The objective of this paper was to verify the applicability of statistical learning (SL) compared to human reasoning with respect to the Universal Thermal Climate Index (UTCI), a complex tool for the assessment of outdoor thermal stress. UTCI is an equivalent temperature index based on the 48-dimensional output of an advanced model of human thermoregulation formed by 12 variables at four consecutive 30-minute intervals, which were calculated for 105642 thermal conditions from extreme cold to extreme heat. Comparing the performance of SL algorithms to the results accomplished by an international endeavor involving more than 40 experts from 23 countries, we found that random forests and k-nearest neighbors closely predicted UTCI values, but that clustering applied after dimension reduction algorithms (principal component analysis and t-distributed stochastic neighbor embedding) were inadequate for risk assessment in relation to the UTCI stress categories. This indicates a potential supportive role for SL, as it will not (yet) fully replace the bio-meteorological expert knowledge.

The landscape of medical education has witnessed significant transformations over the past decades, particularly with the advent of active teaching methodologies. However, despite these advancements, the traditional theoretical assessment methods have remained largely unchanged. This lack of evolution in assessment systems poses a challenge, as it is crucial for assessment methods to evolve in tandem with teaching approaches to ensure a comprehensive and effective learning process in medical education. This paper reviews the integration and effectiveness of open-book examinations (OBEs) in medical education, reflecting their growing significance. An integrative review of the literature was conducted, drawing from a range of relevant publications over the last decade, sourced from databases such as PubMed, Web of Science, Scopus, and ERIC. The inclusion criteria focused on full-text articles in English, with search terms including "medicine," "assessment," "open book examination," "open book exam," and "open book assessment," combined using Boolean operators. Thirteen publications were selected and critically appraised using The Critical Appraisal Skills Program checklist. The analysis identified three primary thematic categories: ' Teaching Strategy for Pandemic and Challenging Conditions,” Tool of Learning & Educational Impact” and “Operational Challenges & Future Directions”. These themes were explored to understand the role and impact of OBEs in medical education. The findings indicate that open-book examinations are a crucial component in the evolving landscape of medical education. While certain reservations remain, OBEs have shown significant potential in fostering critical thinking, argumentation skills, and lifelong learning among medical students. They reflect the ongoing evolution of knowledge in the medical field and contribute to the development of professionals’ adept at navigating and applying complex information. Further research is recommended to solidify these findings and to expand the understanding of OBEs in medical education.

1) Background: Capturing patients’ medical histories significantly influences clinical decisions. Errors in this process lead to clinical errors, increase costs and dissatisfaction among physicians and patients. Physicians in developing countries are overloaded with patients and cannot always follow the proper history-taking procedure. The challenges are acknowledged; however, a comprehensive understanding of the status and the remedies remained unexplored. 2) Objective: This paper aims to investigate the workload, history-taking challenges, and the willingness of the physicians to accept digital solutions. 3) Methods: A cross-sectional online survey was conducted on 104 physicians across Bangladesh, featuring 22 questions regarding their professional environment, workload, digitization status of health records, challenges in history-taking, and attitudes toward adopting digital solutions for managing patient histories; 4) Results: 92.67% of the physicians face workloads, 88.46% struggle in medical history-taking, and only 4.81% use digital medical records. About 70% struggle to complete the necessary history-taking steps, emphasizing the urgent need for solutions. An AI-based Smart Health Gantt Chart (SHGC) system has been introduced for their instant feedback. 93.27% of physicians expressed their willingness to use such a system. 5) Conclusions: The proposed SHGC has the potential to enhance healthcare efficiency in developing nations, benefit physicians, and improve patient-centered care.

.Various synthetic nematicides are currently used effectively in the control of plant parasitic nematodes. However, these nematicides have adverse effects on humans and the environment. Neem oil is eco-friendly alternatives to synthetic nematicides. The effectiveness of repeated neem oil application in suppressing the root-knot nematodes infestation in figs seedlings was therefore examined in this study, both in its natural form (10 ml/L) and in its nano-emulsion form (5 and 7 ml/L). The recorded reduction parameters of M. incognita were J2/250g soil, galls and egg masses / 5g roots of infected fig seedlings were measured at that time, and the effects of these natural additives were compared with the Fosthiazate (Krenkel 75%EC). The impact of such soil amendments on some typical plant parameters, the total microbial count of soil, and the overall enzymatic activity of the fig rhizosphere were also included. Obtained results revealed that the soil population density of root knot nematode suppressed by 80.3% , reduction of nematode egg masses (60.4%) due to the application of nano-emulsion of neem oil (at 7ml/L). Present work recommend the use of nano-emulsion of neem oil as one of the effective and eco-friendly means to reduce the root- knot nematode on fig .

The decarbonization of the built environment, both in new construction and renovation, is crucial to mitigate its relevant impact on climate change and achieve the Paris agreement goals. This study presents a systematic LCA-based methodology to assess the whole life carbon emissions of buildings, applied to a proposal for the regeneration of one of Milan’s disused railway yards. As an entry for the 2020 Reinventing Cities competition, Scalo Lambrate is a project for a mainly residential neighborhood with a public park. Strategies to reduce carbon emissions deriving both from the operational energy and construction and maintenance were evaluated and their effects compared to a reference scenario over a time horizon of 100 years. The results show that, while the opportunities to reduce carbon emissions during the use phase are somehow limited due to the already stringent performance requirements for new builds, the use of fast-growing biogenic materials for construction materials, even if mixed with more traditional ones, can provide a significant reduction of the global warming potential over the whole life cycle, with a reduction of 70% over the baseline. The remaining emissions can be offset with afforestation initiatives that, however, must be assessed against land use issues.

Chronic kidney disease (CKD) is characterized by a continuous decline in kidney function, often persisting for years or even a lifetime. This study presents a new exploration into the extraction and application of insect chitosan (Tenebrio molitor) targeting hemodialysis (HD). Initially, the potential of insect-derived chitosan as a sustainable and effective alternative to traditional sources (i.e. crustaceans) is demonstrated. Efficient extraction methods were developed (totaling between 6 h and 12 h), producing chitosan. Firstly, chitin was efficiently isolated from T. molitor through deproteinization and demineralization, with yields of approximately 5% (w/w). Subsequently, chitosan was obtained from the extracted chitin resulting in yields of between 65.0 ± 0.8% (w/w) and 79.3 ± 0.8% (w/w). Characterization using Fourier Transform Infrared Spectroscopy (FTIR) confirmed structural similarities with commercial chitosan and degrees of deacetylation in the 73 - 75% range. The bioactive properties of chitosan obtained from T. molitor, including antimicrobial and antioxidant activities, were evaluated. All the microorganisms tested were inhibited, exhibiting minimum lethal concentrations between 2 and 8 mg/mL, confirming the antimicrobial activity of the extracted chitosan. In addition, chitosan showed antioxidant activity in the range of 60 to 65 µmol Trolox equivalent/g, suggesting its viability for various medical applications.This study also developed a chitosan-based membrane (CH - M) culminating in a proof-of-concept phase for hemodialysis. The permeation characteristics of CH-M for urea and albumin were studied in vitro to assess their suitability as HD membranes. Urea was permeable to values of over 70% and albumin was retained.

Molluscs are significant species in aquatic ecology. Molluscs are crucial for maintaining ecological balance as secondary consumers and serving as bioindicator species in biomonitoring systems. Molluscs are threatened by pesticides such as commonly used pyrethroid insecticides. Pyrethroids are typical insecticides used to control insects in agriculture and gardening. Pyrethroids are increasingly being utilized in both agricultural and human activities. Pyrethroids enter aquatic bodies through rainfall and drainage systems. The use of pyrethroids is becoming a significant concern for aquatic creatures, particularly molluscs. The discussion will focus on the increasing issue of pyrethroids becoming a nightmare for molluscs. Pyrethroids, due to their lipophilic nature, pose a significant risk to molluscs by affecting their metabolites, producing reactive oxygen species, and influencing neurotransmitter actions. Molluscs are crucial organisms in aquatic ecosystems, and their threats warrant significant discussion and attention. This review will delve into the behaviour of pyrethroids on molluscs.

Burnout represents a concern for all healthcare providers, particularly those specializing in emergency medical care for whom burnout outcomes have been well-documented. What remains unknown is the effect of burnout on redeployed medical specialists during the COVID-19 pandemic from an appointment-centered practice to emergency care directed by public health considerations. This research aims to identify and assess the burnout responses of fourteen medical specialties noted in searched returns of the four most cited articles published since 2020 about non-emergency physicians regarding their burnout brought on by the unanticipated need for them to provide emergency care during the recent pandemic. The hypothesis is that medical specialists accustomed to planning for emergency possibilities in their appointment-centered practice would demonstrate the least burnout regarding COVID-19-related emergencies. Considering coping as a process based on Lazarus's research, comparing and ranking the COVID-19 emergency responses across the various normally appointment-centered medical specialties in their employed coping strategies determines the outcome. With the hypothesis supported, suggested interventions for future pandemics—when these specialists are, again, redeployed to emergency care directed by public health considerations—are those coping strategies identified as most effective in reducing burnout while maintaining the viability of the medical specialty and excellent patient care.

Background: The clinical impact of withdrawal of sodium-glucose cotransporter 2 inhibitor (SGLT2i) on the all-cause readmission in patients with heart failure remains unknown. Methods: Consecutive 212 patients who were hospitalized for heart failure and received SGLT2i during the index hospitalization between February 2016 and July 2022 were evaluated. Of these, 51 patients terminated SGLT2i during or after their index hospitalization. The primary outcome was defined as an all-cause readmission rates/times. Results: Over a median of 23.2 months, an all-cause readmission occurred in 38 of 51 patients (74.5%) withdrawn from SGLT2i and 93 of 161 patients (57.8%) with continuation of SGLT2i (p = 0.099). The total number of all-cause readmissions per year was 0.97 [0-1.50] in patients withdrawn from SGLT2i and 0.50 [0-1.03] in patients with continuation of SGLT2i (p = 0.030). There was no significant difference in total medical cost (62,906 [502-187,246] versus 29,236 [7,920-180,305] JPY per month, p = 0.866) between both patient groups. Conclusions: Termination of SGLT2i may be associated with incremental all-cause readmission and no benefit in reducing total medical costs.

The study assessed the trapping efficacy of locally-modified 1) Gravid Aedes Trap(GAT) lined with insecticide-treated net (ITN) as a killing agent, 2) Autocidal Gravid Ovitrap(AGO) with sticky board in the semi-field system (SFS) and field setting. Fully-balanced Latin square experiments were conducted to compare GAT lined with ITN vs AGO, both with either yeast or grass infusion. Biogents-Sentinel (BGS) with BG-Lure and no CO2 was used as standard trap for Aedes mosquitoes. In the SFS, GAT outperformed AGO in collecting both nulliparous (65% vs 49%,OR=2.22,[95%CI:1.89-2.60],p

Exoskeletons designed to assist patients with activities of daily living are becoming increasingly popular, but still are subject to research. In order to gather requirements for the design of such systems, long-term gait observation of the patients over the course of multiple days in an environment of daily living are required. In this paper a wearable all-in-one data acquisition system for collecting and storing biomechanical data in everyday life is proposed. The system is designed to be cost efficient and easy to use, using off-the-shelf components and a cloud server system for centralized data storage. The measurement accuracy of the system was verified, by measuring the angle of the human knee joint at walking speeds between 3 and 12 km/h in reference to an optical motion analysis system. The acquired data was uploaded to a cloud database via a smartphone application. Verification results showed that the proposed toolchain works as desired. The system reached an RMSE from 2.9° to 8°, which is below most of the comparable system. The system provides a powerful, scalable platform for collecting and processing biomechanical data, which can help to automize the generation of an extensive database for human kinematics.

The pervasive presence of atmospheric pollution, particularly polycyclic aromatic hydrocarbons such as 7,12-dimethylbenz(a)anthracene, instigates aberrant cellular and tissue conditions, precipitating oxidative damage and inflammatory cascades conducive to the onset of cancer, notably mammary cancer. Given the hepatic metabolism of 7,12-dimethylbenz(a)anthracene, the imperative of employing natural antioxidants becomes apparent. In this study, we delve into the antioxidant and hepato-protective properties of Pistacia lentiscus against 7,12-dimethylbenz(a)anthracene-induced toxicity, alongside exploring its potential anticancer attributes. Our investigations unveil Pistacia lentiscus's anti-proliferative efficacy against human breast cancer cell lines. Notably, 7,12-dimethylbenz(a)anthracene-intoxication escalates body weight, disrupts lipid profiles, and incites serum oxidative damage. Concurrently, hepatic and renal oxidative stress ensue, accompanied by heightened antioxidant enzyme activity in the 7,12-dimethylbenz(a)anthracene-exposed-group compared to controls (p<0.05). Nonetheless, Pistacia lentiscus co-administration rectifies biochemical imbalances, significantly attenuates oxidative stress aberrations, and augments antioxidant enzyme responses (p<0.05). Importantly, histological analysis evinces Pistacia lentiscus's shielding effect against 7,12-dimethylbenz(a)anthracene induced hepatocyte injury and steatosis. Our findings underscore Pistacia lentiscus's robust anti-proliferative, antioxidant, and hepato-protective capacities, mitigating metabolic disturbances, oxidative stress propagation in liver and kidney functions, and potential histological alterations, thereby impeding 7,12-dimethylbenz(a)anthracene-induced mammary cancer initiation. We posit that Pistacia lentiscus may serve as a prophylactic agent against breast cancer instigated by this carcinogen.

This paper explores if plants are capable of responding to human movement by changes in their electrical signals. Towards that goal we conducted a series of experiments, where humans over a period of 6 months were performing different types of eurythmic gestures in proximity of garden plants, namely salad, basil, and tomatoes. To measure plant perception, we used the plant spikerbox, a device that measures changes in voltage differentials of plants between roots and leaves. Using machine learning, we find that the voltage differentials over time of the plant predict if (a) eurythmy has been performed, and (b) which kind of eurythmy gestures has been performed. We also find that the signals are different based on the species of the plant. In other words, the perception of a salad, tomato, or basil might differ just as perception of different species of animals differ. This opens new ways of studying plant ecosystems, while also paving the way to use plants as biosensors for analyzing human movement.

Multivariate Time Series Classification (MTSC) is one of most important tasks in time series analysis, aiding in activities such as human motion recognition and medical diagnostics. Existing methods for MTSC do not explicitly model temporal differences and generalize the idea of temporal difference into a efficient temporal module. Additionally, existing methods are not yet able to capture cross-variable relationships well during network training. As a result, they are unable to achieve convincing feature representation, leading to suboptimal classification accuracy. In this paper, we propose a novel MTSC model called Temporal Difference and Cross-variate Fusion Network (TDCFN), which integrates a two-stream differential LSTM network and a cross-variate feature extraction network to enhance feature representation. TDCFN achieves superior classification accuracy by capturing dynamic temporal evolution and inter-variable relationships. The experimental results show that TDCFN can achieve competitive performance with state-of-the-art multivariate time series classification approaches.

Ethical considerations regarding our treatment of animals have gained strength, leading to legislation and a societal focus across various disciplines. This is a subject of study within curricula related to agri-food sciences. The aim was to determine the perceptions of agronomy university students concerning animal welfare in livestock production systems. A survey was conducted to encompass various aspects, from participants' sociodemographic attributes to their attitudes and behaviors regarding animal welfare and the consumption of animal products. Statistical analysis, performed using R software, delved into the associations between participants' characteristics and their perspectives on the ethical, bioethical, and legal dimensions of animal welfare. Associations between demographic factors and ethical viewpoints among students were identified. Gender differences emerged in animal treatment perceptions, while rural and urban environments impacted perspectives on various animals. Bioethical considerations revealed distinctive disparities based on gender and education in concerns for animal welfare, value perceptions, evaluations of animal behaviors, and opinions on animal research. It is crucial to distinguish between animal welfare and ethical considerations arising from coexisting with sentient beings capable of experiencing suffering. Ethical theories provide a lens through which we perceive our obligations toward animals. The responsibility to ensure animal welfare is firmly rooted in recognizing that animals, like humans, experience pain and physical suffering. Consequently, actions causing unjustified suffering or mistreatment, particularly for entertainment purposes, are considered morally unacceptable.

The German health authorities' guidelines for medical devices in 2012 highlighted the importance of cleaning ultrasound probes, emphasizing their validation and reliability. In addition to automated and validated options, alternative manual methods such as wipe disinfection have gained traction due to their independence from additional hardware. The study examines the effectiveness of manual disinfection methods, specifically the cleaning process, addressing concerns raised by the Robert Koch Institute regarding the lack of validation for wipe disinfection of semi-critical devices. The EQUINOS colored wipe disinfection kit identified wetting gaps in all cleanings across four probes tested. The results indicate significant challenges in ensuring complete surface wetting, particularly in complex body parts such as clip-on areas and shapes for additional biopsy attachments, suggesting that manual methods alone may not adequately mitigate the risk of infection transmission (p value .001). The study concludes that while manual disinfection methods are a viable alternative to automated reprocessing, there is a critical need for enhanced training and potentially the development of more effective manual disinfection techniques or colored wipes to ensure patient safety and compliance with healthcare hygiene standards.

This work aims to investigate the effect of process temperature and catalyst content by thermochemical degradation of municipal solid waste (MSW) fraction (organic matter + paper + plastic) on the yield of reaction products (bio-oil, biochar, H2O and gas), physicochemical properties and chemical composition of bio-oils, as well as on the morphology and crystalline phases of biochar in laboratory scale. The organic matter, paper and plastic segregated from the gravimetric composition of total waste sample were subjected to the pre-treatments of drying, crushing and sieving. The experiments were carried out at 400, 450 and 475 °C and 1.0 atmosphere, and at 450 °C and 1.0 at-mosphere, using 5.0, 10.0 and 15.0% (wt.) of FCC zeolite, bath mode, using a laborato-ry scale glass reactor. The bio-oil was characterized for acidic value. The chemical functions present in the bio-oil identified by FT-IR and the composition by GC-MS. Biochar was characterized by SEM/EDS and XRD. Thermal pyrolysis of the MSW frac-tion (organic matter + paper + plastic) shows bio-oil yields between 9.44 and 9.24% (wt.), aqueous phase yields between 21.93 and 18.78% (wt.), solid phase yields between 67.97 and 40.34% (wt.) and gas yields between 28.27 and 5.92% (wt.). The yield of bio-oil decreases with increasing process temperature. For the experiments using FCC, the biochar and gas yields increase slightly with the FCC content, while that of bio-oil de-creases and the H2O phase remains constant. The GC-MS of bio-oils identified the presence of hydrocarbons and oxygenates, as well as nitrogen-containing compounds, including amides and amines. The acidity of the bio-oil increased with increasing temperature and with the aid of FCC as a catalyst. It has been identified the presence of hydrocarbons within bio-oil by addition of FCC catalyst due to the deoxygenation of carboxylic acids, followed by decarboxylation and decarbonylation reactions, producing aliphatic and aromatic hy-drocarbons.

Diabetes mellitus (DM) is a metabolic disorder characterized by the deficiency of insulin production and is one of the concerning health problems worldwide, especially in developing countries. Considering the systemic toxicity associated with current antidiabetic medications and their limited efficacy, there is an urgent need to discover new plant-based natural antidiabetics. Since time immemorial, medicinal plants have played an important role in the management of health disorders. In recent years, herbal medicine has experienced exponential growth in popularity worldwide, owing to its natural origin and fewer side effects, appealing to both developing and developed nations. Ecuador has a rich cultural history in ethnobotany that plays a crucial role in their people's lives. Several Ecuadorian medicinal plants have hypoglycemic or an-ti-hyperglycemic properties that are rich with bioactive phytochemicals. These medicinal plants were extensively used in traditional medicine preparation in Ecuador for many decades to treat diabetes because of their cost-effectiveness, available traditional knowledge, and low toxicity. Many Ecuadorian medicinal plants are reported to have antidiabetic properties that reduce blood sugar levels, and oxidative stress, regulate intestinal function, improve insulin resistance, inhibit α-amylase and α-glucosidase, lower gluconeogenic enzymes, stimulate glucose uptake mechanisms, and play an important role in glucose and lipid metabolism, yet there is a substantial lack of integrated approach between the existing ethnomedicinal practice and pharmacological research. Therefore, this review aims to discuss and explore the traditional medicinal plants used in Ecuador for treating DM and their bioactive phytochemicals, which are mainly responsible for their anti-diabetic properties.

Background: Open AI developed ChatGPT, a language model based on the GPT architecture, designed for text-based communication. Trained on diverse internet texts, ChatGPT generates contextually appropriate responses using machine learning. It understands input through analysis and context interpretation, generating coherent and contextually relevant responses. Interaction is possible through messaging platforms. Materials and Methods: In November 2023, we utilized ChatGPT 3.5, the default version at that time, to answer questions from the Italian National Residency Program Admission Tests (SSMs) of 2021, 2022, and 2023. The questions cover clinical, diagnostic, analytical, therapeutic, and epidemiological scenarios, sometimes accompanied by images. The study compared ChatGPT's answers to the official corrections on the Italian Ministry of University and Research (MUR) website. The scoring method used for evaluation was 1 point for correct answers, 0 points for unanswered questions, and -0.25 points for incorrect answers, reflecting the SSM test scoring system. Results: In summary, ChatGPT was tested with a total of 420 questions, 140 for each test. It achieved an overall accuracy of 80.48%, providing correct answers for 338 questions and incorrect answers for 82 questions. When faced with questions containing both text and images, it answered 55% correctly and 45% incorrectly. The model's performance varied over time, with an 82.14% accuracy rate in 2021 and 2022 (115 correct out of 140) and a 77.14% accuracy rate in 2023 (108 correct out of 140). Applying thisscoring method to the SSM test, ChatGPT would have scored 105 points in 2021 and 2022, and 100 points in 2023. Conclusions: ChatGPT has exhibited above-average performance in the last three SSM tests, highlighting its robust capability to interpret clinical scenarios and offer precise diagnostic and therapeutic guidance. Despite this, some limitations persist, notably the software's inability to interpret non-textual information.

Hansenula polymorpha is a non-conventional, methylotrophic, and thermo-tolerant yeast well known for the industrial production of recombinant proteins. However, the research to evaluate this yeast potential for sugar fermentation to produce alcohols for biofuel applications is at an infant stage. For research advancement, the present work investigated the wild type H. polymorpha strain (DSM 70277) for the co-production of methanol, ethanol, and butanol using a batch fermentation reactor and performing experiments at an ideal temperature of 40°C with a pH of 5.5 using different sugars (fructose, glucose, and xylose) as substrates. The maximum specific growth rates (h-1) of H. polymorpha yeast were 0.59–3.02 for fructose, 0.08–2.60 for glucose, and 0.06–0.08 for xylose. The overall yields (g/g) of methanol were higher from fructose (0.132–0.226) than glucose (0.020–0.021) and xylose (0.009–0.030). Ethanol overall yield (g/g) from fructose (0.130–0.325) was more than glucose (0.054–0.167), and xylose (0.042–0.068). The overall butanol yield (g/g) ranged from 0.018–0.031 (fructose), 0.017 (glucose), and 0.009–0.010 (xylose). Due to the methylotrophic nature of H. polymorpha, a shorter time (preferably 2 h) was found suitable for co-production of methanol, ethanol, and butanol.

Driven by environmental sustainability concerns, the integration of biobased components in curtain wall systems is gaining traction in both research and the construction market. This paper explores the development and validation of a bio-based façade system within the Basajaun H2020 project. The project aimed to demonstrate the feasibility of introducing environmentally friendly bio-based components into the mature curtain wall façade industry. The paper focuses on identifying technological solutions for replacing key components such as profiles, insulation, and the tightness system with bio-based and less environmental impact alternatives presenting the results achieved in the façade system design of the Basajaun project funded by European Union. These solutions aimed at creating a bio-composite-based curtain wall façade that adheres to current building envelope standards and normative; to implement diverse façade typologies for vision panels, opaque sections, and integrated windows; to engineer the prefabrication process for industrialization, enabling wider market replication and simplified transport and installation. The results demonstrate that the Basajaun façade successfully integrates selected components and meets the performance requirements set by regulations. However, questions remain regarding the workability of bio-based profiles as a commercially viable, ready-to-market solution that can replace traditional aluminum profiles in the curtain wall façade industry.

Keywords: Energy harvesting, Hybrid, Medical Wearable Sensor Nodes, Health Monitoring, Power Management

In the construction sector, the integration of biobased materials has emerged as a pivotal aspect of EU policies, aimed at promoting sustainable practices throughout the value chain to mitigate resource consumption and carbon emissions. This paper explores the development and validation activities of a bio-based façade system within the Basajaun H2020 project, focusing on enhancing the utilization of biobased components within building envelopes to replace conventional solutions with eco-friendly alternatives. This paper reports the methodologies employed to detect requirements and outline the testing protocols undertaken to validate the façade system design devised within the project focusing on the original façade components as the bio composite profile. Vision and opaque façade modules are prototyped and tested following curtain wall standards standard for performance and acoustic assessments, to showcase the efficacy of the developed solution. The conducted tests demonstrate the feasibility of integrating bio-based components into building envelopes, aligning with project expectations, and prevailing standards for curtain wall façade solutions. Notably, the designed façade system meets technical conditions and project objectives. Nevertheless, the research underscores the need for further refinements to facilitate solution industrialization and explore broader market applicability. Future efforts will focus on addressing these improvements and assessing the scalability of the solution.

Fractional flow reserve (FFR) is well recognized as a gold standard measure for the estimation of functional coronary stenosis. Technological progressions in image processing have empowered the reconstruction of three-dimensional models of the coronary arteries via both non-invasive imaging modalities, such as Coronary Computed Tomography Angiography (CCTA), and invasive coronary angiography or intravascular imaging. The application of computational fluid dynamics (CFD) techniques to coronary 3D anatomical models allows the virtual evaluation of the hemodynamic significance of a coronary lesion with high diagnostic accuracy in comparison to the invasive FFR using pressure wires. These opportunities providing hemodynamic information based on anatomy have given rise to a new era of functional angiography and coronary imaging. However, further validations are needed to overcome several scientific and computational challenges before these methods are applied in everyday clinical practice. This review aims to present all the data on the studies and methodologies that have been presented for the virtual estimation of FFR, and the diagnostic execution of the virtual tools for the hemodynamic assessment of coronary lesions compared to the invasive FFR.

Bio-inspired gyroid triply periodic minimum surface (TPMS) lattice structures have been the focus of research in automotive engineering because they can absorb a lot of energy and have wider plateau ranges. The main challenge is determining the optimal energy absorption capacity and accurately capturing plastic plateau areas using finite element analysis (FEA). Using nTop's Boolean subtraction method, this study combined walled TPMS gyroid structures with normal TPMS gyroid lattice. This made a composite TPMS-gyroid lattice with relative densities ranging from 14% to 54%. Using the ideaMaker software and the fused deposition modeling (FDM) Raise3D Pro 2 3D printer to print polylactic acid (PLA) bioplastics in 1.75 mm filament made it possible to slice computer aided design (CAD) models and fabricate 36 lattices samples precisely layer by layer technique. Shimadzu 100kN testing equipment was utilized for the mechanical compression experiments. And the validation using finite element analysis (FEA). Further, CTG was examined using a field emission scanning electron microscope (FE-SEM) before and after compression testing. The composite TPMS gyroid lattice showed potential as shock absorbers for vehicles with relative densities of 33%, 38%, and 54%. The Gibson-Ashby model showed that the composite TPMS gyroid lattice deformed mainly by bending, and the size effect was seen when the relative densities were less than 15%. The lattice's relative density had a significant impact on its ability to absorb energy. The research also explored the use of these innovative foam-like composite TPMS-gyroid lattices in high-speed crash box scenarios, potentially enhancing vehicle safety and performance.

The aim of this study was to assess the influence of thermocompression conditions on lignocellulosic biomass such as sugarcane bagasse (SCB) in the production of 100% binderless bio-based materials. Five parameters were investigated: pressure applied (7-102 MPa), molding temperature (60-240°C), molding time (5-30 min), fiber/fine particle ratio (0/100-100/0) and moisture content (0-20%). These parameters affected the properties and chemical composition of the materials. The density ranged from 1198 to 1507 kg/m3, the flexural modulus from 0.9 to 6.9 GPa and the flexural strength at breaking point from 6.1 to 43.6 MPa. Water absorption (WA) and thickness swelling (TS) respectively ranged from 21% to 240% and from 9% to 208%. Higher mechanical properties were obtained using SCB with fine particles, low moisture content (4-10%), high temperature (≥ 200°C) and pressure (≥ 68 MPa), while water resistance was improved using more severe thermocompression conditions with the highest temperature (240°C) and time (30 min) or a higher moisture content (≥ 12.5%). Correlations were noted between the mechanical properties and density, while the material obtained with only fine particles had the highest mechanical properties and density. Material obtained with a 30 min molding time had the lowest WA and TS due to internal chemical reorganization followed by hemicellulose hydrolysis into water-soluble extractables.

Bio-absorbable stents are a novel tool which relieve stenosis and then resorb as the patient grows, avoiding obligatory re-intervention. This case describes the novel use of an iron bio-absorbable stent in a child with surgically repaired Tetralogy of Fallot who post-operatively developed a severely stenotic right ventricular outflow tract.

This article introduces a novel nature-inspired metaheuristic algorithm called Frilled Lizard Optimization (FLO), which emulates the hunting behavior of frilled lizards in their natural habitat. FLO draws in-spiration from the sit-and-wait strategy observed in frilled lizards during hunting. The underlying theory of FLO is presented and mathematically formulated in two phases: (i) an exploration phase, simulating the frilled lizard's attack towards prey, and (ii) an exploitation phase, simulating the lizard's retreat to the top of the tree after feeding. To assess FLO's efficacy in solving optimization problems, the algorithm's performance is evaluated across fifty-two standard benchmark functions, encompassing unimodal, high-dimensional multimodal, fixed-dimensional multimodal, and the CEC 2017 test suite. Comparative analyses with twelve existing metaheuristic algorithms are conducted. The simulation results reveal that FLO, distinguished by its adeptness in exploration, exploitation, and balancing them during search process, outperforms competing algorithms. Additionally, FLO is implemented on twenty-two constrained optimization problems from the CEC 2011 test suite and four engineering design problems, demonstrating its effectiveness in addressing real-world optimization applications.

Dermal injections of hyaluronic acid gel for aesthetic skin rejuvenation are increasingly popular nowadays. Although these products are classified as medical devices, the regulations on their administration by licensed practitioners are still weak, whereas their manufacturers increasingly highlight and advertise the cellular effects that underpin the efficacy of these injections. In this re-view, we discuss all current knowledge on the mode of action of dermally injected hyaluronic acid and the potential toxicological implications especially from crosslinked gels in conjunction with the current global regulations. We conclude that dermal injections of hyaluronic acid have several therapeutic implications that warrant further research, and that strict regulations must be applied on their manufacture/quality control and the required qualifications of licensed aesthetic injectors.

The well-being and sociability of individuals have always been part of modernity. The development of new technologies that meet these aspirations is receiving increasing attention. Thus, strengthening the desired objectives of these tools and minimizing their undesirable side effects is the subject of a growing commitment. The present contribution aims, in this context, to evaluate and analyze the desired and undesirable effects of the interaction of electromagnetic fields with living tissues in general. This involves routines reinforcing expected functions as well as those controlling and protecting against undesirable effects. First, the interactions of electromagnetic fields with tissues are analyzed, involving their thermal biological effects of desired and undesired exposures. The roles of blood and sap fluids in bio-affected tissues are then analyzed. Secondly, the governing electromagnetic, bio-heat equations, and their coupled solution are studied. Third, the thermal behavior of tissues and the exposure adverse effects are examined. Next, monitoring and defending of the effects of exposures are discussed. This contribution illustrates and discusses mathematical modeling routines based on a generalized interaction of electromagnetic fields with living tissues.

The rapid increasing rate of soil and water bodies pollution is the main anthropogenic effect caused by the mismanagement of post-consumer plastics. This research evaluated the effectiveness of cattail (Typha Latifolia) fibers (CFs) as bio-adsorbents of microplastic particles (MPPs) from wastewater. The effect of the adsorption environment composition on the adsorption rate was investigated. Batch tests were conducted to evaluate the “spontaneous” adsorption of MPs onto CFs. Five MPPs materials (PVC, PP, LDPE, HDPE, and Nylon 6) were evaluated. An industrial wastewater (PW) and Type II Distilled Water (DW) were employed as adsorption environments. The batch tests results show that CFs are effective in removing MPPs from DW and PW. However, higher removal percentage of MPPs were obtained in PW, ranging from 89% to 100% for PVC, PP, LDPE, and HDPE; while the adsorption of Nylon 6 increased to 29.9%, a removal increased of 50%. These observations indicate that hydrophobic interactions drive the “spontaneous and instantaneous” adsorption process and that adjusting the adsorption environment effectively enhances the MPPs removal rate. This research demonstrates the important role that bio-substrates can play in reducing the environmental pollution as efficient, sustainable, low cost, and reliable adsorbents for the removal of MPPs from wastewaters.

This study introduces a specialized Automatic Speech Recognition (ASR) system, leveraging the Whisper Large-v2 model, specifically adapted for radiological applications in French language. Our methodology focused on adapting the model to accurately transcribe medical terminology and diverse accents within the French language context, achieving a notable Word Error Rate (WER) of 17.121%. The research involved extensive data collection and preprocessing, utilizing a wide range of French medical audio content. The results demonstrate the system's effectiveness in transcribing complex radiological data, underscoring its potential to enhance medical documentation efficiency in French-speaking clinical settings. The discussion extends to the broader implications of this technology in healthcare, including its potential integration with Electronic Health Records (EHRs) and its utility in medical education. The study also explores future research directions, such as tailoring ASR systems to specific medical specialties and languages. Overall, this research contributes significantly to the field of medical ASR systems, presenting a robust tool for radiological transcription in the French language and paving the way for advanced technology-enhanced healthcare solutions.

Peritoneal fluid is an ovarian exudate from the growing follicle or corpus luteum. Therefore, the free concentrations of estrogens and progesterone are always much higher than in plasma, especially after ovulation. The peritoneum is not vascularised, and peritoneal implants and the superficial portion of deep endometriosis are likely influenced mainly by peritoneal fluid. Follicular phase progesterone concentrations are as high as during the luteal phase in plasma. This explains that most peritoneal implants are rarely proliferative and out of phase with the endometrium. From some 5 mm of depth onwards, endometriosis is rather influenced by plasma hormone concentra-tions, and the deeper parts can be proliferative as the endometrium. Because of these progesterone concentrations, progesterone resistance has to be postulated, permitting endometriosis lesions to initiate and develop. This opens the discussion of whether endometriosis is similar to the basal endometrium. These peritoneal fluid concentrations are important to understand the natural history and medical therapy of endometriosis. Most medical therapies decrease ovarian function and affect peritoneal fluid steroid hormone concentrations. It is suggested that the efficacy of medical therapy for endometriosis-associated pain is a consequence of the decreased estrogen concentrations in the peritoneal cavity and that the local effect of progestins may not be determinant for pain relief. If this is true, a history of endometriosis should not be considered a contraindication for hormone re-placement therapy.

The emergence of Internet of Things (IoT) devices is revolutionizing healthcare. This dynamic healthcare environment relies on Internet of Healthcare Things (IoHT) and Internet of Medical Things (IoMT) technologies. Economic, social, and technological opportunities from the IoHT are transforming healthcare systems. This article covers the history, present condition, and future prospects of IoHT, as well as its topologies, platforms, services, applications, market trends, and solution types. It examines security issues, requirements, and a threat taxonomy, studying smart healthcare privacy and security. It explores future research and the challenges IoHT-based solutions face. International health rules and regulations based on the IoT and their social and economic effects on long-term development are also examined. Integrating IoMT into healthcare infrastructures enhances scalability, efficiency, reliability, and accuracy. Through communication networks and data-processing algorithms, IoMT creates smart hardware and software platforms that enhance decision-making. IoMT devices' low resources raise privacy and security concerns. Security and privacy issues are organised by healthcare IoMT adoption in this study. We give an extensive attack taxonomy against the IoMT infrastructure, encompassing devices, security mechanisms, and their pros and cons. Furthermore, it describes the privacy and security requirements for any unique security solutions against IoMT's multiple attack vectors. This article explains the complicated difficulties, security concerns, and future research pathways needed to safeguard and ensure the long-term expansion of these game-changing technologies in the healthcare ecosystem.

The 2020 revision of South Korea’s Personal Information Protection Act (PIPA) updated procedures for the use of medical data for research. The PIPA provision allowing “pseudonymized information” to be used without the consent of the data subject for scientific research introduced ambiguity regarding the applicability of the PIPA versus the Bioethics and Safety Act (BSA), which allows “anonymized information” to be used for research only after data-subject consent and IRB approval for human-subject research are obtained. The main points requiring clarification include the distinction between “human-subject” and “scientific” research, the definition of anonymization and pseudonymization, the requirements for data-subject consent, and the procedures for institutional review boards (IRBs) and data review boards (DRBs). After reviewing the legal concepts and processes, this article recommends clarification of the guidelines for the use of medical data in research by distinguishing the concept and, in the long run, categorizing medical data based on the degree of risk.

Suboptimal knowledge of clinical pharmacology, therapeutics, and toxicology (CPT) and poor-quality prescribing are threats to patient safety. Our previous national survey of medical faculty identified limited confidence in medical student graduates’ ability to prescribe safely and an interest in a national prescribing competence assessment. Given the in-person challenges posed by the restrictions related to the COVID-19 pandemic, we aimed to re-evaluate opinions and gauge interest in e-learning resources and assessments. Using public sources, a sampling frame of medical school leaders from all 17 Canadian medical schools, including deans, vice-deans, and program directors for clerkship, residency, and e-learning, were invited to participate in a cross-sectional survey. Survey questions were finalized after several rounds of testing and analyses were descriptive.Of 1448 invitations, 411 (28.4%) individuals reviewed the survey, and among them, 278 (67.6%) completed at least one survey question with representation from all schools. While more than 90% of respondents agreed that medical students should meet a minimum standard of prescribing competence, only 17 (7.9%) could vouch for their school meeting objectives in CPT and many had significant concerns about their own or other schools’ recent graduate prescribing abilities. Given the lack of local CPT eCurricula resources, there was strong interest in a national online course and assessment in CPT. Our national survey results suggest an ongoing inadequacy of medical trainees’ prescribing competence and provide a strong endorsement for both a national online CPT course and assessment during medical school.

Diabetic retinopathy (DR) is the primary factor leading to vision impairment and blindness in diabetic people. Uncontrolled diabetes can damage the retinal blood vessels. Initial detection and prompt medical intervention are vital in preventing progressive vision impairment. Today's growing medical field poses more significant workload and diagnostic demands on medical professionals. In the proposed study, a convolutional neural network (CNN) is employed to detect the stages of DR. This research is crucial for studying DR because of its innovative methodology incorporating two different public datasets. This strategy enhances the model's capacity to generalize unseen DR images, as each dataset encompasses unique demographics and clinical circumstances. The network can learn and capture complicated hierarchical image features with asymmetric weights. Each image undergoes preprocessing using contrast-limited adaptive histogram equalization (CLAHE) and the discrete wavelet transform (DWT). The model is trained and validated using the combined datasets of Dataset for Diabetic Retinopathy (DDR) and the Asia Pacific Tele-Ophthalmology Society (APTOS). The CNN model is tuned with different learning rates and optimizers. The CNN model with Adam optimizer achieved 70% accuracy and an area under curve (AUC) score of 0.82. The recommended study results may reduce diabetes-related vision impairment by early DR severity identification.

This study investigates the pivotal areas where Artificial Intelligence (AI) integration in healthcare warrants further exploration, leveraging insights from Boston Specialists, a forefront healthcare provider in AI adoption. Employing a qualitative case study approach, enriched by in-depth interviews and comprehensive literature reviews, we identify three main domains for potential AI expansion: scheduling efficiency, clinical documentation, and AI-driven medical research. Our results underscore the substantial enhancements AI brings to operational workflows and patient care, notably through improved scheduling systems, accuracy in medical documentation, and the facilitation of data-driven research methodologies. These findings suggest a critical need for healthcare institutions to further invest in AI technologies, focusing on these key areas to harness AI's full potential in personalizing care, optimizing efficiency, and advancing medical knowledge. The study concludes with a call for continued investigation into AI's integration within healthcare settings, emphasizing the importance of a supportive organizational infrastructure, ethical considerations, and data security in realizing AI's transformative impact on healthcare delivery and patient outcomes.

Keywords: Marine Coasts; Protected Areas; Defense and Conservation; Asbestos Cement Materials; Wastes; Contamination; Human Health Risk; Medical Geology.

In February 2004, the Food and Drug Administration (FDA) was the first to approve the combination of cisplatin (CDDP) and pemetrexed (PEM) as standard first-line chemotherapy for untreated, unresectable malignant pleural mesothelioma (MPM). However, after that approval, no progress was made in the standard first-line treatment of MPM for almost 15 years. Positive results from a phase 3 study (Mesothelioma Avastin Cisplatin Pemetrexed Study: MAPS) verifying the effect of bevacizumab, an anti-angiogenesis agent added to CDDP/PEM for unresectable MPM, were published in The Lancet in December 2015; however, this did not lead to approval by national drug regulatory agencies. Furthermore, no second-line treatment was established for cases refractory to CDDP/PEM. In August 2018, the Pharmaceuticals and Medical Devices Agency of Japan was the first in the world to approve monotherapy with nivolumab, an immune checkpoint inhibitor (ICI), for previously unresectable, advanced, or recurrent MPM. Following Japan, in October 2020, the FDA approved the combination of nivolumab and ipilimumab for the treatment of previously untreated, unresectable MPM. In this article, we review the transition of drug treatment for MPM, in light of the historical background, focusing on the benefits of ICIs.

The Work Ability Index (WAI) is the most widely used questionnaire for the self-assessment of working ability. Because of its different applications, shorter versions, and widespread use in healthcare activities, it is worthwhile assessing its characteristics. The WAI was distributed online among the workers of a healthcare company; the results were compared with data contained in the workers' personal health records and with absence registers. 340 out of 575 workers (59.1%) participated; 6.5% of them reported poor work ability. Exploratory factor analysis indicated that the one-factor version best described the characteristics of the WAI. The scores of the complete WAI, the shorter form without the list of diseases, and the minimal one-item version (WAS) had equal distribution and were significantly correlated. The WAI score was inversely related to age and significantly lower in women than in men, but it was higher in night workers than in colleagues due to the probable effect of selective factors. The WAI score was also correlated with absenteeism, but no differences were found between males and females in the average number of absences, suggesting that cultural or emotional factors influence the self-rating of the WAI. Workers tended to overreport illnesses in the online survey compared to data collected during occupational health checks. Musculoskeletal disorders were the most frequently reported illnesses (53%). Psychiatric illnesses affected 21% of workers and had the greatest impact on work ability. Multilevel ergonomic and human factor intervention seems to be needed to recover the working capacity of healthcare workers.

INTRODUCTION: With an increase in the aging population, the application of evidence-based practice in geriatric education can strengthen knowledge, skills, and clinical experience for healthcare students caring for older adults. Age Friendly Health Systems (AFHS) is one of the frameworks founded on providing evidence-based and low-risk care centered on what matters most to older adults, their families, and caregivers. Virtual Reality (VR) platforms are gaining popularity due to their ability to provide an immersive, hands-on learning experience resembling an actual medical practice or care setting. Immersive learning enhances students’ sensory perceptions, promoting an innovative and engaging way of acquiring concepts that are difficult to teach in real life. This study aimed to design, develop, implement, and evaluate a case-based training module highlighting AFHS and educating medical students on the 4Ms approach in geriatric care (What Matters, Medication, Mentation, and Mobility). METHODOLOGY: The project was a feasibility study completed in two phases. Phase one included planning and development of a case-based scenario incorporating 4Ms of AFHS. Phase two included implementing and evaluating the VR training module into the geriatric curriculum for medical students. RESULTS: The final VR case displays a hospital and post-acute setting where an elderly patient is admitted for a hip fracture. Students learn how to triage and treat patients from admission to discharge while demonstrating their knowledge of AFHS. Approximately 10% of students completed the evaluation survey, and preliminary results indicate significant knowledge change in pre-post scenario-based training on AFHS. CONCLUSION: The VR education platform and embedded scenario promise an innovative adaptation of technology in learning the concepts of the 4Ms of AFHS. However, future studies should explore VR education with clinical assessment evaluation to ensure competence in providing Age-Friendly care.

Objective: To use the ancient and modern medical record cloud platform (V2.3.5) to organize and explore the medication patterns of the "Three Causes, Extremity, and One Disease Syndrome Formula" by Chen Wuxuan, and to summarize its therapeutic ideas. Method: Collect and organize the "San Yin Si Tian Fang" in the "San Yin Ji Yi Zheng Fang Lun", and use the modern medical record cloud platform (V2.3.5) to conduct medication frequency statistical analysis, cluster analysis, and complex network analysis. As a result, a total of 16 Chinese herbal medicines were collected in the "Three Causes, Extreme and One Disease Syndrome Formula", involving 75 traditional Chinese medicines. Statistical analysis showed that roasted licorice was the most commonly used, followed by Pinellia ternata, papaya, ginger, and Poria cocos; Medications mainly include warm drugs, sweet and pungent flavors, as well as drugs that promote lung and spleen meridians. Cluster analysis can divide the above-mentioned traditional Chinese medicine into two groups, with specific grouping as follows. Group 1: ginger, white peony, aconite, papaya, and achyranthes bidentata; Group 2: roasted licorice, poria cocos, dried ginger, pinellia ternata, and green peel. Conclusion: The characteristics of the 16 prescriptions are biased towards Xin Gan Wen, emphasizing the regulation of the spleen and stomach, which may be related to the common use of prescription by doctors in the Song Dynasty and the tendency towards warm and dry medication.

The Internet of Things (IoT) has a growing presence in society's daily lives. These lightweight devices can be easily deployed and maintained, enabling extensive adoption in different environments. Furthermore, one of the most promising areas for using IoT devices is healthcare, comprising devices referred to as the Internet of Medical Things (IoMT). Several examples of healthcare services are supported by IoMT devices, e.g., continuous health monitoring. Conversely, there is an increasing concern with the cybersecurity aspects of these devices, and several attacks against IoT infrastructures have been launched in the past few years. These cybersecurity concerns also apply to healthcare applications, where the tradeoff between the benefits and security of IoMT devices must be observed. Given the complexity and amount of data IoMT network traffic generates, advanced methods become especially useful in these environments. Although Machine Learning (ML) brings various techniques and solutions to improve cyberattack detection, prevention, and mitigation, essential features are not addressed in the current state-of-the-art benchmark dataset contributions. Thereupon, the main goal of this research is to propose a realistic benchmark dataset to enable the development and evaluation of IoMT security solutions. In order to accomplish this, 18 attacks were executed against an IoMT testbed composed of 40 IoMT devices (25 real devices and 15 simulated devices), considering the plurality of protocols used in healthcare (e.g., Wi-Fi, MQTT, and Bluetooth). These attacks are categorized into five classes: DDoS, DoS, Recon, MQTT, and spoofing. This effort aims to establish a baseline complementary to the state-of-the-art contributions. The outcome supports researchers in investigating and developing new solutions to make healthcare systems more secure using different mechanisms (e.g., machine learning - ML). This research goes beyond merely conducting attacks on IoMT devices. We also attempt to capture the lifecycle of these devices in different vital phases, from the moment they join the network until they leave, which is called profiling. Profiling allows the different classifiers to identify anomalies of each device individually in the healthcare network. The CICIoMT2024 dataset has been published on CIC's dataset page, making it available for other researchers to use.

Paramedics are increasingly being subjected to violence, creating the potential for significant physical and psychological harm. Where a patient has a history of violent behavior, hazard flags - applied either to the individual, their residential address, or phone number - can alert paramedics to the possibility of violence, potentially reducing the risk of injury. Leveraging a novel violence reporting process embedded in the electronic patient care record, we reviewed violence reports filed over a thirteen-month period since its inception in February 2021to assess the effectiveness of hazard flagging as a potential risk mitigation strategy. Upon reviewing a report, paramedic-supervisors can generate a hazard flag if recurrent violent behavior from the patient is anticipated. In all, 502 violence reports were filed, for which paramedic-supervisors generated hazard flags in 20% of cases (n=99). In general, cases were not flagged either because the incident occurred at a location not amenable to flagging, or because the supervisors felt that a hazard flag was not warranted based on the details in the report. Hazard flagging was associated with an increased risk of violence during subsequent paramedic attendance (Odds Ratio [OR] 6.21, p

Continuum robots play the role of end-effector in various surgical robots and endoscopic devices. The robots may be categorized as rigid or soft continuum robots (SCRs). While the SCRs have proven advantages such as safety and compliance, more research and development are required to enhance their capability for specific medical scenarios. This research aims at designing a soft robot considering concepts of geometric and kinematic similarities. The chosen application is a semi-invasive medical application known as Transesophageal Echocardiography (TEE), but the methodology can be implemented in other similar applications. Since established rigid carrier construction make use of principles we find as well embodied in vertebral spines, the paragon for soft robot solution can be the phylogenetic precursor of the spine, the Chorda dorsalis. The feasibility of fabrication of a soft endoscopic device derived from that paragon within a robotics laboratory was shown empirically by producing a three-segment pneumatic SCR. The kinematic model was proposed based on the method of transformation matrices, and an algorithm based on a self-organizing map (SOM) was proposed and applied to realize kinematic similarity. The simulation results indicate that the algorithm acting as an open-loop controller forces the soft robot tip to follow the desired path which in this case is the path of the rigid probe. It is concluded that the solution provides a soft robot that can surrogate and succeed the traditional rigid counterpart owing to size, workspace, and kinematics.

Violence against paramedics is increasingly recognized as an important occupational health problem, but pervasive and institutionalized underreporting hinders efforts at risk mitigation. Earlier research has shown that the organizational culture within paramedicine may contribute to underreporting and researchers have recommended involving paramedics in the development of violence prevention policies, including reporting systems. Eighteen months after the launch of a new comprehensive violence reporting system in Peel Region, Ontario, Canada, we surveyed paramedics about their willingness to report violent encounters. A total of 204 (33% of eligible) paramedics chose to participate, of whom 67% (N=137) had experienced violence since the launch of the new reporting process, with 83% (N=114) reporting the incidents at least some of the time. In choosing to report, participants cited the accessibility of the new reporting process and the desire to promote accountability among perpetrators while contributing to a safer workplace as motivating factors. Their decisions to file a report, however, could be influenced by the perceived ‘volitionality’ and severity of the violent encounters, particularly in the context of (un)supportive co-workers and supervisors. Ultimately, the participants’ belief that the report would lead to meaningful change within the service was a key driver of reporting behavior.

A substantial spike in the need for quality healthcare has resulted from people being more cognizant of health issues. With blockchain, healthcare providers may safely share patient information electronically, which is especially important given the sensitive nature of the data contained inside them. However, flaws in the current blockchain design have surfaced since the dawn of quantum computing systems. The study proposes a novel quantum inspired blockchain system (Qchain) and constructs a unique entangled quantum medical record (EQMR)system with an emphasis on privacy and security. This Qchain relies on entangled states to connect its blocks. Automated production of the chronology indicator reduces storage capacity requirements by connecting entangled BloQ (blocks with quantum properties) with controlled activities. One qubit is used to store the hash value of each block. A lot of information regarding quantum internet is included in the protocol for the entangled quantum medical record (EQMR). EQMR can be accessed in Medical Internet of Things (M-IoT) systems may be kept private and secure, and their where-abouts can be monitored in the event of an emergency. The protocol also uses quantum authentication in place of more conventional methods like encryption and digital signatures. Mathematical research shows that the quantum converged blockchain (QCB) is highly safe against attacks such as the External attack, Intercept-Measure-Repeat attack, and Entanglement-Measure attack. The reliability and auditability evaluations of the entangled BloQ, as well as the quantum circuit design for computing the hash value, are presented. There's also a comparison between the suggested approach and several other quantum blockchain designs.

During the pandemic, educational digitization experienced a significant increase. In Mexico, social service is a crucial component of technical and professional training, a phase during which individuals apply the knowledge gained throughout their university education. The aim of this study is to standardize a digital model for the management of social service in the health care sector within health care units. This study employed an analytical, observational, retrospective, and longitudinal approach, involving two groups of trainees: Group A (n=133), utilizing a Non-Digital Model, and Group B (n=50), employing a Digital Model. In Stage I. the model design underwent validation through the Delphi method with a panel of three experts. The model was implemented on a Classroom® digital platform with the integration of the elements 1) a monthly rotation rubric 2) care services rubric 3) clinical cases or nursing process rubric, and 4) innovation project rubric. The validation of the model achieved 100% agreement (K=1). The variables measured for each group included the school of origin, career, unit of assignment, timely enrolment, and timely delivery of rubrics on the platform. The difference between the two groups was measured using Chi-Square. To measure the impact, the difference in the timeliness of the products was considered. From the University of Quintana Roo, the difference was 20.3 vs 34%. According to the Unit of Attachment the most frequent was HGR No. 17 with Group A at 22.5 vs 52%. According to the product the least delivered was Product 4, with 69% vs 81%. Timely enrollment was observed in Group A at 89% vs Group B at 80% p=0.001. Overall timely delivery in Group A was 81% vs Group B at 91% p=0.001 in the first 6 months post-implementation. Demonstrating that the implementation of the digital platform was effective, representing a significant advance in the adaptation of medical education to the circumstances imposed by the pandemic, highlighting the feasibility and effectiveness of digital teaching methods in the training of health professionals.

Background: Gender stereotypes and biases can influence perceptions of competence and suitability for certain medical specialties. Empathy is an important component of an optimal doctor-patient relationship. The scope of our study is to verify the correlation between “empathetic" behavioral style with attention and sensibility to the gender differences of patients of the medical students. Methods: An online survey was conducted using the Jefferson Scale for Empathy (JSE), to measure empathy in the context of health professions education and patient care; and the Nijmegen Gender Awareness in Medicine Scale (N-GAMS), which measures attitudes and assumptions about gender. A total of 234 students (52.1% M; mean age: 22.68±2.48) from Medicine and Surgery at the University of Salerno (Italy) participated, of whom n° 175 were third-year students and n° 59 were fifth-year students. Results: The JSE score shows that male students have higher scores (77.29±12.38) than females (75.91±10.39). Conversely, female students have higher perspective-taking (JSE Factor 1: Male= 51.26±11.84; Female= 52.72±11.88). In addition, third-year students are much more empathetic than their fifth-year colleagues (JSE Score: 3°ys= 77.35±11.46; 5°ys= 74.49±11.33). With reference to the GS, we found that male students have greater sensitivity than their female colleagues (GS: Male= 2.67±0.68; Female= 2.37±0.48); conversely, they have higher scores of gender stereotype towards patients (GRIP: Male= 2±0.88; Female= 1.59±0.61) and doctors (GRID: Male= 1.88±0.89; Female= 1.64±0.63). Also, the third-year students compared to their fifth-year colleagues are characterized by greater gender sensitivity (GS: 3°ys= 2.57±0.62; 5°ys= 2.42±0.57), less bias with respect to patients (GRIP: 3°ys= 1.77±0.79; 5°ys= 1.90±0.78) but, on the other hand, show more stereotypes and prejudices towards doctors (GRID: 3°ys= 1.77±0.81; 5°ys= 1.75±0.74). Conclusions: Humanistic attitudes, including empathy, should be instilled, and evaluated among trainees as an essential part of their postgraduate medical education.

This study delves into the dynamic field of medical education research, emphasizing the integration of research training within medical curricula. It seeks to understand the impact of such integration on the competencies of future medical professionals. The primary aim is to systematically categorize and analyze the current trends and future directions in medical education research. This involves assessing the influence of research training on medical students' skills and the methodologies used in such research. Methods: The research employs an extensive bibliographic literature review across multiple databases. It classifies studies into categories like experiential or case studies, editorials, and original research articles. This classification is based on criteria such as geographical location, research objectives, theoretical frameworks, and methodologies. Results: Findings reveal a diverse landscape in medical education research, with a significant emphasis on research training. The research showcases varying methodologies and approaches used globally, highlighting the thematic focus and geographical distribution of these studies. Conclusion: Medical education research is a globally expansive and evolving field. It underscores the importance of continuous investigation, particularly focusing on integrating research elements at curricular levels and exploring innovative educational strategies. The study also points out potential gaps in research, especially in underrepresented regions, indicating directions for future research efforts.

Many bio-applicable materials, medical devices, and prosthetics combine both polymer and metal components to benefit from their complementary properties. This goal is normally achieved by their mechanical bonding or casting only. Here, we report an alternative easy method for the chemical grafting of a polymer on the surfaces of a metal or metal alloys using alkoxy amine salt as a coupling agent. The surface morphology of the created composites was studied by various microscopy methods, and their surface area and porosity were determined by adsorption/desorption nitrogen isotherms. The surface chemical composition was also examined by various spectroscopy techniques and electrokinetic analysis. Elements distribution on the surface was determined and successful bonding of the metal/alloys on one side with the polymer on the other one was confirmed by alkoxy amine. The composites show significantly increased wettability, reliable chemical stability of the bonding, excellent bacterial anti-adhesive properties and functionality, i.e. the characteristics promising for their application in biomedical field.

Naturally-derived synthetic leather is a widely used and high-quality type of faux leather or synthetic leather. Many consumers prefer authentic leather goods due to their exceptional qualities, including high water vapor permeability and superior wearing comfort. Consequently, the exploration of artificial leather made from natural materials with exceptional qualities as an alternative to genuine leather has garnered significant interest and is now a highly studied subject. Synthetic leather, sometimes known as imitation leather, has gained popularity recently as a highly suitable alternative to genuine leather. Continuous advances in this area of research increase the range of uses for synthetic leather using natural fibers. Thus, this research aims to explore synthetic leather materials using orange peel waste, which can be applied to the fashion industry. This research applies several types of orange peel waste, such as Pomelo, Sweet orange, and Sunkist orange, to different compositions and strengthening materials, such as bandages and dacron. The resulting bio-composite materials' morphology, mechanics, and adhesive properties were evaluated following ASTM D 2209-00 and ASTM D 4533-04 standards. The results indicate that specimen 1A (Pomelo using bandage as reinforcement) has the most significant effects, with a tensile test value of approximately 472 N/cm2, an elongation of roughly 67.28 % was the highest value on sweet orange using bandage as reinforcement, and a tear resistance of around 14.28 N/cm2 for Pomelo with bandage as reinforcement. Furthermore, the test results also show that composition 2B still does not meet the standards of SNI 1294:2009 and ISO 3376 for tensile strength and ISO 3377-1 for tear strength. Additionally, statistical analysis showed no appreciable changes in the samples analyzed. Furthermore, statistical evaluations showed no significant alterations in the studied samples. The results of this experimental investigation can be explored further and used as a basic framework for the creation of bio-composites from orange peel waste for future fashion.

The traditional manual recording of vaccination records in Germany faced challenges during the COVID-19 pandemic, prompting the introduction of a Covid smartphone app with QR codes. However, this solution brought new challenges, emphasizing the need for a centrally managed European digital vaccination record for efficiency and validity. Thus, this study assesses the feasibility of using the HL7 FHIR standard in the healthcare industry for implementing a digital vaccination pass management and monitoring system. The system aims to offer convenience and improved efficiency for both patients and healthcare providers while promoting interoperability with other healthcare systems. We developed a prototype using modern technologies, such as React, Quarkus, and Keycloak, evaluating the applicability of FHIR in promoting interoperability within the healthcare industry. Results indicate potential benefits for patients and healthcare providers, offering secure access to immunization records, personalized recommendations, and streamlined management. However, challenges in integrating nuanced vaccination processes into the standardized FHIR system, necessitating custom extensions, and issues with manual data entry and identity provider integration, pose obstacles. Despite these challenges, the study suggests that implementing HL7 FHIR can enhance efficiency, data accessibility, and accuracy in the vaccination process, supporting broader digitization efforts in the German healthcare system and beyond.

The Internet of Medical Things(IoMT) has powerful cloud computing ability and efficient data collection ability, which can improve the accuracy and convenience of medical work. As most communications are over open networks, data should encrypted before uploading to ensure the confidentiality of sensitive user data. Searching for encrypted data has become a challenging problem. Public key Encryption with Keyword Search (PEKS) supports the search of encrypted data and provides data privacy protection. PEKS has become a trendy technology, but PEKS still has the following problems: 1. The cloud server, as a semi-honest but curious third party, is likely to return some wrong search results to save computing and bandwidth resources. 2. The single keyword search inevitably produces irrelevant results, wasting computing and bandwidth resources. 3. Most PEKS schemes use bilinear pairing, so the computational efficiency is relatively low. 4. PEKS schemes based on Public Key Infrastructure (PKI) or identity-based cryptography inevitably face problems with certificate management or key escrow. 5. Most PEKS schemes face serious security threats such as Keyword Guessing Attacks (KGA) and File Injection Attacks (FIA). To solve the above problems, we propose a new certificateless verifiable bilinear pair-free conjunctive keyword search encryption scheme(CLVPFCKS) for IoMT using multi-signature.

Violence against paramedics is widely recognized as a serious, but underreported, problem. While injurious physical attacks on paramedics are generally reported, non-physical violence is less likely to be documented. Verbal abuse can be very distressing, particularly if the harassment targets personal or cultural identities, such as race, ethnicity, gender, or sexual orientation. Leveraging a novel, point-of-event reporting process, our objective was to estimate the prevalence of harassment on identity grounds against paramedics in a single paramedic service in Ontario, Canada, and assess its potentially differential impact on emotional distress. In an analysis of 502 reports filed between February 1, 2021, through February 28, 2022, two paramedic-supervisors independently coded the free-text narrative descriptions of violent encounters for themes suggestive of sexism, racism, and homophobia. We achieved high interrater agreement across the dimensions (k=0.73-0.83), and after resolving discrepant cases, we found that 1 in 4 violent reports documented abuse on at least one of the identity grounds. In these cases, paramedics were 60% more likely to indicate being emotionally distressed than for other forms of violence. Our findings offer unique insight into the type of vitriol paramedics experience in the course of their work and its potential for psychological harm.

The objective of this study is to evaluate how two varying amounts of sepiolite-based powder, infused with indigo extract, affect the appearance and durability of a water-based white primer. To examine the influence of this eco-friendly pigment on the coatings' overall appearance, assessments were performed for color, gloss, and surface roughness. Additionally, the coatings were investigated through optical and electron microscopic observations, to evaluate the distribution of the pigment within the polymer matrix. The effect of the pigment on the coating's durability was assessed through accelerated tests, including exposure in a salt spray chamber and a UV-B chamber. These tests aimed to evaluate the emergence of defects and changes in the appearance of the samples over time. Furthermore, the impact of different quantities of sepiolite-based powder on the coating's ability to act as a barrier was assessed using liquid resistance tests and contact angle measurements. These evaluations aimed to understand how the coating responded to various liquids and its surface properties concerning repellency or absorption. In essence, this study underscores the considerable influence of the eco-friendly pigment, demonstrating its capacity to introduce unique color and texture variations to the paint. Moreover, the inclusion of the pigment has enhanced the coating's color stability, its ability to act as a barrier, and overall durability when exposed to harsh environments.

We use COMSOL Multiphysics software to model optical processes in media and the effects of light propagation in whispering gallery mode resonators (WGMRs). Although plane wave irradiating on resonator does not create resonances, it was shown that they can be obtained when focused tangentially on the perimeter of the resonator. We demonstrate that resonances can be excited in resonators by prism coupling when the incident angle of the light is larger than the angle of total internal reflection. We determined the optimal distance between the prism and the resonator to get the strongest resonances. Bio-sensing principle of WGMRs is shown by demonstrating that the shift of resonances increases with a larger number of "bio-molecules" attached to the surface of WGMR. Surface functionalization and surface roughness were explored.

The development of new medical monitoring applications requires precise modeling of the human body effects as well as simulating and emulating realistic scenarios and conditions. The first aim of this paper is to develop realistic and adjustable human body 3D emulation platforms which could be used for evaluating emerging microwave-based medical monitoring/sensing applications such as the detection of brain tumors, strokes, breast cancers as well as for capsule endoscopy studies. The new phantom recipes are developed for microwave ranges for the realistic shaped phantom molds. The second aim is to validate the feasibility and reliability of the phantoms for practical scenarios with electromagnetic simulations using tissue layer models and biomedical antennas. The third aim is to investigate the impact of the water temperature in the phantom cooking phase on the dielectric properties of the stabilized phantom. The evaluations show that the dielectric properties of the developed phantoms correspond closely to those of real human tissue. The error in dielectric properties varies between 0.5-8%. In the practical scenario simulations, the differences obtained with phantoms-based simulations in S21 parameters are 0.1-13dB. However, the differences are smaller in the frequency ranges targeted for medical applications.

Cross-institutional secondary use of medical data benefits from structured semantic annotation, which, ideally, enables matching and merging semantically related data items from different sources and sites. While numerous medical terminologies and ontologies, as well as some tooling, exist to support such annotation, cross-institutional data usage based on independently annotated datasets is challenging for multiple reasons: the annotation process is resource intensive and requires a combination of medical and technical expertise since it often requires judgment calls to resolve ambiguities resulting from non-uniqueness of potential mappings to various levels of ontological hierarchies and relational and representational systems. Divergent resolution of such ambiguities can inhibit joint cross-institutional data usage based on semantic annotation since data items with related content from different sites will not be identifiable based on their respective annotations if different choices were made without further steps such as ontological inference, which is still an active area of research. We hypothesize that a collaborative approach to semantic annotation of medical data can contribute to more resource efficient and high-quality annotation by utilizing prior annotational choices of others to inform the annotation process, thus both speeding up the annotation itself and fostering a consensus approach to resolving annotational ambiguities by enabling annotators to discover and follow pre-existing annotational choices. Therefore, we have implemented a prototypical Collaborative Annotation Tool (CoAT), evaluated its usability, and present first inter-institutional experiences with this novel approach to promoting practically relevant interoperability driven by use of standardized ontologies.

This review summarizes available data on invasive procedures applied with questionable indications in Russia in the recent past: mastectomy with the removal of muscles, gastrectomy for peptic ulcers, spleno-renal anastomosis for diabetes mellitus, thoracic surgery for bronchial asthma, overuse of surgery in tuberculosis, excessive and compulsory treatments of alcohol-dependent patients, etc. Among factors contributing to the use of invasive procedures with unproven efficiency have been the partial isolation from international scientific community, insufficient consideration of the principles of professional autonomy, informed consent and scientific polemics, training of medical personnel. It is known that invasive procedures can exert a placebo effect, which might have contributed to reported efficiency of some methods discussed here. However, by definition, placebo must be free of risks.

Cosmetic surgery is the subfield of plastic surgery that enhances appearance mainly for aesthetic reasons. Currently, cosmetic surgery interventions are highly considered appealing and popular all around the world. Several factors have contributed in this rapidly evolving field such as scientific and economic development, breaking down barriers and cultural norms, globalization, social media and mental disorders. Nowadays, the morality of cosmetic surgery is facing many dilemmas due to its benefits and drawbacks. It is proven that the advantages of cosmetic surgery include improved body confidence, mental health, and function. Additionally, aesthetic corrections can upscale the quality of life and create career opportunities for special targeted groups. Also, cosmetic surgery has a major impact in gender affirmation procedures. Although, herein we also describe the disadvantages of this widely developing field such as minor and major medical complications, potential postoperative risks and addiction in plastic surgeries associated with damaging economic issues. Lack in self-confidence, altered mental health status and ethical crisis consist another negative aspects of aesthetic surgery’s impact.

Recent development for synthesis of bio-based long chain aliphatic polyesters by acyclic diene metathesis (ADMET) polymerization of α,ω-dienes, derived from plant oils and bio-based chemicals, like bis(10-undecenoate) with isosorbide, using ruthenium-carbene catalysts have been reviewed. Development of subsequent (one-pot) tandem hydrogenation afforded saturated polyesters under mild conditions. The polymerizations under bulk (without solvent, 80-90 ºC) or in ionic liquids (50 ºC) under vacuum conditions enabled synthesis of high molar mass polymers (Mn >30,000 g/mol). The polymerization by molybdenum-alkylidene catalyst afforded the highest molecular weight polyesters (44000‒49400 g/mol, in toluene at 25 ºC) exhibiting promising tensile properties (strength and elongation at break) beyond polyethylene, polypropylene. Depolymerizations of these polyesters including closed loop chemical recycling were also demonstrated. Catalyst developments (more active, under mild conditions) play a key role for the efficient synthesis.

This review explores the integration of Virtual and Mixed Reality in medical training. The advent of immersive technologies has revolutionized traditional methodologies, offering immersive, interactive, and flexible learning environments. This study aims to assess the impact, efficacy, and potential of Extended Reality (XR) in medical education. Methods included a comprehensive analysis of current Metaverse’s applications in various medical fields, including surgery, diagnostics, and patient care. Results indicate a significant enhancement in learning outcomes, practical skills, and student engagement. Conclusions suggest that Virtual Reality is a valuable tool for medical training, providing realistic simulations and improving both theoretical knowledge and practical skills. The intersection of virtual reality and cognitive neuroscience presents an exciting frontier for understanding the human brain's response to immersive environments. This review explores how VR impacts learning, with a particular focus on the activation and engagement of the prefrontal cortex during immersive experiences. It delves into various studies that highlight the transformative potential of VR in educational settings and therapeutic applications, demonstrating how VR can facilitate deeper and more effective learning experiences. The review will present a dedicated section on the current methodologies used to analyze the brain's response while immersed in a virtual environment.

Previous research showed that intersex people face specific challenges in their sexual development, including uncertainties or confusion about their gender, a negative genital self-image, and hesitance to engage in romantic and sexual relationships. However, in-depth knowledge of a central period of this development, adolescence, is missing. In our qualitative study, we explore which factors influence the relational and sexual development of intersex youth and what elements contribute to a positive development. We interviewed eighteen intersex persons aged 18-38. We identified three main themes: (1) intersex experiences, (2) the described sexual and relational life course, and (3) factors influencing a positive development. Our findings show that intersex youth face many obstacles to their relational and sexual development, many of which related to healthcare. However, their life stories also illuminate how healthcare professionals but also parents, friends, partners, teachers and others can make a substantial difference in intersex lives by breaking normative, binary thinking on sex and gender.

Currently, Pythagorean fuzzy sets (PFSs) have been widely applied in various fields due to their substantial advantages in expressing and dealing with uncertainty. However, measuring the similarity and difference between PFSs effectively remains an unresolved issue. Inspired by Tanimoto similarity, we propose a novel set of similarity and distance measures for PFSs. We delve into the theoretical properties of the proposed measures and compare it with existing PFSs measures. Numerous numerical examples validate their rationality and effectiveness. Furthermore, our experimental findings suggest that in contrast to existing measures, the introduced measures successfully circumvent various counter-intuitive issues encountered by current measures, and yield more pronounced outcomes in the discrimination of different fuzzy sets. This enhances the uniqueness and superiority of our measures. Finally, we developed two decision models based on the proposed measures and validated their applicability in three applications.

This paper introduces the AltumView Sentinare smart activity sensor for senior care and patient monitoring. The sensor uses an AI chip and deep learning algorithms to monitor the activity of people, collect activity statistics, and notify caregivers when emergencies such as falls are detected. To protect privacy, only skeleton (stick figure) animations are transmitted instead of videos. The sensor is highly affordable, accessible, and versatile. It was a CES 2021 Innovation Award Honoree, and has been selected by Amazon as one of only three fall detection devices integrated into its Alexa Together urgent response service, and has received very positive reviews from Amazon customers. It has also been used in different senior care settings in about ten different countries. The paper presents the main features of the system, the evidences and lessons learned from its practical applications, and future directions.

Interdisciplinary conferences play a vital role in advancing explainable Artificial Intelligence (AI) within increasingly intersecting healthcare and computational biology arenas. Challenges result-ing from algorithmic bias and the necessity for domain-specific Explainable AI (XAI) techniques underscore the increasing significance of transparent and interpretable AI systems used in patient care. Collaborative efforts between clinicians, data scientists, and various stakeholders are nec-essary to innovate solutions tailored to healthcare needs. Specialized conferences may foster these interdisciplinary interactions, providing platforms for knowledge exchange, networking, and collaborative partnerships. The legal, ethical, and societal dimensions of medical AI advocate for an integrative approach that aligns technological advancements with patient-centered care val-ues. The role of specialized conferences is therefore essential for shaping future directions in ex-plainable AI and computational biology that contribute to improved patient outcomes and healthcare innovations.

The present study aimed to evaluate the psychometric properties of the Greek version of the Jefferson Scale of Empathy—Student version (JSE-S) and its association with potential predictors among Greek-speaking undergraduate medical students. This study adopted a cross-sectional, comparative–descriptive research design. The study was conducted during October and November 2023. Cronbach’s α for the JSE-S was 0.846. Cronbach’s α values for the factors “perspective taking”, “compassionate care”, and “standing in the patient’s shoes” were 0.800, 0.715, and 0.748, respectively. The intraclass correlation coefficient for the JSE-S score in the test–retest study was 0.827 (95% CI = 0.647 to 0.915, p-value < 0.001), indicating a high level of reliability. The participants showed moderate empathy levels. Females scored higher than males on the Greek version of the JSE-S (108.8 vs. 102.8, p-value < 0.001). Moreover, students enrolled in the fourth academic year showed higher empathy mean scores than those enrolled in the first year (108.6 vs. 103.6, p-value = 0.012). Statistically significant empathy differences by specialty preferences or faith in God/supreme power were not found. The present study provided satisfactory evidence that the Greek JSE-S is a psychometrically sound measurement instrument. Empathy differences by gender were found in line with prior literature.

Controlling robots in space with necessarily low material and structural stiffness is quite challenging at least in part due to the resulting very low structural resonant frequencies. The frequencies are sometimes so low, the vary act of controlling the robot with medium or high bandwidth controllers lead to excitation of resonant vibrations. Biomimetics or biomimicry emulates models, systems, and elements of nature for solving such complex problems. Recent seminal publications have re-introduced the viability of optimal command shaping, and one recent instantiation mimics baseball pitching to propose control of highly flexible space robots. The readership will find a perhaps dizzying array of thirteen decently performing alternatives in the literature but could be left bereft selecting a method(s) deemed to be best suited for a particular application. Bio–inspired control of space robotics is presented in a quite substantial (perhaps not comprehensive) comparison, and the conclusions of the study indicate the top three performing methods based on minimizing control effort (i.e., fuel) usage, tracking error mean, and tracking error deviation include.

Accurate medical image segmentation is paramount for precise diagnosis and treatment in modern healthcare. This research presents a comprehensive study on the efficacy of Particle Swarm Optimization (PSO) combined with Histogram Equalization (HE) preprocessing for medical image segmentation, focusing on Lung CT-Scan and Chest X-ray datasets. Best Cost values reveal the PSO algorithm’s performance, with HE preprocessing demonstrating significant stabilization and enhanced convergence, particularly in complex Lung CT-Scan images. Evaluation metrics, including Accuracy, Precision, Recall, F-Score, Specificity, Dice, and Jaccard, show substantial improvements with HE preprocessing, emphasizing its impact on segmentation accuracy. Comparative analyses against alternative methods, such as Otsu, Watershed, and K-means, confirm the competitiveness of the PSO-HE approach, especially in Chest X-ray images. The study also underscores the positive influence of preprocessing on image clarity and precision. These findings highlight the promise of the PSO-HE approach in advancing the accuracy and reliability of medical image segmentation, paving the way for further research and method integration to enhance this critical healthcare application.

Introduction: In an era of increasing public awareness regarding the pivotal role of nutrition in the onset and progression of chronic degenerative diseases, there is a growing demand for information and assistance pertaining to the intricate relationship between diet and disease. Nutritional practices, therefore, emerge as a fundamental element in the prevention and management of these maladies, necessitating a proactive response from healthcare professionals (HCP). This study sought to evaluate the impact of participation in a Culinary Medicine (CM) program on Mediterranean diet adherence, food management skills, culinary proficiency, and counseling confidence among HCP. Methods: A mixed-methods pilot implementation program (PIP) was meticulously designed and executed, engaging a cohort of 20 HCP recruited from Hospital Clinic Barcelona. The program unfolded at the Alícia Foundation kitchen-lab and encompassed a series of interactive, hands-on sessions that delved into the realms of gastronomy, food management, culinary skills, and culinary diet therapy, with a specific focus on prevalent diseases and their prevention, treatment, and care. Tailored questionnaires were administered to all participants both before and after the PIP. Results: Of the 20 participants, 14 successfully completed the study, comprising 86% women, 86% aged above 40, 71% nurses, and 7% medical doctors. Interestingly, 86% of the participants had previously received nutrition training, whereas only 14% had received culinary training. Following the completion of the program, there was a remarkable improvement in adherence to the Mediterranean diet (p < 0.01). However, no statistically significant improvements were observed in food management and culinary skills or counseling confidence (p > 0.5). Despite the absence of statistical significance, there was a noteworthy trend towards greater advocacy for dietary changes before resorting to medication, along with enhanced confidence in providing nutritional and culinary guidance to patients. Conclusion: The findings from this study underscore the potential of hands-on CM training as a vital component of nutrition education for HCP. While statistically significant improvements in certain domains were not observed, the program did demonstrate its ability to influence attitudes, knowledge, and behaviors related to healthy cooking and eating for both HCP themselves and their patients. Given these promising trends, future studies with a larger sample size must be performed to further elucidate the impact of CM training on HCP and its potential benefits for public health.

Fermatean fuzzy sets (FFSs) are a versatile tool for handling uncertain problems and have shown great effectiveness in practical applications. However, many existing Fermatean fuzzy similarity measures exhibit counter-intuitive situations, making it challenging to accurately measure the similarity or difference between FFSs. To address this issue, several similarity and distance measures for FFSs are proposed, inspired by the Tanimoto similarity measure. The properties of the proposed measures are also explored, along with several comparative examples with existing measures for FFSs, which illustrate their superior performance in processing fuzzy information from FFSs. The proposed measures have effectively overcome the counter-intuitive challenges posed by many existing measures and significantly outperforms existing measures in differentiating different FFSs. Furthermore, we demonstrate the practical applicability of the proposed measures in solving pattern recognition, medical diagnosis and multiple-attribute decision-making problems.

We review the literature on medical discourse and attempt to build a computational model of it. Medical discourse sheds a light on communication structure of patient-doctor and other communication scenarios in healthcare and should be leveraged to facilitate and automate this communication when it is possible and practical. We propose a unified framework to represent communication discourse at the meta-level, where the subject of the communication is expressed in a language object. So far, the broad range of work on medical discourse is detached from computational discourse analysis, and we explore the possibilities of filling this gap and computationally treat the peculiarities of how information is passed between the agents in a hospital setting. We select the domain of question answering (QA) against a corpus of medical documents of diverse nature to evaluate our computational model of medical discourse. It turns out that applying specific structures obtained in medical discourse studies improves the relevance and efficiency of question answering.

ABSTRACT Heavy metals have been classified as dangerous environmental pollutants. Interest in feasible ways to reduce heavy metals pollution is a noble goal. Adsorption is an effective method based on its effectiveness and low- cost. Nowadays, low-cost bio-sorbents have been utilized to replace costly expensive adsorbents. Rich cellulose materials are effective heavy metal adsorbents, and their performance can be enhanced via chemical modification. The present work reviews the steady progress in the utilization of agriculture by-product wastes as heavy metal bio-sorbent. The unique advantages of these by-products such as renewability, abundance, simple processing, and low cost, justifier this work. The results confirm that the chemically treated agro-wastes exhibit high- removal efficiency (reaches 95% in most cases). The adsorption isotherm studies indicate that the concentration of the metal ions has a significant effect on the adsorption process. The Freundlich model provides a physical adsorption model of the metal ions on the bio-sorbent surface. Langmuir isotherm offers an estimate of the effect of different factors on the efficiency of the process. The adsorption kinetics studies offer an idea of reaction pathways including the adsorption mechanism and the efficiency of the metal ion removal. Applying the pseudo-first-order and pseudo-second-order models describes the adsorption kinetics. This information can be utilized in developing effective strategies to remove heavy metal ions using chemically treated agro-waste. The data confirmed that chemical modification is a significant parameter in the efficiency of metal ion removal. The feasibility and effectiveness of using these cellulosic by-products as bio-sorbent should be given attention and encouraged.

The biofibres wide application as mortars enhancement have been so far restricted by factors related to their chemical composition and hygroscopic nature. Their hydrophilic behavior increases the water demand of mortar-mixtures and diminishes their adhesion to the matrix, while further moisture-related fibre degradation issues may arise. Additionally, the natural fibres seem to be susceptible to degradation caused during the exposure to alkaline environments conditions, such as those of cement mortars, restricting their utilization in construction industry. Therefore, the current study focusses on the potential of fibre modification through treatments that would permanently alter their structure and chemical composition in the whole mass or surface towards their performance improvement. In this study, mild hydrothermally treated wood fibres of black pine and beech species were prepared and incorporated in cement mortars to assess their performance, applying the proportion of 1.5% v/v in the mortar. The mortars workability (at fresh state), physical, hygroscopic, chemical, thermal, and mechanical characteristics at the age of 28, 90 and 365 days and weathering performance by subjecting them at different artificial ageing environments (freeze-thaw cycles or outdoor exposure) were examined. The results indicated the beneficial role of the treated fibres in the dimensional stability, flexural strength, thermal insulation properties and capillary absorption of the mortar specimens, especially during ageing process, with the black pine fibres to reveal the highest improvement. The hydrothermally treated wood fibres seem to ensure the integrity maintenance of cement mortars under all ageing conditions, proving that the specific bio-additives could provide low-cost and eco-friendly mortar enhancement pathways.

The paper aims to develop and test an algorithm for classifying Russian-language text reviews of patients’ experiences with medical facilities and physicians, extracted from social media. This is motivated by the limitations of conventional methods of surveying consumers to assess their satisfaction with the quality of services, which are being replaced by automatic processing of text data from social media. This approach enables to get more objective results due to the increased representativeness and independence of the sample of service consumers. The authors have tested machine learning methods using various neural network architectures. A hybrid method was developed to classify text reviews of medical facilities posted by patients on the two most popular physician review websites in Russia. Overall, more than 60,000 reviews were analysed. The main results are as follows: 1) the classification algorithm developed by the authors has a high efficiency, the best result being achieved by the GRU-based architecture (val_accuracy = 0.9271); 2) applying the named entity search method to text messages following their partitioning improved the classification efficiency for each of the classifiers based on artificial neural networks. To further enhance the classification quality, reviews need to be semantically partitioned by target and sentiment and the resulting fragments need to be analysed separately.

Electrical storm (ES) is defined as the presence of at least three episodes of sustained ventricular tachycardia or ventricular fibrillation within 24 hours. This patient had a previously known arterial hypertension, type II diabetes mellitus, and chronic kidney disease and has presented to the Emergency Department (ED) with symptoms of retrosternal chest pain lasting for several hours prior. The initial 12-lead electrocardiogram revealed ST segment elevation in the anterior leads (V1-V6). Emergent coronary angiography revealed an acute occlusion of the proximal left anterior descending artery (pLAD) and percutaneous coronary intervention was performed with successful implantation of one drug-eluting stent in the pLAD. On the day 8 of hospitalization, patient developed a refractory ES for which he received 50 DC shocks and did not respond to multiple lines of antiarrhythmic medications. Due to a failure of medical therapy, we decided to implant a temporary pacemaker and initiate ventricular overdrive pacing (VOP) that was successful in terminating ES. Following electrical stabilization, the patient underwent a successful ICD implantation. This case demonstrates that VOP can contribute to hemodynamic and electrical stabilization of a patient that suffers from refractory ES and this treatment modality might serve as a temporary bridge to ICD implantation.

Breast cancer is a global health concern, necessitating continuous advancements in diagnostic medical imaging technologies for early detection and improvement of treatment. This paper presents an overview of the past, present and future of breast cancer imaging using light and some results from the current studies. The paper specifically presents the role of Diffuse Optical Tomography (DOT) in breast cancer imaging. Conventional methods, such as X-ray mammography, face limitations. Diffuse Optical Tomography, a non-invasive light-based imaging modality can provide quantitative descriptive and architectural information about breast tissue. The paper discusses the key challenges and recent developments in breast cancer imaging using DOT to overcome some key challenges. This paper aims to contribute to the understanding of the evolving technological landscape in breast cancer imaging using light for improving early detection and patient outcomes.

Harnessing the Remarkable Bio-Remediation Potential of Vernonia spp. for the Sustainable Restoration of Hydrocarbon-Polluted Clay Soil in Ogoni Land, Nigeria This study explores the potential of utilizing Vernonia spp. for eco-friendly bio-remediation of hydrocarbon-polluted clay soil in Ogoni Land, Nigeria. The aim is to find a sustainable and effective solution that promotes the restoration of the polluted soil while minimizing the use of external additives. The process of bio-remediation can occur naturally, through natural attenuation or intrinsic bio-remediation. However, it has been observed that in certain cases, the addition of fertilizers, oxygen, or organic matter is required to enhance the effectiveness of bio-remediation. In this research, we focus on the bio-remediation potential of Vernonia spp., a native plant species known for its strong phytoremediation abilities. By harnessing the remarkable bio-remediation properties of Vernonia spp., we seek to restore the hydrocarbon-polluted clay soil in Ogoni Land in an environmentally friendly and sustainable manner. Our methodology involves conducting greenhouse experiments to assess the bio-remediation efficiency of Vernonia spp. in different soil conditions. We will analyze the soil's physical and chemical properties, as well as the degradation of hydrocarbons over time. The experimental results will provide valuable insights into the effectiveness of Vernonia spp. in removing hydrocarbon pollutants from clay soil. Through this study, we aim to develop a cost-effective and sustainable approach to restore hydrocarbon-polluted clay soil in Ogoni Land. By leveraging the natural bio-remediation potential of Vernonia spp., we can potentially reduce the reliance on external additives, thus minimizing the environmental impact associated with traditional remediation methods. The research article explores methods to promote the growth of pollution-eating microbes in order to enhance bio-remediation. Bio-remediation refers to the use of naturally occurring organisms to break down harmful substances into less toxic or non-toxic forms. In situ bio-remediation involves treating the contaminated material directly at the site, while ex-situ bio-remediation involves removing the contaminated material for treatment elsewhere. This study specifically investigates ex-situ bio-remediation techniques for hydrocarbon-contaminated clay soil. The researchers found that the application of room dry and wet blended bitter leaf showed promising results in the bio-remediation of hydrocarbons in the clay soil. Using Vernonia galamensis, a concentration as high as 0.55 ug/ml was achieved, while Vernonia amygdalina yielded a concentration as high as 0.67 ug/ml when applied at 35g and 40g respectively, based on the wet blended approach. These findings highlight the effectiveness of wet blended Vernonia species in the bio-remediation process.During the remediation process of the clay soil, the pH levels showed a trend of increasing from acidic to normal to alkaline. This can be attributed to the remediation of excessive metals present in the soil. After 40 days, the pH of the clay soil reached 6.97 when treated with 40 grams of Vernonia galamensis, and 7.00 when treated with 40 grams of Vernonia amygdalina. Interestingly, while the remediation efficiency of HC (hydrocarbon) decreased with increasing mass of Vernonia galamensis, the remediation efficiency of HC increased when using Vernonia amygdalina. These observations highlight the varying effects of different Vernonia species on hydrocarbon remediation.The highest remediation values were observed when using Vernonia galamensis at 35g and Vernonia amygdalina at 40g. These particular amounts of these Vernonia species demonstrated effective remediation of the targeted pollutants. However, in comparison to other metals, the remediation effects were relatively lower for zinc (Zn), with only approximately 0.25 ug/ml being remediated. This suggests that the remediation potential of the Vernonia species may vary depending on the specific contaminant.The higher remediation effects observed for Zn metal in the soil can be attributed to the wet blended preparation method of the Vernonia species. In contrast, the room dried Vernonia species exhibited the lowest performance in remediating the soil, with approximately 0.17 ug/ml and 0.10 ug/ml remediation for galamensis and amygdalina, respectively. Both Vernonia leaf extracts achieved a remediation of 0.5 ug/ml for chromium. The sun dried and room dried methods also showed considerable remediation potential, with values above 0.4 ug/ml. The level of significance for the model was attained at 0.05, and the r2 value was appreciable. These findings indicate the effectiveness of different preparation methods and Vernonia species in soil remediation

This research explores the enhancement of bio-oil quality through upgrading with the magnetic bimetallic oxide (CuO-Fe3O4) catalysts supported on the activated rice straw biochar (AcB). These catalysts were employed in a supercritical ethanol-based upgrading process. Various characterization techniques, including elemental analysis, XRD, BET, TGA, and SEM, were utilized to characterize the prepared catalyst. The study revealed significant improvements in the physical characteristics and chemical composition of the bio-oil, with higher heating value (HHV) increasing from 21.3 to 32.1 MJ/kg. Esterification and transesterification were identified as key reactions contributing to this improvement. Notably, the pH of bio-oil increased from 4.3 (raw bio-oil) to 5.63 (after upgrading), signifying reduced acidity. The analysis of the bio-oil's chemical composition highlighted a decrease in oxygen content and an increase in carbon and hydrogen content. At the optimum conditions, the application of supercritical ethanol proved to be an efficient method for enhancing the bio-oil's properties. A crucial transformation occurred during the upgrading process and more than 90% % of carboxylic acids were converted into esters, primarily ethyl acetate at the optimal conditions. This study has demonstrated the effective enhancement of raw bio-oil from rice straw through the utilization of carbon-based bimetallic oxide catalysts in a supercritical upgrading procedure.

The design of binders plays a pivotal role in achieving enduring high power in lithium-ion batteries (LIBs) and extending their overall lifespan. This review underscores the indispensable characteristics that a binder must possess when utilized in LIBs, considering factors such as electrochemical, thermal, and dispersion stability, compatibility with electrolytes, solubility in solvents, mechanical properties, and conductivity. In the case of anode materials, binders with robust mechanical properties and elasticity are imperative to uphold electrode integrity, par-ticularly in materials experiencing substantial volume changes. For cathode materials, the se-lection of a binder hinges on the crystal structure of the cathode material. Other vital consid-erations in binder design encompass cost-effectiveness, adhesion, processability, and envi-ronmental friendliness. Incorporating low-cost, eco-friendly, and biodegradable polymers can contribute significantly to sustainable battery development. This review serves as an invaluable resource for comprehending the prerequisites of binder design in high-performance LIBs and offers insights into binder selection for diverse electrode materials. The findings and principles articulated in this review can be extrapolated to other advanced battery systems, charting a course for the development of next-generation batteries characterized by enhanced perfor-mance and sustainability.

Keywords: Trichoderma sp., biogenic selenium nanoparticles, capping biomolecules, bio-corona, agriculture, plant biostimulants, phytopathogens, physicochemical properties, bioactivity mechanism

Metachrony is defined as coordinated asynchronous movement throughout multiple appendages, such as the cilia of cells and swimmerets of crustaceans. We investigate the process of metachronal propulsion, notably used by species of crustaceans and microscopic cells to move through fluid. A rigid crustacean model with paddles moving in symmetric strokes was created to simulate metachronal movement. Coupled with the surrounding fluid domain, we employ the immersed boundary method to analyze fluid-structure interactions. To explore the effect of nonlinear morphology on the efficiency of metachronal propulsion, we generate and simulate a range of crustacean body shapes, from upward curves to downwards curves. We found that the highest propulsion velocity is achieved when the crustacean model morphology follows a downwards curve, specifically a parabola of leading coefficient k=−0.4. This curved morphology results in 4.5% higher velocity compared to the linear model. As k deviates from −0.4, the propulsion velocity decreases with increasing magnitude, forming a concave downward trend. The impact of body shape on propulsion velocity is shown by how the optimal velocity with k=−0.4 is 71.5% larger than the velocity at k=1. Overall, this study suggests that morphology has a significant impact on metachronal propulsion.

Indigo leaves form various plant species are sources of dyes/pigments, not fully exploited for making sustainable textiles. Blue indigo vat dye extracted from indigo leaves, yields high wash colorfastness but fades slowly with light, and is not easily used for direct printing. Indigo leaves can be used to produce textiles of various color shades, while light resistant Mayan-inspired hybrid pigments have not yet been used for textile coloring. Using blue indigo dyes from 3 plant species, with exhaustion dyeing, intense wash resistant blue colored textiles are produced, and in the case of Indigofera Persicaria tinctoria, textiles have antibacterial activity against S. Epidermis and E. Coli.100% Natural Mayan-inspired blue indigo pigment, made from Sepiolite clay and indigo dye, was used both in powdered and paste forms to perform pigment textile dyeing by pad cure process, and direct screen printing on textiles. A water-based bio-binder (40%) was used efficiently for both padding and printing. Bio-based Na Alginate thickener allowed color fast printing on both polyester and cotton fabrics, while bio-based glycerin allowed good print color fastness on polyester only, yielding prints with excellent color fastness to wash (5/5), to dry and wet rubbing (5/5) and light (7/7).

Burden of diseases measured as disability-adjusted life years per 100,000 people can be mined from public domain data, when they are made available by population health surveillance systems. This can be analysed to allow insightful comparisons with the national average, and to understand differences in trends between the sexes, age groups, time periods, geographic regions and sub-regions. In this illustrative case study, we have analysed the Scottish burden of disease database to understand what ailed the population of the Grampian region before the COVID-19 pandemic. We have identified selected cancers, ischaemic heart disease, Alzheimer’s disease and other dementias amongst the highest contributors to the burden; that drug use disorders and colorectal cancer are showing worsening trends and require health promotion and disease prevention measures from ages 15 and 25 respectively, especially in Aberdeen City; and that males are more vulnerable to atrial fibrillation and flutter, diabetes mellitus and oesophageal cancer, while females are to cerebrovascular disease. We demonstrate the usefulness of our analysis and methodology for the wider health system, allowing targeted medical research investments and coordinated response from public health and health service delivery. We also show the need for up-to-date surveillance data, forecasts and evidence on the impact of interventions to be made available widely.

The study aimed to assess the prevalence of the frailty syndrome in older patients hospitalized in the geriatric ward depending on the diagnostic criteria used, the feasibility of particular diagnostic scales in hospitalized patients, and their compatibility. Material and methods: Patients admitted to the Department of Geriatrics of Hospital of the Ministry of the Interior and Administration in Bialystok within eight months were included in the study. Four diagnostic scales were used to identify the frailty syndrome: Fried criteria, 7-point Clinical Frailty Scale (CFS), 40-item Frailty Index (FI), and FRAIL Scale. The compatibility of the scales was determined using Cohen's Kappa statistics. Results: 416 patients (mean age 81.2 ± 6.91 years, 77.4% women) were included in the study. Depending on the scale, the prevalence of frailty syndrome varied from 26.8% ( FRAIL Scale), 52.3% (Clinical Frailty Scale), and 58.1% (Fried criteria) up to 62.9% (Frailty Index). We observed the highest feasibility for CFS (100%), intermediate for Frailty Index (95.2%), FRAIL Scale (89.7%), and the lowest for Fried scale (79.8%). The highest level of agreement was found between the CFS and Fried scale, with 70.2% consistent ratings (Cohen Kappa 0.49). Conclusions: Patients in the geriatric ward are characterized by a high prevalence of frailty, although it differs depending on the criteria. The Frailty Index found the highest prevalence and the lowest in the case of the FRAIL scale. The feasibility of scales and their comparability differed; the most difficult to use in daily practice was the Fried scale, while the Clinical Frailty Scale was determined feasible in all patients. The highest agreement was observed between the Fried criteria and the Clinical Frailty Scale and the lowest between the FRAIL scale and the remaining ones.

Culture signifies the customs, language, ceremonies, Indigenous Medical Knowledge (IMK) and other material objects of a tribe. These and many other features are a representation of identity for many Zambian communities. IMK practices are skills inherent by certain individuals in a tribal grouping who are chosen by the spirits (gods) or trained by those who practice. This intrinsic skill is in danger of diminishing as a result of modern medication. This article attempts to understand the role of traditional healers (also known as asing’anga in local language) in preservation of IMK in Chibombo District of Zambia. In so doing, the paper examined methods of preservation used by asing’anga and the challenges faced. Using hermeneutic phenomenology and linear snowball sampling, findings revealed that preservation was done through training. The study found unwillingness, expiration, and spirituality as challenges in the process of preserving IMK. The study recommended that the Lenje Cultural Association consider documenting and disseminating information to the local people by showcasing what is available in the Mukuni Culture Village Museum and Library. This was seen as a way through which many youths would be encouraged to appreciate the indigenous values in their culture.

Introduction: The distribution of typical bacterial redox enzymes such as pyruvate-ferredoxin oxidoreductase (PFOR) in protozoa remains interestingly puzzling. Previous studies have demonstrated diverse cellular localizations of PFOR in amitochondriate anaerobic protozoa such as Trichomonas vaginalis. PFOR is of particular pharmacological importance because it catalyzes the reductive bio-activation of nitro-based prodrugs to cytotoxic radical metabolites. Metronidazole was developed primarily as an antiprotozoal agent against infections caused by T. vaginalis. However, its antimicrobial spectrum was subsequently expanded to cover anaerobic bacterial infections. It has been shown that mutations in the genes encoding PFOR result in inherent resistance of T. vaginalis and anaerobic bacteria to metronidazole. Aims: To analyze the phylogenetic distribution of PFOR in selected protozoa and bacteria using proteins encoded by housekeeping genes as controls. Using comparative bioinformatics to test the hypothesis that PFOR was most likely acquired through horizontal gene transfer from bacteria, proteome-wide analysis and gene expression analysis to identify other genes that were putatively acquired through horizontal gene transfer from bacteria to protozoa. Methods: Sequence similarity queries were performed using the proteins of interest against the NCBI non-redundant protein sequence database with BLASTP version 2.12.0+ from the NCBI website. Multiple sequence alignments were performed with MEGA version X software using the Muscle algorithm. These were then exported in Mega format to construct phylogenetic trees using the neighbor-joining algorithm and the Poisson substitution model. Complete proteomes of representative protozoan and bacterial species were downloaded in fasta format from the ensemblgenomes database. HMM profile libraries were used to screen the proteomes with hmmscan of the HMMer package. Whole proteome BLAST searches were performed between protozoan species of interest against closely related protozoa. The results were compared to the proteome BLAST against the intestinal bacteria Desulfovibrio vulgaris. Gene enrichment analysis was performed between the exclusively present proteins in the protozoa and D. vulgaris. Only results with p-values <0.05 were considered for analysis. Results and conclusions: A plausible explanation for the restricted occurrence of PFOR in protozoa is based on the hypothesis that bacteria serve as potential sources of genes that enhance optimal adaptation of protozoa in hostile environments. The expanded cladograms of Entamoeba and Cryptosporidium with their closely related genera substantiated this hypothesis. The exclusively expressed proteins obtained from E. histolytica and the putative bacterial gene donor, D. vulgaris, showed an over-representation of eleven genes involved in small molecule metabolism, generation of precursor metabolites, and carbohydrate metabolism. If these results can be reproduced in other PFOR-possessing protozoa, it would provide a more validated evidence to support the horizontal transfer of pfor from bacteria. Subsequent syntenic analyses of the significantly enriched genes would be required to provide further information regarding the positional relatedness of these genes at the chromosomal level. Since metronidazole is an established and well tolerated drug for treating infections caused by PFOR-possessing pathogens, it can be considered as a potential drug candidate for the treatment of infections caused by Cryptosporidium, Spironucleus and Blastocystis.

The results of the investigation showed that second-order kinetics govern the adsorption process, and the corresponding rate constants were found. To evaluate the parameters related to the adsorption process, the adsorption equilibrium was examined using a variety of mathematical models, such as the Langmuir, Freundlich, Temkin, and Dubinin-Radushkevich isotherm models. The Langmuir isotherm was found to be the best appropriate among all models for describing the adsorption of Cu2+ and Ni2+ ions using bio-nanocomposite beads. The positive values of ΔH° indicate that the adsorption is physical and endothermic, in agreement with experimental results. The negative value of ∆G° shows that the adsorption process is spontaneous. Positive ΔS° values indicate increased randomness at the solid/liquid interface, during adsorption of Cu2+ and Ni2+ cations onto the engineered bio-nanocomposite. The maximum adsorbed amounts of metal ions by the bio-nanocomposite used were 370.37 mg/g for Ni2+ and 454.54 mg/g for Cu2+ from single system. For the binary system, according to the Langmuir isotherm, the maximum adsorbed amounts of Ni2+ and Cu2+ were 357.14 mg/g and 370,37 mg/g, respectively. There is proof that Alginate-Moroccan clay bio-nanocomposites can serve as a different, less expensive source of sorbents for the removal of metal ions from single and binary systems.

Post-menopausal women are at risk of osteoporotic vertebral fractures (OVFs), which if undetected and untreated, can lead to significant pain and morbidity. However, OVFs are often not reported by radiologists on routine chest radiographs. Artificial Intelligence (AI) is increasingly used in medical applications with improvements in detection and diagnosis. This study aims to investigate the clinical value of a newly developed AI tool, Ofeye 1.0 for automated detection of OVFs on lateral chest radiographs in post-menopausal women (&gt;60 years) who were referred to undergo chest x-rays for other reasons. A total of 510 de-identified lateral chest radiographs from three clinical sites were retrieved and analysed by Ofeye1.0 tool. These images were then reviewed by a consultant radiologist to decide whether there is any fracture present or not with findings served as the reference standard for determining the diagnostic performance of the AI tool. The percentage of radiologist reports which included the OVF was analysed by comparing diagnostic reports with AI findings, while the accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) of the AI tool were calculated. Out of all the original radiologist reports, missed OVFs were found in 14% images but were detected by the AI tool. The AI tool demonstrated a relatively high specificity 92.8% (95% CI: 89.6, 95.2%), moderate accuracy 80.3% (95% CI: 76,3, 80.4%), PPV 73.7% (95% CI: 65.2, 80.8%) and NPV 81.5% (95%CI: 79, 83.8%), but low sensitivity 49% (95%CI: 40.7, 57.3%). The high false negative results were mainly due to mild OVFs with &lt;20% vertebral height loss. The new AI software tool has high specificity with a low false positive rate of 5.1%, showing that it can be used as a complimentary tool to the routine diagnostic reports for reduction of missed OVF in elderly women. The low sensitivity with high false negative rates indicate the necessity of radiologist’s in identifying and reporting early OVFs.

The integration of artificial intelligence (AI) into medical imaging has guided in an era of transformation in healthcare. This literature review explores the latest innovations and applications of AI in the field, highlighting its profound impact on medical diagnosis and patient care. The innovation segment explores into cutting-edge developments in AI, such as deep learning algorithms, convolutional neural networks, and generative adversarial networks, which have significantly improved the accuracy and efficiency of medical image analysis. These innovations have enabled rapid and accurate detection of abnormalities, from identifying tumors during radiological examinations to detecting early signs of eye disease in retinal images. The article also highlights various applications of AI in medical imaging, including radiology, pathology, cardiology, and more. AI-based diagnostic tools not only speed up the interpretation of complex images but also improve early detection of disease, ultimately delivering better outcomes for patients. Additionally, AI-based image processing facilitates personalized treatment plans, thereby optimizing healthcare delivery. This literature review highlights the paradigm shift that AI has brought to medical imaging, highlighting its role in revolutionizing diagnosis and patient care. By combining cutting-edge AI techniques and their practical applications, it is clear that AI will continue shaping the future of healthcare in profound and positive ways.

Introduction: At the end of 2019 the Covid-19 pandemic caused a huge amount of restrictions across the world which affected teaching around the world as it was not prepared to move from traditional face-to-face to an online conversion overnight, so the aim of this paper is to determine the changes in undergraduate anatomy teaching strategies post-pandemic compared to pre-pandemic. Methods: A systematic review was conducted based on the PRISMA statement. Data were retrieved from the searches conducted in the different databases, and the articles to be retrieved were selected with the help of the Rayyan platform. Using the OPMER and JBI tools, the quality of evidence was assessed for the selection of the articles included in the review. Results: The teaching of medicine, specifically anatomy, presented serious problems due to the fact that throughout history it has been taught in the classroom by means of cadaveric dissection and when this ceased to be available, new methods arose through the use of digital resources to try to make up for the needs of the lack of dissection laboratories which lost a great deal of content in this restructuring, which have been improving with the passing of the courses taught and the development of new material that has been better adapted to the needs of the students. Discussion: The authors agree that in the future the best way to teach anatomy will continue to be face-to-face dissection without neglecting the strategies developed during this pandemic and to be taken if necessary to restructure curricula in the future to improve teaching.

Recently, Artificial Intelligence (AI)-based algorithms have revolutionized the medical image segmentation processes. Thus, the precise segmentation of organs and their lesions may contribute to an efficient diagnostics process and a more effective selection of targeted therapies as well as increasing the effectiveness of the training process. Thus, AI may contribute to the automatization of the image scan segmentation process and increase the quality of the resulting 3D objects, which may lead to the generation of more realistic virtual objects. In this paper, we focus on the AI-based solutions applied in the medical image scan segmentation, and intelligent visual-content generation, i.e. computer-generated three-dimensional (3D) images in the context of Extended Reality (XR). We consider different types of neural networks used with a special emphasis on the learning rules applied, taking into account algorithm accuracy and performance, as well as open data availability. This paper also attempts to summarize the current development of AI-based segmentation methods in medical imaging and intelligent visual content generation that are applied in XR. Finally, this paper concludes with possible developments and open challenges in AI application in Extended Reality-based solutions. Finally, the future lines of research and development directions of Artificial Intelligence applications both in medical image segmentation and Extended reality-based medical solutions are discussed.

Respiratory viral infections (RVI) are common reasons for healthcare consultations. The inpatient management of RVI consumes significant resources. From 2009-2014, we assessed the costs of RVI management in 4776 hospitalized chil-dren aged 0-18 years participating in a quality improvement program, where all ILI patients underwent virologic testing at the National Reference Centre followed by de-tailed recording of their clinical course. The direct (medical or non-medical) and indirect costs of inpatient management outside the ICU (“non-ICU”) versus management requiring ICU-care (“ICU”) added up to 2,767.14€ (non-ICU) vs. 29,941.71€ (ICU) for Influenza, 2,713.14€ (non-ICU) vs. 16,951.06€ (ICU) for RSV infections, and 2,767.33€ (non-ICU) vs. 14,394.02€ (ICU) for human rhinovirus (hRV) infections, respectively. Non-ICU inpatient costs were similar for all 8 RVI studied: Influenza, RSV, hRV, ade-novirus (hAdV), metapneumovirus (hMPV), parainfluenzavirus (hPIV), bocavirus (hBoV) and seasonal coronavirus (hCoV) infections. ICU-costs for Influenza however, ex-ceeded all other RVI. At the time of the study, Influenza was the only RVI with antivi-ral treatment options available for children, but only 9.8% of Influenza patients (non-ICU) and 1.5% of ICU-patients with Influenza received antivirals; only 2.9% were vac-cinated. Future studies should investigate the economic impact of treatment and pre-vention of Influenza-, COVID-19-, and RSV post vaccine introduction.

Given its exceptional attributes, aerogel is viewed as a material with immense potential. Being a natural polymer, cellulose offers the advantage of being both replenishable and capable of breaking down naturally. Cellulose-derived aerogels encompass the replenish ability, biocompatible nature, and ability to degrade naturally inherent in cellulose, along with additional benefits like minimal weight, extensive porousness, and expansive specific surface area. Even with increasing appreciation and acceptance, the undiscovered possibilities of aerogels within the textile sphere continue to be predominantly uninvestigated. In this context, we outline the latest advancements in the study of cellulose aerogel formulation and their diverse impacts on textile formations. Drawing from the latest studies, we reviewed the materials used for the creation of various kinds of cellulose-focused aerogels and their properties, analytical techniques, and multiple functionalities in relation to textiles. This comprehensive analysis extensively covers the diverse strategies employed to enhance the multi-functionality of cellulose-based aerogels in the textile industry. Additionally, we focused on the global market size of bio-derivative aerogels, companies in the industry producing goods, and prospects moving forward.

Background: Citicoline, a medical food, lacks proven efficacy for ischemic stroke and has uncertainties around its harms. The continued prescription should be reevaluated given the more robust, high-quality Evidence against that medical food. This essay is based on a recent Cochrane review and uses only one all-cause mortality as the primary outcome. Therefore, the essay should be considered as something other than an updated Cochrane review but like a reflection based on Evidence-based Medicine and Philosophy of Science analysis. Question Research: Why citicoline (a medical food) should not be prescribed to treat people with acute ischemic stroke: The certainty of the Evidence.? Objective: Demonstrate from evidence-based medicine and philosophy of science perspective that citicoline should not be prescribed for acute ischemic stroke due to lack of efficacy and harm uncertainties. Search publications: We searched in PubMed and Cochrane Library from 2020 until 30 October 2023. We, furthermore, used engineering machines Bing and Google Scholar to detect additional papers. Additionally, we also reviewed reference lists of the retrieved publications and review articles and searched the websites of the U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA). Selection criteria: We included systematic reviews, meta-analyses, randomized clinical trials, clinical guidelines focused on acute ischemic stroke and comparing citicoline versus placebo or no intervention. We excluded narrative reviews, observational studies and ongoing trials. Data collection and analysis: We identified only new randomized clinical trials and assessed the risk of bias in seven domains. The other eight trials were already included in the mentioned Cochrane review. The systematic reviews with or without meta-analyses were assessed using McMaster University guidelines. We estimated risk ratios (RRs) for that outcome. We measured statistical heterogeneity using the I² statistic. We conducted our analyses using the fixed effect model. We did not use the GRADE approach due to what is shown in a Cochrane review published in 2020 by Martí-Carvajal et al. We used the RevMan 5.4 software from Cochrane Collaboration to conduct the forest plot. We used a Trial Sequential Analysis with Copenhagen Trial Unit Software. We estimated a Bayes factor from the relative risk and 95% confidence interval. Results: We identified only one new RCT (N = 99) reported mortality data and three clinical guidelines. We conducted a new meta-analysis with nine trials (N = 4461) having a high risk of bias and showing little to no difference in mortality between citicoline and placebo (17.1% vs 18.4%; RR 0.94, 95% CI 0.82 to 1.06; I2 = 0%). The Bayes factor was 0.7, indicating weak Evidence for the null over the alternative hypothesis. Trial sequential analysis suggested sufficiency of Evidence for mortality. No guidelines recommend citicoline. Conclusions: This essay reassessed citicoline for acute ischemic stroke after the 2020 Cochrane review. Adding a new RCT further supported the lack of mortality benefit with citicoline. The overall evidence quality could be better. Analyses using evidence-based medicine and philosophy of science approaches do not support prescribing citicoline due to a lack of efficacy substantiation and potential harms.

There are four categories of medical waste that cannot be mixed as this will cause serious problems such as environmental pollution or infection. In the past, the classification of medical waste often involved a lot of human and material resources to process, with workers at risk of exposure to infectious substances. Therefore, an augmented reality (AR) and artificial intelligence (AI) medical waste classification system and method were developed. This innovative medical waste classification system and method combines AR and AI identification technology to reduce the risk of manual judgment errors by clinical staff when handling medical waste.

This research employs a spatial optimization approach customized for addressing equitable emergency medical facility location problems, through the p-dispersed-median problem (p-DIME). The p-DIME integrates two conflicting classes of spatial optimization problems, dispersion, and median problems, aiming to identify the optimal locations for emergency medical facilities to achieve a balanced spatial distribution of emergency medical services (EMS) while effectively serving demands. To demonstrate the utility of the p-DIME model, we selected Gyeongsangbuk-do in South Korea, recognized as one of the most challenging areas for providing EMS to the elderly population (aged 65 and over). This challenge arises from the significant spatial disparity in the distribution of emergency medical facilities. The results of the model assessment gauge the spatial disparity of EMS, provide significantly enhanced solutions for a more equitable EMS distribution in terms of service coverage, and offer policy implications for future EMS location planning. In addition, to address the computational challenges posed by p-DIME's inherent complexity, involving mixed-integer programming, this study introduces a solution technique through constraint formulations aimed at tightening the lower bounds of the problem's solution space. The computational results confirm the effectiveness of this approach in ensuring reliable computational performance, with significant reductions in solution times, while still producing optimal solutions.

Wildfires are a rising environmental threat which health impact remains poorly documented, in particular beyond the fire period. This ecological study investigates changes in health conditions before, during, and after two consecutive wildfires that occurred in France´s Gironde district in the summer 2022. Electronic records from the district´s emergency medical communication centre were used to identify calls with respiratory and cardiovascular diseases, and two specific subgroups of those, asthma (all ages and 0-5 years) and cardiac arrest, respectively. Compared to before the fires, respiratory disease cases were fewer during each fire (OR = 0.85, 95% CI: 0.79, 0.90 and OR = 0.62, 95% CI: 0.58, 0.67, respectively), cardiovascular disease cases, more common during the second fire, and asthma cases, higher following the fires (ORall ages= 1.85, 95% CI: 1.56, 2.21 and ORchildren= 3.52, 95% CI: 2.62, 4.80). Asthma cases also rose during the same calendar time in 2021, but to a lesser extent. In sum, except for asthma, emergency calls data in Gironde reveal few significant potentially smoke-related symptoms around fire periods, apart from post-fire asthma. Whether the effects are smoke- or season-related remains to be determined, preferably using additional data sources.