Background: The use of peripherally inserted central catheters and midline catheters is growing due to their potential benefits. These devices can increase patient safety and satisfaction while reducing the use of resources. As a result, many hospitals are establishing vascular access specialist teams staffed by nurses who are trained in the insertion and maintenance of these catheters. Objective: Evaluate ex-ante whether the benefits of replacing peripheral venous catheters, peripherally inserted central catheters and midline catheters with ultrasound-guided peripherally inserted central catheters and midline catheters by a vascular access specialist team outweigh their costs. Methods: Cost-benefit analysis from the perspective of the healthcare provider based on administrative data. The study estimates the reduction in resources used when replacing peripherally inserted central catheters, midline catheters and peripheral venous catheters with ultrasound-guided peripherally inserted central catheters and midlines, as well as the additional resources required for their use. Results: Each ultrasound-guided peripherally inserted central catheter replacing a peripherally inserted central catheter, results in a measurable resource reduction of approximately €31. When 3 peripheral venous catheters are replaced by an ultrasound-guided peripherally inserted central catheter, the saving is €63. Similarly, each ultrasound-guided midline catheter replacing a midline, results in a reduction of €16, while each ultrasound-guided midline catheter replacing 3 peripheral venous catheters results in a reduction of €96. Conclusion: The benefits of replacing peripheral venous catheters, peripherally inserted central catheters and midline catheters by introducing a vascular access specialist team trained in the implantation of ultrasound-guided peripherally inserted central catheters and midline catheters, outweigh its cost mainly because of the decrease in hospital stay due to the lowered risk of healthcare-associated infections. These results motivate the implementation of the service, adding to previous experience suggesting that it is also preferable from the point of view of patient safety and satisfaction.

Background Corpus callosum abnormalities (CCA) are midline developmental brain malformations and are usually associated with a wide spectrum of other neurological and non-neurological abnormalities. The study aims to highlight the diagnostic role of fetal MRI to characterize heterogeneous corpus callosum abnormalities using the latest classification system. It also helps to identify associated anomalies, which have prognostic implications on the postnatal outcome. Methods In this study, retrospective data from antenatal women who underwent fetal MRI between January 2014 and July 2023 at Rush University Medical Center were evaluated for CCA and classified based on structural morphology. Patients were further assessed for associated neurological and non-neurological anomalies. Results The most frequent class of CCA was complete agenesis (79.1%), followed by hypoplasia (12.5%), dysplasia (4.2%) and hypoplasia with dysplasia (4.2%). Amongst them, 17% had isolated CCA, while the majority (83%) had complex forms of CCA associated with other CNS and non-CNS anomalies. Out of the complex CCA cases, 58% were associated with other CNS anomalies, while 8% were associated with non-CNS anomalies. 17% of cases had both. Conclusion The use of fetal MRI is valuable in the classification of abnormalities of the corpus callosum after the confirmation of a diagnosis suspected on prenatal ultrasound. This technique is an invaluable method for distinguishing between isolated and complex forms of CCA, especially in the cases of apparent isolated CCA. The use of diffusion-weighted imaging or diffusion tensor imaging in fetal neuroimaging is expected to provide further insights into white matter abnormalities in fetuses diagnosed with CCA in the future.

Carbon (C) cycle n inland waters, including its concentrations and carbon dioxide (CO2) emis-sions from water surfaces are at the forefront of biogeochemical studies, especially in the re-gions, strongly impacted by on-going climate change. Towards better understanding of C stor-age, transport and emission in Central Asian mountain regions, extremely poorly studied until now, here we carried out systematic measurements of dissolved C and CO2 emissions in 15 riv-ers and 5 lakes located along a macro-transect of various natural landscapes in the Sayan-Altai mountain region, from high mountains of the Western Sayan in the northwest of Tyva to arid (dry) steppe and semi-deserts in intermountain basins of the southeast of Tyva, the border with Mongolia. New data on major hydrochemical parameters, CO2 fluxes by floating chambers, dis-solved organic and inorganic carbon concentrations collected over four main hydrological sea-sons allowed to assess the current C biogeochemical status of these water bodies in order to judge possible future changes under climate warming. We further tested the impact of perma-frost, river watershed size, lake area and climate parameters as well as ‘internal’ biogeochemical drivers (pH, mineralization, organic matter quality and bacterial population) on CO2 concentra-tion and emissions in lakes and rivers of this region, and compared them with available data on other subarctic and mountain settings.

Rhombencephalosynapsis (RES) is a rare, congenital developmental disorder of the central nervous system. Even after many years of its identification, the etiology and pathogenesis of RES remain unclear. It occurs in combination with many syndromes and thus has overlapping symptoms. The clinical presentation of this disorder varies depending on the severity of the maldevelopment of vermis. Here, we present a case of a 60-year-old Indian female diagnosed with Rhombencephalosynapsis. Clinical and MRI characteristics of RES along with treatment options have been discussed.

Glial cells provide physical and chemical support and protection for neurons. Secreted neurotrophic factors, scaffolds and vesicles regulate in addition to normal homeostasis, repair following neural tissue injury or degeneration. We previously demonstrated that human CNS glia have revascularization capacity by inducing endothelial cell sprouting and microchanneling driven by glial cell secreted components. The clinical potential of using secreted factors and vesicles generated by glial cells in conditioned media was shown by their re-normalization of pathological blood vessels and 3D tissue wound healing and remodeling capacity. To identify secreted components of glial cells and how CNS and PNS glial cells differentially regulate neural tissue homeostasis, disease and injury response, we developed a novel culture method for various types of glial cells that allow for isolating and characterizing secreted glial components, free of animal factors and contaminants normally associated with serum-based culture conditions. Our culture method will enable to identify secreted components using ultrasensitive RNA, glycoconjugate and protein analysis technologies. The characterization of glial secreted factors involved microchanneling may help in development of new clinical therapies for glial and neural cells or axons to migrate and reform connections.

Cerebrospinal fluid contacting neurons (CSF-cNs) are a specific type of neurons located around the ventricles in the brain and the central canal in the spinal cord and have been demonstrated to be intrinsic sensory neurons in the central nervous system (CNS). One of the important channels responsible for the sensory function is polycystic kidney disease 2-like 1 (PKD2L1) channel. Most of the studies concerning the distribution and function of the PKD2L1-expressing CSF-cNs in the spinal cord have previously been performed in non-mammalian vertebrates. In the present study immunohistochemistry was performed to determine the distribution of PKD2L1-immunoreactive (IR) CSF-cNs in the spinal cords of 4 mammalian species: mouse, rat, cat, and macaque monkey. Here, we found that PKD2L1-expressing CSF-cNs were present at all levels of the spinal cord in these animal species. Although the distribution pattern was similar across these species, differences existed. Mice and rats presented a clear PKD2L1-IR cell body labeling, whereas in cats and macaques the PKD2L1-IR cell bodies were more weakly labeled. Ectopic PKD2L1-IR neurons away from the ependymal layer were observed in all the animal species although the abundance and the detailed locations varied. The apical dendritic protrusions towards the lumen of the central canal were clearly seen in all the animal species, but the sizes of protrusion bulbs were different among the species. PKD2L1-IR cell bodies/dendrites were co-expressed with doublecortin, MAP2 (microtubule-associated protein 2) and aromatic L-amino acid decarboxylase, but not with NeuN (neuronal nuclear protein), indicating their immature property and ability to synthesis monoamine transmitters. In addition, in-situ hybridization performed in rats revealed PKD2L1 mRNA expression in the cells around the central canal. Our results indicate that the intrinsic sensory neurons are conserved across non-mammalian and mammalian vertebrates, and that this may play an essential role in the regulation of motor and sensory functions as well as in the maintenance of homeostasis in the CNS.

A stable match, an intercuspated maxilla-mandible relation is the universally accepted goal for dental restorative interventions, yet the underlying sensorimotor mechanisms to achieve this goal in the natural jaw closure remains to be elucidated. Dentists have intuitively regarded peripheral sensory innervation from tooth contacts as a significant control element for jaw muscle actions, both in the state of health and in cases of pathological dysfunction. However, therapeutical interventions for reshaping the dental arch anatomy and jaw relations have not always been successful. Repetitive masticatory chewing cycles, swallowing, talking, as well as volitional jaw-opening and -closing involve stereotyped neural commands from the central nervous system that are modulated in reaction to the sensory afferent feedback from the peripheral neurons and their sensor organs. The aim of this article is to describe, on a fraction of a second time-scale, the minuscule tilts and kinematic events of mandible during the making of a stable match with maxilla. Evidence of the importance of tooth contacts as the sensorimotor motivation of each of the successive kinematic steps of the “mandible-meets-maxilla-narrative” are discussed.

This article provides a general overview of the bio-inspired computing method called DNA-Based Computing (DBC), including its theory and applications. The main theme of DBC is the central dogma of molecular biology (once information of DNA/RNA has got into a protein, it can’t get out again), i.e., DNA to RNA (sequences of four types of nucleotides) and DNA/RNA to protein (sequence of twenty types of amino acids) are allowed, not the reverse ones. Thus, DBC transfers few-element information (DNA/RAN-like) to many-element information (protein-like), solving a given cognitive problem. DBC can take many forms; this article elucidates two main forms, denoted as DBC-1 and DBC-2. Using arbitrary numerical examples, it is shown that DBC-1 can solve the following cognitive problems: “similarity indexing between seemingly different but inherently identical objects” and “recognizing regions of an image separated by a complex boundary.” DBC-2 can solve the following cognitive problem: “pattern recognition when the relevant information is insufficient.” Smart manufacturing-based systems (digital twins and big data analytics) must solve the abovementioned problems to make the manufacturing enablers (machine tools and monitoring systems) more self-reliant and autonomous. Consequently, DBC can improve the cognitive problem-solving ability of smart manufacturing-relevant systems and, thereby, can enhance its biologicalization.

Over the past three decades, the region has undergone significant changes that have transformed the social, economic and political landscape. The traces of these changes are particularly visible in the post-socialist states of Central and Eastern Europe. These processes have sometimes fragmented, sometimes reshaped, and sometimes transcended borders, reshaping the region. The focus of this study is on the 'geography' of companies, i.e. the concentration of companies with more than 10 employees in the region in the 15 countries selected, according to various criteria. The countries covered by the study are Albania, Austria, Bosnia and Herzegovina, Bulgaria, Croatia, the Czech Republic, Hungary, Kosovo, Montenegro, Northern Macedonia, Poland, Romania, Serbia, Slovakia, Slovenia, Poland, Slovakia and Slovenia. The data of the active economic operators (over 300 thousand) of the countries included in the study were analyzed by turnover and size. The spatial distribution of enterprises at the NUTS3 level presents a far more diverse picture than what is typically observed in economic indicators such as GDP. Additionally, the disparities in this particular distribution are not as pronounced or distinct as those of general economic indicators.

Cerebral ischemia, which is a leading cause of disability and mortality worldwide, sets off a chain of molecular and cellular pathologies that are associated with some central nervous system (CNS) disorders, mainly including ischemic stroke, Alzheimer's disease (AD), Parkinson's disease (PD), epilepsy and other CNS diseases. In recent times, despite significant advancements in the treatment of the pathological processes underlying various neurological illnesses, effective therapeutic approaches specifically targeted at minimizing the damage of such diseases remain absent. Remarkably, ischemia causes severe damage to cells in Ischemia-associated CNS Diseases. Cerebral ischemia initiates oxygen and glucose deprivation, which subsequently promotes mitochondrial dysfunction, including MPTP opening, mitophagy dysfunction, and excessive mitochondrial fission, triggering various forms of cell death, such as autophagy, apoptosis, as well as ferroptosis. Ferroptosis, a novel type of regulated cell death (RCD), is characterized by iron-dependent accumulation of lethal reactive oxygen species and lipid peroxidation. Mitochondrial dysfunction and ferroptosis both play critical roles in the pathogenic progression of Ischemia-associated CNS Diseases. In recent years, growing evidence has indicated that mitochondrial dysfunction interplays with ferroptosis to aggravate cerebral ischemia injury. However, the potential connections between mitochondrial dysfunction and ferroptosis in Cerebral Ischemia have not yet been clarified. Thus, we analyze the underlying mechanism between mitochondrial dysfunction and ferroptosis in Ischemia-associated CNS Diseases. We also discovered that GSH depletion and GPX4 inactivation cause lipoxygenase activation and calcium influx following cerebral ischemia injury, resulting in MPTP opening and mitochondrial dysfunction. Additionally, dysfunction in mitochondrial electron transport and an imbalanced fusion-to-fission ratio can lead to the accumulation of reactive oxygen species and iron overload, which further contribute to the occurrence of ferroptosis. This creates a vicious cycle that continuously worsens cerebral ischemia injury. In this study, our focus is on exploring the interplay between mitochondrial dysfunction and ferroptosis, which may offer new insights into potential therapeutic approaches for the treatment of Ischemia-associated CNS Diseases.

Phantom Limb Pain (PLP) is a challenging condition affecting a significant proportion of amputees. In this article we describe the case of a 54-year-old Paralympic athlete with Phantom Limb Syndrome following right leg amputation and widespread sports-related enthesitic pain, who underwent a Whole Body Cryostimulation (WBC) cycle, an emerging treatment known for its rapid pain-relieving and anti-inflammatory effects. Assessments were conducted before and after a 10-session WBC cycle, including pain and quality of life assessment, and use of medications. A substantial reduction in enthesitic pain, PLP intensity, paresthesia, tingling related to atmospheric events and an improved function and quality of life were reported after the WBC cycle and lasted for two weeks. One month after WBC, the enthesitic pain following sports activity and PLP gradually returned but with lesser intensity. Similarly, the stump's sensitivity to atmospheric changes returned but with lower frequency. Pain at night remained lower than before WBC with significantly improved quality of sleep. This case study suggests that WBC could be a valuable adjuvant treatment for alleviating PLP. Controlled studies are warranted to validate the findings of this case-report and elucidate the mechanisms underlying the positive effects of WBC in this condition.

Optimization of Magnetohydrodynamics parameters on the velocity profile and temperature distribution of incompressible fluid flow on a porous channel was evaluated. The fluid flow was considered to be unsteady, incompressible and flowing in 2-D in porous channel. The effects of magnetic parameter, Darcy’s number and fluid pressure on velocity profiles, and the effect of variable viscosity and Eckert number on temperature distribution in incompressible fluid flow were determined. The flow was considered to be in a channel running along the x-axis on which the magnetic field exist and finally along the y-axis on the porous part of the channel. The resulting model equations were solved by Finite Difference Method (FDM) in MATLAB software. Analysis of results indicated that increasing Darcy’s number and fluid pressure leads to increase in fluid velocity profile, while increasing magnetic parameter decreases fluid velocity profile. Also, it was observed that increase in both Eckert number and fluid viscosity lead to increase in temperature distribution. Optimization in temperature was achieved by increasing the magnetic field while viscosity was optimized by increasing the length of the porous part of the channel. This study will helpful to contribute alternative equations and methodology to engineering and in factories where getting the MHD parameters optimally is the main objective, particularly on temperature, velocity and pressure.

Tunneled central venous catheters (CVC) are mainly considered as rescue vascular access option in dialysis but still used in about one quarter of prevalent patients worldwide as being associated with poor performances and higher risks. Study design. In this retrospective single-center study, we aimed to report on clinical performances achieved with high-flow tunneled CVC (DualCath, DCath) and compared it with arteriovenous accesses (AVAs; AV fistula, AV graft, Thomas Shunt) in a hospital-based dialysis unit. Methods. Sixty-eight stage 5 chronic kidney disease dialysis dependent patients (CKD5D) receiving high volume hemodiafiltration were followed-up for 30 months. The study consisted of two phases: baseline cross-sectional and longitudinal follow-up of key performance indicators. Clinical performances consisting of effective blood flow and blood volume, recirculation, urea and ionic Kt/V and total Kt, ultrafiltration volume and percent reduction of ß2-M were measured monthly as part of quality control in our unit. Results. At baseline, effective blood flow with DCath was close to 400 ml/min, similar to AVAs. Recirculation with DCath (7%, 6-13%) was higher than AVAs. Diffusive dialysis dose delivered with DCath (spKt and eKt/V) and convective dialysis dose achieved with DCath were slightly lower than AVAs, but still much higher than recommended by guidelines. Percent reduction of ß2-M achieved with DCath was also 4 to 10% lower than AVAs. On longitudinal follow-up, main clinical performance indicators of DCath (total Kt and total ultrafiltration volume, L/session) were maintained very stable over time and close to those achieved with AVAs. Conclusions. As shown in this study, high-flow DualCath tunneled two single lumen silicone catheters may be used to deliver high volume hemodiafiltration in a reliable and consistent manner without compromising clinical performances. These results rely from the specific design of the two silicone cannulas and the strict adherence to best catheter practices.

In the digital era, enhancing the heritage resources of a tourist route means describing and networking them to promote their visibility and attractiveness. Prior studies mainly assess mountainous region’s natural resources through multi-indicator descriptive evaluation. This study aims to develop a comprehensive measurement of indicator’s value while assessing the tourism development potential of mountainous rural area. It concerns the main tourist route of the UNESCO M'Goun Geopark, located in the central High Atlas of Morocco. It also involves analyzing the criteria for choosing this destination by segmenting tourists' consumption experiences. Statistical analysis of the collected data reveals five dimensions of destination choice and four visitor groups. This article proposes to discuss findings and their applicability in terms of tourism destination management and decision-making, which can help local governments to rationally allocate tourism resources and land use.

This paper uses preliminary studies of archaeological sites (burial mounds and settlements) from the Iron Age through Medieval periods (ca. 800 BCE to 1200 CE) in the Juuku Valley on the South side of Lake Issyk-Kul to model land-use across vertical mountain zones. To do so, we have established a radiometric chronology, conducted test excavations of an Iron Age settlement and a Turkic period burial, undertaken preliminary archaeobotanical research, and pedestrian surveys. Seed remains of wheat (Triticum aestivum), barley (Hordeum vulgare), broomcorn millet (Panicum milaceum) and foxtail millet (Setaria italica) and legumes were recovered in very small quantities from an Iron Age upland settlement at 2100 m asl and a Turkic period burial mound at 1934 m asl. These preliminary archaeobotanical results are compared to the Talgar Iron Age settlements on the north side of the Tian Shan Mountain range in Kazakhstan studied earlier by Robert Spengler. Small samples of faunal remains found at the Turkic period kurgan and from a profile at the upland Iron Age settlement indicate livestock herding of sheep/goats, cattle, and horses in Juuku Valley. The goal of this paper is to test the hypothesis that pastoral transhumance and agropastoralism were economic strategies used by ancient societies during the Iron Age through Medieval periods in mountain-river valley areas between 750 m to 2500 m asl. These economic strategies that combined the pasturing of sheep, goats, cattle and horses with the cultivation of cereals were adapted to the use of different vegetational zones along a vertical gradient. This paper based on preliminary research of upland sites of the Juuku Valley in Kyrgyzstan, initiates a long-term research study of four millennia of settlements that ranged from pastoral transhumance, pastoral nomadism, and combined mountain agriculture using survey data and test excavations.

Purpose: Glue inhalation is a common unconventional substance of abuse and it contains neurotoxic and volatile solvents. We examined the toxicity profile and CNS activities of glue inhalation in Wistar rats.Methods: Acute toxicity was investigated using graded concentrations of 0.5, 1, and 2 mL of glue inhalation (n=3/group) for 4 hours in phase one followed by concentrations of 5, 10, and 20 mL of glue (n=1/group) for 4 hours in phase two. These animals were then observed for signs of toxicity and/or mortality for 24hours. The sub-acute toxicity was studied using 24 male Wistar rats at graded concentrations of Air, 2, 4 and 8mL glue (n=6/group) for 28 days. Blood samples were collected for biochemical and haematological evaluations, and vital organs (lung, liver, kidney, heart, brain, and eye) were used for histological analysis. Behavioural studies were carried out using Elevated Plus Maze, Hole Board Test, Open Field Test, Tail Suspension Test and Forced Swim Test. Dependence and abstinence effect were also evaluated. Results: The Lethal Dose (LD₅₀) of the inhalational glue was 14.14 ml. Glue significantly increased liver function parameters like TB, DB, ALP, ALT, TP, electrolyte levels (K⁺ and HCO₃) but reduced cholesterol level in exposed rats. Glue inhalation had significant anxiolytic and depressant effects on the rats at concentrations of 4mL and 8mL. Histological analysis revealed liver and lung tissue abnormalities and subconjunctival inflammation in eye tissue at 8mL. Conclusion: The study therefore suggests that glue inhalation has anxiolytic and depressant effects in Wistar rats.

For each $t\in(-1,1)$, exact values of the least upper bounds $$ H(t)=\sup_{\E X=t,\,\E X^2=1} \frac{\E\abs{X}^3}{\E \abs{X-t}^3},\quad \sup_{\E X=t,\,\E X^2=1} \frac{L_1(X)}{L_1(X-t)} $$ are obtained, where $L_1(X)=\E|X|^3/(\E X^2)^{3/2}$ is the non-cental Lyapunov ratio. It is demonstrated that these values are attained only at two-point distributions. As a corollary, S.\,Shorgin's conjecture is proved that states that the exact value is $$ \sup\frac{L_1(X)}{L_1(X-\E X)}= \frac{\sqrt{17 + 7\sqrt7}}{4} = 1.4899\ldots, $$ where the supremum is taken over all non-degenerate distributions of the random variable $X$ with the finite third moment. Also, in terms of the central Lyapunov ratio $L_1(X-\E X)$, an analog of the Berry--Esseen inequality is proved for Poisson random sums of independent identically distributed random variables with the constant $$ 0.3031\cdot H\left(\frac{\E X}{\sqrt{\E X^2}}\right) \left(1-\frac{(\E X)^2}{\E X^2}\right)^{3/2} \le 0.3031\cdot \frac{\sqrt{17 + 7\sqrt7}}{4}<0.4517.$$ where $\Law(X)$ is the common distribution of the summands.

HIV early detection (CD4 counts ≥350 cells/μL) is correlated with higher life expectancy among people living with HIV (PLHIV). Several factors including physical, cultural, structural, and financial barriers have contributed to HIV late detection. This is the first-of-its-kind study on the regional differences in early detection of HIV within Tajikistan and any country in the Central Asia region. Utilizing Tajikistan Ministry of Health's national HIV data (N=10,700) spanning 2010 to 2023, we developed median regression models with median CD4 cell count as the outcome and as predictors: time (years), region, age, gender, and area (urban/rural status). Individuals younger than 19 years old are more likely to be detected early for HIV, whereas those older than 39 years are more prone to late detection. Given their active engagement in age-related and sexual activities, those older than 39 years face a higher risk of HIV transmission to others if diagnosed late. Therefore, they require further attention and targeted interventions. Females are detected earlier compared to their male counterparts, regardless of region of residence. Rural populations are detected earlier in most years compared to their urban counterparts. The COVID-19 pandemic accelerated HIV early detection in 2021 but most regions have returned to near pre-pandemic levels of detection in 2022 and 2023. These fluctuations in early detection may signify a shift in attention and resource allocation, potentially affecting efforts to address access gaps during the initial year of the COVID-19 pandemic. There are significant health inequities among different demographic and geographic groups which warrant further attention.

Breast cancer is the most common cause of mortality due to cancer for woman both in Lithuania and worldwide. Chances of survival after diagnosis differ significantly depending on the stage of disease at the time of diagnosis and other factors. One way to estimate survival is to construct a Kaplan-Meier estimate for each factor value separately. However, in cases when it is impossible to observe a large number of patients (for example, in case of countries with lower numbers of inhabitants) dividing data into subsets, say, by stage at diagnosis may lead to results where some subsets contain too little data so that results of Kaplan Meier (or any other) method will become statistically incredible. The problem may become even more acute if the researcher would like to use more risk factors, such as stage at diagnosis, sex, place of living, treatment method, etc. Alternatively, Cox models are used to analyse survival data with covariates, and they don’t require dividing the data into subsets according to chosen risks factors (hazards).

Subacute sclerosing panencephalitis (SSPE) is a progressive neurological complication that affects the central nervous system. It occurs as a late complication of the measles infection the young children and adolescents who are commonly affected present with personality changes and neurological deficits. The diagnosis can be done via clinical features, electroencephalography, and cerebrospinal fluid analysis. At present, there is no cure for SSPE. The immunisation against measles is the main strategy in preventing this condition. Here, we present a case of a 22-year-old Indian male diagnosed with Subacute sclerosing panencephalitis.

Although, central venous pressure (CVP) is among the most frequent estimated hemodynamic parameters in the critically ill setting, extremely little is known on how intensive care unit (ICU) nurses use this index in their decision-making process. The purpose of the study was to develop a new questionnaire for accessing how ICU nurses use CVP measurements to address patients’ he-modynamics investigating its validity and reliability. A cross-sectional study was conducted among 120 ICU nurses from four ICUs of Greece. Based on a comprehensive literature review and the evaluation of a five-experts panel a new questionnaire, named “CVP-Score”, was created having 8 items. The construct validity and the reliability of the questionnaire were examined. The half of the study participants’ (51.7%) was working at a specialized ICU, and they had a mean [±Standard Deviation (SD)] ICU experience of 13(±7.1) years. The estimated construct validity of the new-developed tool was acceptable, while the internal consistency reliability as measured by Cronbach alpha was excellent (0.901). CVP Score had acceptable test-retest reliability (r=0.996, p<0.001) and split-half reliability (0.855). CVP Score is a valid and reliable instrument for measuring how critical care nurses use CVP measurements in their decision-making process.

Considering future tasks in soil health, resources management and environmental protection, farmers are challenged to develop sustainable strategies for managing soil and land resources. In this study, the long-term sustainability of two fertilization strategies, - current, with synthetic fertilizers (SYN) vs conservative, with organic sources of nitrogen (organic amendments plus green manure with a legume - CONS) - was assessed in a processing tomato/durum wheat rotation. The EPIC model was used, validated with field data then run to simulate the management for 30 years under 3 current and future climates. Yield, soil organic carbon (SOC) stock change, nitrogen use efficiency (NUE), water use efficiency (WUE) and nitrate leaching were considered as sustainability indicators. Under all the future climate scenarios, tomato yield increased in CONS, remaining almost stable in SYN. Wheat yield increased both in CONS and SYN, but the average yield in CONS was considerably lower than in SYN. NUE and nitrate leaching followed the same trend, both decreasing in CONS, while WUE was higher in CONS compared to SYN. The effect of CONS on SOC was always positive. Thus, the alternative N fertilization strategy proposed can be a favorable option for maintaining soil health and a sustainable crop production.

The aim of this study was to examine the relationship of the distance between the apex tip of the upper central tooth (U1A) and the anterior nasal spine (ANS) and the nasal floor (NF) with the vertical cephalometric values using cone-beam computerized tomography (CBCT). A total of 122 patients who applied to Department of Orthodontics between January 2011-June 2019 were included. On the CBCT’s, distances between the U1A and the NF and ANS were measured. Statistical significance was considered as p&lt;0.05. Of 122 individuals 73.8% (n=90) were female and 26.2% (n=32) were male with an mean age of 22,8±3,3 years. A statistically significant moderate positive correlation was found between the NF-U1A mean values and the measurements of N-Me, ANS-Me and ANS-Gn, S-Go, and N-ANS measurements (p &lt;0.01). A statistically significant positive correlation was found between the ANS-U1A mean values and Ar-Go-Me, total posterior angles, N-Me, SN/GoGn and Y-axis angle, ANS-Me and ANS-Gn (p &lt;0.01). In this study, we found that the distance of U1A from ANS and NF points was related to orthodontic vertical direction parameters. It was demonstrated that the ANS-U1A and NF-U1A points can serve as reference points for identifying the orthodontic vertical growth pattern on CBCT scans.

This review explores the application of the conservative management model for pain to sports-related concussions (SRCs), framing concussions as a distinct form of pain syndrome with a pathophysiological foundation in central sensitization. Drawing parallels with proven pain management models, we underscore the significance of a proactive approach to concussion management. Recognizing concussions as a pain syndrome allows for the tailoring of interventions in alignment with conservative principles. This review first covers the epidemiology and controversies surrounding prolonged concussion recovery and persistent post-concussion symptoms (PPCS). Next, the pathophysiology of concussions is presented within the central sensitization framework, emphasizing the need for early intervention to mitigate the neuroplastic changes that lead to heightened pain sensitivity. Five components of the central sensitization process specific to concussion injuries are highlighted as targets for conservative interventions in the acute period: peripheral sensitization, cerebral metabolic dysfunction, neuroinflammation, glymphatic system dysfunction, and pain catastrophizing. These proactive interventions are emphasized as pivotal in accelerating concussion recovery and reducing the risk of prolonged symptoms and PPCS, in line with the philosophy of conservative management.

Abstract: Obstructive sleep apnea (OSA) is well known to often improve with non-supine positioning as opposed to su¬pine positioning. Emerging research supports a role for sleep position management in patients with central sleep apnea (CSA) as well. We report a case of de novo Complex Sleep apnea Syndrome (CompSAS) in a 78-year-old female, who presented after a car accident due to unclear syncope. Diagnostic polysomnography (PSG) showed a moderate OSA. A CompSAS developed under Automatic positive airway pressure (APAP), while download data of 4 years showed a good adherence. No significant benefit was reported under Adaptive Servo Ventilation (ASV) and BiPAP-ST, while a reduction of CSA in non-supine position was noticed. Oxygen and sleep positional therapy (SPT) were considered resulting in a significant improvement of CSA and sleep quality. Further research on the prevalence of positional CSA is needed.

Based on multi-source remote sensing data, scenario analysis, and model simulation, the Pareto optimal solutions for water supply, water purification (N retention), and carbon storage and sequestration services under different scenarios were sought by adjusting its land use structure. The results showed that. In Scenario 1(S1), the water supply service needs to increase by 86.820 to 11.211 billion cubic metres, the water purification (N retention) service needs to decrease by 11,400 to 11,700 tons, and the carbon storage and sequestration service need to decrease by 2.070 to 2.487 billion tons. In Scenario 2(S2), the water supply service needs to increase by 8.243–10.666 billion cubic metres, the water purification (N retention) service needs to decrease by 11,300–1.10 million tons, and the carbon storage and sequestration service needs to decrease by 2.033 to 2.466 billion tons. In Scenario 3 (S3), the water supply service needs to increase by 7.832–11.437 billion cubic metres, the water purification (N retention) service needs to decrease by 1.16–10,800 tons, and the carbon storage and sequestration service needs to decrease by 19.220 to 2.380 billion tons. After land use optimisation and adjustment, the S3 ecological land structure is complete and consistent with the vision of ecological protection and urban development in the study area, which is the optimal scenario. After optimising the S3 ecosystem service supply pattern, the water supply, water purification (N retention), and carbon storage and sequestration services could connect the western and eastern ecosystem service supply areas, balance the overall ecosystem service supply pattern of the study area and meet the demand for ecosystem services. The results can guide regional land planning and ecosystem service management optimisation.

Central Asian countries are the core area of the Belt and Road Initiative (BRI). However, as part of the former Soviet Union, we know very little about the urbanization processes in these countries after the collapse of the Soviet Union. Here, were used land-cover type data, vegetation index data, and grided population data to quantify the urban expansion, urban population changes, and urban environment changes across cities in Central Asia from 2000 to 2020, and took Xinjiang, China as a reference. We found that the urbanization in the study area was uneven. Specifically, the urban expansion in Xinjiang, China and Kazakhstan was faster than in the other countries in the study area. Due to rapid urban expansion, the urban population density in Xinjiang, China decreased from 2000 to 2020, but rapid urban population growth was maintained. Consequently, the pressure of the urban population growth in Xinjiang, China was less than that in the other countries of Central Asia. On average, more than 35% of the urban built-up areas underwent significant greening in Xinjiang, China and more than 3.63 million residents directly benefited from the increase in urban greenness. Although the urban greenness in Xinjiang increased significantly, the overall greenness was still lower than in most cities in Central Asia. In the future, the cities in Xinjiang, China should continue to promote the construction of urban ecological civilization and strengthen their role as a link in the Belt and Road Initiative.

New antibiotics are unquestionably needed in the fight to the emergence and spread of multidrug-resistant bacteria. So far, antibiotics targeting bacterial central metabolism have been poorly investigated. By determining the minimal inhibitory concentration (MIC) of desmethylphosphinothricin (Glu-γ-PH), an analogue of glutamate with a phosphinic moiety re-placing the γ-carboxyl group, we previously showed its promising antibacterial activity on Escherichia coli. Herein we synthetized and determined the growth inhibition exerted on E. coli by an L-Leu dipeptide derivative of Glu-γ-PH (L-Leu-D,L-Glu-γ-PH). Furthermore, we compared the growth inhibition obtained with this dipeptide with that exerted by the free amino acid, i.e. Glu-γ-PH, and by their phosphonic and non-desmethylated analogues. All tested compounds were more effective when assayed in chemically defined minimal medium. The dipeptide L-Leu-D,L-Glu-γ-PH had a significantly improved antibacterial activity (2 μg/mL), at a concentra-tion between the non-desmethytaled (0.1 μg/mL) and the phosphonic (80 μg/mL) analogues. Also in Bacillus subtilis the dipeptide L-Leu-D,L-Glu-γ-PH displayed an activity comparable to that of the antibiotic amoxicillin. This work highlights the antibacterial relevance of the phosphinic pharmacophore and proposes new avenues to the development of novel antimicrobial drugs containing the phosphinic moiety.

Rapid urbanization has led to many ecological problems such as landscape fragmentation, decreased landscape connectivity, and decreased biodiversity. Building an ecological security pattern is an important way to ensure ecological security and maintain sustainable urban development. Harbin is an important large-scale city in northeastern China, and the urban central district of Harbin is used as the study area. Ecological sensitivity assessment, MSPA, gravity model, landscape connectivity assessment and MCR model were used to extract ecological source areas, ecological corridors and ecological nodes in the study area to construct and optimize the ecological security pattern. Research shows that: A total of 23 ecological source areas were identified, mainly located along the Songhua River in the central part of the study area and in the mountain forest areas within the A-cheng District in the southeastern part of the study area. 48 ecological corridors were extracted, mainly in Daowai District, A-cheng District and the eastern part of Xiangfang District. There are 8 important ecological corridors and 10 important connecting corridors. 61 ecological nodes of the first level and 65 ecological nodes of the second level were extracted. High, higher, medium, lower and low security areas were classified based on the minimum cumulative resistance surface, with the highest proportion of high ecological security areas accounting for 45.75% of the study area. 65 ecological breakpoints were extracted and restoration measures were proposed. Finally, The structure of the ecological security pattern optimization of "two axes, two belts and four areas" is proposed, and corresponding ecological management measures are put forward. The experimental system of this study can provide new ideas for the construction of ecological security patterns in other regions and provide scientific support for the ecological sustainable development of similar urban areas.

The abilities of quantitative description of noise are restricted due to its origin and only the statistical and spectral analysis methods can be applied while an exact time evolution cannot be defined or predicted. It emphasizes the challenges faced in many applications including communication systems where noise can play, on one hand, a vital role impacting signal-to-noise ratio but possessing, on the other hand, unique properties such as infinite entropy (infinite information capacity), exponentially decaying correlation function and so on. Despite the deterministic nature of chaotic systems, the predictability of chaotic signals is limited for a short time window putting them close to random noise. In this article, we propose and experimentally verify an approach to achieve Gaussian-distributed chaotic signals by processing the outputs of chaotic systems. The mathematical criteria, on which the main idea of the study is based on, is the Central Limit Theorem which states that the sum of a large number of independent random variables with similar variances approaches a Gaussian distribution. The study involves more than 40 mostly three-dimensional continuous-time chaotic systems (Chua’s, Lorenz’s, Sprott’s, memristor-based, etc.) whose output signals are analyzed according to criteria that encompass the probability density functions of a chaotic signal itself and its envelope and phase, statistical and entropy-based metrics such as skewness, kurtosis, and entropy power. We found that two chaotic signals of Chua’s and Lorenz’s systems exhibited superior performance across the chosen metrics. Furthermore, our focus extended to determining the minimum number of independent chaotic signals necessary to yield a Gaussian-distributed combined signal. The analytic and experimental results indicate that the sum of at least three non-Gaussian chaotic signals closely approximates Gaussian distribution. It allows generation of reproducible Gaussian-distributed deterministic chaos by modeling simple chaotic systems.

In patients with primary central nervous system lymphoma (PCNSL), the choice of surgical strategy for histopathologic assessment is still controversial, particularly in terms of preoperative corticosteroid (CS) therapy. To provide further evidence for clinical decision-making, we retrospectively analyzed data from 148 consecutive patients who underwent surgery at our institution. Although patients treated with corticosteroids preoperatively were significantly more likely to require a second or third biopsy (p=0.049), it was only necessary in less than 10% of the cases with preoperative corticosteroid treatment. The choice of surgical procedure did not affect diagnostic accuracy (p&gt;0.05). Preoperative CSF sampling did not provide additional information but was associated with delayed surgery (p=0.02). Surprisingly, diagnostic accuracy was significantly lower when patients were treated with anticoagulation or dual antiplatelet therapy (p=0.015). In conclusion, preoperative CS therapy can challenge the histological diagnosis of PCNSL. At the same time, our data suggest that preoperative CS treatment only presents a relative contraindication for an early surgical intervention. The standard surgical approach is stereotactic biopsy, but other approaches can be individually considered. If a definitive diagnosis cannot be made after the first surgical intervention, the timing of a repeat biopsy after discontinuation of CS remains a case-by-case decision.

The VEMoS AXL system is a new optical biometer based on spectral domain optical coherence tomography (SD-OCT) that has been tested in terms of intrasession repeatability and compared with a swept-source optical coherence tomography biometer (SS-OCT), which is considered the gold standard, for an agreement analysis. A biometric analysis was performed three consecutive times in 120 healthy eyes of 120 patients aged between 18 and 40 years with the SD-OCT system and afterwards a single measurement was obtained with the SS-OCT system. Within-subject standard deviations were 0.004 mm, 4.394 µm and 0.017 mm for axial length (AL), central corneal thickness (CCT), and anterior chamber depth (ACD) measures obtained with the SD-OCT biometer, re-spectively. The agreement between devices was good for AL (Limits of agreement, LoA: -0.04 to 0.03 mm) and CCT (LoA: -4.36 to 14.38 µm), whereas differences between devices were clinically relevant for ACD (LoA: 0.03 to 0.21 mm). In conclusion, the VEMoS AXL system provides consistent measures of anatomical parameters, being most of them interchangeable with those provided by the SS-OCT-based gold standard.

Exploring the spatio-temporal differentiation characteristics and coupling coordination relationship of the composite ecosystem of urban agglomerations is of great significance for promoting the synergistic development and integration construction of urban agglomerations. This paper is based on LUCC data, DEM, temperature, precipitation and other multi-source data, taking the central Yunnan urban agglomeration as an example. The entropy weight method is first used to determine the comprehensive weights to evaluate the regional economic and social development level. Then, the InVEST (Integrated Valuation of Ecosystem Services and Trade-offs)model was used to quantitatively calculate and analyze the spatial and temporal evolution characteristics of the four ecosystem services, including water conservation, soil conservation, carbon sequestration services, and habitat quality. The coupling coordination model was used to quantitatively analyze the evolution of the coupling coordination of the composite ecosystems in the central Yunnan urban agglomeration during the period of 2010-2020, and to reveal its development law. The results show the following: ①During the study period, the socio-economic subsystems in central Yunnan urban agglomeration demonstrated an outward radiative growth from Kunming City, marked by underdeveloped sub-centers and prevalent low-level areas. ②Trends in ecosystem services varied, with water and soil conservation showing fluctuating increases, carbon sequestration remaining stable, and habitat quality declining. The integrated ecosystem services critically important zone is mainly located in the northeastern region and southwestern edge of the study area. ③Economic, social and ecological subsystems are highly coupled, with consistent overall development trends and strong interactions. ④The increase in the degree of harmonization amounted to 7.82%, with lagging subsystems varying in different degree of harmonization subregions. The study can provide a scientific basis for urban agglomerations to formulate scientific and reasonable development policies, promoting regional sustainable development and optimizing the spatial pattern of the national territory.

Grasping the spatial and temporal patterns of forest fires, along with the key factors that drive them and the ability to forecast such events accurately, is essential for the successful management of forests. In China's southern region, forest fires significantly endanger the ecological system, public safety, and economic well-being. Through the application of Geographic Information Systems (GIS) and LightGBM (Light Gradient Boosting Machine) model, this study investigates the determinants of fire incidents and formulates a predictive model for forest fire occurrences, alongside a zoning strategy, within the Central-South area. The results indicate: (i) Spatially, fire points exhibit significant clustering and autocorrelation characteristics; (ii) The Central-South Forest Fire Prediction Model shows exceptional accuracy, reliability, and predictive power, with high performance metrics across training and validation sets, including over 85% accuracy, precision, recall, and F1 scores, along with AUC values above 89%, underscoring its efficacy in forecasting forest fires and distinguishing between fire events; (iii) Throughout the year, forest fire risks in the Central-South region of China vary by region and season, with risk spikes from March to May in Guangdong, Guangxi, Hunan, Hubei, and Hainan. From June to August, localized risks are observed in Heyuan and Huangshi, while from September to November, an increase in risk is noted in Guangdong (Meizhou, Heyuan, Shaoguan), Guangxi (Nanning, Hezhou, Yulin), and Hunan (Binzhou, Yongzhou, Hengyang) due to cooler, drier conditions and leaf litter accumulation. From December to February, the risk continues in specific areas across Guangdong, Guangxi, Hunan, and Hubei.

Background: This study examines the relationship between energy usage, health issues, and pro-environmental behavior (PEB) in Kyrgyzstan, amidst the country's commitment to transition from coal-based energy to renewable sources in line with the Paris Agreement. The purpose is to investigate citizens' attitudes towards PEB and their intentions to engage in environmentally friendly actions, focusing on gas, electricity, and coal. Methods: Drawing upon the Theory of Planned Behavior (TPB) framework, a survey was conducted among 1,455 respondents to explore attitudes towards PEB and energy sources' impact on health issues. Results: Decarbonization efforts in Kyrgyzstan and Central Asia are in their early stages, with coal remaining a primary energy source. The study emphasizes the importance of governmental policies and citizen action in achieving decarbonization goals. Rising electricity costs outweigh the increase in indirect energy costs for food, posing challenges for households in adapting to changing energy dynamics. Conclusions: Targeted interventions and communication strategies are crucial to promote pro-environmental behavior and facilitate the transition to sustainable energy sources. Understanding the relationships between health concerns, air pollution awareness, PEB, and energy source choices can inform policymakers and organizations in their efforts to ensure a sustainable and healthy future for Kyrgyzstan and other Central Asian countries.

Turbo-roundabouts are one of the most frequently recommended road junction design options when it comes to increasing traffic capacity and traffic safety. This is in particular true of suburban areas, with dominant traffic flow on the main road and moderate traffic flow on the side road. Other intersections handling local traffic and considerably constricting the availability of space are usually located in the vicinity of such intersections. Another factor contributing to less availability of land for construction in these locations is the presence of surrounding residential housing. Then choosing the suitable turbo-roundabout type becomes the main issue. The article presents a case study for the selection of a type of turbo roundabout under the conditions of considerably constricted land availability, based on analyses of provision of swepth path for the chosen design vehicles. The article considers the typical Egg type turbo roundabouts, "flattened" turbo roundabouts and ellipse based roundabouts, with unconventional geometries of the truck apron and central island. For each of the analysed roundabout types setting out methods were described in detail, which enable designers to quickly select a type of roundabout suitable for specific constrained site conditions.

The Badenian/Sarmatian boundary in the Central Paratethyan basins is characterized by a change from open marine conditions during the late Badenian to the assumed brackish conditions during the early Sarmatian. Foraminiferal and palynological results of the Badenian/Sarmatian boundary interval in the Babczyn 2 borehole (SE Poland) showed that the studied interval accumulated under variable, unstable sedimentary conditions. The Badenian/Sarmatian boundary as correlated with a sudden extinction of stenohaline foraminifera is interpreted as due to the shallowing of the basin. The lack of foraminifera and palynomorphs just above the Badenian/Sarmatian boundary can reflect short-term anoxia. The composition of euryhaline assemblages characteristic for the lower Sarmatian part of the studied succession indicates marine to hypersaline conditions.

Takotsubo syndrome (TTS) is a cardiomyopathy that presents clinically as a transient and reversible left ventricular wall motion abnormality (LVWMA) that can recover spontaneously within hours to weeks. Studies have shown that it mainly affects older people. Postmenopausal women in particular have an increased prevalence. Physical and emotional stress are widely discussed and generally recognized trigger factors. As age also appears to play a major role in the development of TTS, this review will take a closer look at age- and gender-specific aspects. First and foremost, postmenopausal women and the associated lower oestrogen concentration should be mentioned here. Another important role is played by the hypothalamic-pituitary-adrenal (HPA) axis and the associated glucocorticoid-dependent negative feedback and the resulting immune response. Inflammaging is another term that is increasingly used in connection with TTS. In the following, these risk factors are considered in more detail and linked to the increased sympathetic activity as a possible consequence of chronic stress. Based on the imbalance between the sympathetic and parasympathetic nervous system, we venture an explorative proposal and would like to present a new possible therapeutic approach.

Whether and how P2X7 receptor knockout (KO) modulates central post-stroke pain (CPSP) induced by lesions of the ventrobasal complex (VBC) of the thalamus regarding behavioral, molecular, and electrical recording parameters remains unclear. Following the experimental protocols of a rat hemorrhage CPSP model, the VBC of the thalamus of wild-type and P2X7 receptor KO mice was injected with 10 mU/0.2 μl type IV collagenase to produce an animal model of stroke-like thalamic hemorrhage. Behavioral data showed that the CPSP group induced thermal and mechanical pain, while the P2X7 receptor KO group showed reduced thermal and mechanical pain behaviors. Molecular assessments revealed that the CPSP group had lower expression of NeuN and KCC2 and higher expression of GFAP, IBA1, and BDNF. The P2X7 KO group showed lower expression of GFAP, IBA1, and BDNF and higher expression of KCC2 than the CPSP group. The expression of NKCC1, GABAa receptor, and TrkB did not differ significantly between the control, CPSP, and P2X7 receptor KO groups. Muscimol application increased multiunit numbers and [Cl-] influx in the membrane in the CPSP group, while P2X7 receptor KO reduced multiunit activity and [Cl-] outflux. P2X4 receptor expression was significantly decreased in the 100 kb but not the 50 kb site in the P2X7 receptor KO group. Altogether, the P2X7 hypothesis of CPSP was proposed, wherein P2X7 receptor KO changed the CPSP pain behavior, numbers of astrocytes and microglia, CSD amplitude of the anterior cingulate cortex and the medial dorsal thalamus, BDNF and KCC2 expression, [Cl-], and P2X4 activation in 100 kb with P2X7 receptors. The present findings have implications for the clinical treatment of CPSP symptoms.

(1) Background: A simple approach to map irrigated landcover has been introduced by using measures derived from optical spectral range as an alternative to thermal range. It has been demonstrated that substituting surface temperature (Ts, ‘thermal approach’) with SWIR transformed reflectance (STR, ‘optical approach’) to detect surface moisture is feasible with comparable results. (2) Methods: Using an iterative thresholding procedure to minimize within-class variance, the bilevel segmentation of variables derived from Landsat-8 representing surface moisture and vegetation cover was achieved for the 2020-21 summer for a key irrigation district in Australia. (3) Results: The results of irrigated landcover by optical approach found to be comparable with those by thermal approach. The classification accuracy was assessed using water delivery records at farm level. Though the overall accuracy is high in both cases, the optical approach (97.6%) performed slightly better than the thermal approach (93.9%). (4) Conclusions: The feasibility of using STR to map irrigated landcover has been confirmed by a high-level overall accuracy assessment. This has broader implications in terms of irrigated landcover assessment, as the use of satellite imagery in these applications may not necessarily be limited to microwave or thermal sensors.

Background: To examine the effects of continuous positive airway pressure (CPAP) therapy on central corneal thickness (CCT) in patients with obstructive sleep apnea (OSA) followed for 12 months. Methods: Participants were patients with OSA and an indication for CPAP who were enrolled after diagnosis and graded according to the apnea hypopnea index (AHI) determined in an overnight polysomnography. Each subject underwent a full ophthalmologic examination including ultrasound pachymetry (USP) with an SP3000 USP (Tomey Inc) at the time points just before CPAP onset, and after 3 and 12 months of CPAP treatment. Results: The study sample comprised 40 eyes of 20 patients. Adherence to CPAP was adequate (5.23 ± 1.77 h/night). After receiving 12 months of CPAP, positive correlation was observed between hours of CPAP use and CCT (r = 0.382, p = 0.015). Intermittent hypoxemia pre-CPAP or hypoxia severity pre-CPAP were also positively correlated with the CCT recorded after 12 months of CPAP (r = 0.394, p = 0.012; r = 0.324, p = 0.041). Significant correlations were, however, not observed after only 3 months of CPAP treatment. In addition, compared to measurements at 3 months, intraocular pressure was higher after 12 months of treatment. Conclusions: Our findings indicate that 12 months of correct adherence to CPAP are needed to detect significant CCT thickening, and that the greater the pre-CPAP hypoxemia, the greater the capacity for an increase in CCT to be produced in response to 12 months of this therapy.

Aim: To evaluate the panmacular subthreshold micropulse laser treatment results among patients with central serous chorioretinopathy (CSC) and their correlation with functional and morphological parameters. Material and methods: The examined group included 10 non-treated and 41 treated patients with acute, recurrent, and chronic CSC (13 F, 38 M, mean age 44.11±6.5) and 14 healthy controls (6 F, 8 M, mean age 45±9.3). The BCVA examination, ophthalmoscopy, microp-erimetry, angio-OCT and OCT were performed. The medical history regarding chronic general disorders and known risk factors were recorded. Results: Complete resorption of SRF was obtained in 100% aCSC, 86.66% cCSC, and 63.63% r CSC. BCVA and RetSens significantly improved most of the patients treated in aCSC. The lowest BCVA and RetSens, but the largest pachyvessel and disease duration, were found in rCSC. A strong negative correlation between final BCVA and disease duration was found. No patient demonstrated laser lesions following treatment. Conclusions: The panmacular MPLT therapy leads to long-term enhancement of functional and morphological parameters in all CSC patients. The acute CSC patients showed the most significant improvement. The procedure is safe and could be considered a preferred treatment option for all active CSC cases. Timely treatment is crucial for beneficial outcomes.

Since the controllers of the variable speed seawater pump and the 3-way valve of a ship central cooling system receive the feedback signal from the same output, the two controllers may interfere and operate inefficiently under certain conditions. Therefore, studying an efficient control tuning method for the central cooling water system is necessary. The central cooling water system was modeled in this study using MATLAB Simulink, utilizing actual operation data, and unknown parameters are estimated to fine-tune. The model is then verified using another operating data set. Additionally, transfer functions are developed for freshwater output temperature against 3-way valve openness input and seawater pump motor electric power frequency input. Then, the two PI controllers are tuned through the Internal Model Control guide, supposing the two systems are decoupled. Moreover, the modified IMC tuning method is suggested for the seawater pump system, which has larger time constants because of a heat exchanger. This method simplifies combining the two PI controller tuning, enhancing the seawater pump's overall efficiency and 3-way valve operation. This study determined that the proposed tuning methods through the IMC guide confirmed the efficiency of controlling the seawater pump speed and 3-way valve with reasonable control of freshwater outlet temperature.

We derive some Quantum Central Limit Theorems for expectation values of macroscopically coarse-grained observables, which are functions of coarse-grained hermitean operators consisting of non-commuting variables. Thanks to the hermicity constraints, we obtain positive-definite dis- tribution for the expectation values of observables. These probability distributions open some pathway for an emergence of classical behaviours in the limit of innitely large number of identical and non-interacting quantum constituents. This is in contradistinction to other mechanisms of classicality emergence due to environmental decoherence and consistent histories. The probabil- ity distributions so derived also enable us to evaluate the nontrivial time-dependence of certain differential entropies.

Nowadays, the transactions carried out with digital currencies are increasing. Citizens are asked to respond to growing challenges related to the sustainable management of digital currencies in their daily lives. However, due to the lack of digital skills of users, the sustainable management of digital currencies hides risks. The methodology of this study was based on the Digital Competence Framework for Citizens (DigComp) and is applied through a questionnaire completed by 443 respondents. The main objective was to evaluate their digital skills from the perspective of digital currency use. The analysis of the responses was carried out by using Structural Equation Modeling (SEM). The most important result from this research reveals that users of digital currencies are significantly capable of developing sustainable communication to solve everyday problems. At the same time, users of digital currencies mostly detect digital threats and effectively manage fake news without being affected by them. However, users of digital currencies consider that security issues are important, but only for transactions and not for their supporting functions. The study concludes with suggestions for improving the experience of digital currency users through individual actions, thus having a positive impact on the state and banking institutions.

Micro-nanoparticles' characteristics in geothermal fluids can be applied to detect of deep hidden geothermal resources. Observations using a nanoparticle tracking analyzer (NTA) indicated that the karst geothermal water collected in the central area of Shandong Province (Jinan and Zibo) contains many natural micro-nanoparticles with sizes primarily ranging between 100 nm and 5 μm. The micro-nanoparticles’ type, shape, crystal form, and chemical composition in the samples were analyzed using transmission electron microscopy (TEM). TEM images and energy dispersive spectroscopy showed that the micro-nanoparticles in geothermal water samples were mostly amorphous, irregular, or nearly spherical, with rough edges. The micro-nanoparticles were mainly carbonates, sulfates, and chlorine-containing Fe, Ca, Na, and Mg. The characteristics of the particles can reveal the properties of the deep, hot reservoirs and aquifers from where they originate. Therefore, we believe that natural micro-nanoparticles can be essential to detecting and studying deep, hidden geothermal resources, which is a novel approach to exploring deep, hidden geothermal resources.

Vision impairment may delay responses to hazards when driving. In a proof-of-concept driving simulator study, we evaluated a hazard warning device designed for vision impaired drivers. Three groups participated: 11 persons with central vision loss (CVL; median age 60 years), 12 with homonymous field loss (HFL; 52 years) and 11 with normal vision (NV; 60 years). CVL is characterised by impaired visual acuity and contrast sensitivity while HFL is a loss of vision in the same half of the visual field (blind side) in both eyes. Participants completed drives with and without the device which gave a directional vibro-tactile warning for an approaching pedestrian hazard when collision risk exceeded a pre-defined threshold. Warnings significantly (p< 0.001) reduced brake response times for CVL (∆= 0.54s) and HFL (∆= 0.30s), but not NV participants. For HFL participants, the reduction was greater (p = 0.02) for hazards on the blind (∆= 0.57s) than seeing side (∆= 0.10s). The warnings significantly reduced collision rates for CVL participants from 11 to 0% (all hazards) and for HFL participants from 30 to 1.7% (blind side hazards). Thus, hazard warnings may be beneficial in improving safety of vision impaired drivers; further research is warranted.

In recent years, how to combine intelligent prospecting algorithms such as random forest with a large number of geological and mineral data for quantitative prediction of exploration geochemistry has become an important topic of concern to quantitatively improve the accuracy of target delineation. The ore-forming geological conditions in the central Kunlun area of Xinjiang are great and have good prospecting prospects. However, due to the exhaustion of shallow deposits and the lag of geological prospecting work in the past ten years, there has been no expected breakthrough in the search for large and super-large metal deposits for many years. There has been a serious shortage of reserve resources. The use of new theories, new methods and new technologies for mineral resources investigation and evaluation has become an urgent need in the current prospecting work. In view of this, based on the existing spatial database of geological and mineral resources in the central Kunlun of Xinjiang, combined with the geological characteristics, genesis and metallogenic regularity of the area, this paper carried out a series of studies on gold polymetallic minerals with the help of geographic information system and data science programming software platform. The researchers integrated geological and regional geochemical data, and constructed a random forest metallogenic discriminant model based on two different sampling methods (integrated random undersampling and selection of training samples) to predict the mineralization of gold polymetallic minerals in the central Kunlun area of Xinjiang and delineate the metallogenic target area. The quantitative prediction of gold polymetallic mineral resources in the central Kunlun area of Xinjiang by two random forest models is compared and discussed: the known ore spots, fault structures and geochemical information are extracted, and the known gold polymetallic ore spots and geochemical data are used to form a training set and a prediction set to construct a machine learning random forest model. The results of prediction evaluation and metallogenic prospect division show that for different sampling methods, the performance evaluation parameters of the training process show that the prediction accuracy of the selected training samples is higher, and the selected training samples are more reliable because they can fully learn the complex information of the original data. In the metallogenic prospect prediction and metallogenic potential division, the random forest model of selecting training samples has more reference value and further exploration research significance in the production problem considering the actual exploration cost because of its small area of high potential prediction area and high proportion of ore bearing per unit area. At the same time, this study innovatively improves the prediction accuracy, reduces the exploration risk, and expands the prospecting idea of machine learning algorithm in mathematical geology in the central Kunlun area of Xinjiang. The delineated metallogenic potential area has positive guiding significance for the actual gold polymetallic prospecting work in this area.

Arid- and semi-arid Central Asia is particularly sensitive to climate change. The changes in extreme precipitation in Central Asia stemming from climate warming are the subject of intense debate within the scientific community. This study employed a Morlet wavelet analysis to examine the annual occurrence number of extreme precipitation in Central Asia from May to September during the period of 1951–2005. Their modulating planetary-scale climate modes were identified by using a linear regression analysis. Two major scales of the temporal variability were derived: 2–3.9 yr and 4–6 yr. The dominant variability was 2–3.9-yr scale and was associated with the negative phase of the Polar/Eurasia (POL) pattern. The 4–6-yr scale provided a secondary contribution and was closely linked to the negative phase of the North Atlantic Oscillation (NAO). These planetary climate modes acted as precursors of extreme precipitation over Central Asia. The negative phase of POL directly contributed to a negative height anomaly over Central Asia, which was intimately related to extreme precipitation. In contrast, the negative NAO phase possibly manifested as a Rossby wave source, which was subsequently exported to Central Asia through a negative–positive–negative Rossby wave train.

Background: Classical Hodgkin's lymphoma (cHL) is a lymph node disease, however, extranodal involvement is present in about 10% of affected individuals. Various forms of direct central nervous system (CNS) involvement have been reported, including intracranial, epidural, leptomeningeal, and intramedullary spinal cord cHL (Table 1). We hereby describe the clinical presentation, work up, and outcomes of two distinctive cases of cHL with intracranial extra-axial spread in patients receiving novel combination and traditional chemotherapy. Methods: This case series (n=2) was conducted following the CARE guidelines. Institutional review board (IRB) approved protocol #24-015 for HIPPA waiver of subjects in our retrospective study. Results: Patients with cHL exhibiting CNS symptoms or relapse refractory cases benefit from neuroimaging and excluding infectious etiologies. Suspicious lesions include iso- to hypointensity on T1 weighted and iso- to hyperintensity on T2 MR scans. Diagnosis is confirmed with biopsy. Treatment with A-AVD has shown more benefit than traditional ABVD chemotherapy. There has been shown progression free survival with nivolumab-AVD (N-AVD) over brentuximab-AVD (B-AVD). Conclusion: cHL with CNS involvement is rare and requires comprehensive workup to exclude infectious and other malignancies. Diagnosis relies on neuroimaging and subsequent brain biopsy. Treatment with novel N-AVD has shown greater PFS in patients with advanced cHL.

The production of particles outside the region of nucleon-nucleon kinematics due to interactions involving dense cold clusters of quark-gluon matter in nuclei is calculated. The possibility of observing this process in the region of central rapidities and large transverse momenta in heavy ion collisions at low energies with MPD detector at the NICA collider has been demonstrated.

Introduction: intraocular pressure (IOP) measurement is an essential part glaucoma’s diagnosis and follow-up. Goldmann applanation tonometry (GAT) is the gold standard for IOP measurement but it’s affected by many factors like central corneal thickness (CCT). Racial differences in CCT are reported but the Syrian population was never studied.Research design and methods: 57 subjects with 114 eyes visiting Damascus hospital were examined and 100 eyes were included. IOP was measured using GAT and CCT was measured using OCULUS Pentacam AXL Corneal Topography, demographic data and history of ocular surgery, systemic co-morbidities and history of medications were collected. IOP values were corrected for CCT.Results: 56% were males, the mean age was 48.1. 24% of subjects had hypertension. Males had higher CCT with 557.23± 25.33 compared with 531.34 ± 41.88 for females. There was a moderately positive correlation between CCT and IOP (r=0.232, p-0.02), CCT and IOP values were linearly correlated (ANOVA, p=0.02).Conclusions: This study showed that the correlation between CCT and IOP is present in the Syrian population. Males had a slightly thicker corneas than females and CCT didn’t significantly change with age.

West Nile virus (WNV) is a re-emerging flavivirus, primarily circulating among avian hosts and mosquito vectors, causing periodic outbreaks in humans and horses, often leading to neuroinvasive disease and mortality. Spain has reported several outbreaks, most notably in 2020 with seventy-seven human cases and eight fatalities. WNV has been serologically detected in horses in the Community of Madrid, but to our knowledge, it has never been reported from wild birds in this region. To estimate the seroprevalence of WNV in wild birds and horses in the Community of Madrid, 159 wild birds at a wildlife rescue center and 25 privately owned equines were sampled. Serum from thirteen birds (8.2%) and one equine (4.0%) tested positive with a WNV competitive ELISA designed for WNV antibodies detection, but sensitive to cross-reacting antibodies to other flaviviruses. VNT confirmed WNV antibodies in four bird samples (2.5%), and antibodies to undetermined flavivirus in four additional samples. One equine sample (4.0%) tested positive for WNV, although this horse previously resided in a WN-endemic area. ELISA positive birds included both migratory and resident species, juveniles and adults. Two seropositive juvenile birds suggest local flavivirus transmission within the Community of Madrid, while WNV seropositive adult birds may have been infected outside Madrid. The potential circulation of flaviviruses, including WNV, in birds in Madrid Community raises concerns, although further surveillance in mosquitos, wild birds and horses in Madrid is necessary to establish the extent of transmission, and the principal species involved.

Introduction/Aim: Central sensitivity to thyroid hormones refers to the sensitivity of the hypothalamic-pituitary-thyroid (HPT) axis to changes in circulating free thyroxine (fT4). The relationship between fT4 levels and iodine intake is complex. The aim of the present study was to assess central sensitivity to thyroid hormones in pregnancy against iodine intake. Materials & Methods: One thousand one hundred two blood and urine samples were collected from pregnant women (with a mean age+SD of 30.4+4.6 years) during singleton pregnancies; women with known/diagnosed thyroid disease were excluded. Specifically, TSH & fT4 and 24-hour urinary iodine excretion (UI) were measured in each trimester and at two months postpartum. The Thyroid Feedback Quantile-based Index (TFQI) was calculated to assess central sensitivity to thyroid hormones. For the statistical analysis of TFQI by time period, analysis of variance (ANOVA) was used, while Pearson's correlation was used to assess TFQI versus UI. Results: The mean TFQI index ranged from -0.06 (first trimester) to -0.07 (two months postpartum), while the corresponding UI was 141 and 172 μg/L, respectively. The TFQI-UI correlation was negative (Pearson r: -0.325, p: 0.04 and r: -0.399, p: 0.023), for UI values over 250 μg/L, in the first and the third trimester of pregnancy, respectively. Discussion: TFQI is a new index reflecting central sensitivity to thyroid hormones. Lower TFQI indicates higher sensitivity to thyroid hormones. In our sample TFQI was inversely related to iodine intake, in the first trimester of pregnancy (the critical period of organogenesis) and the third trimester (the critical period of fetal growth). Thus, the observed changes in TFQI may reflect different ways of central action of thyroid hormones, according to the phase of pregnancy. The negative association between maternal TFQI (indicative of central sensitivity to thyroid hormone) and urine iodine levels during the third trimester of pregnancy may reflect the combined influence of maternal and fetal thyroid function. Our results are intriguing and have the potential to enhance our comprehension of the changes in the HPT axis’ function via variations in central sensitivity to thyroid hormones and its interplay with nutritional iodine status during pregnancy.