Olympic Games have a huge impact on the cities where they are held, both during the actual celebration of the event and before and after it. This study presents a new approach based on spatial analysis, GIS, and data coming from Location Based Social Networks to model the spatiotemporal dimension of impacts associated with the Rio 2016 Olympic Games. Geolocalized data from Twitter are used to analyze the activity pattern of users from two different viewpoints. The first monitors the activity of Twitter users during the event -the arrival of visitors, where they came from, and the use resident and tourist made of different areas of the city. The second assesses the spatiotemporal use of the city by Twitter users before the event, compared to the use during and after the event. The results not only reveal which spaces were the most used while the Games were being held but also changes in the urban dynamics after the Games. Both approaches can be used to assess the impacts of mega-events and to improve the management and allocation of urban resources such as transport and public services infrastructure.

Madrid Nuevo Norte (Madrid New North) is an urban redevelopment program applied in the city of Madrid in Spain. In relevance with this, the aim of this paper is twofold: firstly, the project examines if Nuevo Norte project is aligned with the principles of sustainability. Secondly, the paper investigates the impact of Nuevo Norte on the application of city marketing strategies in Madrid. For that purposes, questionnaires were distributed through Internet in 122 urban developers and planners located in the Spanish capital. The results indicated that overall, Nuevo Norte contributes in the sustainable development of Madrid; however, concerns were identified regarding the budget and the timeline of the project. In addition, NNMP provides significant opportunities to local authorities to implement sustainable city marketing strategies, aiming to improve the competitiveness and the quality of life in the city of Madrid. To this end, it seems that city marketing, through the construction of Mega projects, should sift to sustainability, ensuring a better life for local residents and communities in general. The research is expected to assist local authorities in Spain to harness the potential of mega projects, such as Nuevo Norte, in designing city marketing strategies and to promote Madrid in an international context as a city that gives emphasis in urban sustainability.

Site environments and instrumental characteristics of carbon dioxide (CO₂) measurements operated by local governments in the Kanto Plain, the center of which is Tokyo were summarized for this study. The observation sites were classified into environments of three types: urban, suburban, and woodland. Based on a few decades of accumulated hourly data, the diurnal and seasonal variations of CO₂ concentrations were analyzed as a composite of anomalies from annual means recorded for each site. In urban areas, the highest concentrations appear before midnight in winter. The second peak corresponds to the morning rush hour and strengthening of the inversion layer. Suburban areas can be characterized as having the highest concentration before dawn and the lowest concentration during the daytime in summer in association with the activation of respiration and photosynthesis of vegetation. In these areas, concentration peaks also appear during the morning rush hour. Woodland areas show background features, with the highest concentration in early spring: higher than the global background by about 5 ppmv.

This work shows the preliminary description of the origin of a sedimentary - exhalative outcrop of Jurassic Lower Pliensbachian. The location of this deposit was achieved by applying an examination based in the identification of sedimentary transgressions of heterochronies ages and the identification of a Rift – type mega –structure. According with the methodology, it was carried out a study of the discordant relationships between two types of sediments: continental and marine. According the characterization, it was noted the existence of light rare earths, in values that show positive anomalies in comparison with the distribution of elements in upper continental crust according to the Clarke [1], reflecting so a felsic affinity of the mineral deposit. Also, positive anomalies of platinum and Pd, were determined with marginal contents of Au and Ag; and finally the base metals Zn, Pb and Cu were detected in low contents, which could be due to the presence of altered shale. According to the sedimentary lithology found, which was of siliciclastic type; to the exhalative roots observed during the fieldwork; the presence of quartz minerals such as biotite and muscovite; the presence of minerals of hydrothermal remobilization like chalcopyrite with some base metals, altered shale, as well as sulfur deficiency; this mineral reservoir could be defined as a SEDEX – type.

The 2022-2023 Chilean summer showed increased temperatures and similar burned area, compared to the 2016-2017 season, where more than 500,000 hectares were compromised, mainly in the rural areas. After a brief review, it is revealed that the effects of forest fires on soil and hydrological properties are barely debated in Chile. Here, we showed a climatological analysis where temperature records in the 2016-2017 season were unusual, as well as another unexpected increase in the summer of 2022-2023, resulting in high-severity fires known as ‘mega-fires’ or “storm-fires”. Mega-fires affect forest plantations and native forests mainly from 33º S (Maule Region) to 39º S (Los Ríos Region) and they are expected to become frequent due to climate change, moving from the north to the south. We present an overview of the influence of wildfires on soil components in the most affected areas (inland, Coastal, and Andes ranges), their hydrological impacts, and potential erosion risk due to high winter precipitation. We propose several management practices that could help to prevent or mitigate these events, including pre-and post-fire interventions, such as afforestation and seeding, selective logging, mulching, erosion barriers, soil preparation, and dam monitoring. We argue that any effective plan in fire-prone and affected areas should include a combination of actions taken at the hillslope scale at integral ecosystem management, whose effectiveness should be monitored and verified regionally at the watershed scale.

Integration of 5D Building Information Modelling (BIM) into large rail projects has the potential to significantly enhance cost management and control. Nevertheless, 5D-BIM implementation has encountered difficulties stemming from technical, functional, and governance-related factors. This paper builds a conceptual framework to support financial decision-making, enhances project management, and promotes efficient project delivery. The framework encompasses a set of interrelated elements that include project governance, BIM policies and standards, digital platforms, BIM LOD, cost estimation classification, and continuous improvement. The proposed framework acknowledges the significance of project governance in guiding and organizing the implementation of 5D-BIM. Additionally, BIM policies and standards ensure the adherence to quality standards for the produced BIM models. Digital platforms serve as the basis for multiple users to generate, access, share, and exchange project information. BIM LOD promotes collaboration and coordination among all project stakeholders. Cost estimation classification aligns the estimation process with the development of project scope and financial decision-making. Continuous improvement plays a vital role in optimizing processes, enhancing efficiency, and achieving higher-quality outcomes. Moreover, it fosters stakeholder satisfaction, improves project performance, and nurtures a conducive environment for innovation and learning. The study analyses the framework utilization in the Victorian rail projects and identifies key implementation challenges. This can be summed up as follows: The main technical hurdles were the lack of current horizontal infrastructure standards for data exchange and the lack of compatibility with current cost management standards. Increased project complexity and the absence of clear project governance strategies and processes posed organizational challenges. A further validation of the framework in real-world rail projects was recommended to achieve the implementation goals.

Although South Africa is well known for its incredible biodiversity, targeted efforts are still re-quired to accelerate the discovery and description of the still-unknown species in this floristically mega-diverse country. In addition, new species discovery is a new opportunity for the devel-opment of ethnobotanical knowledge. In the present study, we collected data on current knowledge of plant richness in the country and expert taxonomists’ opinions and used statistical modelling technique to predict what might still be missing in South Africa’s flora. According to experts’ opinions and our modelling, we might be missing 1400-1575 plant species in the country. We predicted that we might take 40-45 years to identify and describe these species and that be-tween 64 and 315 taxonomists will be required. The pool of taxonomists who took part in this study have spent a total of R 680 670 000 (US $40 039 411) to describe 419 species. This implies that, in theory, R 1 624 510.74 (US $95 559) was spent, on average, to describe 1 species. At this rate, R 2 558 604 415.00 (US $150 506 142) would be required to describe the 1575 (modelling) or R 2 274 315 036.00 (US $133 783 237) for the 1400 remaining species (expert opinion) in the current context where both full- and part-time taxonomists are committed to biodiversity assessment in the country. It is important to highlight that this estimate does not correspond to what is required specifically for only species description but does integrate all connected activities, e.g., running cost, bursary, salaries, grants, etc. Furthermore, we must bear in mind that these estimates do not account for the possibility of taxonomic revision which, on its own, needs to be funded, nor do they account for molecular laboratory requirement. However, if we consider that 15% of the predicted funds are spent solely on taxonomic activities, this means that we would need ~R243 673 (US$ 14 334) on 1 species. Overall, our study provides an important figure that can inform policy development including funding and recruitment strategies of taxonomists to fuel efforts towards a comprehensive assessment of the unique South Africa’s biodiversity. The implication of new species discovery is that it opens windows for traditional knowledge development.

One of the most serious concerns about mega event-related changes to small cities is how to effectively utilize newly developed public attractions after the Olympic Games. Making connections with existing local amenities and forming attraction networks can be effective strategies for continuing a city’s revitalization. However, despite the expected benefits, attraction network research shows that these benefits often fail to materialize. With the case of Gangneung, a 2018 winter Olympic hosting city, this study investigated visitation patterns to nineteen selected attractions using network analysis. The results indicate that the most influential nodes are located on the northern coast, the eastern coast, and in the south downtown area, those nodes being the central locations where the strongest of connections are made. New attractions such as the Olympic Park and Walwha Linear Park were rather isolated. While seasonal and periodic variations, visitors’ residences, and destination choice attitudes had a significant effect on visitation patterns, the attraction networks, modes of transportation, proximity to region, and type similarity were not significant factors in the forming of visitation patterns. The results make a methodological contribution to tourist behavior and network research. In addition, beyond individual attraction development, the results provide practical implications in regard to networking and cooperation between multiple attractions using temporal and spatial strategies such as management/investment prioritizing, travel route development, and program scheduling.

This paper elucidates the impact of uncertainty on the Markowitz asset allocation and how it performs. The findings imply that when evaluated out-of-sample, estimation errors in parameters might significantly affect how well an allocation performs. Numerous publications that address this ambiguity have been highlighted to emphasize our findings further. In our work, we compare these approaches to alternative allocation strategies and explain their performance in both expected and real out-of-sample events. We find that the Markowitz framework can be improved by using tactics that take uncertainty into account. Longer sample numbers, however, may not always translate into better outcomes. Applying a short-sale constraint can also enhance the initial portfolio. Finally, we find that even more basic approaches to asset allocation, such as equally weighted allocation, perform reasonably well.

The typically qualitative treatment of evidence underlying different causal hypotheses that attempt to explain singular historic events is criticized. Instead of using ad hoc qualitative arguments, it is here advocated to use Bayes theorem to assess how well evidence either support or weaken a specific causal hypothesis. It is argued that such a practice will enable scientists who study singular historic events to discuss, compare and aggregate different beliefs in a meaningful way.

Patients with polycythemia vera (PV) are at increased risk of thrombosis and hemorrhages. Although hydroxyurea (HU) has been the frontline therapy for patients at high-risk of vascular complications, about 25% of patients develop resistance/intolerance to this therapy. The aim of this non-interventional, multicenter cohort study was to understand the clinical characteristics and HU treatment response of Portuguese PV patients. HU resistance/intolerance was defined according to adjusted European LeukemiaNet (ELN) criteria. 134 PV patients with a mean disease duration of 4.8±5.0 years were included and followed up for 2 years. At baseline, most patients were ≥60 years old (83.2%), at high risk for thrombotic events (87.2%), and receiving HU therapy (79.1%). A total of 10 thrombotic events and 8 hemorrhagic events were reported, resulting in a 5-year probability of thrombo-hemorrhagic events of 17.2%. Hematocrit (p=0.007), hemoglobin (p=0.012) and MPN10 symptom score (12.0±11.6 vs 10.3±9.1; p=0.041) decreased significantly at the 24-month visit compared to baseline. Overall, 75.9% of patients met at least one of the adjusted ELN criteria for HU resistance. 14.4% of patients remained on HU throughout the study. The results from this real-world study may help identify the subset of patients at higher risk of disease sequelae who may benefit from earlier second-line treatment.

A reliable flood early warning system must take into account the mechanisms that cause heavy precipitation events and accurate surface hydrology modeling. In this project, analysis of atmospheric processes and hydrological modelling of selected flood events over Dire Dawa is conducted using various observational/reanalysis data and uncoupled WRF-Hydro model simulations. To comprehend the processes causing such severe precipitation occurrences, large scale atmospheric fields linked to selected extreme precipitation events are examined using ERA5 reanalysis. The land surface was configured at 1 km resolution while 250 m sub-grid resolution was set to perform the routing process. Model forcing for the uncoupled WRF-Hydo model is obtained from ERA5 reanalysis data. Sensitivity of stream-flow simulation to various parameter values such as hydrolic conductivity and surface infiltration coefficient was carried out for August 2006. The result of the sensitivity experiment reveals that infiltration-runoff, hydrolic soil conductivity and saturated volumetric soil moisture with the parameter value of 0.1, 1.5 and 1.0, respectively are found to produce realistic spatial and temporal distribution of stream-flow. The extreme flood events of March 2005 and April 2007 were studied further to assess the performance of WRF-Hydro model and to understand the underlying atmospheric mechanisms causing these heavy precipitation events. The result of hydrological simulation demonstrated that uncoupled WRF-Hydro simulation reproduced both the temporal evolution and the spatial pattern reasonably well. Our analysis indicated that the amount of precipitation during these two events exceeded the long-term average by several factors, furthermore, the anomalies cover larger areas of eastern Ethiopia. Associated to these extreme events, upper level subtropical westerly jet-streams were anomalously stronger and also extended further southward favouring upper level divergence over the region. At lower level, the notable circulation anomalies include anomalous positive pressure anomaly over Sudan/Egypt leading to northerly flow anomaly over Red Sea, strengthening of southerly influx from southern Indian ocean due to stronger Mascarene High. The encouraging results from WRF-Hydro simulation suggest that this modelling framework can be implemented in operational context within national and regional forecasting centers as a key component to establish a flood monitoring and early warning system.

Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most frequently prescribed drugs for cancer pain. We used Delphi methodology to evaluate the opinions of clinicians on NSAIDs and paracetamol, with a specific focus on their safety profile. Consensus was reached on 7 statements. High level of consensus was reached regarding use of NSAIDs and gastrointestinal, cardiovascular, and renal risk in patients taking low-dose aspirin and assessment of liver function during long-term treatment with paracetamol. Consensus was also reached that assessment and monitoring of eGFR is important in the elderly being administered NSAIDs. It was further agreed that NSAIDs can often play a key role in association with opioids in treatment of cancer pain and that paracetamol is the analgesic of first choice for patients with mild chronic pain. When NSAIDs are administered in combination with steroids, it was agreed that the risk of gastrointestinal damage is increased since steroids delay the healing of ulcers, and that paracetamol can be used during pregnancy and does not affect the health of the fetus. This Delphi study highlights that there is a poor agreement on how these drugs are routinely prescribed. However, the consensus was reached for 7 key statements and may represent a valid contribution to daily practice.

Introduction: Real-world safety studies can provide important evidence on the thromboembolic risk associated with COVID-19 vaccines, considering that millions of people have been already vaccinated against COVID-19. In this study, we aimed to estimate the incidence of thromboembolic events after COVID-19 vaccination and to compare the Oxford–AstraZeneca vaccine with other COVID-19 vaccines. Methods: We conducted a retrospective real-world safety study using data from two different data sources: the Italian Pharmacovigilance database (Rete Nazionale di Farmacovigilanza, RNF) and the Campania Region Health system (Sistema INFOrmativo saNità CampanIA, SINFONIA). From the start date of the COVID-19 vaccination campaign (December 27th, 2021) to September 27th, 2022, information on COVID-19 vaccinations and thromboembolic evets were extracted from the two databases. The reporting rate (RR) and its 95% confidence interval (95%CI) of thromboembolic events for 10,000 doses was calculated for each COVID-19 vaccine. Moreover, the odds of being vaccinated with the Oxford–AstraZeneca vaccine vs. the other COVID-19 vaccines in cases with thromboembolic events vs. controls without thromboembolic events were computed. Results: A total of 12,692,852 vaccine doses were administered in Campania Region, of which 6,509,475 (51.28%) were in female and mostly related to the Pfizer-BioNtech vaccine (65.05%), followed by Moderna (24.31%), Oxford–AstraZeneca (9.71%), Janssen (0.91%), and Novavax (0.02%) vaccines. A total of 641 ICSRs with a COVID-19 vaccines and a vascular events were retrieved from the RNF for the Campania Region, of which 453 (70.67%) were in female. Most ICSRs reported the Pfizer-BioNtech vaccine (65.05%), followed by Oxford–AstraZeneca (9.71%), Moderna (24.31%), and Janssen (0.91%). A total of 2,451 events were reported in the ICSRs (3.8 events for ICSRs) of which 292 were thromboembolic events. The highe RRs of thromboembolic events were found with the Oxford–AstraZeneca vaccine (RR: 4.62, 95%CI: 3.50-5.99) and Janssen vaccine (RR: 3.45, 95%CI: 0.94-8.82). Thromboembolic events were associated with a higher likelihood of exposure to the Oxford–AstraZeneca vaccine compared to Pfizer-BioNtech (OR: 6.06; 95%CI: 4.22-8.68) and Moderna vaccines (OR: 6.46; 95%CI: 4.00-10.80). Conclusion: We observed a higher reporting of thromboembolic events with viral-vector based vaccines (Oxford–AstraZeneca and Janssen) and an increased likelihood of being exposed to the Oxford–AstraZeneca vaccine compared to the mRNA vaccines (Pfizer-BioNtech and Moderna) among thromboembolic cases.

This paper considers the problem of predicting earthquakes. It uses a small amount of information to create a descriptive key that can be used as a footprint to describe an event. A frequency grid clusters events that occurred at the same time and then the algorithm averages the history of these events over preceding days, in particular the gaps when the events did not occur. The gaps are measured for the clustered events only and can be used to create a description that is quite unique. Results suggest that seismic events can in fact be traced using this key and subsequently recognised again, if the same conditions reoccur. They also suggest that force direction may be more important than magnitude, after the initial cluster selections are made. Greek and USA datasets have been looked at and the prediction accuracy can be 70% or better. The author therefore suggests that this is an interesting method that deserves attention.

The analysis reported here is unique in that it is the first study of the original data from the Pfizer/BioNTech BNT162b2 mRNA vaccine clinical trial (CA4591001) to be carried out by a group unaffiliated with the trial sponsor. Our study is a forensic analysis of the 38 trial subjects who died between July 27, 2020, the start of Phase 2/3 of the clinical trial, and March 13, 2021, the data end date of their 6-Month Interim Report. Phase 2/3 of the trial involved 44,060 subjects who were equally distributed into two groups and received Dose 1 of either the BNT162b2 mRNA vaccinated or the Placebo control (0.9% normal saline). At Week 20, when the BNT162b2 mRNA vaccine received Emergency Use Authorization from the U.S. FDA, subjects in the placebo arm were given the option to be BNT162b2 vaccinated. All but a few accepted. Surprisingly, a comparison of the number of subject deaths per week during the 33 Weeks of this study found no significant difference between the number of deaths in the vaccinated versus placebo arms for the first 20 weeks of the trial, the placebo-controlled portion of the trial. After Week 20, as subjects in the Placebo were unblinded and vaccinated, deaths among this still unvaccinated cohort of this group slowed and eventually plateaued. Deaths in the BNT162b2 vaccinated subjects continued at the same rate. Our analysis revealed inconsistencies between the subject data listed in the 6-Month Interim Report and publications authored by Pfizer/BioNTech trial site administrators. Most importantly, we found evidence of an over 3.7-fold increase in number of deaths due to cardiovascular events in BNT162b2 vaccinated subjects compared to Placebo controls. This significant adverse event signal was not reported by Pfizer/BioNTech. Potential sources of these data inconsistencies are identified.

Effective healthcare relies on accurate and timely diagnosis; however, obtaining large amounts of training data while maintaining patient privacy remains challenging. This study introduces a novel approach utilizing federated learning (FL) and a cross-device multi-modal model for clin-ical event classification using vital signs data. Our architecture leverages FL to train machine learning models, including Random Forest, AdaBoost, and SGD ensemble model, on vital signs data from a diverse clientele at a Boston hospital (MIMIC-IV dataset). The FL structure preserves patient privacy by training directly on each client's device without transferring sensitive data. The study demonstrates the potential of FL in privacy-preserving clinical event classification, achieving an impressive accuracy of 98.9%. These findings underscore the significance of FL and cross-device ensemble technology in healthcare applications, enabling the analysis of large amounts of sensitive patient data while safeguarding privacy.

The COVID-19 pandemic has put a lot of pressure on health systems worldwide. Mass vaccination against SARS-CoV-2 has reduced morbidity and mortality worldwide. Despite their safety profiles, vaccines like any other medical product can cause adverse events. Yet, in countries with poor epidemiological surveillance and monitoring systems, reporting vaccine-related adverse events is scarce. The objective of this study was to describe self-reported vaccine adverse events after receiving one of the available COVID-19 vaccine schemes in Ecuador. A cross-sectional analysis based on an online self-reporting 32-questionnaire was conducted in Ecuador from April 1st to July 15th, 2021. Participants were invited by social media, radio, and TV to voluntarily participate in our study. A total of 6,654 participants were included in this study. A 38.2% of the participants reported having at least one comorbidity. Patients received AstraZeneca, Pfizer, and Sinovac vaccines, and these were distributed 38.4%, 31.1%, and 30.5%, respectively. Pain, inflammation at the injection site (20,01%), and headache (16,91%) were the most reported adverse events. Women addressed ESAVIs (64%), more often than men (36%). After receiving the first dose of any available COVID-19 vaccine, a total of 19,481 self-reported ESAVIs were informed (86.9% were mild, 11.6% moderate and 1.5% severe). In terms of vaccine type and brand, the most reactogenic vaccine was AstraZeneca with 57.8%, followed by Pfizer (24.9%) and Sinovac (17, 3 %). After the second dose, 6,757 self-reported ESAVIs were reported (87.0% mild, 10.9% moderate, and 2.1% severe). AstraZeneca vaccine users reported a higher proportion of ESAVIs (72.2%) in comparison to Pfizer/BioNTech (15.9%) and Sinovac Vaccine (11.9%). Swelling at the injection site, headache, muscle pain, and fatigue were the most common ESAVIs for the first as well as second dose. In conclusion, most ESAVIs were mild. AstraZeneca users were more likely to report adverse events. Participants without a history of COVID-19 infection, as well as those who receive the first dose, were more prone to report ESAVIs.

Background: Recent infectious disease outbreaks have brought increased attention to strengthening the capacity to prevent, detect, and respond to natural biological threats. However, deliberate biological events also represent a significant global threat that have received relatively little attention. The Biological Weapons Convention provides a foundation for the response to deliberate biological events, but the political mechanisms to respond to and recover from such an event are poorly defined. Methods: We performed an analysis of the epidemiological timeline, the international policies triggered as a notional deliberate biological event unfolds, and the corresponding stakeholders and mandates assigned by each mandate. Findings: The results of this analysis identify a significant gap in both policy and stakeholder mandates: there is no single policy nor stakeholder mandate for leading and coordinating the response activities associated with a deliberate biological event. These results were visualized using an open source web-based tool published at https://dbe.talusanalytics.com. Interpretation: While there are organizations and stakeholders responsible for roles in leading security or public health response, these roles are non-overlapping and are led by organizations not with limited interaction outside such events. The lack of mandates highlights a gap in the mechanisms available to coordinate response and a gap in guidance for managing the response. The results of the analysis corroborate anecdotal evidence from stakeholder meetings and highlight a critical need and gap in deliberate biological response policy.

Natural events such as floods, fires, tsunamis, earthquakes and others have nowadays caused serious damage to human beings and nature. The precise detection of these natural events and especially the earthquake has nowadays become the focus of many computer and geoscientific researchers. Computer science and machine learning algorithms have revolutionized early detection and prediction of these events. Hence, a fuzzy method has been initially used in this article to enhance the authenticity of data based on application of effective variables and then combination of neural network algorithms of the MLP perceptron and radial network of RBF in form of a collective learning system in order to more accurately identify seismic events on a small scale. It was observed after simulating the proposed method that the proposed method has significantly improved based on actual error and root-mean-square error (RMSE) criteria compared to basic methods.

In the past two decades the world experienced an exceptional number of unprecedented extreme weather events, some causing major human suffering and economic damage, such as the March 2012 heat event, which was called “Meteorological March Madness.” From the beginning of space era a correlation of solar flares with pressure changes in atmosphere within 2–3 days or even less was reported. In this study we wanted to test the possible relation of highly warm weather events in North-East America with Solar Energetic Particle (SEP) events. For this reason we compared ground temperatures T_M in Madison, Wisconsin, with energetic particle fluxes P measured by the EPAM instrument onboard the ACE spacecraft. In particular, we elaborated case events and the results of a statistical study of the SEP events related with the largest (Dst ≤ −150nT) Coronal Mass Ejection (CME)-induced geomagnetic storms, between with the years 1997–2015. The most striking result of our statistical analysis is a very significant positive correlation between the highest temperature increase_. ΔT_M and the time duration of the temperature increase ΔT_M (r = 0.8, p <0.001) at “winter times” ( r = 0.5, p , 0.01 for the whole sample of 26 SEP examined events). The time response of T_M to P was found to be in general short (a few days), but in the case of March 2015, during a gradual P8 increase, a cross-correlation test indicated highest c.c. within 1 day (p < 0.05). The March 2012 “meteorological anomaly” was elaborated in the case of South-East Europe, where, beside a period of strong winds and rainfall (6-13.3.2012), intense precipitation in North-East Greece (Alexandroupoli) were found to be correlated with distinct high energy flux enhancements. A rough theoretical interpretation is discussed for the space—atmospheric extreme weather relationship we found. However, much work should be done to achieve early warning of space weather dependent extreme meteorological events. Such future advances in understanding the relationships between space weather and extreme atmospheric events would improve atmospheric models and help people’s safety, health and life.

The ocean’s mixed layer depth (MLD) plays an important role in understanding climate dynamics, especially during extreme weather occurrences like hurricanes. This study investigates the effects of Hurricane Katrina (2005) on the MLD in the Gulf of Mexico, using the Delft3D modeling system. By integrating hydrodynamics and wave dynamics modules, we simulate the ocean’s response to extreme weather, focusing on temperature, salinity and MLD variations. Our analysis reveals significant cooling and mixing induced by Katrina, resulting in spatial and temporal fluctuations in temperature (~± 4°C) and salinity (~± 2.5 ppt). The MLD is estimated using a simple threshold method, revealing a substantial deepening to ~120 m on August 29th-30th during Hurricane Katrina in the middle of northern Gulf of Mexico, compared to an average MLD of ~20-40 m during pre-storm conditions. It took about 18-days to recover to ~84% of the pre-storm level after Katrina. Compared to the stand-alone FLOW model, the coupled FLOW+WAVE model yields a deeper MLD of ~5%. The MLD recovery and wave effect on the MLD provide insights from various scientific, environmental and operational perspectives, offering a valuable basis for ocean management, planning and applications, particularly during extreme weather events.

Drought poses a significant environmental risk and can deeply affect the growth of grasslands. However, there is still uncertainty regarding the precise impact of varying levels of drought on grassland growth. To address this gap, we utilized several key indicators, including the Nor-malized Difference Vegetation Index (NDVI), Enhanced Vegetation Index (EVI), the Global Or-biting Carbon Observatory-2 based Solar-induced Chlorophyll Fluorescence (GOSIF), and the Gross Primary Productivity (GPP), in conjunction with drought indices (the Standardized Precip-itation Evapotranspiration Index (SPEI) and the soil moisture (SM). Our study aimed to compre-hensively assess the consistency of spatio-temporal patterns in grassland vegetation and its re-sponsiveness to different drought levels in the Inner Mongolia region from 2002 to 2020. Results indicated that NDVI, EVI, GOSIF, and GPP in grassland vegetation across Inner Mongolia exhibited significant increasing trends from 2002 to 2020. Specifically, NDVI, EVI, GOSIF, and GPP all dis-played consistent spatial patterns, with 25.83%, 21.18%, 22.65% and 48.13% of the grassland area showing significant increases, respectively. Drought events, as described by SPEI and SM, in June 2007 to September 2007 and June 2017 to July 2017, were selected to evaluated the response of grassland vegetation to drought. The drought events of 2007 and 2017 resulted in reductions in NDVI, EVI, GOSIF, and GPP relative to multi-year average (2002-2020). GOSIF exhibited a more intense response to drought, suggesting that GOSIF may reflect the inhibition of water stress on grassland photosynthesis better than NDVI and EVI during drought in 2007 and 2017. The reduc-tions in NDVI, EVI, GOSIF and GPP in grassland increased significantly across different drought-levels, with the sharpest reductions observed during extreme drought. Under the severe and extreme drought events, the most substantial reductions in NDVI, EVI, GOSIF, and GPP were observed in the temperate steppe (TS). Moreover, the effects of different drought severity levels within the same grassland type varied, with the most significant reductions in NDVI, EVI, GOSIF and GPP observed during extreme drought. Our results provide new perspectives for developing and implementing effective strategies to address grassland carbon cycling management and climate change in Inner Mongolia.

Background: Galectin-3 (Gal-3) is a biomarker involved in a wide range of diseases including cardiac remodeling following acute myocardial infarction (AMI). Identification of prognostic markers in patients with AMI can guide strategies towards improved survival and the quality of life. Methods: Our study included 59 patients with AMI and preserved ejection fraction. We determined the Gal-3 plasma concentration within 24 hours of chest pain onset from aortic root, femoral/radial artery, coronary sinus and cubital vein. Major adverse cardiovascular events (MACE) were evaluated at six months follow-up. Results: MACE at six months post-AMI was recorded in 20 patients (34%). The Gal-3 plasma concentration from aortic root and the femoral/radial artery were independent predictors of MACE at six months follow-up after the first AMI (OR 1.228; 95%CI: 1.011-1.491; p=0.038; OR 3.438; 95%CI: 1.275-9.265; p=0.015). ROC analysis identifies the Gal-3 plasma concentration from aortic root as a better predictor of MACE or death (cut-off &gt;10.86 ng/ml; AUC 0.858; 95%CI: 0.744-0.973; p&lt;0.001) than Gal-3 plasma concentration from femoral/radial artery (cut-off &gt;10.18 ng/ml; AUC 0.742; 95%CI: 0.596-0.888; p=0.006). Conclusion: The Gal-3 plasma concentration in patients with AMI determined during coronary angiography, especially from the aortic root, within 24 hours after chest pain onset is a valuable biomarker of prognosis at six months follow-up.

Sleep timing is one of the dimensions of sleep that refers to the time of day when sleep occurs. It was included in sleep-related research because of the potential associations between overweight and consumption of meals and snacks. This cross-sectional study aimed to investigate associations between sleep timing, meal and snack consumption, and weight status in 1333 schoolchildren aged 7-14 years. The midpoint of sleep was used as a sleep timing measure obtained by the midpoint between bedtime and wake-up time and classify as Early, intermediate, and Late. Schoolchildren in the Early group were less likely to be overweight (OR: 0.83, 95% CI 0.69; 0.99), had higher odds of mid-morning snack consumption (OR: 1.95, 95%CI 1.56; 2.44) and lower probability to consume the evening snack (OR: 0.75, 95%CI 0.59; 0.94) compared with the Intermediate group. The Late group had lower odds of mid-morning snack consumption (OR: 0.67, 95%CI 0.55, 0.80) than the Intermediate group. The consumption of mid-morning and evening snacks was associated with the Early and the Late midpoint of sleep. These results suggest that bedtime and wake-up time are relevant to consuming meals and snacks and may also be related to a greater probability of being overweight in children and adolescents.

The advent of immunotherapy and specifically of immune checkpoint inhibitors (ICIs) for the treatment of solid tumors has deeply transformed therapeutic algorithms in medical oncology. Approximately one third of patients treated with ICIs may develop immune-related adverse events, being the gastrointestinal tract often affected with different grades of mucosal inflammation. Checkpoint inhibitors colitis (CIC) presents with watery or bloody diarrhoea and in case of severe activity requires ICIs discontinuation. The pathogenesis of CIC is multifactorial and still partially unknow: anti-tumor activity that collaterally effects the colonic tissue and the upregulation of specific systemic inflammatory pathways (i.e., CD8+ cytotoxic and CD4+ T lymphocytes) are mainly involved. Many open issues remain on treatment timing and options, and biological treatment, above all with anti-TNF alpha, can be offered to these patients aiming to rapidly resume the oncological therapies. This review aims to summarize the pathogenetic mechanisms underlying CIC and to discuss evidenced-based management including the role of biological therapy.

Rare cardiac adverse events are reported post vaccinations. For the SARS-CoV-2 vaccines, higher numbers of these cardiac adverse events are being reported with myocarditis disproportionately occurring in younger males. The etiology of these cardiac adverse events associated with vaccines including SARS-CoV-2 is unknown. The etiology of the higher frequency of these cardiac adverse events temporally associated with SARS-CoV-2 vaccines is also unknown. This article proposes that innate immune responses to vaccines cause elevated histamine levels post vaccination; the histamine level reached may exceed the vaccinees’ histamine tolerance level for several days. This article proposes that the elevated histamine level is causative for the reported cardiac adverse events. For myocarditis reported adverse events, this article proposes that elevated histamine levels induce cardiac capillary pericyte induced vasoconstrictions followed by localized ischemia and anoxia; this is followed by the release of troponin from myocyte cells affected by anoxia. This hypothesis is supported by the temporal onset timing of adverse events reported following SARS-CoV-2 vaccinations in the United States Department of Health and Human Services Vaccine Adverse Event Reporting System (VAERS). This model applies to multiple vaccines with innate immune response histamine levels generated varying by each vaccine and incidence frequencies correlate with vaccine reactogenicity.

We define degree of dependence of two events A and B in a probability space by using Boltzmann-Shannon entropy function of an appropriate probability distribution produced by these events and depending on one parameter (the probability of intersection of A and B) varying within a closed interval I. The entropy function attains its global maximum when the events A and B are independent. The important particular case of discrete uniform probability space motivates this definition in the following way. The entropy function has a minimum at the left endpoint of I exactly when one of the events and the complement of the other are connected with the relation of inclusion (maximal negative dependence). It has a minimum at the right endpoint of I exactly when one of these events is included in the other (maximal positive dependence). Moreover, the deviation of the entropy from its maximum is equal to average information that carries one of the binary trials defined by A and B with respect to the other. As a consequence, the degree of dependence of A and B can be expressed in terms of information theory and is invariant with respect to the choice of unit of information. Using this formalism, we describe completely the screening tests and their reliability, measure efficacy of a vaccination, the impact of some events from the financial markets to other events, etc.

Background: We attempted to find if there were gender differences in different types of Negative life events and Suicidal ideation among Chinese adolescents, then analyze the relationship between different types of Negative life events and Suicidal ideation among these young students. Methods: Based on the data from 6 middle-schools and 3 universities in 3 cities of Western China, the gender difference in different types of Negative life events and Suicidal ideation and their related factors were investigated and analyzed in the study. Results: Gender differences were found during different types of Negative life events and Suicidal ideation; Negative life events could predict the intensity of Suicidal ideation by gender, to some specific types. Conclusions: Negative life events were proved to be risk factors of adolescents’ Suicidal ideation regardless of different gender stereotypes, but the specific classification of negative life events which had significant impact on adolescents’ Suicidal ideation also indicated significant gender divisions. For males, negative life events of punishment and adaptation had a significant and boosting impact on their Suicidal ideation, the higher the scores of punishment and adaptation negative life events had, the greater intensity of male adolescents were to have Suicidal ideation. Thus, the above two types of negative life events may be the main stressors predicting male adolescents' Suicidal ideation; For females, in addition to punishment, other types of negative life events all had significant impacts on their Suicidal ideation, which can be treated as the main stressors to trigger female adolescents' Suicidal ideation; Additionally, parents’ marital status of remarriage and divorce were proved to be significant indicators to adolescents’ Suicidal ideation, the age variable was proved to be strongly correlated with Suicidal ideation among female adolescents.

Aim: This study aimed to investigate the association between periampullary diverticulum (PAD) and difficult biliary cannulation, as well as to evaluate the impact of different types of PAD on the cannulation success rate and adverse events. Methods: A total of 636 patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) during the study period were prospectively studied and divided into two groups based on the presence or absence of PAD. In group A, 126 patients had PAD compared with 510 patients in group B without PAD. The primary outcome measurements were ERCP procedures time, selective cannulation techniques, and cannulation difficulty in addition to cannulation success rate and ERCP-related adverse events. The difficult cannulation was analyzed using logistic regression considering age, co-morbidities, the presence of PAD types, and indications as independent factors. Results: The average cohort age was 65.30±16.67 years, and 52.7% were male. Significant higher rates of choledocholithiasis, cholangitis, and biliary pancreatitis were reported in the group of PAD (p<0.05). Successful selective cannulation was achieved in 97.6% in group A and 95.3% in group B (p>0.05). The cannulation time was significantly longer in the presence of PAD (5.1 min, vs. 4.09 min, p<0.05). There was no significant difference in the rate of overall adverse events and post ERCP pancreatic PEP. Conclusion: The presence of PAD did not affect the duration or success of the ERCP procedure. Furthermore, it was associated with longer cannulation time and increase in the cannulation difficulty, especially with PAD type 1.

Observed ENSO statistics exhibits a non-gaussian behavior, which is indicative of the presence of nonlinear processes. In this paper we use the Recharge Oscillator model (ROM), a largely used Low-Order Model (LOM) of ENSO, as well as methodologies borrowed from the field of statistical mechanics to identify which aspects of the system may give rise to nonlinearities that are consistent with the observed ENSO statistics. In particular, we are interested in understanding whether the nonlinearities reside in the system dynamics or in the fast atmospheric forcing. Our results indicate that one important dynamical nonlinearity often introduced in the ROM cannot justify a non-gaussian system behavior, while the nonlinearity in the atmospheric forcing can instead produce a statistics similar to the observed. The implications of the non-Gaussian character of ENSO statistics for the frequency of extreme El Nino events is then examined.

Various natural disasters such as floods, fires, earthquakes, etc. have affected human life. Detection and classification of large and small earthquakes caused by natural or abnormal events have been always important to Earth scientist. One of the most important research challenges in this field is the lack of an effective method for identifying and categorizing various types of seismic events at less important and important levels. Based on latest achievements of Data Mining international institutions such as Rexer-KDnugget-Gartner and also newest authentic articles, SVM, KNN, C4.5, MLP are from most important and popular and leading classifiers in data world.Therefor in present study, a boost learning system consisting support vector machine algorithms with linear regression, MLP Neural Network ، C4.5 decision tree and KNN near neighborhood have been utilized in a combined form to detect and categorize micro seismic events. In general, the steps involved in the proposed method are: 1) performing artificial seismic tests, 2) data gathering and analysis, 3) conducting preprocessing and separating training and testing samples, 4) generating relevant models with training samples and detecting and categorizing test samples and 5) extracting a cluster with the maximum candidate using boost learning. After simulations, it was observed that the accuracy of proposed boost method to the best answer was about 6.1% higher compare to other methods and the error rate was 0.082% of recalling. Accuracy of detection and classification to the best answer were also improved compare to other methods up to 2.31% and 6.34%, respectively.

The paper combines two new original concepts about eco-energetic systems. The first one is related to the M.E.N. (Mega-Eco-Nega-Watt) paradigm, which is based on three different but complementary ecological economic spaces: MEGAWATT, as needed energy, ECOWATT, as ecological energy, and NEGAWATT, as preserved energy, even the renewable energies and technologies, in the context of electrical energy production. The second concept presented in this paper is the eco-energetic efficiency, introduced in order to facilitate a correlation between the energetic efficiency of the system and a necessary, new defined ecological coefficient. The proposed formula for eco-energetic efficiency enables an interesting form of reporting to the different situations in which the input energy, output energy, lost energy and externalities, involved in an energetic process interact to produce energy in a specific energetic system, in connection with the circular economy model. Finally, is presented an original diagram of the energetic chains to produce electricity in a resilience regim, with high eco-energetic efficiency from originating in different primary energetic sources as external (gravitation & solar sources), fuels (classical & radioactive), internal sources and others. Even what kind of energetic sources are used to obtain electricity, as coals, gas, wood, hydropower, nuclear power, wind power, biomass, solar systems, and others, the entire process should be sustainable in what is the transdisciplinary integration of the different representative spheres as energy, socio-economy, ecology (environment), with the main core, sustainable education, inclueding the law and administrative aspects, as necessary fields of the knowledge based society/economy.

Gardasil 4, a human papilloma virus vaccine, has been shown to protect against various cancers, including cervical cancer. Common side effects include injection site pain, fever, headaches, and muscle aches. In some individuals, the severe side effect of postural orthostatic tachycardia syndrome (POTS) has been reported. POTS is characterized by the abnormal response of lightheadedness, blurry vision, and dizziness while transitioning to an upright posture. POTS predominately affects women, with more than eighty-five (85) percent of POTS patients being female. POTS on average, takes five years and eleven months to receive the diagnosis. Additionally, ​A strong association between POTS and Ehlers Danlos Syndrome Type III (EDS) exists. Eighty (80) percent of patients with EDS have POTS. This severe side effect dictates that providers need to be aware of this strong association of HPV vaccinations and POTS. ​In this report we will present a case of a young women with a past medical history significant for EDS type III who was diagnosed with POTS after receiving Gardasil 4 vaccination. This case demonstrates the need for physicians to be aware of the association of POTS with EDS type III and HPV vaccination. Physician awareness of the associations, signs and symptoms of POTS and earlier testing at the first presentation of signs and symptoms will limit the negative impact on patient’s quality of life.

Geopolitical situations, such as the Ukraine–Russia war, the Israel–Hamas war, and pandemics, can disrupt supply chains, such as the rerouting of oil tankers via South Africa to avoid the impact of the Israel–Hamas conflict. These events will probably occur again, but they are black swan events and difficult to predict. How can firms manage these events to minimise disruption to their supply chains? This paper proposes that a blockchain architecture has the potential to build resilience in supply chains and give them the flexibility to withstand the challenges of black swan events. The decentralisation ability of blockchain technology enables separation of the discrete elements of a sustainable supply chain so contagion does not impact the overall sustainable supply chain. To achieve flexibility in a sustainable supply chain ecosystem requires governance, leadership, and management. Also, artificial intelligence (AI), in conjunction with blockchain, is a technology that can enhance the flexibility and resilience of the supply chain. Thus, AI can act as a controller, co-ordinator, and an integrator in sustainable supply chain systems.

Weight and age interact to modify cognitive effects of head acceleration events after two seasons of youth football Abstract This is a follow-up study of youth American football players in a second season of play. Season-one findings identified a relationship between a head acceleration measure (HITsp) and cognitive score changes with weight modifying the effect in 9 to 10 year-olds. Sixty-eight youth completed a second season of play wearing helmet-mounted sensors and were assessed with neuropsychological tests pre- and post-season. Regression analysis of the full sample demonstrated a small but significant negative effect of HAE on cognition as indexed by test score changes: R2 = .06, F = 4.06, p = .024. Outcome differences between those who started playing at ages nine to 10, compared to those who started between 11 and 13 were identified: t(66) = -3.39, p<.01, d = -.84, 95th CI -2.77 to -.72. Regression models including players’ weights found that the relationship of weight to outcome was different by group: greater negative cognitive effects were found in younger-heavier players (R2 = 0.21, F =3.21, p = 0.03) and older-lighter players (R2 = 0.18, F =4.26, p <.001). These findings confirmed a negative relationship of HAE and cognitive change and point to player weight as an important developmental factor to consider in understanding concussion biomechanics.

Introduction and objectives: arrhythmogenic cardiomyopathy (ACM) is a hereditary heart disease defined by the progressive replacement of the ventricular myocardium with fibroadipose tissue, which can act as a substrate for arrhythmias, sudden death, or even give rise to heart failure (HF). Sudden death is frequently the first manifestation of the disease, particularly among young patients. The aim of this study is to describe a new pathogenic variant in the PKP2 gene. Methods: A descriptive observational study that included 8 initially non-interrelated families with a diagnosis of ACM undergoing follow-up at our HF and Familial Cardiomyopathies Unit, who were carriers of the NM_004572.3:c.775_776insG; p. (Glu259Glyfs*77) variant in PKP2 gene. The genetic testing employed next-generation sequencing for the index cases, and the Sanger method for the targeted study with family members. We compiled personal and family histories, demographic and clinical characteristics, data from the additional tests at the time of diagnosis, and arrhythmic events at diagnosis and during follow-up. Results: We included 47 subjects, of whom 8 were index cases (17%). Among the evaluated family members, 16 (34%) were carriers of the genetic variant, 3 of whom also had a diagnosis of ACM. The majority were women (26 patients; 55.3%), with a mean age on diagnosis of 48.9 ± 18.6 years, and a median follow-up of 39 [24-59] months. Worthy of note are the high incidence of arrhythmic events as the form of presentation and in follow-up (21.5% and 20.9% respectively), and the onset of HF in 25% of the sample. The most frequent ventricular involvements were right (4 patients 16.7%) and biventricular (4 patients 16.7%); we found no statistical differences in any of the variables analysed. Conclusions: This variant is a pathogenic variant of gene PKP2 that has not previously been described and is not present in the control groups associated with ACM. It has incomplete penetrance, a highly variable phenotypic expressivity, and was identified in 8 families of our geographical area in Malaga (Andalusia, Spain), where we can establish a founder effect and describe the clinical and risk characteristics.

Vagueira Beach on the Central Portuguese coast, is known as one of the places in Europe most affected by coastal erosion. The area has suffered more than 156 meters of coastline retreat over the period 1958 to 2001. With the aim to evaluate the influence of local factors on coastal erosion, this paper assesses the anthropogenic and natural factors that are related with the retreat of the coastline, by adopting statistical correlation and regression analyses. Through the Pearson's correlation coefficient (r) it was observed that local factors such as annual dredging at the Aveiro Port entrance (r = 0.93), the total length of groins in the Espinho-Vagueira section (r = 0.89), and storm events (r = 0.52) are directly related to coastline retreat in the area. A multiple linear regression model was developed in which coastline retreat is explained by these same factors over the period 1980 to 2006. With a coefficient of determination of R² = 0.91, it was observed that length of groins (significant at the 1% level), dredging of the port entrance (significant at the 5% level) and precipitation (as a proxy for storm events; significant at the 10% level) are significantly correlated with coastline retreat. Hence, it is shown that anthropogenic factors are the main drivers of coastline retreat in Vagueira Beach. This study provides an innovative approach for the assessment of coastal erosion, resulting in important information that can be used for decision-making related to coastal zone management as it allows to understand in greater detail the main drivers of coastal erosion.

Today, maritime transport is responsible for moving approximately 80 percent of the volume of world trade, which has favored Colombia, which, due to its geographical position, has managed to become one of the most competitive and dynamic economies in the world. South America. For this reason, this investigation is carried out in a port of their country, with the aim of identifying and analyzing restrictions or critical points that may cause delays in the unloading of goods, these would also cause delays in the loading of vehicles. To do this, it began with a diagnosis of the current situation through interviews with the operational personnel of the port, then a simulated model was designed in the ARENA software, in which it was observed that the weighing activities are where the queues were formed, this will cause a delay in the download. As possible solutions, it is recommended to senior management that a proper verification of the operation of the weighing equipment be carried out in order to unload goods more quickly. In addition, a replacement weighing equipment must be purchased. With this change, it would be possible to reduce inefficiencies or cost overruns caused by download delays, which are reducing the fluidity of the goods and the competitiveness of the organization

The urban museum has become a multi-functional institution that transcends the functional display of artifacts. The museum has become, in cities, a hybrid institution that keeps its doors open late to support a wide variety of special events. This study explored London’s ‘Museum Lates’ programs and event characteristics, using museums’ theoretical views as cultural tourism attractions. Furthermore, the study applied the contextual model of learning to understand visitor attendance motivations. Authors employed an interpretive approach using interviews with two types of participants, event visitors, and event coordinators. Findings suggested that attendees possess a complex of personal, physical, and socio-cultural motivations for participating in museum lates events. The characteristics of late events – extraordinary quality and evening time atmosphere – produce different effects than current museum exhibitions held during regular operating hours. Museum lates events can contribute to achieving cultural sustainability, adding cultural construct to the traditional three-pillars of sustainability. Keywords: Museums; special events; late opening; visitors' motivations; sustainability, touristic attractions

Adolescence is a critical developmental period associated with an increase in stress, the appearance of anxiety and depressive symptoms, and changes in sleep patterns. Even though the disruption of sleep patterns in stress and anxiety and depressive disorders is well known, the independent effects of childhood trauma and stressful life events on sleep patterns are less understood. We tested the independent effects of stress (childhood trauma and stressful life events) while controlling for anxiety and depression on adolescent sleep patterns. Seven hundred fifty-two adolescents completed self-report questionnaires about childhood trauma, stressful life events, anxiety, and depression. Four sleep factors identifying movement during sleep, sleep regularity, sleep disturbances and sleep pressure were extracted in the principal component analysis of sleep questions. Both childhood trauma and recent stressful life events were significantly associated with sleep disturbances before and after controlling for anxiety and depression.

The paper presents construction, laboratory tests as well as the first field application of a new fiber-optic rotational seismograph. The system based on fiber-optic gyroscope (FOG) with determined Angle Random Walk of the order of 10-8 rad/Sqrt(s) and a few rad/s maximum detectable amplitude of rotation in the frequency range from DC to 328.12 Hz. It has been designed for rotational seismology area of interest. This work also presents exemplary relevant measurements which were conducted using a set of two devices installed in the geophysical observatory in Książ, Poland.

In this study an adjusting post-processing approach is implemented for improving intra-hourly forecasts of solar power and ramp events of PV solar power systems at different locations in the United States. This study also serves as an out-of-sample test to evaluate the performance of the adjusting approach with different locations and timescales. Thus, various individual intra-hourly forecasts of solar power are combined and adjusted by applying the adjusting approach. Both point and probabilistic forecasts of solar power are included. After that, solar power ramp event forecasting by the adjusting approach is carried out.

Burning Man is probably the most famous art festival in the world. What started as a bonfire ritual for a small group of friends held on San Francisco beach in 1986, has evolved into an iconic event. Held annually for one week before the Labor Day weekend, the festival attracts over 60,000 participants each year and yields over $8 million in tickets and contributions.This preprint reveals some preliminary results from the economic analysis of Burning Man that is based on the unique data from over 500 surveys collected during several Burning Man events between 2012 and 2018.The paper’s main findings demonstrate that Burning Man is not some hippie get-together with lots of booze and drugs. Instead, it is a lucrative and exclusive event that is attended by bright, wealthy and well-educated people, both from the United States and abroad. A typical Burner is a 32-old childless male with a college degree and an average annual income above $100,000 who attended Burning Man at least two times before and who spends between $5,000 and $6,000 on tickets, fares, gear, and supplies.

The European Union Water Framework Directive (2000/60/EC; WFD) aims to achieve a good ecological and chemical status of all bodies of surface water by 2027. The development of an integrated guidance on surface water chemical monitoring (e.g. WFD Guidance Document No. 7/19) has been transferred into national German law (Ordinance for the Protection of Surface Waters, OGewV). For the majority of compounds, this act requires a monthly sampling frequency to assess the chemical water quality status of a surface water body. To evaluate the representativeness of the sampling strategy under the OGewV, high-frequency online monitoring data is investigated under different sampling scenarios and compared with current, monthly grab sampling strategy. About 23 million data points were analyzed for this study, three chemical parameters (dissolved oxygen, nitrate-nitrogen, chloride concentration) and discharge data were selected from four catchment of different sizes ranging from 51391 km² to 84 km² (Elbe, Vereinigte Mulde, Neiße and two stations at Lockwitzbach). In this paper we proposed short-term online-monitoring (STOM) as a sampling alternative. STOM considers the placement of online sensors over a limited duration and return interval. In general we: (I) compare the results of conventional grab sampling with STOM, (II) investigate the different performance of STOM and grab sampling using discharge data as proxy for analyzing event-mobilized pollutants and (III) investigate the related uncertainties and costs of both sampling methods. Results show, that STOM outperforms grab sampling for parameters where minimum/maximum concentrations are required by law as the probability to catch a single extreme value is higher with STOM. Furthermore, parameters showing a pronounced diurnal pattern, like dissolved oxygen, are also captured considerably better. The performance of STOM showed no substantial improvements for parameters with small concentration variability, as nitrogen-nitrate The analysis of discharge events as a proxy parameter for event-mobilized pollutants proved that the probability of capturing samples during events is significantly increased by STOM.

Keywords: Climate change, stress factors, Vitis spp., extreme climate events, sustainable agriculture

Background: There is considerable evidence to support the association between environmental tobacco smoke (ETS) exposure and children’s burden of disease. However, literature on the health outcomes of prenatal ETS exposure among Chinese children has not yet been comprehensively reviewed. Objective: This systematic scoping review examines the currently available evidence and identifies gaps for further research on the health consequences of prenatal ETS exposure among Chinese children. Methods: Following the JBI scoping review methodological framework, we conducted a computer-aid search of three electronic databases-- PubMed, EBSCOhost, and ProQuest to include studies from January 2011 to May 2023 that addressed the health outcomes of Chinese children whose mothers were exposed to ETS at any stage of the pregnancy. Further, a methodological quality assessment of the selected articles was conducted, using JBI Critical Appraisal Checklists. Results: A total of 30 articles were reviewed, including eleven high-quality studies and nineteen moderate-quality studies. Five main themes, including hypertension, foetal and children’s development, behavioural disorders, respiratory outcomes, and other health outcomes. Majority of studies showed positive link between prenatal ETS exposure and increase risk of preterm birth, and moderately, foetal growth restriction. Few studies explored other potential adverse outcome of ETS, including hypertension, respiratory morbidity, lung function and asthma in their children. Conclusion: The current available evidence on prenatal ETS exposure in Chinese children has unveiled a wide range of health outcomes, including preterm birth, foetal development, behavioural disorders and much more. However, Chinese studies in this area are still lacking and a gap still exists in relation to the strength of association between prenatal ETS exposure and some health risks. Efficient anti-smoking policies and smoking cessation programs should be developed to promote maternal and child health. Further research is also needed to provide better evidence in this field.

To investigate the intricate dynamics of brain activity when interacting with a dynamic environment, it is imperative to continuously generate and update expectations regarding forthcoming events and their corresponding sensory and motor responses. This study aims to explore the interconnectivity in time perception across predictable and unpredictable conditions. The necessary data for this study were acquired from EEG signals, sourced from an existing database that involved an experiment conducted on a group of healthy participants. The individuals were subjected to two distinct conditions, predictable and unpredictable, encompassing various time delays. The functional connectivity between brain regions was estimated using a method known as the phase lag index. This method was employed to discern disparities in time perception between the two conditions. A comprehensive comparison of the two conditions across different delays demonstrated noteworthy variations, particularly in the gamma, beta, and theta frequency bands. The differences between delays were more pronounced in the predictable condition. Subsequently, an in-depth analysis was conducted to scrutinize the dissimilarities between the conditions within each delay. Notably, significant differences were observed across all delays. In the unpredictable condition, an increase in connectivity was detected within the alpha band during the 400-ms delay, specifically between occipital and temporal regions. Moreover, the mean connectivity in the unpredictable condition surpassed that of the predictable condition. In the delta band, distinct connectivity patterns were observed across different delays, involving connections between central and frontal regions. Specifically, a heightened connectivity between central and prefrontal regions was noted during the 83-ms delay. Notably, the right hemisphere of the prefrontal cortex played a vital role in time perception. Furthermore, a decline in connectivity across the delta, theta, and beta bands was observed in both conditions during the longest delay (800 ms) when compared to other delays

Noctuidae is known to have high species diversity, although the genomic diversity of Noctuidae species have not been studied extensively. Investigation of transposable elements (TEs) in this family can improve our understanding on the genomic diversity of Noctuidae. In this study, we annotated and characterized genome-wide TEs in ten noctuid species belonging to seven genera. With multiple annotation pipelines, we constructed a consensus sequence library containing 1,038 –2,826 TE consensus. The genome content of TEs showed high variation in the ten Noctuidae genomes, ranging from 11.3% to 45.0%. The relatedness analysis indicated that the TE content, especially the content of LINEs and DNA transposons, are positively correlated with the genome size (r=0.86, p-value=0.001). We identified SINE/B2 as a lineage-specific subfamily in Trichoplusia ni, a species-specific expansion of LTR/Gypsy subfamily in Spodoptera exigua, and a recent expansion of SINE/5S subfamily in Busseola fusca. We further revealed that of the four TE classes, only LINEs showed phylogenetic signal with high confidence. We also examined how the expansion of TEs contributed to the evolution of noctuid genomes. Moreover, we identified a total of 56 horizontal transfer TE (HTT) events among the ten noctuid species and at least three HTT events between the nine Noctuidae species and 11 non-noctuid arthropods. One of HTT events caused by a Gypsy transposon might have caused the recent expansion of Gypsy subfamily in the S.exigua genome. By determining the TE content, dynamics, and HTT events in the Noctuidae genomes, our study emphasized that TE activities and HTT events had substantial impacts on the Noctuidae genome evolution.

Background and Aim: Cancer is a disease characterized by uncontrolled cell growth and invasion of tissues. It seems that personality differences and psychological factors are important factors that lead to different reactions to cancer. Therefore, the main purpose of the present study was to investigate the relationship between type D, stress level of life events, personality traits, and anxiety sensitivity in people with breast cancer attending to Tehran Bu-ali Hospital. Methods: The study was a correlational study in which 100 cancer patients referred to Bu-ali Hospital in Tehran, selected by the available sampling method from April to June 2018. The tools used included the Denollet DS-14 Type D Questionnaire, the Paykel Life events Questionnaire, the Eysenck Personality Questionnaire, the ASI Anxiety Scale, Floyd et al., Data analysis in this study is taken place by using SPSS software, two descriptive levels (percentage, frequency, etc.) and regression. Results: The study results showed that there is a relationship between type D personality with stress of life events, neurosis, extraversion, and psychopath dimensions of personality and anxiety sensitivity in breast cancer patients. Conclusion: Psychological factors play a role in the incidence and exacerbation of breast cancer, and ultimately patients with personality type D and personality traits such as psychosis and high anxiety sensitivity and more stress of life events show more symptoms.

Neuromuscular adverse events following cancer treatment with anti-programmed cell death protein 1 (PD-1) monoclonal antibodies are relatively rare, yet potentially fatal. Using the PRISMA approach, we performed a systematic review to characterize the clinical presentation, diagnostic workup, and management of neuromuscular disorders (NMDs) in patients treated with nivolumab or pembrolizumab. Sixty-three publications on 85 patients (mean age 66,9 years (range 34–86); male/female 2.6:1; 59% metastatic melanoma) were identified from selected indexing databases until June 2018. Forty-eight patients had received nivolumab and 39 pembrolizumab. The mean number of PD-1 inhibitor treatment cycles prior to onset of symptoms was 3,6 (range 1–28). Symptoms included oculomotor (47%); respiratory (43%), bulbar (35%), and proximal weakness (35%); as well as muscle pain (28%). Diagnoses were categorized as myasthenia gravis (27%), neuropathy (23%), myopathy (34%) and a combination of these (16%). After critical review of the data, however, evidence did not support the stated NMD diagnosis in 13% of cases, while up to 14% of patients had signs of additional NMDs. PD-1 inhibitor associated myasthenia was associated with cardiac complications in almost 30% of patients and with a more rapid clinical progression compared with idiopathic myasthenia. Mortality was high despite adequate treatment strategies including corticosteroid, IV immunoglobulins and plasmapheresis. In conclusion, clinical presentation of NMDs associated with PD-1 inhibitors is often atypical, with significant overlap between myasthenia gravis and myopathy; and cardiac/respiratory complications are common, leading to more severe disease courses than idiopathic myasthenia.

Turnovers in the National Football League (NFL) occur whenever a team loses possession of the ball due to a fumble, or an interception. Turnovers disrupt momentum of the offensive team, and represent lost opportunities to advance downfield and score. Teams with a positive differential turnover margin in a given game win $70\%$ of the time. Turnovers are statistically rare events, occurring apparently randomly. These characteristics make them difficult to predict. This investigation advances the hypothesis that turnovers are predictable in NFL football. Machine learning models are developed to learn the concept: At any point within a football game, what is the likelihood that a turnover will be observed on the next play from scrimmage? Results presented suggest evidence to support the working hypothesis. Under certain conditions, both fumbles and interceptions can be anticipated at low false discovery rates (less than $15\%$). This approach may be useful to inform in-game strategies to mitigate the negative consequences of turnovers by an offensive team, or to maximize their probability by a defensive squad.

Assessment of extreme events and climate change on reservoir inflow is important for water and power stressed countries. Projected climate is subject to uncertainties related to climate change scenarios and Global Circulation Models (GCMs’). Extreme climatic events will increase with the rise in temperature as mentioned in the AR5 of the IPCC. This paper discusses the consequences of climate change that include extreme events on discharge. Historical climatic and gauging data were collected from different stations within a watershed. The observed flow data was used for calibration and validation of SWAT model. Downscaling was performed on future GCMs’ temperature and precipitation data, and plausible extreme events were generated. Corrected climatic data was applied to project the influence of climate change. Results showed a large uncertainty in discharge using different GCMs’ and different emissions scenarios. The annual tendency of the GCMs’ is bi-vocal: six GCMs’ projected a rise in annual flow, while one GCM projected a decrease in flow. The change in average seasonal flow is more as compared to annual variations. Changes in winter and spring discharge are mostly positive, even with the decrease in precipitation. The changes in flows are generally negative for summer and autumn due to early snowmelt from an increase in temperature. The change in average seasonal flows under RCPs’ 4.5 and 8.5 are projected to vary from -29.1 to 130.7% and -49.4 to 171%, respectively. In the medium range (RCP 4.5) impact scenario, the uncertainty range of average runoff is relatively low. While in the high range (RCP 8.5) impact scenario, this range is significantly larger. RCP 8.5 covered a wide range of uncertainties, while RCP 4.5 covered a short range of possibilities. These outcomes suggest that it is important to consider the influence of climate change on water resources to frame appropriate guidelines for planning and management.

Background: Approximately 75% of all head and neck cancer patients are treated with radiotherapy (RT). RT to the oral cavity results in acute and late adverse events which can be severe and detrimental to a patient’s quality of life and function. The purpose of this study was to explore associations between RT dose to a defined oral cavity organ at risk (OAR) avoidance structure, provider and patient reported outcomes (PROs), opioid use, and hospitalization. Methods: This was a retrospective analysis of prospectively obtained outcomes using multivariable modeling. The study included 196 patients treated with RT involving the oral cavity for a head and neck tumor. A defined oral cavity OAR avoidance structure was used in all patients for RT treatment planning. Validated PROs were collected prospectively. Opioid use and hospitalization were abstracted electronically from medical records. Results: Multivariable modeling revealed the mean dose to the oral cavity OAR was significantly associated with opioid use (p=0.0082) and hospitalization (p=0.0356) during and within 30 days of completing RT. Conclusion: The findings of this study may be valuable in RT treatment planning for patients with tumors of the head and neck region to reduce the need for opioid use and hospitalization during treatment.

Globally mangrove forests are substantially declining and a globally synthesized database of the drivers of deforestation and drivers’ interaction is scarce. Here we synthesized the key social-ecological drivers of global mangrove deforestation by reviewing about two hundred published scientific studies over the last four decades (from 1980 to 2021). Our focus was on both natural and anthropogenic drivers with gradual and abrupt impacts and their geographic ranges of effects and how these drivers interact. We also summarized the patterns of global mangrove coverage decline between 1990 and 2020 and identified the threatened mangrove species and their geographic ranges. Our consolidated studies reported a 8,600 km2 decline in the global mangrove coverage between 1990 and 2020 with the highest decline occurring in South and Southeast Asia (3870 km2). We could identify 11 threatened mangrove species, two of which are critically endangered (Sonneratia griffithii and Bruguiera hainseii). Our reviewed studies pointed to aquaculture and agriculture as the predominant driver of global mangrove deforestation though the spatial distribution of their impacts varied. Gradual climate variations, i.e. seal-level rise, long-term precipitation and temperature changes and driven coastline erosion, constitute the second major group of drivers. Our findings underline a strong interaction across natural and anthropogenic drivers with the strongest interaction between the driver groups aquaculture and agriculture and industrialization and pollution. Our results suggest prioritizing globally coordinated empirical studies linking drivers and mangrove changes and a global development of policies for mangrove conservation.

Natural circulation loop (NCL) systems are buoyancy-driven heat exchangers that are used in various industrial applications. The concept of passive heat exchange in NCL systems is attractive, because there is no need for an externally driven equipment (e.g., a pump) to maintain the fluid circulation. However, relying on buoyancy as the sole driving force may lead to several potential difficulties, one of which is generation of (possibly) time-varying nonlinearities in the dynamical system, where a difference in the time scales of heat transfer and fluid flow causes the flow to change from a steady-state regime to either an oscillatory regime or a flow-reversal regime, both of which are undesirable. In this paper, tools of symbolic time series analysis (e.g., probabilistic finite state automata (PFSA)) are proposed to identify selected regimes of operation in NCL systems, where the underlying principle is built upon the concept of pattern classification from measurements of fluid-flow dynamics. The proposed method is shown to be capable of identifying the current regime of operation from the initial time response under a given set of operational parameters. The efficacy of regime classification is demonstrated by testing on two data sets, generated from numerical simulation of a MATLAB SimuLink model that has previously been validated with experimental data. The results of the proposed PFSA-based classification are compared with those of a hidden Markov model (HMM) that serves as the baseline.

Transposable elements (TEs) are mobile genetic elements capable of rapidly altering the genome through their movements. The importance of TE activity has been documented in many biological processes, such as introducing genetic instability, altering patterns of gene expression, and accelerating genome evolution. Increasing appreciation of TEs results in the growing number of bioinformatics software to identify insertion events. However, the application of existing TE finding tools is limited by either narrow-focused design of the package, too many dependencies on other tools, or prior knowledge required as input files that may not be readily available to all users. Here, we report a simple pipeline, TEfinder, developed for the detection of new TE insertions with minimal software dependencies using four inputs that can be easily generated with popular variant calling pipelines. The external software requirements are BEDTools, SAMtools, and Picard. Necessary inputs include TEs present in the reference genome, binary paired-end alignment, reference genome index, and a list of TE names. We tested TEfinder pipeline among several evolving populations of Fusarium oxysporum generated through a short-term adaptation study. Our results demonstrate that this easy-to-use tool can effectively detect new TE insertion events, making it accessible and practical for TE analysis.

In a recent paper [1], I argued against backward in time effects used by several authors to explain delayed choice experiments. I gave an explanation showing that there is no physical influence propagating from the present to the past and modifying the state of the system at a time previous to the measurement. However, though the solution is straightforward in the case of delayed choice experiments involving only one particle, it is subtler in the case of experiments involving two entangled particles because they give rise to EPR-like situations. Considering that a measurement is not an actual change of the physical state of a system and is relative to the observer allows to understand that there is neither backward in time effects nor instantaneous collapse of the second system when the first one is measured, as is often postulated. This allows also to get rid of any non-locality [2]. In this paper, I want to go further into the consequences of this way of considering the measurement, that I have called Convivial Solipsism, and show that even if, in the usual sense, there is no physical effect of the present or of the future on the past, we must nevertheless consider that the observer’s past is sometimes not entirely determined and that it becomes determined only when certain measurements are done latter. This apparent contradiction disappears if one understand that each observer builds, through her own measurements, her own world (that I call the phenomenal world in Convivial Solipsism) which is different from what we are used to consider as the common world shared by everybody.

Numerous studies were published suggesting that troponin level is related to adverse outcomes in chronic cardiac and non-cardiac conditions. Our study investigated whether troponin levels gathered from an unselected blood sample taken during outpatient care are associated with adverse outcomes in a population with stable coronary artery disease. In a cohort of 949 patients with stable coronary artery disease, average age of 67.5 ± 9.5 years, 69.5% male, 52.1% diabetics, 51.6% with previous myocardial infarction, 57.9% with triple-vessel disease, 21.7% of patients encountered new events during an average period of monitoring of 2.07 ± 0.81 years. Troponin I/99th percentile categorized into tertiles emerged as an independent predictor of death and combined events risk (hazard ratio: 2.02 (1.13-3.60), p=0.017; 2.30 (1.37-3.88, p=0.002, respectively). A troponin ratio > 0.24 was able to identify 53.3% of patients at risk of death and heart failure hospitalization. In patients with stable coronary artery disease and adherent to treatment, troponin level is independently associated with death and heart failure hospitalization in a medium-term follow up.

Background: As the world tends to recover from the crisis created by the COVID-19 pandemic, vaccines have served as one of the most valuable tools of combat and large-scale immunization has helped to tide over the catastrophe. However, several reports of post -vaccination neurological complications around the globe have surfaced up in recent literature. This study was conducted with an aim to describe the spectrum of neurological ailments requiring hospitalization following COVID-19 vaccination.Methods: An ambispective observational study was carried out from March 2021 to February 2022 at a tertiary care institute with 25 patients who satisfied the inclusion criteria of a new onset neurological illness requiring hospitalization within 4 days to 42 days of vaccination. The patients were duly followed upto months after discharge.Results: The median age of the sample was 36 years and the median latency of onset of neurological events was 14 days. Guillain-Barré syndrome was documented in 11 patients; majority were acute motor axonal neuropathy (45.45%) followed by acute inflammatory demyelinating polyradiculoneuropathy (36.36%) and acute motor sensory axonal neuropathy (18.18%). Central nervous system demyelination was reported in 9 patients; two patients had acute disseminated encephalomyelitis, 2 patients were diagnosed with myelin oligodendrocyte glycoprotein antibody-associated disease, one patient with aquaporin-4 positive neuromyelitis optica spectrum disorder , and the rest were labelled as seronegative central nervous system demyelination. Vascular events were noted in 5 patients comprising of 2 cases each of cerebral venous sinus thrombosis and intracerebral hemorrhage and a case of Moyamoya angiopathy. All patients were conservatively managed and had a complete to partial recovery suggestive of a favorable outcome after 3 months. Conclusion: The pathomechanisms of post -vaccination neurological complications is yet to be elucidatedand any causal association attributable to vaccination warrants further research. Compared to the enormity of the vaccinated population, the adverse effects are miniscule to hinder and discourage vaccination.

The software design of autonomous vehicles (AVs) incorporates artificial intelligence (AI) characteristics to enhance their safety and overall driving performance. Central to vehicle’s operation is the ability to reason effectively in complex and uncertain environments. However, traditional logical systems, such as monotonic logic, often struggle to handle the inherent uncertainties and exceptions encountered in real-world scenarios. This paper proposes the utilization of non-monotonic logic in order to enhance the reasoning capabilities of autonomous vehicles. By incorporating non-monotonic reasoning, vehicles can navigate intricate traffic scenarios, make plausible inferences, and adapt their decisions when faced with conflicting information. This research aims to provide a comprehensive review of non-monotonic logic's application in autonomous vehicles, highlighting its advantages over traditional logical systems and its potential impact on safety and performance. Additionally, through this research, we seek to contribute to the advancement of autonomous driving technology by enhancing the reasoning capabilities of vehicles in various scenarios, such as car- following related to critical safety events. The personalized cognitive agent is proposed in driving behavior to consider particularly in their assumptions of homogeneous drivers. The personalized cognitive agent is incorporating heterogeneous driving behaviors, based on individual user preferences, characteristics, and needs. Driving behavior is a complex interplay of various factors, encompassing both human and external elements. Human factors, including age, experience, and gender, contribute significantly to how individuals navigate the roads. These factors influence decisions, reactions, and risk-taking tendencies on the part of drivers. Additionally, external factors such as weather conditions further compound this intricate dynamic, requiring drivers to adapt their behavior to the prevailing environment. The goal of a personalized cognitive agent is to provide tailored and customized experiences to cognitive vehicles, taking into account the unique requirements and individual preferences of occupants inside autonomous vehicles.

Background: In 1962, Susser and Stein observed that the mortality rates of peptic ulcers in England and Wales increased markedly in the 1910s, maintained at a high level during the 1910s-1940s, and began to decline steadily since the early 1950s. They termed this epidemic pattern a birth-cohort phenomenon, but its mechanism has never been elucidated. Susser and Stein speculated that the occurrences of extraordinary social environmental factors roughly fit the fluctuations, but the role of environmental factors in peptic ulcers has never been identified. Objectives: This study aims to elucidate the mechanism of the birth-cohort phenomenon of peptic ulcers and identify the role of environmental factors in the disease. Methods: Starting from an etiology identified recently, this study uses the two inverse operations in calculus, differentiation, and integration, to analyze the existing data. First, a fluctuation curve in the birth-cohort phenomenon is differentiated into multiple annual mortality rates caused by individual environmental factors. Second, these annual mortality rates are integrated to reproduce the fluctuation curve in the birth-cohort phenomenon. Results: The differentiation reveals a parallel relationship between the psychological impacts of environmental factors and the mortality rates of peptic ulcers, whereas the integration reproduces a representative fluctuation curve in the birth-cohort phenomenon. The successive occurrences of multiple social environmental factors from the 1910s to 1940s maintained the increase in mortality rates, while the sustained improvements in living environments explained the steady decline of the mortality rates from the early 1950s. Conclusion: The parallel relationship suggests a causal role of environmental factors in peptic ulcers, whereas the reproduction of a representative fluctuation curve indicates that multiple environmental factors caused the birth-cohort phenomenon by Superposition Mechanism. Significantly, this study challenges the current reductionist approach used to study disease in modern medicine by demonstrating the effectiveness of an opposite methodological concept focused on integration.

Atrial fibrillation (AF) is a common arrhythmia associated with various risk factors and significant morbidity and mortality. This article presents findings from a study involving 115 patients with permanent AF. The study examined demographics, risk factors, associated pathologies, complications, and anticoagulant therapy. The results showed a slight predominance of AF in males, with the highest incidence in individuals aged 75 and above. Common risk factors included arterial hypertension, dyslipidaemia, diabetes mellitus type 2, and obesity. Comorbidities such as congestive heart failure, mitral valve regurgitation, and pulmonary disorders were prevalent among the patients. Major complications included congestive heart failure, stroke, and myocardial infarction. Thromboembolic and bleeding risk assessment using CHAD2DS2-VASc and HAS-BLED scores demonstrated a high thromboembolic risk in all patients. The majority of patients were receiving novel oral anticoagulants (NOACs) before admission, while NOACs were also the most prescribed antithrombotic therapy at discharge. The study highlights the importance of risk factor management and appropriate anticoagulant therapy in AF patients to reduce complications and improve outcomes.

Based on the daily observation data of 2254 meteorological stations in China from 1961 to 2021 after homogenization and correction, the extreme value analysis method that combines relative threshold and absolute threshold was used to identify extreme climate events in the mainland of China, namely extreme high temperature, extreme low temperature, extreme drought, extreme precipitation and extreme typhoon events. The frequency and linear variation trends of individual extreme events in the past 60 years were investigated. On this basis, the multi extreme events composite risk grade index (MXCI) was constructed, which can objectively reflect the comprehensive characteristics of multi extreme climate events in different regions. The results show that the high value areas of MXCI were mainly located in Southeast China and Southwest China. The MXCI presented a decreasing trend in most of the western and southeastern regions of China, while an increasing trend from Southwest China to the south of Northeast China, due to the frequent occurrence of extreme high temperature, extreme drought and other extreme events in these regions.

Tyrosine kinase inhibitors (TKI) and immune checkpoint inhibitors (ICI) significantly improve the outcomes of patients with advanced clear cell renal cell carcinoma (ccRCC), but high-grade toxicities can occur, particularly during combination therapy. Herein, we report a patient with advanced metastatic ccRCC, who developed grade 4 cholestasis during combined therapy with nivolumab and cabozantinib. After the exclusion of common disorders associated with choles-tasis and a failure of corticosteroids (CS), a liver biopsy was performed that demonstrated severe ductopenia. Consequently, a diagnosis of vanishing bile duct syndrome related to TKI and ICI administration was made, resulting in CS discontinuation and ursodeoxycholic acid administra-tion. After a 7-months follow-up, liver tests had returned to normal values. Immunological studies revealed that our patient had developed robust T-cells and macrophages infiltrates in his lung metastasis, as well as in skin and liver tissues at the onset of toxicities. At the same time, peripheral blood immunophenotyping revealed significant changes in T-cell subsets suggesting their potential role in the pathophysiology of the disease.

Water is essential to all life-forms including various ecological, geological, hydrological, and climatic processes/activities. With changing climate, associated El Nino/Southern Oscillation (ENSO) events appear to stimulate highly uncertain patterns of precipitation (P) and evapotranspiration (EV) processes across the globe. Changes in P and EV patterns are highly sensitive to temperature variation and thus also affecting natural streamflow processes. This paper presents a novel suite of stochastic modelling approaches for associating streamflow sequences with climatic trends. The present work is built upon a stochastic modelling framework HMM_GP that integrates a Hidden Markov Model with a Generalised Pareto distribution for simulating synthetic flow sequences. The GP distribution within HMM_GP model is aimed to improve the model's efficiency in effectively simulating extreme events. This paper further investigated the potentials of Generalised Extreme Value Distribution (EVD) coupled with an HMM model within a regression-based scheme for associating impacts of precipitation and evapotranspiration processes on streamflow. The statistical characteristic of the pioneering modelling schematic has been thoroughly assessed for their suitability to generate/predict synthetic river flows sequences for a set of future climatic projections. The new modelling schematic can be adapted for a range of applications in the area of hydrology, agriculture and climate change.

Flying-fox populations are increasingly threatened by heat events, starvation events and other stressors due to habitat clearing and human/flying-fox conflict.These factors are unlikely to resolve, meaning that a well-coordinated and timely approach to flying-fox disasters is imperative for the mitigation of further flying-fox population impacts.

This study aims to explore the associations between pediatric adverse events (PAEs) and hospital and patient characteristics within the inpatient hospital setting, focusing solely on the framework of pediatric quality indicators (PDIs) from the Agency for Healthcare Research and Quality (AHRQ). Specifically, the study focuses on NQI 03 Neonatal Blood Stream Infection (NBSI). The analysis utilizes discharge data from the Healthcare Cost and Utilization Project (HCUP) Kids’ Inpatient Databases (KID) for the year 2019. Through this analysis, the study seeks to answer research questions regarding associations between hospital characteristics and patient characteristics with NQI 03. The methodology employs bivariate and multivariate logistic regression models to analyze patient-level encounters of NBSI. The results indicate that smaller, rural, and non-teaching hospitals exhibit significantly lower odds of NQI 03 compared to large hospitals. Various individual factors such as gender, age, race, service lines, payment sources, and major operating room procedures also demonstrate differing levels of significance in relation to NQI 03, warranting further investigation. This study provides contextual expansion on the findings and offers valuable insights into PAEs in the inpatient hospital setting, specifically focusing on NBSI within the PDIs framework. It highlights areas for developing evidence-based interventions and guidelines for clinicians and policymakers. Ultimately, the findings contribute to the growing understanding of factors influencing NBSI and emphasize the importance of targeted strategies for improving pediatric patient safety.

We present a case of a 47-year-old male who died unexpectedly from acute pulmonary hemorrhage 555 days after completing the BNT162b2 (Pfizer) COVID-19 vaccination primary series. Before death, he exhibited symptoms of a mild respiratory infection. Despite a healthy medical history and no medication use, the patient’s condition rapidly deteriorated and he experienced severe respiratory distress, followed by cardiopulmonary arrest with evidence of profuse pulmonary bleeding. Autopsy findings revealed massive lung congestion without embolism, normal heart size, moderate coronary atherosclerosis without myocardial infarction, and no evidence of other hemorrhagic events. The patient tested negative for COVID-19 and other respiratory pathogens at autopsy. Despite these findings, the medical examiner determined the cause of death was attributed to atherosclerotic and hypertensive cardiovascular disease, without considering the recent pulmonary hemorrhage and unremarkable medical history. Investigation into the vaccine batch indicated a higher-than-average number of serious adverse events, including fatalities. The patient's BNT162b2 batch was among the top 2.8% for reported deaths. Moreover, the autopsy failed to investigate potential contributions from the vaccine, such as the presence of the Spike protein or related antibodies. The evidence suggests that the pulmonary hemorrhage, exacerbated by a viral infection, was the immediate cause of death, with the COVID-19 vaccine potentially playing a role in the development of cardiopulmonary pathology and hemorrhage. We propose autopsy protocols for COVID-19 vaccine recipients to better investigate vaccine-related pathologies among those with one or more prior injections.

This study assesses coastal flooding extension mapping based on two innovative approaches. The first is based on the coupling of two robust numerical models (SWASH and LISFLOOD), in this case, discharges were extracted from the wave overtopping results from SWASH 1D and set as boundary conditions for LISFLOOD on the crest of an existing seawall where overtopping typically occurs. The second, hereby called the ‘Tilted Bathtub Approach’ (TBTA), is based on wave run-up levels and buffering the affected area of a prior flooding event, adjusting it for expected sea-states according to different return periods. The proposed approaches are applied to a case study on the Northern Portuguese coast, at Furadouro beach, in the municipality of Ovar, which has been facing multiple flooding episodes throughout recent years, including a dramatic storm in February 2014. This event was used as validation for the proposed methods. A 30 years long hourly local wave climate time series was used both to perform an extreme value analysis in order to obtain expected sea-states according to different return periods, and also for performing a sensitivity test for established empirical formulas to estimate wave run-up at this particular case. Results indicate both approaches are valuable: they yield coherent flood extension predictions that align well with the real inundated area from the 2014 storm. The convergence of these findings underscores the potential for these methods in future coastal flood risk assessment and planning.

Background: no reports have examined the profile of drug-induced dysphagia in detail. The goal of this study was to investigate if there are any differences in the profiles of drug-induced dysphagia. Methods: This study used the Japanese Adverse Drug Event Report (JADER) database. Further, reported odds ratios (RORs) were used to analyze data on adverse drug events from 2004 to 2021. The top ten drugs with the most drug-induced dysphagia occurrences were used as target drugs. The association between RORs and drug-induced dysphagia caused by the target drugs was evaluated, and the age distribution and time of onset of drug-induced dysphagia for each drug were compared. RORs were the primary endpoint. Moreover, age and time of onset of drug-induced dysphagia were secondary outcomes. Results: In total, 756,965 reports were analyzed. All the target drugs were associated with drug-induced dysphagia. Among them, cevimeline was a novel finding, as no dysphagia was observed during the clinical trial. For most drugs, the onset of drug-induced dysphagia was occurring within approximately 25 days of administration. However, even after long-term use, paroxetine and milnacipran were associated with drug-induced dysphagia. Conclusion: The onset profile of drug-induced dysphagia may differ from one drug to the next.

Cropland area is closely related to food production. More previous focuses were paid on impacts of extreme events on food production, but less on cropland dynamics. This study took the Farming-Pastoral Ecotone of Northern China (FPEN) as a case area, to investigate its cropland area dynamics and driving factors in view of perspectives of extreme events, environmental conditions, socioeconomic development, urban expansion, and ecological construction. We used ridge regression approach to quantify contributions of these drivers to cropland area dynamics. Results showed that cropland area increased significantly at a rate of 333.5km2/a during 1992−2020 and were spatially clustered in east of the FPEN. Impact extent and size each driving factor on cropland trend presented large spatiotemporal differences, but ecological construction (EC) had overall the greatest impact on cropland area changes, followed by urban expansion (UE). In comparison, TL10p has the smallest. UE-dominated areas increased 41.9% since 2010s, but still less than EC. Furthermore, we found that extreme events effects on cropland area trend evidently increased. Particularly, TH90p displayed the most increase (~99.4%). Cropland area changes dominated by extreme temperature events in 2010−2020 increased nearly six times than that in 1992−2010. These findings suggest that increasing impacts of extreme weather events on cropland area changes should be cautioned.

In an era of unparalleled technical advancement, the pharmaceutical industry is struggling to transform data into increased research and development efficiency, and as a corollary, new drugs for patients. Here, we briefly review some of the commonly discussed issues around this counterintuitive innovation crisis. Looking at both industry and science related factors, we posit that traditional preclinical research is front-loading the development pipeline with data and drug candidates that are unlikely to succeed in patients. Applying a first principles analysis, we highlight the critical culprits and provide suggestions as to how these issues can be rectified through pursuit of a Human Data-driven Discovery (HD3) paradigm. Consistent with other examples of disruptive innovation, we propose that new levels of success are not dependent on new inventions, but rather the strategic integration of existing data and technology assets. In support of these suggestions, we highlight the power of HD3, through recently published proof-of-concept applications in the areas of drug safety analysis and prediction, drug repositioning, rational design of combination therapies and the global response to the Covid19 pandemic. We conclude that innovators must play a key role in expediting the path to a largely human focused, systems-based approach to drug discovery and research.

Corona viruses cause extensive SARS epidemics via super spread events (SSE). Due to variation in infection risk and heterogeneity of reproduction numbers specific distinction between SSE’s and typical case events is essential. SARS transmissions unveil a complex scenario in which SSE’s are shaped by multiple factors. Specific screening strategies for infection emergence within potential super spreading groups will help to efficiently control the SARS-2 pandemic and alleviate the partially effective general restriction measures.

Traditional flood hazard analyses often rely on univariate probability distributions; however, in many coastal catchments, flooding is the result of complex hydrodynamic interactions between multiple drivers. For example, synoptic meteorological conditions can produce considerable rainfall-runoff, while also generating wind-driven elevated sea levels. When these drivers interact in space and time, they can exacerbate flood impacts; this phenomenon is known as compound flooding. In this paper, we build a Bayesian Network based on Gaussian copulas to generate the equivalent of 500 years of daily stochastic boundary conditions for a coastal watershed in Southeast Texas. In doing so, we overcome many of the limitations of conventional univariate approaches and are able to probabilistically represent compound floods caused by riverine and coastal interactions. We calculate the resulting water levels using a 1D steady-state hydraulic model and find that flood stages in the catchment are strongly affected by backwater effects from tributary inflows and downstream water levels. By comparing with a bathtub modeling approach, we show that simplifying the multivariate dependence between flood drivers can lead to an underestimation of flood impacts, highlighting that accounting for multivariate dependence is critical for the accurate representation of flood risk in coastal catchments prone to compound events.

All types of sports are potential application scenarios for automatic and real-time visual object and event detection. In rink hockey, the popular roller quad skate variant of hockey team sports, it is of great interest to automatically track player’s movements and positions, player’s sticks and, also, making other judgments, such as being able to locate the ball. In this work, we introduce a real-time pipeline composed by an object detection model, created specifically for rink hockey games, followed by a knowledge-based event detection module. Even in the presence of occlusions and quick motions, our deep learning object detection model effectively identifies and tracks, in real-time, important visual elements such as: ball; players; sticks; referees; crowd; goalkeeper; and goal. Using a curated dataset composed by a collection of videos of rink hockey, comprising 2525 annotated frames, we trained and evaluated the algorithm performance and compare it to state of the art object detection techniques. Our object detection model, based on YOLOv7, presents a global accuracy of 80%, and presents a good performance in terms of accuracy and speed, according to our results, making it a good choice for rink hockey applications. In our initial tests, the event detection module successfully detected one important event type in rink hockey games, the occurrence of penalties.

Hyperhomocysteinemia (HHcys) is recognized as an independent risk factor for various significant medical conditions, yet controversy persists around its assessment and management. The diagnosis of disorders affecting homocysteine (Hcys) metabolism faces delays due to insufficient awareness of its clinical presentation and unique biochemical characteristics. In cases of arterial or venous thrombotic vascular events, particularly with other comorbidities, it is crucial to consider moderate to severe HHcys. A nutritional approach to HHcys management involves implementing dietary strategies and targeted supplementation, emphasizing key nutrients like vitamin B6, B12, and folate crucial for Hcys conversion. Adequate intake of these vitamins, along with betaine supplementation, supports Hcys remethylation. Lifestyle modifications, such as smoking cessation and regular physical activity, complement the nutritional approach to enhance Hcys metabolism. For individuals with HHcys, maintaining a plasma Hcys concentration below 50 μmol/L consistently is vital to lower the risk of vascular events. Collaboration with healthcare professionals and dietitians is essential for developing personalized dietary plans addressing specific needs and underlying health conditions. This integrated approach aims to optimize metabolic processes and reduce the associated health risks.

Extreme value analysis (EVA) is well-established to derive hydrometeorological design values for infrastructure that has to withstand extreme events. Since there is evidence of increased extremes with higher hazard potential under climate change, alterations of EVA are introduced for which statistical properties are no longer assumed to be constant but vary over time. In this study, both stationary and non-stationary EVA models are used to derive design life levels (DLLs) of daily precipitation in the pre-alpine Oberland region of Southern Germany, an orographically complex region characterized by heavy precipitation events and climate change. As EVA is fraught with uncertainties, it is crucial to quantify its methodological impacts: two theoretical distributions (i.e., Generalized Extreme Value (GEV) and Generalized Pareto (GP) distribution), four different parameter estimation techniques, (i.e., Maximum Likelihood Estimation (MLE), L-moments, Generalized Maximum Likelihood Estimation (GMLE), and Bayesian estimation method) are compared. Discrepancies due to the parameter estimation methods may reach up to 45 % of the mean absolute value, while differences between stationary and non-stationary models are of the same magnitude (differences in design levels up to 40%). Despite the underlying large methodological uncertainties, there is a robust tendency for increased DLLs in the Oberland region towards the end of this century based on the (non-)stationary models.

Many estuarine ecosystems and the fish communities that inhabit them have undergone substantial changes in the past several decades, largely due to multiple interacting stressors that are often of anthropogenic origin. Few are more impactful than droughts, which are predicted to increase in both frequency and severity with climate change. In this study, we examined over five decades of fish monitoring data from the San Francisco Estuary, California, U.S.A, to evaluate the resistance and resilience of fish communities to disturbance from prolonged drought events. High resistance was defined by the lack of decline in species occurrence from a wet to a subsequent drought period, while high resilience was defined by the increase in species occurrence from a drought to a subsequent wet period. We found some unifying themes connecting the multiple drought events over the fifty-year period. Pelagic fishes consistently declined during droughts (low resistance), but exhibit a considerable amount of resiliency and often rebound in the subsequent wet years. However, full recovery does not occur in all wet years following droughts, leading to permanently lower baseline numbers for some pelagic fishes over time. In contrast, littoral fishes seem to be more resistant to drought and may even increase in occurrence during dry years. Based on the consistent detrimental effects of drought on pelagic fishes within the San Francisco Estuary and the inability of these fish populations to recover in some years, we conclude that freshwater flow remains a crucial but not sufficient management tool for the conservation of estuarine biodiversity.

The VisionCube is a 2-unit CubeSat developed in-house, of which the primary mission is aimed at detecting the occurrence of transient luminous events in the upper atmosphere and obtaining corresponding images from the low Earth orbit. An on-board TLE observation system of the VisionCube cubesat is designed and developed by incorporating a photon-sensitive MaPMT and a CMOS image sensor. Also, a distinctive TLE observation software which enables detecting the TLEs and capturing images in a timely manner is devised. By taking into account the limited resources of a small CubeSat in size and power, the on-board observation system is developed employing a system-on-chip design architecture by which both hardware and software can be integrated seamlessly. The purpose of this study is to investigate the functionality of the hardware and the validity of the software algorithm to show the on-board system will operate properly with no human intervention during the space operation. To this end, a ground simulation facility is constructed to emulate the space environment of the TLE occurrence using a set of UV LEDs inside a darkbox. Based on the analysis of the spectral and temporal properties of the TLEs, the randomly generated UV LED pulses are opted for verification scenarios for the TLE observation system. The validation results show that the hardware and the software algorithm of the on-board observation system can effectively detect the TLEs and obtain the images during the on-orbit operation.

Background: Despite a range of available treatments, there is a remaining unmet need for patients with severe post-partum hemorrhage (sPPH). Objective: This manuscript evaluated efficacy and safety of recombinant activated factor VIIa (rFVIIa) in sPPH management. Methods: An open-label, multi-center, randomized controlled trial (RCT; NCT00370877) and four observational studies (OS; OS-1 [NCT04723979], OS-2, OS-3 and OS-4) were analyzed regarding efficacy (need for subsequent invasive procedures, including uterine compression sutures, uterine or iliac artery ligation, arterial embolization or hysterectomy) and safety (incidence of thromboembolic events [TE] and maternal mortality) of rFVIIa for sPPH. The RCT, and OS-1 and OS-2, included a control group of women who did not receive rFVIIa (with propensity score-matching used in OS-1 and OS-2), whereas OS-3 and OS-4 provided descriptive data for rFVIIa exposed women only. Results: A total of 446 women exposed to rFVIIa and 1,717 non-exposed controls were included. In the RCT, fewer rFVIIa exposed women (50% [21/42]) had an invasive procedure versus non-exposed women (91% [38/42]; odds ratio 0.11, 95% confidence interval 0.03–0.35). In OS-1, more rFVIIa exposed women (58% [22/38]) had an invasive procedure versus non-exposed women (35% [13.3/38]; odds ratio 2.46, 95% confidence interval 1.06–5.99). In OS-2, 17% (3/18) of rFVIIa exposed women and 32% (5.6/17.8) of non-exposed women had an invasive procedure (odds ratio 0.33, 95% confidence interval 0.03–1.75). Across all included women, TEs occurred in 1.5% (0.2% arterial and 1.2% venous) of rFVIIa exposed women and 1.6% (0.2% arterial and 1.4% venous) of non-exposed women with available data. Conclusions: The positive treatment effect of rFVIIa in the RCT was not confirmed in the OS. However, the safety analysis did not show any increased incidence of TEs with rFVIIa treatment.

Cardiovascular diseases (CVDs) represent the leading cause of global mortality with 1,7 million deaths a year. One of the alternative systems to drug therapy to minimize the risk of CVDs is represented by alpha-linolenic acid (ALA), an essential fatty acid of the Omega-3 series, known for its cholesterol-lowering effect. The main purpose of this review is to analyze the effects of ALA and investigate the relevant n-6/n-3 ratio in order to maintain functionally beneficial effects. Concerning the lipid-lowering preventive effects, ALA may favorably affect the values of LDL-C and triglycerides in either adult and pediatric populations and it has a positive and protective effect against hypertension, suggesting that ALA is an useful diet-related antihypertensive compound. According to the 2009 EFSA statement, dietary ALA may contribute to reducing the risk of CVDs, thanks to anti-hypertensive, anti-atherosclerotic and cardio-protective effects.

Background. Oral anticoagulants (OACs) reduce stroke and systemic embolism (SE) in patients with atrial fibrillation (AF) but increase the risk of major bleeding (MB). No study has addressed the incidence and outcomes of bleeding in AF patients in the Middle East (ME). The Jordan AF study evaluated clinical profiles and one-year outcomes of AF patients who sustained bleeding events. Methods. Patients in 29 hospitals and clinics (May 2019 - December 2020) were enrolled and followed up for one year. Demographics and one-year events were compared in patients with or without bleeding. Results. Of 2018 patients enrolled; 166 patients sustained MB or clinically relevant non-major (CRNM) bleeding (8.2 events per 100 patient-years), including 47 patients who had MB (2.3 events per 100 patient-years). Compared with 1852 (91.8%) patients who did not have bleeding, patients with MB were older and had a higher prevalence of hypertension, diabetes mellitus (DM), heart failure, and malignancy, More patients with MB than those with no bleeding were using OACs (93.6% vs. 78.9%, p=0.02). Patients with MB had significantly higher one-year rates of stroke/SE (23.4% vs. 3.6%, p<0.0001) and all-cause mortality (31.9% vs 11.6%, p=0.001). Independent predictors of MB were stroke/SE (OR 10.8, 95% CI 5.3-21.9, p<0.0001), malignancy (3.4, 1.3-8.5, p=0.01), use of OACs (4.4, 1.3-14.7, p=0.02) and DM (1.9, 1.0-3.5, p=0.04). Conclusions. MB and CRNM bleeding occurred in (≈8%) of patients with AF at one year. Patients with MB (≈2%) had worse baseline clinical profiles and one-year prognosis compared with those who did not have bleeding. Keywords: Atrial fibrillation; Major bleeding events; Clinically-relevant non-major bleeding; Oral anticoagulants; Middle Eastern population; Prognosis. Clinical studies registration: the study is registered on clinicaltrials.gov (unique identifier number NCT03917992).

Modern oncological therapy utilizes various types of immunotherapy. Immune checkpoint inhib-itors (ICIs), chimeric antigen receptor T cells (CAR-T) therapy, cancer vaccines and bispecific an-tibodies are improving patients’ outcomes. However, stimulation of the immune system, benefi-cial in terms of fighting against cancer, generates the risk of harm to other cells in a patient's body. Kidney damage belongs to the relatively rare adverse events (AEs). Best described, but still, su-perficially, are renal AEs in patients treated with ICIs. International guidelines issued by Euro-pean Society for Medical Oncology (ESMO) and American Society of Clinical Oncology (ASCO) cover the management of immune-related adverse events (irAEs) during ICI therapy. There are scarce data concerning renal adverse drug reactions of other immunotherapeutic methods. This implicates the need for the collection of safety data during ongoing clinical trials and in the re-al-life world to characterize the hazard related to the use of new immunotherapies and manage-ment of irAEs.

Although work events can be regarded as pivotal elements of organizational life, only a few studies have examined how positive and negative events relate to and combine to affect work engagement over time. Theory suggests that to better understand how current events affect work engagement (WE), we have to account for recent events that have preceded these current events. We present competing theoretical views on how recent and current work events may affect employees (e.g., getting used to a high frequency of negative events or becoming more sensitive to negative events). Although the occurrence of events implies discrete changes in the experience of work, prior research has not considered whether work events actually accumulate to sustained mid-term changes in WE. To address these gaps in the literature, we conducted a week-level longitudinal study across a period of 15 consecutive weeks among 135 employees, which yielded 849 weekly observations. While positive events were associated with higher levels of WE within the same week, negative events were not. Our results support neither satiation nor sensitization processes. However, high frequencies of negative events in the preceding week amplified the beneficial effects of positive events on WE in the current week. Growth curve analyses show that the benefits of positive events accumulate to sustain high levels of WE. WE dissipates in the absence of continuous experience of positive events. Our study adds a temporal component and informs research that has taken a feature-oriented perspective on the dynamic interplay of job demands and resources.

Abstract: The emergence of the COVID-19 pandemic has led to the rapid and worldwide devel-opment and investigation of multiple vaccines. While most side effects of these vaccines are mild and transient, potentially severe adverse events may occur and involve the endocrine system. This narrative review aims to explore the current knowledge on potential endocrine adverse effects following COVID-19 vaccination, with thyroid disorders being the most common. Data about pi-tuitary, adrenal, diabetes, and gonadal events will also be reviewed. This review also provides a comprehensive understanding of the pathogenesis of endocrine disorders associated with SARS-CoV-2 vaccines. A PubMed/MEDLINE, Embase database (Elsevier), and Google Scholar research were performed. Case reports case series, original studies, and reviews written in English and published online up to 31 August 2023 were selected and reviewed. Data on endocrine adverse events of SARS-CoV-2 vaccines is accumulating. However, their causal relationship with COVID-19 vaccines is not strong enough to make a definite conclusion, and further studies are needed to clarify the pathogenesis mechanisms of endocrine disorders linked to COVID-19 vac-cines.

Remotely sensed data play a crucial role in monitoring the El-Niño/La-Niña Southern Oscillation (ENSO), which is an oceanic-atmospheric phenomenon occurring quasi-periodically with several impacts worldwide, such as specific biological and global climate responses. Since 1980, Earth has witnessed three strong ENSO events (1982–1983, This study aims, 2015-2016). In September 2022, La-Niña entered its third year and was unlikely to continue through 2023. Instead, since 2022 forecasts pointed to a transition from La-Nina to a Neutral phase in summer or late 2023. The onset of the El-Niño occurred around April 2023, and it is anticipated by sophisticated models to be a strong event through the Northern Hemisphere winter (December 2023 - February 2024). The aim of this study is to demonstrate the ability of the combination of two new methods to improve the accuracy of the above claim because El-Niño apart from climate anomalies, significantly impacts Earth’s ecosystems and human societies, regulating the spread of diseases by insects (e.g., malaria and dengue fever), and influencing nutrients, phytoplankton biomass, and primary productivity. This is done by exploring first the previous major El-Niño events in the period January 1876-July 2023. Our calculations show that the ongoing 2023-2024 El-Niño will not be the strongest.

Background: Brief Resolved Unexplained Events (BRUEs), formerly known as Apparent Life-Threatening Events (ALTE), are concerning episodes of short duration (typically &lt; 1 min) characterized by a change in breathing, consciousness, muscle tone, and/or skin color. In some cases, SARS-CoV-2 infection has been associated with episodes of BRUEs in previously healthy children.This study aimed to compare the demographic, respiratory, perinatal, and infectious characteristics in children affected by BRUE before the COVID-19 pandemic and after the spread of SARS-CoV-2. Methods: We conducted a retrospective observational study covering January 2018 to March 2020 (pre-COVID-19) and April 2023 (during the ongoing COVID-19 pandemic). Collected variables included clinical information during pregnancy and neonatal details of children with BRUE. Results: The number of children in the pre-COVID-19 period was 186 (41%); after the emergence and spread of SARS-CoV-2, it was 268 (59%). The risk of infection at birth for children developing BRUE was higher during the pandemic. Children were less likely to have ongoing symptomatic infection during BRUE during the pandemic (coefficient B = 0.783; p=0.009). Respiratory symptoms during BRUE were more frequent during the pandemic (coefficient B = 0.654; p=0.052). Fever during BRUE was less likely during the pandemic (coefficient B = -0.465, p=0.046). Conclusions: The study suggests that the COVID-19 pandemic has significantly impacted children with BRUE, potentially due to changes in hygiene practices and maternal-fetal infections.

We report on ground-based measurements of the atmospheric electric field (Ez= -Potential Gradient (PG)) and current density (Jz) that were conducted at two locations in Israel. One is the Emilio Segre cosmic ray station located on Mt. Hermon (34.45 N, 2020 m AMSL) located in northern Israel near the Syrian-Lebanon border and at the other at the Wise astronomical observatory in the Negev desert highland plateau of southern Israel (31.18 N, 870 m AMSL). We searched for possible effects of strong, short-term solar events on the potential gradient and the vertical current density, as disruption to the Global Electric Circuit are often observed following strong solar events. The first case study (St. Patrick Day, 17 March 2015) was classified as the strongest event of 2015. The second case study (8 Sep 2017) was categorized as the strongest event of 2017 and one of the twenty strongest events on record to date. The results show that the electrical parameters measured at ground level at both stations were not affected during the two massive proton events and the ensuing geomagnetic storms. The magnetospheric shielding in lower latitudes is strong enough to shield against flux of energetic particles from solar events, obscuring any impact that may be noticeable above the local daily variations induced by local meteorological conditions (aerosol concentrations, clouds, high humidity, and wind speed) which were investigated as well.

Drug-induced pruritus triggers a desire to scratch, thereby diminishing one’s quality of life. Certain instances of this phenomenon follow complex mechanisms of action that diverge from histamine-mediated pathways, known contributors to pruritus. However, investigations into the relationship between drugs and pruritus are limited. In this study, data mining techniques were employed to comprehensively analyze the characteristics of drugs linked to pruritus, using the FDA Adverse Event Reporting System(FAERS) Data maintained in the United States. Reports linked to pruritus demonstrated noteworthy differences in gender, age, and weight when compared with non-pruritus cases. Among the leading candidates for drugs prompting pruritus were ophthalmic drugs, systemic antibacterials, contrast media, dermatological antifungals, and dermatological preparations. Principal component analysis showed that the second principal component served as an indicator for distinguishing between onsets at mucous membranes or the skin surface. Additionally, the third principal component functioned as an indicator for categorizing administration methods as either invasive or noninvasive. Furthermore, a hierarchical cluster analysis conducted on these obtained principal components revealed the potential for classifying drugs based on the site of pruritus onset and the method of drug administration. These findings contribute to the development of targeted prevention and treatment strategies for avoiding pruritus in clinical practice.

The origin of the man at the Earth is directly associated with the determination of directions of the flow distribution of the ancient man migration to adjacent territories. In such studies traditionally mainly landscape and climatological changes are considered. We suggest that along with the above factors, regional tectonic-geodynamic factors played a dominant role in the character of migration. The considered African-Levantine-Caucasian region is one of the most complex regions of the world, where collisional and spreading processes of geodynamics converge. First is determined an essential influence of the Akchagylian hydrospheric maximum (about 200 m above the mean sea level) limiting the ancient men migration from Africa to Eurasia. We propose that the Levantine Corridor emerged after the end of the Akchagylian transgression and landscape forming in the Eastern Mediterranean. This corridor location was formed by the movements between the Dead Sea Transform and the boundary of the carbonate platform of the Mesozoic Terrane Belt. Further landscape evolution was largely determined by the geodynamic behavior of the deep mantle rotating structure occurring below the central part of the region under study. All the mentioned events around and in the Levantine Corridor have been studied in detail on the basis of the combined geodynamic, paleogeographic, and paleomagnetic analyzes performed in northern Israel (Carmel uplift and Galilee plateau). Careful studies of the Evron quarry geological section indicate that it is a unique one for the dating of the marine and continental archaeological sequences and sheds light on the movement of the ancient man along the Levantine Corridor.

Earthquake is among the most devastating natural disasters causing severe economic, environmental, and social destruction. Earthquake safety assessment and building hazard monitoring can highly contribute to urban sustainable development through identification and insight into optimum materials and structures. While the vulnerability of structures mainly depends on the structural resistance, the safety assessment of buildings can be highly challenging. In this paper, we consider Rapid Visual Screening (RVS) method which is a qualitative procedure for estimating structural scores for buildings suitable for medium- to high-seismic cases. This paper presents an overview of the common RVS methods, i.e., FEMA P-154, IITK-GGSDMA, and EMPI. To examine the accuracy and validation, a practical comparison is performed between their assessment and observed damage of reinforced concrete buildings from a street survey in the Bingöl region, Turkey, after the 11 May 2003 earthquake. The results demonstrate that the application of RVS methods for preliminary damage estimation is a vital tool. Furthermore, the comparative analysis showed that FEMA P-154 creates an assessment that overestimates damage states and is not economically viable while EMPI and IITK-GGSDMA provide for more accurate and practical estimation, respectively.

In a recent paper, we extended previous studies on solar-terrestrial relationships by investigating the origin of the March 2012 heatwave in northeast USA. In the present study we check the possible relationship of solar activity with the early March 2012 bad weather in northeast Thrace, Greece. To this end, we examined data from various remote sensing instrumentation monitoring the Sun (SDO satellite), the Interplanetary Space (ACE satellite), the Earth’s magnetosphere (Earth based measurements, NOAA-19 satellite), the top of the clouds (TERRA and AQUA satellites) and the near ground atmosphere. Our comparative data analysis suggests that: (i) the winter-like weather (rainfall, fast winds, decreased temperature) in Thrace started on 6 March 2012, on the same day as the heatwave starting in USA, (ii) during the March 2012 winter-like event in Thrace (6-15 March), the ACE satellite recorded enhanced fluxes of solar energetic particles (SEPs), while SOHO and PAMELA recorded solar protons at very high energies (> 500 MeV), (iii) Thrace experienced particularly intense cyclonic circulation, during periods of magnetic storms on 8 - 10 and 12-13 March, which occurred after the arrival at ACE of two interplanetary shock waves, on March 8 and March 11, respectively, (iv) at the beginning of the two above mentioned periods large atmospheric electric fields were recorded, with values ranging between ~-2000V/m - ~1800V/m on 8 March, (v) the winter-like 8-10 March 2012 weather occurred after the detection of the main SEP event related with a coronal mass ejection released in the interplanetary space as a result of intense solar flare activity observed by SDO on 7 March 2012, (vi) the 8-10 March weather was related with a deep drop of ~630C in the cloud top temperature measured by MODIS/TERRA, which favors strong precipitation. Finally, we analyzed data from the electric power network in Thrace (~410N) and we found, for the first time sudden voltage changes of ~3.5kV in the electric grid in Greece, during the decay phase of the March 2012 superstorm. We discuss the winter-like March 2012 event in Thrace in terms of solar cosmic ray influence on the low troposphere mediated by positive NAO. Finally, we infer that the novel finding of the geomagnetic effects on the electric power grid in Thrace may open a new window into space weather applications research.

As a result of the cancer immunotherapy revolution hundreds of clinical trials of the newly approved immunotherapies are now under way to improve responses. Not unexpectedly, the 2018 Nobel Prize in Physiology or Medicine was awarded to James P. Allison and Tasuku Honjo for their development of cancer therapy by blockade of co-inhibitory signals. While success stories of terminal cancer patients achieving complete remissions are accumulating, not enough research has been done into the risks of the new therapies. Since the use of immunotherapy is becoming more common, and is expected to develop into first- and second-line treatments, immunotoxicity and autoimmunity are emerging as the nemesis of immunotherapy. Immune-related adverse events (IrAEs) could affect any tissue, their incidence may reach up to 90% of patients and toxicity is dose-dependent. While the combination of two immune checkpoint inhibitors (ICIs) increased efficacy, the incidence of severe adverse events was also increased. Apparently, ICIs cannot be restricted to the targeted anti-tumor T cell population. The long lasting objective of cancer regression can only be achieved by paying a price: tolerance to healthy self tissues is compromised. In the face of an ipilimumab induced pan-lymphocytic activation, a therapeutic paradigm shift is required. The task is not desperately trying to put the genie back in the bottle by immune suppressive treatments, but instead harnessing the autoimmune forces by an off label low-dose combined anti-CTLA-4 and anti-PD1 antibody blockade, which is supplemented with conventional interleukin-2 stimulation and hyperthermia. The proof-of-principle of the low-dose-combination therapy was demonstrated in a heavily pre-treated triple negative breast cancer (TNBC) patient with far advanced pulmonary metastases and severe shortness of breath, who had exhausted all conventional treatment. Her pulmonary metastases went into complete remission with transient WHO I-II diarrhea and skin rash. She lived for 27 months after starting the low-dose-combination therapy. She had recurrence as a sternal mass and pleural metastases up to 3 cm. Since the low-dose-combination protocol consists only of approved drugs and treatments, this exceptional response should instigate further research efforts.

The Canadian Prairies are associated with high natural hydroclimatic variability including the frequent periodic occurrence of droughts and pluvials. These extremes carry various risks in-cluding significant damage to the economy, environment and society. The well-documented level of damage necessitates further risk assessment and planned reductions to vulnerability, particu-larly in light of a warming climate. A logical starting point involves awareness and information about the changing characteristics of such climate extremes. We focus on the compound occurrence of droughts and pluvials as the risks from this type of event are magnified compared to the hy-droclimatic extremes in isolation. Also, research on compound droughts and pluvials is limited. Therefore, the purpose of this paper is to synthesize recent literature concerning the risks of com-pound droughts and pluvials, including examples of past occurrences, with a focus on the Cana-dian Prairies. Since literature from the Prairies is limited, global work is also reviewed. Rela-tionships between drought and pluvials are characterized using the SPEI Global Monitor for the Prairies, emphasizing the recent past, and through synthesis from the Prairie literature. That re-search mostly considers drought and pluvials as separate events, but is integrated here to charac-terize the relationships of these extremes. Examples of periods of compound droughts and exces-sive rainfall provide insights into the regional hydroclimatic variability. Furthermore, most lit-erature on future projections strongly suggests that this variability is likely to increase, mainly driven by anthropogenic climate change. These findings suggest means of decreasing vulnerabil-ity and associated damages. Although the study area is the Canadian Prairies, the work is rele-vant to other regions that are becoming more vulnerable to increasing risks of and vulnerabilities to such compound extremes.

Tuberculosis (TB) associated with diabetes (DM) is a growing problem, particularly in low and medium-resource countries. We conducted an open-label, parallel-group, randomized, and controlled trial in a tertiary care center in Mexico City to assess TB preventive treatment with isoniazid (INH) or rifampicin (RIF) in people with DM. Participants were assigned six months of INH 300mg/day plus pyridoxine 75mg or three months of RIF 600mg/day. The primary outcomes were adverse events resulting in permanent treatment cessation and considered possibly or probably related to study drugs. We included 130 subjects, 68 randomized to INH and 62 to RIF. We prematurely halted the study based on recommendations of the Adverse Event Safety Panel. There was no difference between arms in the overall frequency of adverse events. However, the INH group had significantly more permanent treatment interruptions due to grade 2 recurrent or grade 3 or 4 hepatoxicity. In comparison, the RIF arm had more treatment interruptions due to grade 3 or 4 gastrointestinal intolerance. TB preventive treatment is not safe enough to be considered a universal indication to patients with DM and LTBI. These results underline the need to search for alternative TB prevention in DM patients with better safety profiles.

Immune checkpoint inhibition therapy (ICIT) is an emerging field in oncology especially opening new horizons to chemotherapy refractory patients. This paper provides deep insight into immune related adverse events (irAEs) posing a major challenge and drawback to ICIT, and presents right management strategies for very complex complications. Moreover, for the first time in literature, a non-linear mathematical model is introduced to measure the ICIT success rate and to decide about the optimum ICIT duration. Furthermore, a strategy is presented to overcome or to delay the progression after initial good response in a subset of patients.

Anti-CD19 chimeric antigen receptor (CAR) T-cells represent a novel immunotherapy that has shown remarkable success in the treatment of adult relapsed or refractory (R/R) B-cell non-Hodgkin's lymphoma, adult R/R mantle cell lymphoma, and R/R acute paediatric lymphoblastic leukaemia. One barrier to the widespread use of CAR T-cell therapy is toxicity, primarily cytokine release syndrome (CRS) with a variable grade of severity. The main manifestations of CRS are fever, hypotension, cytopenia, organ dysfunction among others. Neurological toxicities vary widely and range from headaches to encephalopathy. In addition, anti-CD19 CAR T-cell therapy provokes an array of less frequent events, such as coagulopathies, delayed cytopenia, and cardiovascular toxicities. In general, toxicities are usually reversible and resolve on their own in most cases, though severe cases may require intensive care and immunosuppressive therapy. Deaths due to CRS, neurologic toxicity and infectious complications have been reported, which highlights the gravity of these syndromes and the critical nature of appropriate intervention. In this paper, we look at all available FDA- and EMA-approved information about the pathophysiology, clinical manifestations, risk factor reviews of existing toxicity grading systems, current management strategies, and guidelines for anti-CD19 CAR T-cell toxicities. We also present new approaches, which are under investigation, to mitigate these adverse events.

This study evaluates the incidence and characteristics of adverse events (AEs) following the second COVID-19 booster dose, leveraging Taiwan's distinctive approach of extending booster vaccinations to all citizens, unlike the targeted high-risk group strategies in other countries. Utilizing data from Taipei Veterans General Hospital's Vaccine Adverse Event Reporting System (VAERS) from October 27, 2022, to January 19, 2023, the research examines AEs in 441 out of 1711 second booster recipients, considering factors like age, vaccine brands, and booster combinations. The findings reveal incidence rates (IR) of 25.6% (95% CI: 21.1-30.8) after the first booster and 24.9% (95% CI: 20.5-30.0) after the second, mostly non-serious, with those having AEs post-first booster 5 times more likely to report them again (Incidence rat rato, 5.02, P&lt;0.001). Significantly, switching from the mRNA1273 vaccine to another brand reduced AE risk by 18%. The study underscores that AEs are more repetitive than cumulative with additional booster doses, advocating for personalized vaccination strategies based on individual medical histories and previous vaccine reactions. These insights are valuable for healthcare providers in discussing potential AEs with patients, thereby improving vaccine compliance and public trust, and for policymakers in planning future booster vaccination strategies.

Despite innovative advances in anti-infective therapies and vaccine development technologies, community-acquired pneumonia (CAP) remains the most persistent cause of infection-related mortality globally. Confronting the ongoing threat posed by Streptococcus pneumoniae (the pneumococcus), the most common bacterial cause of CAP, particularly to the non-immune elderly, remains challenging due to the propensity of the elderly to develop invasive pneumococcal disease (IPD), together with the predilection of the pathogen for the heart. The resultant development of often fatal cardiovascular events (CVEs), particularly during the first seven days of acute infection, is now recognized as a relatively common complication of IPD. The current review represents an update on the prevalence and types of CVEs associated with acute bacterial CAP, particularly IPD. In addition, it is focused on recent insights into the involvement of the pneumococcal pore-forming toxin, pneumolysin (Ply), in subverting host immune defenses, particularly the protective functions of the alveolar macrophage during early-stage disease. This, in turn, enables extra-pulmonary dissemination of the pathogen, leading to cardiac invasion, cardiotoxicity and myocardial dysfunction. The review concludes with an overview of the current status of macrolide antibiotics in the treatment of bacterial CAP in general, as well as severe pneumococcal CAP, including a consideration of the mechanisms by which these agents inhibit the production of Ply by macrolide-resistant strains of the pathogen.