics continue to show promise as valuable tools in managing diabetes and its associated complications and comorbidities.

Businesses now formally enter the phase of "think power differentiation and gap" in response to the new economic climate. While AI, big data, empowerment via the internet, and other aspects of the digital economy help to improve technical capabilities and save operating costs, they also push businesses to innovate their strategies at a faster rate. Enterprises are strategically choosing to de-enterprise, moving from focusing on a single business functioning benefit to building an ecosystem of platform services that will give them a competitive edge. Additionally, the organization's structure is evolving continually from a vertical model to a curved working style, in order to achieve this, businesses must recognize the importance of data analysis in day-to-day management and operations, encourage the development of an organizational atmosphere that is driven by data, fully utilize digital technology, modularize areas or production links that perform related tasks, and encourage the reform of organizational structures. By streamlining the output of the product or service to the external community while also enhancing the company's financial performance model, switching from process-to result-oriented evaluation, and putting in place a customized authority and accountability framework. Replace outcome-focused evaluation with process-focused evaluation, and create a customized incentive scheme that balances power, accountability, and rewards.

This research delves into librarians' perceptions of artificial intelligence (AI) support in learning experiences, lifelong learning, and digital literacy within the library context, undertaking a comparative analysis between Malaysia and Indonesia. Employing a survey methodology, a self-developed questionnaire was administered to 59 librarians in Malaysia and 85 in Indonesia. The questionnaire, utilizing a Likert scale, systematically explored subjective judgments on AI's impact across various dimensions. A noteworthy finding is the consistent and harmonized perception among librarians in both countries, underscoring a universal recognition of AI's perceived support for learning experiences, lifelong learning, and digital literacy. Of particular interest is the emphasis on sustainability in librarians' perspectives, as they recognize the enduring value of AI in fostering educational growth. Despite the limitations inherent in perceptual measures and a relatively modest sample size, the empirical and practical contributions of this study are significant. It offers a nuanced exploration of librarians' viewpoints, providing valuable insights for future research endeavors. Moreover, the study's findings have immediate practical implications for the integration of AI tools in library services, policy-making, and professional development, with a focus on ensuring sustainable implementation for long-term benefits.

Cerebral ischemic stroke poses a significant global cause of death, with ischemia-reperfusion injury contributing to neuronal cell death and tissue damage. However, significant therapeutic approaches with meaningful treatment effects for patients with ischemic stroke in actual clinical practice are lacking. This study investigated the potential neuroprotective effects of sildenafil, a phosphodiesterase-5 inhibitor, in a global cerebral ischemia model. We explored the impact of sildenafil on GFAP and AQP-4 expression, which are markers associated with astrocyte activation and water homeostasis, respectively. The immunofluorescence analysis revealed that the number of cells co-expressing the markers, which increased in the ischemia-induced group, was significantly reduced in sildenafil-treated groups, suggesting a potential mitigating effect on ischemia-induced astrocyte activation. Additionally, we conducted diverse behavioral tests, including the open-field test, novel object recognition, Barnes maze, Y-maze, and passive avoidance tests, to assess the effect of sildenafil on the cognitive function impaired by ischemia. Cognitive improvements were observed following sildenafil administration (20mg/kg) compared to the untreated group. Taken together, the results presented here suggest sildenafil's potential as a neuroprotective agent for alleviating delayed neuronal cell death and cognitive function impaired by ischemia.

Introduction: Emotional intelligence plays a critical role in nursing leadership, influencing organizational dynamics and patient care. However, there is limited understanding of the impact of Emotional Intelligence on leadership in Primary Health Care in the Greek context. Methods: A longitudinal experimental design assessed the effects of an educational intervention on EI and leadership among Greek Primary Health Care nurses. Questionnaires, including the Wong and Law Emotional Intelligence Scale (WLEIS) and Multifactor Leadership Questionnaire - form 5x (MLQ), were administered pre- and post-intervention. Results: The intervention group exhibited significant improvements in Emotional Intelligence and adoption of transformational leadership styles compared to the control group. Tables highlighted nuanced changes in leadership dynamics post-intervention. Conclusions: Educational interventions effectively enhance nurses' Emotional Intelligence and influence leadership styles, emphasizing the need for tailored professional development programs in nursing education.

The prognostic abilities of artificial intelligence and neuroscience in forensics and the criminal justice system stand as a reformatory paradigm for understanding any criminal conduct. While the use of artificial intelligence has been labeled transformational data analytical capabilities, neural predictive approaches also enable an intricate understanding of culpability and criminal propensities. The literature on the complex nature of neuroprediction and artificial intelligence, its ethical deliberations and its usability in curving recidivism are analyzed. This theoretical review elucidates the complex interplay, nuptial relationships and convergence of these relationships in the quest for justice. The consequences of not protecting individual rights in the criminal justice system are surveyed using grounded theory. The degree of acceptability and dependability of AI-generated evidence in legal proceedings are also reviewed. All these topics are yet to be contemplated under one roof to offer an argumentative view. The author expects to prompt readers and new commers to embrace more sociolegal and technological research before incorporating such research in the Indian Judiciary. The review focuses on the question of whether to blame such technology inclusion wholly or rather to prioritize the acquisition of bias-free pretrained datasets and processing models.

Water is a fundamental resource for ecosystems, humans, and the development of all economic sectors; it is necessary to identify and evaluate its environmental pressures or impacts. The water footprint (WF) is an appropriate indicator for the consumption of water used to produce a product. The present study uses this tool to evaluate the green and blue water requirements and the sustainability of irrigation water use for agroindustrial avocado production in Ziracuaretiro, Michoacán (2012-2021). Our analysis was based on aggregating weather and soil data at the municipal level and official government databases of avocado cultivated surface, fruit production, and water rights concessions. The analysis considers the homogeneity of information throughout the study area. We estimated that rainfed plantations require 839.03 m³/ton and irrigated plantations require 2355.80 m³/ton, with an average of 1597.47 m³/ton. In addition, we determined that avocado cultivation can demand up to 124.3% of agricultural water concessions in this municipality. In addition to the WF estimates, the analysis indicates that such studies are fundamental for decision-makers to develop and implement water use-efficiency strategies and shows the need for further research related to water consumption of avocado as a crop at more detailed scales to reduce uncertainty.

The commercialization of historic streets constitutes a pivotal aspect of urban cultural heritage, and the comprehension of their visual perception serves as a valuable asset to urban planning and cultural conservation efforts. However, current research concerning the disparities in visual perception among diverse demographics within historic streets, as well as their spatiotemporal dynamics, remains insufficient. This study aims to utilize mobile eye-tracking technology to delve deeply into the visual perception characteristics of diverse demographics within commercialized historic streets, while also analyzing their spatiotemporal dynamics. We explore the disparities in visual perception of historic streets among groups with varying degrees of architectural knowledge and professional literacy. Through meticulous observation using mobile eye-tracking technology, we elucidate the visual perception patterns of different demographic characteristics through statistical analysis and spatiotemporal modeling. The findings reveal significant discrepancies in visual attention and perception among various groups. Participants with a higher understanding of architecture tend to focus more on architectural details and structures within the streetscape compared to those with a lower understanding, who exhibit greater interest in elements such as shops and signage. Moreover, during the process of perceiving the streetscape, participants’ eye movements transition from surrounding landscapes and historical edifices upon initial entry to the district, gradually shifting towards the commercial activities and distinctive architecture within the district. This study delves deeply into the visual perception characteristics and spatiotemporal dynamics of commercialized historic streets, providing invaluable insights for urban planning and cultural preservation endeavors. By revealing the impact of different demographic characteristics on the visual perception of historic streets, it offers new insights for urban planning and cultural heritage conservation.

The genus Strophantus belongs to the Apocynaceae family of flowering plants which grows primarily in tropical Africa. The plants are widely used in traditional herbal medicine. S. sarmentosus, in particular, is used for the treatment of, e.g., joint pain and rheumatoid arthritis, wound infections, head lice, diarrhoea, snake bite, and eye conditions. Despite the widespread use, dedicated research characterizing bioactive plant components is scarce. Investigations focussed mainly on the cardenolides, because of their cardioactivity and historical use as cardiotonic. There are also studies concerning the antibacterial, antioxidant and anti-inflammatory activity of plant extracts. This review summarizes the present knowledge about the biochemical and analytical reserach on Strophantus, in general, and S. sarmentosus, in particular, and describes the current state-of-the-field based on the available sientific literature.

Novel functionalized and/or grafted crosslinked chitosan adsorbents were synthesized and used to remove several toxic heavy metal ions from contaminated water efficiently and selectively. The chitosan biopolymer was functionalized by maleic anhydride (CS_MA), which also acted as a crosslinking agent. Separately, Glutaraldehyde-crosslinked chitosan (CS_GA) was grafted with poly(methyl methacrylate) (CS_MMA). The synthesized adsorbents were used to adsorb and remove heavy metal ions from contaminated water. The metal ions were nickel, lead, chromium, and cadmium. The adsorption capacity of the adsorbents was analyzed under various conditions of contact time, adsorbent dose, initial concertation, temperature, and pH and evaluated against those of pure chitosan (CS) and the crosslinked one (CS_GA). The ultimate conditions for the ions removal were 0.5g/100ml adsorbent dose, an initial metal ion concentration of 50 ppm, a temperature of 45oC, and a pH 9. CS_MMA, which had the highest removal percentages for all metal ions, ranging from 92% to 94%. The adsorption was demonstrated to fit a pseudo-first-order model that followed a Langmuir adsorption isotherm. The results highlight the capacity of the synthesized polymers to efficiently remove major toxic contaminants at low cost from contaminated water, present especially in low-income areas, without harming the environment.

Despite global efforts to improve vaccination coverage, the number of zero dose and under immunized children has increased in the African continent, particularly in Nigeria where more than 2.3 million unvaccinated children currently reside, making it the country with highest number of unvaccinated children on the African continent. It is thus imperative to identity barriers and facilitators of immunization in Nigeria with a view to formulate and design targeted interventions that can effectively bridge the immunization gap in Nigeria. In this review, we systematically mapped and summarized existing literature and data on key barriers to vaccine uptake, and facilitators influencing immunization practices in Nigeria. The electronic databases were systematically searched and articles that reported determinants of routine immunization uptake in Nigeria from inception of the databases up till October 2023 were included. The eligible articles were evaluated using a set of pre-defined criteria and the extracted data were analysed and visualized. This scoping review identified barriers spanning logistical, socio-economic, cultural, and healthcare system-related aspects, highlighting the need for a multi-pronged approach to address these challenges. While considerable progress has been made over the years, persistent barriers like distance between area of residence of caregivers and immunization centers, vaccine shortages, poor interpersonal relationship between healthcare workers and caregivers and cultural/religious influences persist. Lastly, collaborative efforts among stakeholders and communities remain paramount in ensuring improved routine immunization coverage across the Nigeria’s diverse socio-cultural landscape.

The bentonite slurry trenches are becoming increasingly popular in the excavation process of trenches, especially for diaphragm wall construction. The problem that needs to be addressed is the stability of bentonite slurry trenches. This paper presents a stability analysis of trenches with temporary support of bentonite slurry, with unit weights ranging from 10.5 to 12.0 kN/m3, in the realistic stratum: C3 in the Hue city area. The analysis employs the shear strength reduction technique (SSR) with Mohr-Coulomb materials for the numerical method to evaluate the factor of safety (FS). The finite element method (FEM) software program (RS) and the finite difference method (FDM) FLAC software were applied. Additionally, the limit equilibrium method (LEM) of Bell-Washbourne and three-dimensional (3D) Bishop are used for calculating trench stability. The analysis results show a good agreement between RS2 and FLAC2D and RS3 and FLAC3D. Secondly, upon comparison, it is noted that the safety factors of the 3D software programs (RS3, FLAC3D) are higher than those of the 2D software programs (RS2, FLAC2D), ranging from 52.3 to 63.0% for trench lengths of 6m. However, for trench lengths of 54m, the safety factor values in 2D and 3D are nearly equal. Thirdly, the safety factor of the Bell-Washbourne method (LEM) is lower than the numerical analysis methods (FLAC and RS programs). Using the three-dimensional numerical method appears to be effective for estimating stability.

Chronic obstructive pulmonary disease (COPD) patients are particularly susceptible to respiratory infections like influenza, which exacerbate symptoms and increase healthcare utilization. While smoking cessation and influenza vaccination are recommended preventive measures, their combined impact on healthcare resource utilization is underexplored. The Charlson Comorbidity Index (CCI) assesses comorbidity burden in COPD patients and may influence healthcare outcomes. We conducted a retrospective analysis of 357 COPD patients, evaluating smoking cessation success over one year and influenza vaccination receipt, stratifying patients by CCI scores. Healthcare utilization outcomes included emergency room visits, hospitalizations, and medical expenses. Results showed that 51.82% of patients quit smoking and 59.66% received influenza vaccination, with higher comorbidity prevalence in advanced COPD stages (p=0.002). Both smoking cessation and influenza vaccination independently correlated with decreased emergency room visits, hospital admissions, days, and costs. Patients who both quit smoking and received influenza vaccination exhibited the lowest healthcare utilization rates. In conclusion, smoking cessation and influenza vaccination significantly reduce healthcare resource utilization in COPD patients, with the combination yielding synergistic benefits, particularly in those with lower CCI scores. Integrating these interventions and comorbidity management in COPD strategies is essential for optimizing patient outcomes and healthcare efficiency.

We consider fractional integral operators $(I-T)^d, d \in (-1,1)$ acting on functions $g: \mathbb{Z}^{\nu} \to \mathbb{R}, \nu \ge 1 $, where $T $ is the transition operator of a random walk on $\mathbb{Z}^{\nu}$. We obtain sufficient and necessary conditions for the existence, invertibility and square summability of kernels $\tau (\mathbf{s}; d), \mathmb{s} \in \mathbb{Z}^{\nu}$ of $(I-T)^d $. Asymptotic behavior of $\tau (\mathbf{s}; d)$ as $|\mathbf{s}| \to \infty$ is identified following local limit theorem for random walk. A class of fractionally integrated random fields $X$ on $\mathbb{Z}^{\nu}$ solving the difference equation $(I-T)^d X = \varepsilon$ with white noise on the right-hand side is discussed, and their scaling limits. Several examples including fractional lattice Laplace and heat operators are studied in detail.

Achieving Net Zero emissions target is driving up the need for offshore wind as an alternate energy source. Ireland has the capacity to produce upwards of 30GWof power through offshore wind alone. Wind resource assessments are extremely vital in determining the long term trends of a site. The instruments used for this often suffer breakdowns or miss readings which impacts the long term trend analysis. Wind time series data from Ireland’s Marine Institute is used which is shown to have significant gaps in it’s 20 years of service. Data imputation is necessary to fill in these gaps as accurately as possible. This paper compares LSTMs and ARIMA as two competing methodologies for data imputation. LSTMs are shown to be marginally superior to ARIMA imputation with a mean squared error of 0.45 compared to that of ARIMA of 0.60.

Colpodella species are free-living opportunistic pathogens that cause human and animal infections and use ticks and flies as vectors. Trophozoite and cyst stages of Colpodella species can be distinguished from stages of the prey Parabodo caudatus using Sam-Yellowe’s trichrome staining. Colpodella species obtain nutrients by attaching to their prey, aspirating the prey’s cytoplasmic contents into a posterior food vacuole and encysting. It is unclear whether both trophozoite and cyst stages are present during infection. Molecular techniques identified Colpodella species in all reported infections. However, no morphological information was reported to aid life cycle stage identification in hosts. This review discusses the increased incidence of Colpodella infection in animals and in vectors and the need to identify stages used for transmission and pathogenesis. The potential for zoonotic infections through tick and fly bites is a public health concern. We previously used Sam-Yellowe’s trichrome staining to identify life cycle stages of Colpodella sp. In order to gain a better understanding of transmission and pathogenesis, identifying Colpodella life cycle stages in infected tissue and in vectors will provide important insights regarding nutrient uptake in hosts by determining whether attachment of trophozoites to host cells occurs, and identifying trophozoites and cysts in infected hosts.

This comprehensive review has systematically examined the use of heterogeneous solid acid catalysts in the production of biodiesel from wastewater-derived sludge by using the PRISMA methodology. The manuscript highlighted the composition and characteristics of wastewater-derived sludge, presenting both the opportunities and challenges associated with its use as a feedstock for biodiesel production. Various types of catalysts were dis-cussed, with a detailed exploration of heterogeneous solid acid catalysts, including zeolites, hetero-polyacid (HPA), mixed metal oxides, and sulphonic acid group catalysts. The advantages and limitations of these catalysts were critically analyzed, providing a balanced view of their potential in industrial applications. The application section delved into the catalytic transesterification reaction, mechanisms of biodiesel production, and the effects of catalyst loading on yield. Performance metrics such as catalytic activity, stability, recyclability, cost-effectiveness, and environ-mental impact were thoroughly evaluated, offering a clear understanding of the efficacy of these catalysts. Synthesis and characterization techniques were also reviewed, shedding light on the latest preparation methods and characterization techniques. Recent advances in catalyst development were presented, showcasing the innovative strides made in enhancing catalyst performance. The environmental and economic implications of using solid acid catalysts for bio-diesel production were assessed, emphasizing the importance of sustainability and economic viability.

The prevalence of diabetes mellitus (DM) continues to rise globally, posing significant health challenges and burdens. This metabolic disorder, characterized by elevated blood glucose levels, contributes to various complications including cardiovascular diseases, kidney failure, and stroke. While conventional diabetic drugs exist, they often come with adverse side effects, necessitating the exploration of safer and more cost-effective alternatives, particularly from natural sources like medicinal plants. This study investigates the potential of Neocarya macrophylla (Nm) Ethyl acetate leaf fraction in managing DM. Utilizing a high-fat diet/streptozotocin-induced diabetic rat model, the study explores several key aspects including effective dose determination, biological activity, impact on body mass index (BMI), and complete blood count. Statistical analysis was conducted using GraphPad Prism version 9.1. The determination of the minimum effective dose reveals that 120mg/kg of Ethyl acetate fraction of Nm reduced the blood glucose by 28.9% after 4 hours. In addition, ethyl acetate fraction (120 mg/kg) possessed the most hypoglycemic activity compared to the other fractions of Nm. The Ethyl acetate fraction of Nm at 120mg/kg significantly reduced fasting blood glucose levels compared to the diabetic control(p=0.001) and slightly decreased BMI. Furthermore, the fraction demonstrated significant improvement in the parameters of some of the blood count indices such as red blood cells (p<0.001), total white cells (p<0.01) and platelet (p<0.001) compared to the diabetic control. These findings underscore the potential of Nm as a holistic therapeutic option for managing DM and its haematological complications. In conclusion, this study sheds light on the hypoglycemic potential of Nm Ethyl acetate leaf fraction, offering valuable insights into its effectiveness, safety, and broader physiological impacts. Further research into the mechanisms underlying its therapeutic effects is warranted to fully harness its therapeutic potential in diabetes management.

Aluminium alloys are used for fabrication of fuel clad of research grade nuclear reactors as well as of several types of core components of high flux research reactors. In order to carry out design and safety analysis of these components, their mechanical and fracture properties are required by the designer. In this work, experiments have been conducted on tensile specimens machined from an aluminium alloy block to evaluate the material stress-strain curve. For evaluation of fracture properties, experiments have been conducted on disc shaped compact tension specimens in order to determine the fracture toughness of aluminium alloy. From crystal plasticity based finite element analysis and experimental data, a material damage parameter for prediction of crack initiation has been evaluated. The variation of the parameter for various values of initial a/W ratios of the disc-shaped CT specimens have been studied. It was observed that the damage parameter is independent of crack geometry and hence, it qualifies as transferable material property which can be used to predict crack initiation in a component of this material subjected to different kinds of loading conditions. In addition, the JR curves of the disc-shaped CT specimens have also been evaluated from experiments. The material damage parameter has also been used to study the crack initiation in single crystal fracture specimens with two different orientations. It was observed that the [111] orientation is more susceptible to crack initiation and propagation compared to the [100] orientation as the damage parameter is high in the ligament of the specimen ahead of the crack-tip for the same level of load. The results of the experiments and the material damage parameter shall be helpful for integrity analysis of fuel clad of research reactors as well as components of high flux research reactors.

Transplanted organs experience several episodes of ischemia and Ischemia-reperfusion. The graft injury resulting from ischemia-reperfusion (IRI) remains a significant obstacle to the successful survival of transplanted grafts. Temperature plays an important role in cellular metabolic rates since biochemical reactions are highly temperature dependent. Therefore, ischemia-triggered degradative reactions could be mitigated by lowering temperature. Whether a local hypothermia on liver before blockage of blood flow protects liver grafts against IRI has not been investigated. In this study, we applied local hypothermia to mouse donor livers for a specific duration before stopping blood flow to liver lobes, a procedure called "liver precooling." Mouse donor liver temperature in control groups was controlled at 37ºC. Subsequently, the liver donors were preserved in cold University of Wisconsin solution for various durations followed by orthotopic liver transplantation. Liver graft injury, function and inflammation were assessed at 1- and 2-days post-transplantation. Liver precooling exhibited a significant improvement in graft function, revealing more than a 47% decrease in plasma aspartate transaminase (AST) and alanine aminotransferase (ALT) levels, coupled with a remarkable reduction of approximately 50% in liver graft histological damage compared to the control group. The protective effects of liver precooling were associated with the preservation of mitochondrial function, substantial reduction in hepatocyte cell death, and a significantly attenuated inflammatory response. A retrospective analysis of patient data revealed a close correlation between hypothermia and enhanced liver graft function. Taken together, reduction of the cellular metabolism and enzymatic activity to a minimum level before ischemia protects against IRI during transplantation.

There is a recent growth and development with regard to the female athlete. This trend has been reflected in a greater concern for aspects such as nutrition, body composition and the health of female athletes, given the repercussion of these factors on their sporting performance. The aim was to carry out an anthropometric and nutritional assessment of elite Spanish female football athletes based on different biochemical parameters. Ethical consent was obtained from a total of 21 players from a Spanish elite women's football team(20-33years). Anthropometric analysis was carried out using the International Society for the Advancement of Kineanthropometry(ISAK). Clinical analyses were performed by the club's medical staff at the beginning of the season through serum and fasting urine samples taken by the players. The athletes presented fat% of 19.1(SD±2.89). 100% of the players had Mg values within the reference values. Values below reference values were observed for Hb (85.7%), vit.D (33.3%), ferritin (23.8%), serum iron (28.6%), transferrin (4.8%) and TSI (42.9%); and above for CK (42.9%), basal cortisol (38.1%), testosterone (19%) and creatinine, total cholesterol, iron, transferrin, TSI and serotonin (4.8%). Differences in Mg levels were only observed between playing positions (p&lt;0.05). There were associations between age and vit.D levels (r=0.607), and weight with vit.D levels (-0.464) and blood cholesterol (-0.487) among others. Given the nutritional knowledge of Spanish elite female football players, as well as the prevalence of deficiencies in iron metabolism parameters and vit.D levels in athletes, the need to implement a correct nutritional assessment and education in this type of athletes is highlighted

This study investigates the impact of General Government Final Consumption Expenditure (GC) on GDP growth in Saudi Arabia during major economic crises from 1990 to 2022, focusing on periods marked by fluctuations in oil and non-oil revenues. By integrating these revenue streams, the research provides a more comprehensive analysis of fiscal policy effectiveness during economic downturns. Using an Autoregressive Distributed Lag (ARDL) model, the study reveals that Government Consumption significantly stabilizes and stimulates the Saudi economy amidst revenue volatility. Key findings highlight the dual role of Government Consumption (GC) as both a buffer against immediate economic shocks and a stimulus for economic recovery. The study contributes to the discourse on fiscal policy in oil-dependent economies by demonstrating the critical role of diversified revenue strategies in enhancing economic resilience. Recommendations are offered for policymakers to optimize fiscal strategies, ensuring robust economic recovery and long-term stability in volatile markets. This research underscores the necessity for Saudi Arabia to refine its fiscal policies towards greater economic diversification and stability.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a single stranded RNA virus which has resulted in the Coronavirus Disease 2019 (COVID-19) pandemic and has infected millions of people all over the world. SARS-CoV-2 has been mutating rapidly resulting in the emergence of multiple variants to escape the host immune system mainly by mutations in its receptor binding domain (RBD) of the spike protein. This rapid evolution of the SARS-CoV-2 posed a great challenge regarding the efficacy and effectiveness of the current SARS-CoV-2 vaccines. The RBD and full-length spike of SARS-CoV-2 is the main target of the neutralizing antibodies. Many SARS-CoV-2 variants are considered to have the potential to escape from the host immune system. In this study, the RBD of Alpha, Beta, Gamma, Kappa and Omicron and the full-length spike of BA.1, BA.2, BA.3, BA.4/5, BQ.1.1 and XBB.1.5 Omicron variants were used as coating antigens in Enzyme Linked Immuno-Sorbent Assay (ELISA) to check the neutralization capability of COVID-19 convalescent sera from patients of first wave of infection occurring in Wuhan. Our results show that the currently circulating Omicron BQ.1.1, XBB.1.5 and previous Omicron BA.1, BA.2 and BA.4/5 do not show significant reduction in neutralization, while Omicron BA.3 and previous variants Alpha, Beta, Gamma, Kappa, and Omicron showed a significantly reduced neutralization when compared to the wild-type Wuhan strain. These results indicate patients recovering from natural infection of early original Wuhan strain may have the potential to resist infection of current circulating variants and the vaccines using the prototype antigen may still working for newly emerged variants.

Atherosclerotic cardiovascular disease, a leading cause of morbidity and mortality worldwide, is a chronic inflammatory disease, linked to a state oxidative stress, with several well-identified culprits, of which low-density-lipoprotein cholesterol (LDL-C) and lipoprotein(a). No specific treatment is currently available to lower lipoprotein(a). It is, therefore, of paramount importance to identify nutritional factors that could lower lipoprotein(a). Growing evidence shows that although reducing saturated fatty acid (SFA) intake decreases LDL-C, it could increase lipoprotein(a). Optimal dietary recommendations may therefore differ depending on an in-dividual’s baseline lipoprotein(a) and LDL-C levels. Assessing the diet-induced true LDL-C response and net balance of these two atherogenic entities is difficult because LDL-C measurement is confounded by lipoprotein(a) cholesterol content. We have estimated, for the first time, the net atherogenic result of diet-induced variations of both LDL-C and lipoprotein(a), thanks to our new concept of LDLapoB risk equivalent=apoB+lp(a)x5 (in nmol/L). This is illustrated, via the rare case of a physician with very high lipoprotein(a) and hypobetalipoproteinemia. She experiences twice a considerable lipoprotein(a) increase (+32%, + 28mg/dL, + 67nmol/L) and higher LDLapoB risk equivalent (138mg/dL versus 123mg/dL) on a mediterranean diet, low in SFA. A reasonable SFA intake, despite causing marginal LDL-C increase, may be advisable in patients with high lipoprotein(a) who need personalized dietary recommendations.

The circular economy is one of the main strategies for mitigating the environmental impacts of civil construction, due to the generation of construction and demolition waste (CDW). In this transition, evaluating alternatives for using buildings as material banks is a way to make the process of reusing construction components more efficient. Thus, the article aimed to evaluate the state of the art of publications on the relationship between the circular economy in civil construction and the conceptual model of buildings as material banks, to mitigate the environmental impacts of CDW. The authors chose the methodological design of Systematic Literature Review, using the Scopus and Web of Science databases for research, with the following search strings: ("construction" or "civil construction" or "built environment" or "construction industry" ) and ("circular economy" or "circular construction") and ("material banks" or "BAMB" or "buildings as material banks" or "building stocks" or "building materials") and ("construction waste" or "demolition waste" or "CDW" or "construction and demolition waste" or "environmental impacts"). After a screening in which only articles published in journals were selected, from 2013 to 2023, inclusion and exclusion criteria were applied, to evaluate only those that had a direct relationship with CDW management through circular economy strategies and buildings such as banks of material. As a result, 93 articles remained, which were analyzed using quantitative and qualitative approach. The quantitative results showed an increase in publications since 2020, which are concentrated in European countries and China. The predominance of applied studies was also noted, through case studies that evaluate the management of materials and waste in the urban environment. The qualitative analysis, carried out using a SWOT Matrix, highlighted the strengths of the buildings, such as material banks, the potential reduction of resource extraction and urban mining, promoting the circulation of construction products. However, the recycling of waste, such as aggregates, still stands out as the main end-of-life strategy adopted, even without occupying the top of the waste hierarchy.

Purpose: The deterioration of oral function has been getting much attention as “Oral frailty”. This study evaluated the change in tongue pressure, one of the objective items of oral frailty, to examine the relationship between body position and tongue pressure. Methods: This study was prospective, observational study in a single-center. The participants were categorized by Clinical Frailty Scale (CFS). Tongue pressure was measured in the following positions: dorsal, sitting, and sitting with plantar grounding. Differences in tongue pressure between CFS and between body positions were statistically analyzed. Results: A significant decrease in tongue pressure was demonstrated in CFS4 compared to CFS3. Furthermore, in CFS5 and CFS6, tongue pressure decreased in the sitting po-sition compared to that in the dorsal position and recovered to the dorsal level with plantar grounding. Conclusions: Tongue pressure decreased as the progression of frailty. It decreased by sitting, and this decrease was alleviated by plantar grounding.

This review examines methodologies studying soil carbon in urban green spaces, a field requiring higher attention as their ecosystem services are valued and urban mitigation plans against climate change are developed. In the growing global urbanization, urban green spaces play a crucial role as nature-based solutions to address climate challenges, demanding efficient carbon accounting and reduction strategies. In this research, a systematic review was conducted assessing publications from 2021 to 2023 in the databases Web of Science and Scopus. Findings expose the lack of standardization in the methodologies used to study soil carbon in urban green spaces, evidencing in situ measurements at different sampling depths and studies without longitudinal monitoring over time. In addition, studies originated primarily in universities from China, United States and Spain, which focused on carbon in the form of Soil Organic Carbon and Total Carbon. Based on these findings, recommendations are made advocating for the combination and standardizing methodologies. This review offers valuable insights that shed light on an ignore and often overseen issue. Further studies and standardized methodology are needed, to help cities efforts in their pursuit of carbon neutrality by acknowledging the influential role of urban soils, especially green spaces.

Cardiopulmonary resuscitation (CPR) is a widely practiced lifesaving skill. Conventional CPR is based on manual chest compressions and delivering mouth-to-mouth breaths. There has been advancement in biomedical technology over the last few decades which has led to the introduction of new techniques and devices in CPR as well. In light of these advancements, we propose SMEAR (Standard, Mechanical, ECMO Assisted, Augmented virtual and Remote) classification system to provide structured overview from traditional to novel methods and devices. The standard or Manual CPR, widely practiced by the general public during out-of-hospital cardiac arrests, combines active chest compressions with or without mouth breathing. However, to enhance CPR’s efficacy, various mechanical devices have been developed, encompassing Active Chest Compression, Passive Decompression, and those integrated with Automated External Defibrillators. Feedback sensor-equipped devices, include the Metronome, Accelerometer, Barometer, and Triaxial Field Induction. Mechanical devices, classified by their compression mechanisms, can be isolated – like the Piston-driven, Load-distributing, and Active Compression-Decompression (ACD) – or combined, as in ACD-ITV (Impedance Threshold Device), ACD-IAC (Interposed Abdominal Compression), and ACD-ITV-EECP (Enhanced External Counter Pulsation). Beyond mechanics, Extracorporeal CPR offers veno-arterial Extracorporeal Membrane Oxygenation in refractory cardiac arrest and can improve outcomes. Augmented Virtual Reality usage in training and provision of CPR is at the early stages. It has the potential of expanded usage in training public to provide high-quality CPR. A provider can be remotely guided step by step via telephone or smartphone applications, ensuring continuous support until professional assistance arrives.

The prevalence of patients on buprenorphine therapy presenting for elective surgery has increased. Buprenorphine is a widely used medication for management of patients with chronic pain. It is also used for maintenance therapy for patients with a history of opioid use disorder (OUD). Due to lack of standardized protocol for managing patients on buprenorphine peri-operatively, we performed a retrospective analysis to compare pain score outcomes and post-operative opiate requirements between patients who continued versus discontinued buprenorphine. We identified 35 patients, 11 continued buprenorphine and 24 discontinued buprenorphine. The average Post-Anesthesia Care Unit (PACU) pain score was 7.54 for those who discontinued pre-operative buprenorphine and 5.59 for those who continued (P value 0.0339). The average post-operative Morphine Milligram Equivalent (MME) use was 86.13 for those who continued pre-operative buprenorphine and was 107.70 for those who discontinued buprenorphine (P value 0.6439). The results from our study correlate with several previous studies which showed lower PACU pain scores in patients who continued buprenorphine. There is a benefit of decreased pain post-operatively when pre-operative buprenorphine is continued and having a decrease in relapse in those with a history of OUD.

Background: Boronic acids form di-ester bonds with cis-hydroxyl groups in carbohydrates. The formation of these adducts could impair the physical and chemical properties of the precursors, even their biological activity. Methods: Two carbohydrate-derivatives from D-fructose and D-arabinose and phenylboronic acid were synthesized in a straightforward one-step procedure and chemically characterized by spectroscopy and X-ray diffraction crystallography. Also, an acute toxicity test was performed to determine their Lethal Dose50 (LD50) by using the Lorke’s method. Results: Analytical chemistry assays confirmed adducts by the generation of the diester bonds with a β-D-pyranose of carbohydrates, including signals corresponding to the formation of new bonds, like the stretching of B-O bonds. The NMR spectra yielded information about the stereoselectivity in the synthesis reaction by the finding of just one signal in the range for the anomeric carbon in the 13C NMR spectra of both adducts. The acute toxicity tests showed that LD50 value for both compounds is 1265 mg/kg, while Effective Dose 50 for sedation is 531 mg/kg. However, differences were in the onset and lapse of sedation. Conclusions: These adducts are bioactive and highly safe agents. Further biological evaluation is desirable to explore medical purposes.

M184V is a single-base mutation in the YMDD domain of reverse transcriptase (RT). The M184V resistance-associated mutation is related to virological unresponsiveness to lamivudine (3TC) and emtricitabine (FTC) and induces high-level resistance to these two antiretroviral agents. M184V is rapidly selected in the setting of non-suppressive antiretroviral therapy (ART) and accumulates in the HIV reservoir. There were continuous efforts to evaluate the impact of M184V mutation on the treatment outcomes in people with HIV (PWH). Since lamivudine remains an extensively used part of recommended antiretroviral combinations, M184V is commonly detected in patients with virological failure. ART guidelines do not recommend the use of drugs impacted by resistance-associated mutations as they have been confirmed to comprise a risk factor for virological failure. However, previous authors suggest that 3TC/FTC can remain active even in the presence of M184V. Obtaining the viral resistance profile for each individual both treated or ART-naïve is a key challenge for lifelong treatment management.Given the potential benefits of lamivudine in the ART combinations, the investigation of M184V remains of high interest for clinicians and researchers. This is a review of literature for the challenges in treating both naïve and experienced individuals carrying the M184V resistance mutation, including virological failure, virological suppression, and resistance to ART.

In the current era of emerging technologies and cutting-edge inventions, it is equally important to consider the ethical aspects of research and innovations to have an ethical space for the sustainable progress and safety of humanity. The field of nanotechnology research and innovation often faces criticism due to its potential adverse impacts on health, the environment, limited accessibility, high costs, and concerns about data privacy. Therefore, it is crucial to address and resolve these ethical issues systematically. In this regard, we present our findings and methods for exploring the application of the ethics technology assessment method by considering its relevance at different stages of innovation development. Specifically, the present work provides a conceptual framework for ethics technology assessment focused on evaluating a significant innovation in nanotechnology within the domain of food safety with specific reference to mycotoxin remediation. By leveraging the value-sensitive design approach, we described various strategies for analyzing the ethical implications of nanotechnology-based innovations in mycotoxin remediation. Through comprehensive ethics technology assessment, nanotechnology-based innovations can be guided toward becoming more value-oriented, thereby making substantial contributions to social progress.

The research investigates the factors affecting the financial performance of Micro, Small, and Medium Enterprises (MSMEs) in Indonesia and their impact on the country’s economic growth. The research methods of the studies involve data collection through surveys or interviews, followed by statistical analysis. The study found that entrepreneurial qualities such as motivation, entrepreneurial orientation, and risk behavior positively influence the financial performance of MSMEs. MSMEs that manage working capital optimally tend to increase profitability and growth, despite operational difficulties like worker shortages. MSMEs engaged in foreign trade usually achieve higher profitability. Bank loans can enhance profitability and sales, but the collateral requirement may hinder growth. The owner’s involvement doesn’t affect growth but can enhance profitability. Factors like the Human Capital Index, interest rates, the Indonesian Rupiah exchange rate, and inflation do not significantly impact MSME investment. However, business units, labor, investment, and exports of MSMEs significantly influence Indonesia’s economic growth. MSMEs play a crucial role in job creation, rural development, economic diversification, and GDP contribution in Indonesia. Despite challenges, they have the potential for sustainable growth. The research also explores strategies for overcoming challenges faced by MSMEs and investigates the role of universities in supporting the MSME sector. The University of Indonesia (UI) supports the MSME sector through strategic initiatives, including education, training, mentoring, and internship programs. The research provides valuable insights into the operation of MSMEs in Indonesia and their contribution to the economy, highlighting areas for further exploration and potential strategies for supporting the growth and sustainability of these enterprises.

Background: Despite continuous improvements in revascularization techniques, refractory angina without potential revascularization options remains a relevant clinical issue with significant impact on patient’s quality of life. Recently, a novel device, the Coronary Sinus Reducer (CSR), has been introduced into clinical practice as a therapeutic option for patients with disabling angina pectoris. In this single-center, observational study, we evaluated the mid-term (3-month) safety and efficacy of the CSR in a real-world cohort. Methods: The study population consisted of 55 patients with refractory angina without potential revascularization options, predominantly men (87.3%) with a high cardiovascular risk factor burden and advanced angina (baseline CCS angina class 3.15 ± 0.6). In terms of procedure safety, all patients underwent successful device deployment with only one periprocedural complication. Results: At the 3-month follow-up we observed statistically significant improvement in angina control measured CCS class and SAQ-7 Total questionnaire along with increased abolition of physical limitation – 6-MWT (233.3 ± 107.1 vs 305.2 ± 126.8; p&lt;0.0001). Additionally, we observed significant improvement in terms of quality of life measurements SF-36, the EQ-5D-5L questionnaire, and the EQ-VAS. Conclusions: Our real-world data suggest that CSR implantation is a relatively safe procedure and appears to be particularly effective in relieving angina symptoms and improving quality of life in subjects with refractory angina.

The paper presents the reconstruction of paleoenvironmental conditions in the Gdansk, Bornholm and Arcona Basins of the Baltic Sea over the last millennium. A complex study (including geochemical, XRF, grain size, AMS and micropalaeontological analyses) of five sediment cores, retrieved by short gravity corer of Niemistö type, was performed. The cores are mainly represented by undisturbed silty muds of olive-grey and grey colours. The age models for the cores were built based on Pb distribution along the sediment sequences as radiocarbon dating resulted in excessively old age. Despite generally very low foraminiferal amount and diversity the increased inflow activity was reconstructed during the Medieval Climate Anomaly. The strongly positive North Atlantic Oscillation (NAO) index during this period led to a prevalence of westerlies over the Baltic region and stronger saltwater intrusions. In the recent sediments, the reconstructed inflow frequency demonstrates a decadal variability rather than the reduction, although, the general decline compared to the Medieval Climate Anomaly is seen.

Introduction: Agricultural practices significantly influence soil microbial populations and physicochemical properties, which are crucial for crop growth and quality. This study aims to investigate the impact of different agrochemical applications on soil microbial dynamics, soil physicochemical properties, as well as yield and proximate properties of maize. Methods: Carefully gathered topsoil samples at depths ranging from 1 to 15 cm, were transported to Jimma University to cultivate maize. Over a period of up to 120 days, soil and maize samples were collected at specified days to analyze various parameters, including soil pH, microbial populations, as well as nutrient content both in soil and plants. The collected data was statistically analyzed using one-way ANOVA, with a significance level of p < 0.05. Results: The soil bacterial and fungal populations were measured on days 5, 10, 20, 40, 80, and 120. The highest total mesophilic bacterial count (TMBC) was measured in the pots containing compost (G) and the lowest in pots that received macronutrient fertilizers and glyphosates (B) (i.e. 91.8 x 105 and 13.13 x 105 cfu/g of soil, respectively). The highest total mesophilic fungal count (TMFC) was observed in pots containing glyphosates and compost (F) (i.e. 67.25 x 104 cfu/g soil) and again the lowest in pot treated with macronutrient fertilizers and glyphosate (B) (i.e. 3.23 x 104 cfu/g soil). Moreover, the pots treated with macronutrient fertilizers and glyphosate (B), macronutrient fertilizers (A), and micronutrient fertilizers (C) exhibited the lowest levels of Fe and Zn. Furthermore, the pots receiving macronutrient fertilizer combined with glyphosate (B), as well as those receiving macronutrient fertilizers (A) alone had the lowest concentrations of Mn and Cu micronutrients. Finally, in maize the lowest protein, fats, and carbohydrates (g/100g) were found in the pots treated with macronutrient fertilizer combined with glyphosate (B, 2.21 ± 0.2), micronutrient fertilizer (C, 8.57 ± 0.25), and glyphosates only (D, 57.34 ± 0.1). Maize treated with compost (G) showed the highest levels of Fe, Cu, and Zn, while macronutrient fertilizer combined with glyphosate (B) resulted in the lowest content of these micronutrients. Additionally, maize receiving micronutrient fertilizer (C) had the highest concentration of Mn, whereas those treated with glyphosates (D) had the lowest. Conclusions: Significant variations in soil’s mesophilic bacterial and fungal populations, micronutrient levels, and nutritional composition were observed, indicating treatment-related changes. Generally, treatment with micromineral fertilizer combined with glyphosate (B) seemed to deplete the soil while compost treatment improved. Compost-treated soils exhibited the highest mesophilic bacterial and fungal count, as well as Fe and Zn micronutrient concentrations. The use of agrochemicals also had a negative effect on maize yield quality. The fluctuations in the soil parameters underscore the multifaceted effects of agrochemical treatments.

Perfluoroalkyl and polyfluoroalkyl substances (PFAS) are persistent environmental contaminants of emerging concern, recognized for their toxicity and potential carcinogenic properties. PFAS chemicals are reported to act as endocrine disruptors through their interactions with various nuclear receptors (NRs). Despite their significant impact, comprehensive screenings and detailed analyses of PFAS binding strengths at both the orthosteric and allosteric sites of NRs are currently lacking in the literature. Our study addresses this gap by focusing on the binding interaction analysis of both common and uncommon PFAS with key nuclear receptors such as the vitamin D receptor (VDR), peroxisome proliferator-activated receptor gamma (PPARγ), pregnane X receptor (PXR), and estrogen receptor alpha (ERα). We used advanced docking simulations to screen 9,507 PFAS chemicals at the orthosteric and allosteric sites of the PPARγ, PXR, VDR, and ERα. We verified the accuracy of our docking protocol through multiple docking procedures and validations. The python code used for PFAS chemical screening is deposited in the supplementary file. Among the PFAS assessed at the orthosteric site of the VDR, 21 demonstrated similar binding affinities compared to the calcitriol, while 130 PFAS, exhibited stronger binding affinities than calcitriol. At the VDR allosteric site, where lithocholic acid (LCA) natively binds, 412 PFAS matched the binding energies of LCA, and 2,229 showed even greater binding energies. Similar testing on the PXR, PPARγ, and ERα revealed that the orthosteric site of PPARγ had 1,863 PFAS binding with a higher affinity than native ligand ET1 and 693 PFAS binding at the allosteric site with greater affinity than T35 native ligand. At the PXR orthosteric site, 650 PFAS bound with a greater affinity than native ligand 4WH, while at the allosteric site, 9,148 PFAS demonstrated a greater binding affinity than the known allosetric ligand glycerol. At the orthosteric site of ERα, 40 PFAS displayed binding with a greater affinity than the native ligand estradiol and at the allosteric site, only 8 PFAS exhibited greater binding affinity than coactivator ligand SRC-1. Further, our mixture modeling analysis indicates that PFAS can bind in various combinations with themselves and with endogenous or native ligands simultaneously, to disrupt the endocrine system and cause carcinogenic responses. These findings reveal that PFAS can interfere with nuclear receptor activity by displacing endogenous or native ligands by binding to the orthosteric and allosteric sites. This study elucidates the mechanisms through which PFAS exert their endocrine-disrupting effects, potentially leading to more targeted environmental regulations and therapeutic strategies. Importantly, this study is the first to explore the binding of PFAS at allosteric sites and to model PFAS mixtures at nuclear receptors. Given the high concentration and persistence of PFAS in humans, this study called for the urgent need for further research into the carcinogenic mechanisms of PFAS and the development of intervention strategies that target nuclear receptors. Our ongoing studies extend these findings by further investigating the interactions of PFAS and co-exposed chemicals with nuclear receptors. These investigations are supported by experimental verification, which will enhance our understanding of PFAS broad effects and aid in the design of effective mitigation strategies.

Patients with chronic kidney disease (CKD), particularly those with end-stage kidney disease (ESKD) undergoing dialysis or kidney transplantation, face ongoing challenges in relation to the risk of COVID-19. In addition to their underlying condition, factors such as immune-evasive variants, immunosuppressive therapies, and the need for dialysis contribute to poor COVID-19 outcomes in this population. Severe COVID-19 can lead to the deterioration of CKD/ESKD, resulting in acute kidney injury, septic shock, and respiratory failure. Moreover, patients with CKD/ESKD have shown impaired response to COVID-19 vaccination, with seroconversion failures associated with the burden of immunosuppressive treatments, further heightening their vulnerability to severe disease. Despite the current endemic, it is crucial to acknowledge the ongoing significance of COVID-19 as a serious threat to patients burdened with chronic diseases like CKD and ESRD. Understanding the impact of COVID-19 on these patients is essential, as they remain at risk of severe disease progression. This paper presents the results of a literature review to enhance our understanding of COVID-19-related risks in patients with CKD/ESKD. Expert insights and illustrative scenarios provide practical perspectives and highlight the importance of risk stratification based on clinical factors for guiding targeted measures and treatments to mitigate COVID-19 risks in these vulnerable patients.

In the realm of metal steel and iron manufacturing, there is a constant drive to optimize production efficiency and enhance the quality of the final products. This abstract explores a paradigm shift in this industry through the utilization of Computational Fluid Dynamics (CFD) as a powerful tool for achieving these goals .The study focuses on various critical aspects of the manufacturing process. Firstly, it delves into three-phase processes such as slag and gas entrainment in liquid steel, which have a significant impact on the overall product quality. Understanding and optimizing these processes is crucial to ensure the desired chemical composition and physical properties of the final metal.The abstract investigates the role of CFD in vacuum degassing, a process that plays a pivotal role in removing impurities, such as hydrogen and oxygen, from the liquid steel. By leveraging CFD to simulate and analyze the fluid flow patterns, researchers and engineers can design more efficient vacuum degassing systems, leading to improved product purity and reduced waste.Another crucial aspect explored in this abstract is the alloy melt and mixing process. By employing CFD simulations, researchers can gain insights into the movement of different alloy components and optimize their distribution within the melt. This aids in achieving the desired alloy composition, ensuring uniformity, and enhancing the mechanical properties of the final product.In addition, the study delves into the movement and flotation of inclusions, which are unwanted impurities present in the metal. CFD can be utilized to model and analyze the behavior of these inclusions, enabling engineers to design efficient strategies for their removal, thereby enhancing the purity and integrity of the final product.Moreover, the abstract considers the impact of melt temperature losses, which can occur during different stages of the manufacturing process. By employing CFD, it becomes possible to understand and mitigate these temperature losses, leading to improved energy efficiency and better control over the manufacturing parameters.Part 1 of this abstract critically evaluates the use of CFD in iron making, analyzing its benefits and limitations. It highlights how CFD can aid in process optimization, improving the understanding of complex phenomena involved in iron making, and ultimately leading to enhanced production efficiency.Part 2 focuses on the application of CFD in steel making and steel operation. It explores the fluid flow dynamics during different stages of steel production, including refining, casting, and rolling. By leveraging CFD, engineers can optimize these processes, leading to improved product quality, reduced defects, and increased productivity.This abstract demonstrates the transformative potential of Computational Fluid Dynamics in metal, steel, and iron manufacturing. By utilizing CFD as a tool to model and analyze complex fluid flow phenomena, researchers and engineers can revolutionize the production process, maximizing efficiency, and ensuring high-quality end products.

The article offers a comprehensive overview of recent breakthroughs in eco-friendly polymers and polymer composites, underscoring their pivotal role in addressing sustainability challenges across diverse industrial sectors. Despite encountering obstacles related to performance and processability, biopolymers sourced from renewable materials emerge as promising alternatives for the plastics that are currently used by human beings. Natural fillers are highlighted as a strategic avenue for crafting sustainable composites, with residual natural fillers being particularly explored. Heightened environmental concerns propel discussions on the criticality of integrating biodegradable materials with natural fillers, underlining the urgency for clear frameworks and financial incentives to support adoption of these materials. Additionally, the article examines the potential of biodegradable polymers and polymer composites, with a specific emphasis on the utilization of polyhydroxyalkanoate (PHA) in composite materials and its market prospects. Moreover, it emphasizes the indispensable need for ongoing research and development endeavors to address environmental challenges within the polymer sector, reflecting a mounting interest in sustainable materials across industries.

Due to the host immunological disease brought on by infection is sepsis, multiple organ dysfunction syndrome (MODS), which has a high morbidity and mortality rate, could be the result. With advances in pathogen detection technologies, breakthroughs in anti-infection drugs, and the creation of organ function support, the clinical diagnosis and treatment of sepsis have advanced significantly. Pathogen-induced abnormal immunological responses, which can range from excessive inflammation to immunosuppression, are recognized to play a significant role in the high death rate. Unfortunately, no medications that are specifically intended to treat sepsis have been licensed. In order to offer a theoretical foundation for the management of sepsis, we will now discuss current advancements in research on immunological responses in sepsis. The prognosis of sepsis patients may be improved by developing and optimizing a dynamic immune system treatment plan based on anti-infection therapy, fluid replacement, support for organ function, and timely application of immunomodulatory therapies

This study provides a comprehensive analysis of global patent trends in battery recycling, focusing on secondary batteries and related technologies across Korea, China, and the United States. The data, collected from various patent databases, was quantitatively analyzed to identify technology trends and direct future development. The analysis reveals distinct emphases on technologies such as lithium-ion and waste battery recycling, highlighting notable differences in patent activities among key companies and countries. China's large number of patents in battery manufacturing processes contrasts with the USA's focus on electrochemical cell construction and storage systems, while Korea shows significant activity in waste battery technology. The study underscores the competitive landscape and innovation efforts in the battery recycling sector, providing insights into the technological focuses and priorities of each country. It also identifies key challenges, such as the need for consistent innovation and broader geographic coverage in Korea, enhancing patent influence and international presence in China, and ensuring high patent quality and fostering innovation in lagging sectors in the United States. Addressing these challenges through enhanced collaboration, increased R&D investments, and supportive policies is crucial for strengthening the global position and driving further innovation in the battery recycling sector.

This study challenges the prevailing belief in the necessity of complex models for accurate forecasting by demonstrating the effectiveness of parsimonious econometric models, namely ARCH(1) and GARCH(1,1), over deep learning robust approaches, such as LSTM and 1D-CNN neural networks, in modeling historical volatility within pre-emerging stock markets, specifically the Moroccan and Bahraini stock markets. The findings suggest reevaluating the balance between model complexity and predictive accuracy. Future research directions include investigating the potential existence of threshold effects in market capitalization for optimal model performance. This research contributes to a deeper understanding of volatility dynamics and enhances forecasting models’ effectiveness in diverse market conditions.

Asthma is a significant public health concern. This study identified the provinces with the highest morbidity and mortality rates due to asthma among the working-age population (15-69 years) in the Republic of Ecuador. The secondary objective was to explain the possible differences attribut-able to occupational exposure. This nationwide ecological and exploratory study was conducted in 24 provinces between 2016 and 2019. Government databases were used as sources of infor-mation. Standardized rates were calculated for codes the J45 and J46. The hospitalization mor-bidity rate for asthma decreased from 6.51 to 5.76 cases per 100,000 working-age population, and the mortality rate has consistently been low and stable from 0.14 to 0.15 deaths per 100,000 working-age population. Geographic differences between the provinces were evident. The risk of hospitalization and death due to asthma was higher in the Pacific coast (five provinces) and the Andean region (two provinces). The high rates observed in provinces with greater agricultural and industrial development could be the main determinants of national heterogeneity and could act as occupational risk factors. The contribution of occupational hazards in each province should be examined in depth through ad hoc studies. These findings provide valuable information for creating public policies aimed at promoting and safeguarding the respiratory health of the popu-lation, particularly that of workers.

In order to explore the effects of glutamate on the growth performance, antioxidant capacity and protein metabolism of juvenile Chinese mitten crab. 0%, 1% and 2% glutamate were supplemented to low protein (30%) and normal protein (35%) diets respectively. There were 5 parallel tanks in each treatment, and the feeding duration was 8 weeks. The results showed that dietary glutamate did not significantly affect the weight gain of Chinese mitten crab. Diets supplemented with 2% glutamate significantly decreased the crude protein of crabs. The T-AOC of crabs fed the 30% protein diets was significantly lower than crabs fed the 35% protein diets. At 30% protein level, the superoxide dismutase (SOD) activity significantly increased with the increase of glutamate content. Dietary glutamate significantly down-regulated the relative expressions of mTOR, PI3K, S6K1 and 4EBP at 35% protein level. In conclusion, dietary glutamate cannot significantly increase the growth of Chinese mitten crab, but it can improve the antioxidant capacity in Chinese mitten crab under low protein condition.

High-density polyethylene (HDPE) waste poses a significant environmental challenge due to its non-biodegradable nature and the vast quantities generated annually. However, conventional recycling methods are energy-intensive and often yield low-quality products. Herein, HDPE waste is upcycled into anti-aging superhydrophobic thin films suitable for outdoor applications. A two-layer spin-casting method combined with heating-induced crosslinking is utilized to produce an exceptionally rough superhydrophobic surface, featuring a root mean square (RMS) roughness of 50 nm, an average crest height of 222 nm, an average trough depth of –264 nm, and a contact angle (CA) of 148°. To assess durability, weathering tests were conducted, revealing the films' susceptibility to degradation under harsh conditions. The films' resistance to environmental factors is improved by incorporating a UV absorber, maintaining their hydrophobic properties and mechanical strength. Our research demonstrates a sustainable method for upcycling waste into high-performance, weather-resistant superhydrophobic films.

Purpose: This research investigates the influence of supplier relationship management methods on the operational efficiency and customer satisfaction of Italian restaurants.Design/Methodology/Approach: Employing a qualitative research methodology, data was gathered via interviews and questionnaires from a sample of 200 individuals across many Italian restaurants throughout Italy.Findings: The investigation uncovered robust relationships between supplier relationship management approaches and other operational factors, highlighting the interdependence of management tactics. Efficient management of supplier relationships not only improves the efficiency of the supply chain, but also has an impact on the procurement of ingredients, the variety of menu options, and the integration of technology.Research Limitations/Implications: Although technology developments were shown to enhance operational efficiency, their influence on customer satisfaction was minimal. The research highlights the complex nature of factors that influence customer happiness, indicating the need of adopting a well-rounded strategy that combines technology with personalised care. Identified continuous improvement opportunities provide valuable insights for restaurant owners to enhance strategy and better meet consumer expectations.Practical Implications: This research provides useful insights on the management of Italian restaurants, but it has limitations due to its qualitative approach and dependence on self-reported data.Social Implications: However, the results add to the current knowledge and provide practical consequences for restaurant owners who want to improve their operational efficiency and customer pleasure.Originality/Value: Italian restaurants may achieve long-term success in a highly competitive culinary industry by acknowledging the interdependence of management strategies and using customer-focused techniques.

Background: The two-stage technique combining the Endoscopic Retrograde CholangioPancreatography (ERCP) with common bile duct (CBD) clearance carried out before the laparoscopic cholecystectomy represents the most common approach for CBD stones. Over time, different techniques have been proposed to manage cholecysto- choledocholithiasis (CCL) advantageously in one stage. Among these, the laparoendoscopic rendez-vous (LERV) addresses the CCL issue with a laparoscopic cholecystectomy with insertion of a guide wire performed at initial stage of the procedure, followed by the clearance of the bile duct carried out by the endoscopists. The goal of this study was to evaluate the efficacy and safeness of LERV procedure recording results and complications, also making a comparison between our results and current literature. Methods: We reviewed our experience of all consecutive patients with cholecysto-choledocholithiasis managed with LERV between January 2018 and December 2023. LERV success rate, operative time, length of hospital stay, stone recurrence, incidence of endoscopic and surgical complications were analysed. Results: A total of 120 patients underwent LERV in our facilities. We reported a 97% LERV success rate, 1.6% conversion-to-open rate, a median intraoperative time of 122 (range 95-220) min. The median hospital stay was 4 (range 2-38) days. An overall morbidity of 15% was reported (18/120): 15 Clavien-Dindo type 1/2, 2 type 3a and one type 3b. In two cases a re-operation during the hospital stay was necessary. At a median follow-up of 14 months (3-59) five patients experienced stone recurrence requiring redo-ERCP in two cases. Conclusion: LERV offers the significant advantage of a single stage procedure and hospitalisation along with a lower risk of post-ERCP pancreatitis, failed CBD cannulation and complications. Our experience confirms safety and effectiveness of the technique for CCL management.

To meet the dual-carbon objective, China's economy needs to move from a carbon-intensive to a green economy. Green technology innovation and renewable energy development are key to promoting green economic growth. The study uses 2010–2022 provincial panel data from 30 Chinese provinces. The super-efficient SBM model measures the province's green economic growth index. A panel fixed-effects model is used to experimentally evaluate how green technology innovation and renewable energy development affect green economic growth. Green financing moderates and a panel threshold model tests the threshold effect of renewable energy development on green economic growth. The results demonstrate that (1) China's green economic growth is rising and has a "U" shape. (2) all selected variables significantly impact green economic growth. However, population density, government intervention, and industrial structure are inversely associated with GEG. Green economic growth is significantly boosted by the moderate role of green finance in the development of renewable energy and green technological innovation. (3) Renewable energy development has a single threshold non-linear effect on green economic growth, depending on its development level and green technological innovation. Considering China's current condition and research findings, this study examines the green energy transition to promote green economic growth and high-quality economic development. Meanwhile, puts forward some important policy recommendations.

Methylation is a biochemical process involving the addition of a methyl group (-CH3) to various chemical compounds. It plays a crucial role in maintaining the homeostasis of the endothelium, which lines the interior surface of blood vessels and has been linked, among other conditions, to coronary artery disease (CAD). Despite significant progress in CAD diagnosis and treatment, intensive research continues into genotypic and phenotypic CAD biomarkers. This review explores the significance of the methylation pathway and folate metabolism in CAD pathogenesis, with a focus on endothelial dysfunction resulting from deficiency in the active form of folate (5-MTHF). We discuss emerging areas of research into CAD biomarkers and factors influencing the methylation process. By highlighting genetically determined methylation disorders, particularly the MTHFR polymorphism, we propose the potential use of the active form of folic acid (5-MTHF) as a novel CAD biomarker and personalized pharmaceutical for selected patient groups. Our aim is to improve the identification of individuals at high risk of CAD and enhance their prognosis.

Introduction:The concept of same-day discharge has garnered increasing significance within orthopedic surgery, particularly in hip and knee procedures. Despite initial concerns surrounding the absence of prolonged hospital care, a burgeoning body of evidence highlights numerous advantages associated with same-day discharge, ranging from mitigating in-hospital infections to offering substantial financial and psychosocial benefits for both patients and healthcare providers. In this study, we aim to scrutinize the trends in same-day discharge specifically within the realm of total hip arthroplasties. Method:This retrospective analysis delves into the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database spanning from 2016 to 2021. Result:In this study, same-day hip patients skewed younger, comprising 48.3%females compared to 55.6% in hospitalized hip patients. Operatively, same-day hip surgeries boasted shorter durations, averaging 83.9 minutes, in contrast to the 92.3minutes for hospitalized hip procedures. Postoperatively, same-day hip patients exhibited significantly diminished rates of 30-day readmissions (1.7%vs. 3.5%), procedure-related readmissions (1.0%vs.2.1%), reoperations (1.1%vs.1.9%), and mortality (0.02% vs. 0.04%). In addition, we found that that unplanned readmissions in the same-day group are significantly predicted by being over 65 years old (OR: 2.0), having hypertension (OR: 1.6), chronic steroid usage (OR: 2.2), and severe COPD (OR: 2.0), while gender, emergent surgery indication, and smoking were not significant predictors. Moreover, the prevalence of the same-day discharge concept experienced a remarkable ascent from 2016 to 2021, with rates escalating from 1.5% to 25.6% of all total hip arthroplasties over a span of just six years. Conclusion:In conclusion, same-day discharge is a feasible and safe option for selected THA patients, improving healthcare efficiency and patient satisfaction.

This study assesses the impact of militarization, industrialization, technological innovation, and energy consumption on CO2 emissions in NATO countries, divided into "traditional" (Group 1) and "new member" states (Group 2), using data from 1985 to 2019. It identifies heterogeneity in effects and dependencies between the groups. Employing Pedroni and Kao panel cointegration tests, a long-term equilibrium relationship among the variables is confirmed. The analysis, using panel ARDL and GMM methods, reveals distinct outcomes for each group. In Group 1, military spending and energy consumption significantly increase CO2 emissions, while industrialization and technological innovation reduce them. Conversely, in Group 2, technological innovation and energy consumption raise emissions, whereas military spending and industrialization decrease them. The findings suggest Group 1 should strategize military expenditure and energy consumption to cut emissions, whereas Group 2 should focus on eco-friendly technology and efficient energy use to achieve environmental sustainability.

Mutations in the SACS gene are associated with autosomal recessive spastic ataxia of Charlevoix-Saguenay disease (ARSACS) or complex clinical phenotypes of Charcot-Marie-Tooth disease (CMT). This study aimed to identify SACS mutations in a Korean CMT cohort with cerebellar ataxia and spasticity. As a result, eight pathogenic SACS mutations in four families were identified as the underlying causes of these complex phenotypes. The prevalence of CMT families with SACS mutations was determined to be 0.3%. All the patients showed sensory, motor, and gait disturbances with increased deep tendon reflexes. Lower limb magnetic resonance imaging (MRI) was done in four patients, and all had fatty replacements. Of note, they all had similar fatty infiltrations between the proximal and distal lower limb muscles, different from the neuromuscular imaging feature in most CMT patients without SACS mutations who had distal dominant fatty involvement. Therefore, these findings were considered a characteristic feature in CMT patients with SACS mutations. Although further studies with more cases are needed, our results highlight lower extremity MRI findings in CMT patients with SACS mutations and broaden the clinical spectrum. We suggest screening for SACS in recessive CMT patients with complex phenotypes of ataxia and spasticity.

Metabolic Associated Steatohepatitis Liver Disease (MASLD) currently impacts a quarter of the global population and its prevalence is expected to increase in the future. As a result, the incidence of hepatocellular carcinoma associated with MASLD is also on the rise. Notably, hepatocellular carcinoma in this group does not always develop alongside liver cirrhosis, often leading to a more advanced stage at diagnosis. The challenge lies in accurately identifying patients who are at a higher risk of hepatocellular carcinoma to tailor screening processes effectively. Additionally, several therapeutic approaches are being explored to prevent hepatocellular carcinoma, although there are yet no universally accepted guidelines

The review aims to assess fifteen (15) academic literature sources, highlighting the application of machine learning algorithms in the maintenance operations of optical fiber networks. It exhibits the collection of data using PRISMA methodology—Preferred Reporting Item for Systems Review and Meta-Analyses. The application, results, and performance metrics are discussed based on the collected observations, computations, and statistics in the studies, which revealed records of high accuracy degrees ranging from 86% to 98% on average and quality ML models including Neural Networks (NNs), Support Vector Machines (SVMs), and LSTM, as well as deep learning models that disclosed effective results of determining challenges and problems within the optical fiber lines. The review mainly centralized on superior machine learning technologies that surpass traditional techniques in fault detection and localization for improved optical fiber networks’ operations while providing insights into the limitations and challenges encountered in real-world applications of these models, offering a comprehensive perspective on the optical fiber network’s domain.

Entropion is a condition characterized by the total or partial inversion of the eyelid margin, resulting in contact between the outer skin and the corneal or conjunctival surface, and sometimes both. This condition can affect various animals, including horses, pigs, goats, sheep, rabbits, felines, and particularly canines. It typically manifests in the lower lid's lateral portion but can affect any part of the lid. This contact between eyelashes or facial hair and the cornea or conjunctiva leads to severe irritation, causing self-inflicted trauma, as evidenced by clinical signs of pain, irritation, ulcerations, and vision loss. Entropion can be classified as primary (congenital or developmental) or secondary (spastic and scarring). Diagnosis relies on clinical signs, the animal's history, and its breed. It's essential to assess the degree of entropion in the dog without applying topical anesthesia. This study conducts a literature review on surgical techniques for correcting various types of entropion in canines.

Drought and arsenic contamination pose a serious threat to global rice crop yield. Existing solutions focus on either heavy metal or drought remediation, but not both. Examination of the Oryza sativa metagenome via the National Center for Biotechnology Information (NCBI) database revealed promising candidates within the aquaporin gene family capable of efficiently mitigating both arsenic toxicity and drought stress. Rice cotyledons were genetically augmented with arsenic-resistant OsNIP2;1 and OsNIP3;2 genes, and drought-resistant OsPIP2;2 genes. In moderate drought conditions and 25 ppm arsenic-contaminated soil, transgenic plants showed drought tolerance and reduced translocation of arsenic from root to shoot. Soil arsenic levels plummeted from 25 ppm to 5 ppm, demonstrating the strategy's efficacy. Statistical significance was confirmed using T tests. Thus, aquaporin-augmented Oryza sativa offers a promising solution to mitigate both arsenic and drought stress in rice plants improving crop yield and facilitating soil decontamination.

Convolutional Neural Networks (CNNs) are often criticized for their lack of transparency, acting as 'black boxes' in decision-making, a challenge compounded by class imbalance in ECG datasets, which limits their clinical application. This study introduces a CNN-based ECG signal classification model that enhances interpretability and addresses class imbalance through the Synthetic Minority Over-sampling Technique (SMOTE). The model also integrates Uniform Manifold Approximation and Projection (UMAP) for dimensionality reduction and SHAP value analysis, facilitating the visualization of decision boundaries and the assessment of feature contributions. Our evaluation using the MIT-BIH Arrhythmia Database highlights the model's high performance, with accuracy and precision nearing 1.00 for Normal ECG (NOR), Left Bundle Branch Block (LBBB), Right Bundle Branch Block (RBBB), and Ventricular Premature Beat (PVC) in the six-class task. In the ten-class task, the model demonstrated robustness, particularly with an accuracy of 0.9846, precision of 0.9783, recall of 0.9736, and F1 score of 0.9760 in Pacemaker Fusion Beat (PFHB), supported by an AUC of 0.9999 and AP of 0.9885. These results underscore the model's efficacy in cardiac rhythm recognition and resilience to class imbalance. Future research will explore sophisticated model architectures and feature extraction methods to enhance the model's generalization and clinical applicability for early heart disease diagnosis and personalized treatment.

A large share of the reinforced concrete (RC) building stock in Mediterranean countries faces a dual challenge of seismic vulnerability and energy inefficiency, calling for urgent renovation efforts. While energy upgrades have been the focus of previous renovation policies, recent research highlights the critical need for integrated retrofitting solutions that address both structural integrity and energy performance. Multi-criteria decision-making (MCDM) approaches are a promising tool for optimizing the combined choice of these integrated interventions, considering various decision variables (DVs) of economic, social, environmental, and technical nature. To understand the impact of climate and seismic hazard conditions on multi-criteria-based retrofitting assessment, a case-study RC school building is selected and assumed to be located in three distinct climate conditions, cold, mild, and warm, and three seismic hazard levels, low, medium and high. Moreover, given the complexity and challenges of quantifying seismic performance metrics for practitioners, an available simplified (practice-oriented) approach is compared herein with a more thorough research-based one for quantifying the seismic performance of RC buildings within the MCDM framework. Both approaches are applied to the case-study building, considering twelve possible combinations of energy and seismic interventions. The accuracy of the practice-oriented approach and its impact on the retrofitting rankings is evaluated, emphasizing the importance of accessible and efficient evaluation methods in facilitating informed decision-making for building renovation

In this research, we present the Combined Theoretical Signal (CTS) model, which integrates influences from dark matter, quantum fluctuations, and higher-dimensional effects. Our goal is to provide a potential framework for unifying gravity and quantum physics. We validate the CTS model against observational gravitational wave data and perform residual analysis to assess its accuracy. The results suggest that CTS aligns well with the observational data and provides a robust theoretical model that may contribute significantly to the quest for a universal theory. This model has the potential to enhance our understanding of the fundamental forces and the structure of the universe, supporting a hierarchical tree structure rather than parallel universes.

Ever since the virus was discovered in the 80s of the 19th century, plant viruses had a great impression within the field of plant pathology. In this book we trace the growth in the research on plant viruses beginning from traditional era (1882-1900) in which a new pathogen was discovered other than fungi and bacteria, later known as virus; biological era (1900-2000) in which the mode of spread and relationship of the virus with its vector was understood; biochemical/biophysical era (1930-1968) that marked the basis of virus purification and chemical characterization; molecular era of plant virology (1943-1995) in which establishment, progression & transmission of plant viruses was described within the host at molecular details ; era of viral molecular genetics (1980–2000), in which a significant role was played by the plant virologists to understand the position and function of genes, methods of viral gene cloning, gene silencing and other viral genome associated properties ; era of plant viral diagnostics (1980 – 2021) which led to rapid, specific and sensitive detection of plant viruses.

This study introduces a method for quantitatively assessing the complexity and predictability of fish behavior in closed systems through the application of information entropy, offering a novel lens to understand how fish adapt to environmental changes. Utilizing simulations rooted in a random walk model for fish movement, we delve into entropy fluctuations under varying environmental conditions, including responses to feeding and external stimuli. Our findings underscore the utility of information entropy in capturing the intricacies of fish behavior, particularly highlighting the synchrony in collective actions and adaptations to environmental shifts. This research not only broadens our comprehension of fish behavior but also paves the way for its application in fields like aquaculture and resource management. Through our analysis, we discovered that smaller grid sizes in simulations capture detailed local fluctuations, while larger grids elucidate general trends, pinpointing a 2.5m grid as optimal for our study. Moreover, changes in swimming speeds and behavioral adaptations during feeding were quantitatively analyzed, with results illustrating significant behavior modifications. Additionally, employing a Gaussian Mixture Model helped to clarify the nuanced changes in fish behavior in response to altered light conditions, demonstrating the layered complexity of fish responses to environmental stimuli. This investigation confirms the efficacy of information entropy as a robust metric for evaluating fish shoal behavior, offering a fresh methodology for ecological and environmental studies, with promising implications for sustainable management practices.

While the role of safe riding behavior as a safety contributor for cyclists has been increasingly studied in recent years, there have been few studies analysing cycling behavior in relation to crash-related outcomes in Baltic countries. Indeed, to the best of our knowledge, this is the first time this issue has been addressed in the case of Latvia. Aim: The objective of this study was to assess the relationships among self-repotted cyclists’ behavior, traffic safety literacy, and their cycling crash involvement rates. Method: A total of 299 cyclists aged M=32.8 from across Latvia (42% females) participated in an online survey, which comprised questions regarding respondents’ demographics, frequency of riding, and the number of crashes in the past five years. The Cycling Behavior Questionnaire (CBQ) and the Cyclist Risk Perception and Regulation Scale (RPRS) were applied to assess cyclists' behavior patterns and traffic safety literacy. Results: According to the findings, it can be inferred that cyclists frequently engage in riding errors and traffic violations while cycling. Those who exhibit more antisocial behavior patterns are also more likely to be involved in road crashes. Conversely, cyclists with greater positive behavior rates more often also tend to possess better knowledge of traffic rules and exhibit a heightened risk perception, indicating a greater awareness of road traffic safety. Conclusion: All in sum, this study underscores key age differences, with older individuals significantly less involved in riding crashes, exhibiting fewer driving errors and a higher level of risk perception, which serves as a crucial factor in road safety. At the practical level, these results stress the need to address both traffic safety literacy and protective cycling factors of cyclists, in a manner to improve overall road safety and promote active transport modes in Latvia.

Since December 2019, the COVID-19 virus has rapidly spread worldwide, prompting the World Health Organization (WHO) to declare it a pandemic and advocate for the widespread use of face masks to mitigate transmission. In this review, we delve into the potential impact of prolonged face mask use on temporomandibular joint (TMJ) health, an area that has garnered limited attention amidst COVID-19 research. Research has revealed that improper mask fit, and constant readjustment can lead to TMJ abnormalities. Similarly, there is a demonstrated correlation between continuous mask usage and increased incidence of headaches, temporomandibular pain, and diminished quality of life. Many studies have highlighted discomfort in the preauricular area, headaches, TMJ noises, headache, jaw pain, and muscle fatigue, as well as dermatological disorders that have been attributed to prolonged mask wear and its impact on TMJ. Our study catalyzes future research endeavors, urging a deeper exploration of the implications of long-term mask wear, not only in the context of the COVID-19 pandemic but also among occupational groups regularly exposed to extended mask use. By unraveling the complexities of TMJ health in the face of evolving preventive measures, we aim to enhance our understanding and safeguard the well-being of mask-wearers worldwide.

Background: Localization of acute appendicitis in a hernia sac is a rare phenomenon with a frequency of around 0.08 - 1 %. Even fewer cases of postoperative hernias with a vermiform appendix in the hernia sac have been described. We selected 23 cases in the English literature describing this phenomenon and analyzed diagnostic and treatment options. Case presentation: We present a 72-year-old woman who was complaining of a painful, rigid mass in the anterior abdomen wall for two days. After performing an ultrasound, incarcerated ventral hernia was diagnosed and emergency surgery was performed. During the surgery, gangrenous appendicitis was found in the hernia sac. It was decided to do an appendectomy and primal hernioplasty. Postoperative period was uneventful. Conclusion: Appendicitis within incisional hernia is an extremely rare phenomenon. Diagnosis may be challenging because of dominating incarcerated hernia symptoms. However, computed tomography might play a crucial role, by differentiating causes of acute abdomen. Appendectomy is the standard option for appendicitis treatment, however, there is no consensus on how abdominal wall integrity should be restored.

: This study aimed to validate the effects of self-compassion-based forest healing therapy as an intervention for reducing stress and promoting coping resources. Therefore, we investigated the effects of self-compassion-based forest healing therapy on stress, self-compassion, and connectedness to nature. A total of 30 participants were divided into an experimental and control group. Two sessions of forest healing meditation activities were held at the Forest of Healing every two weeks between October and November 2023. As a repeated measures experiment, data were collected before the intervention, after the first intervention, and after the second intervention. Perceived stress, positive and negative affect, and salivary cortisol were measured to assess physiological and psychological stress in participants. Connectedness to nature and self-compassion were measured to evaluate stress-coping resources. The results showed that the forest healing program had significant positive effects on stress and emotional states in the experimental group after the intervention. Further, there was a significant incremental effect on connectedness to nature and self-compassion in the experimental group. Therefore, self-compassion meditation-based forest healing therapy is a feasible and efficient approach for facilitating stress management and coping resource building.