The purpose of this study is to identify the different effects exerted by planting density and nitrogen fertilization on high-salinity Reclaimed Paddy Fields(RPF) and General Paddy Fields(GPF), and to find the amount of fertilization and the planting density suitable for the growth of forage rice in each paddy field. In both experimental locations, there was no significant change in the soil due to N treatment, but in the case of RPF, electrical conductivity(EC) decreased significantly from more than 5dS/m to up to 2.87dS/m during the yellow ripe stage due to the influence of floods and concentrated precipitation on the fields. In all soils, as both the amount of N treatment and the planting density increased, there was a proportional relationship in which the number of tillers and the dry weight also increased, with the occurrence of lodging also being increased. The dry weight, as expected, was 1.5 times higher at a planting distance of 10 cm, rather than 16 cm. In addition, in both locations N treatment led to an increase in the dry weight, but when N treatment reached 400kg/ha (2.0), the dry weight decreased instead. Moreover, although there was no clear difference in feed value according to N treatment, in RPF, neutral detergent fiber(NDF) was higher than 60%, RFV was less than 98, and TDN was also low, confirming that the quality of rice was higher in GPF.

The importance of frailty in older people is getting constant recognition as an important aspect both in terms of public health, as well in personal level for the appropriate management of an older person health condition. This is reflected by the continuously increasing number of research studies carried out in several settings across different countries. Sometimes this is very solid, but in other cases there is a considerable gap in terms of accurate and well grounded documentation of frailty status. This is the case in Greece, where we are missing clinically validated tools to approach frailty. We are missing frailty screening tools, such as for instance PRISMA 7, the gold standard tool of Fried criteria is somehow problematic since the question referring to physical activity originates from a questionnaire that has not been translated and validated, while Clinical Frailty Scale has been validated for the translation but not for the capacity to detect frailty. Aim of this study is to validate these tools for their accuracy to detect frailty by using a measurable index of frailty, previously proposed for use in clinical studies: the Short Physical Performance Battery (SPPB). 74 male and female participants have been evaluated for their frailty status using different tools. We observed that PRISMA 7 translation detects frailty only when one question is removed at a cut-off of ≥ 2 and indicated a sensitivity of 88.1%, and specificity of 99.9% with a good correlation with SPPB measurements (r = 0.858; p < 0.001). When CFS was validated using SPPB it demonstrated a very good correlation (r = -0.838; p < 0.001 respectively) as it was the case for the modified Fried Criteria (r = -0.725; p < 0.001). All items demonstrated a good correlation between them. We can here propose that we can accurately assess frailty status in the community setting by using a modified version of Fried criteria, Clinical Frailty Scale translation in Greek and we can screen for frailty by using the Greek translation of PRISMA 7 only after removing the item 6 of the questionnaire.

This study demonstrates the efficacy of structured pruning and architectural fine-tuning on the YOLOv7-tiny model for eye state detection, emphasizing optimization for real-time applications. Structured pruning significantly reduced the model's complexity and storage size while maintaining high detection accuracy, as evidenced by stable precision, recall, and mAP@.5 metrics across iterations. Further fine-tuning adjusted the model's width and depth, optimizing efficiency and processing speed without compromising performance. These optimizations yielded YOLOv7-tiny variants that are both computationally efficient and accurate, suitable for resource-constrained environments. The findings highlight the critical role of model optimization in deploying effective neural networks for specific detection tasks in real-time scenarios.

The security of several fully homomorphic encryption (FHE) schemes depends on the intractability assumption of the approximate common divisor (ACD) problem over integers. Subsequent efforts on solving the ACD problem as well as its variants were also developed during the past decade. In this paper, an improved orthogonal lattice (OL) based algorithm, AIOL, is proposed to solve the general approximate common divisor (GACD) problem. The conditions for ensuring the feasibility of AIOL are also presented. Compared to the Ding-Tao’s OL algorithm, the well-know LLL reduction is used only once in AIOL, and when the error vector r is recovered in AIOL, the possible difference between the restored and the true value of p is given. The experimental comparisons towards the Ding-Tao’s algorithm and ours are also provided for validating our improvements.

Fruit quality is a critical factor in the produce industry, affecting producers, distributors, consumers, and the economy. High-quality fruits are more appealing, nutritious, and safe, boosting consumer satisfaction and revenue for producers. Artificial Intelligence can aid in assessing the quality of the fruit using images. This paper presents a general machine-learning model for assessing fruit quality using deep image features. The model leverages the learning capabilities of the recent successful networks for image classification called Vision Transformers (ViT). The ViT model is built and trained with a combination of various fruit datasets and learned to distinguish between good and rotten fruit images. The general model demonstrated impressive results in accurately identifying the quality of various fruits such as Apples (with a 99.50% accuracy), Cucumbers (99%), Grapes (100%), Kakis (99.50%), Oranges (99.50%), Papayas (98%), Peaches (98%), Tomatoes (99.50%), and Watermelons (98%). However, it showed slightly lower performance in identifying Guavas (97%), Lemons (97%), Limes (97.50%), mangoes (97.50%), Pears (97%), and Pomegranates (97%).

We evaluate the nested sum $\sum_{a_{n - 1} = c}^{a_n } {\sum_{a_{n - 2} = c}^{a_{n - 1} } { \cdots \sum_{a_0 = c}^{a_1 } {x^{a_0 } } } }$ where $a_n$ and $c$ are any integers and $x$ is a real or complex variable. Consequently, we evaluate multiple sums involving the terms of a general second order sequence, the Horadam sequence (W_j (a, b; p, q)), defined for all non-negative integers j by the recurrence relation W₀ = a, W₁ = b; W_j = pW_j−1 − qW_j−2 (j≥2); where a, b, p and q are arbitrary complex numbers, with p ≠ 0, q ≠ 0.

Different aspects in applying the nucleation theorem to the description of crystallization of liquids are analyzed. It is shown that, by employing the classical Gibbs' approach in the thermodynamic description of heterogeneous systems and assuming that the basic assumptions of classical nucleation theory commonly employed in application to crystallization hold, a general form of the nucleation theorem can be formulated valid not only for one-component but generally for multi-component systems. This result is taken then as the starting point for the derivation of particular forms of this theorem for the cases that the deviation from equilibrium is caused by variations of either composition of the liquid phase, temperature, or pressure. In this procedure, recently developed by us expressions for the curvature dependence of the surface tension, respectively, the dependence of the surface tension on pressure and/or temperature are employed. It is shown that the formulation of the nucleation theorem as proposed by Kashchiev [J. Chem. Phys. 76, 5098-5102 (1982)] holds also for multi-component systems as far as mentioned above assumptions are fulfilled. In the application of classical nucleation theory to crystallization processes it is assumed as one of its basic ingredients that the bulk properties of the critical clusters are widely identical to the properties of the newly evolving crystal phase. This assumption is, however, in general, it is not true. This limitation of the theoretical description can be overcome by the application of the generalized Gibbs approach for the specification of the dependence of the properties of critical crystal clusters on the degree of metastability of the liquid phase. Applying this method, it is demonstrated that a similar formulation of the nucleation theorem as derived based on classical nucleation theory holds true also in cases when a dependence of the state parameters of the critical clusters on the degree of deviation from equilibrium is appropriately accounted for.

Background: Iranian traditional medicine is a holistic school of medicine with a long prolific history. It describes numerous concepts and the relationships between them. However, no unified terminology has been proposed for the concepts of this medicine up to the present time. Considering the extensive use of concepts in the numerous textbooks written by the scholars over centuries, comprehending the totality of the terminology is obviously a very challenging task. To resolve this issue and overcome the obstacles, and code the concepts in a reusable manner, constructing an ontology of the concepts of Iranian traditional medicine seems a necessity.Methods: Makhzan al-Advieh, an encyclopedia of materia medica compiled by Mohammad Hossein Aghili Khorasani, was selected as the resource to create an ontology of Mizaj. The steps followed to accomplish this task included (1) compiling the list of classes for Mizaj; (2) arranging the classes in taxonomy; (3) determining object properties and their cardinalities; (4) specifying annotation properties including codes, labels, synonyms, and definitions for each concept; (5) reviewing the fields pertaining to Mizaj of all monographs in Makhzan al-Advieh. The ontology was created using Protégé with adherence to the principles of ontology development provided by the Open Biological and Biomedical Ontology (OBO) foundry. Results: Mizaj ontology was constructed with a final inclusion of 105 classes, three object properties, and 1078 axioms in the Iranian Traditional Medicine General Ontology database, IrGO, freely available at http://jafarilab.com/irgo/. An indented tree view and an interactive graph view using WebVOWL were used to visualize the ontology. All classes were linked to their instances in the UNaProd database to create a knowledge-base of Mizaj. Conclusion: We constructed an ontology-based knowledge base of ITM concepts of Mizaj in the domain of materia medica to help offer a shared and common understanding of this concept, enable reuse of the knowledge, and make the assumptions explicit. Extending IrGO will bridge the gap between traditional and conventional schools of medicine and help guide future research on new treatment options.

Background: General Practitioners (GP) have an important role in the prevention of suicidal behavior. The purpose of this study was to explore their views and experiences of identifying and assessing suicidal ideation. Methods: Ten GPs were recruited through convenience sampling, based on accessibility, interest and willingness to participate. In-depth interviews were carried out and results transcribed ver-batim. Aspects of experiences with suicidal patients emerged through the thematic analyses process. Results: The GPs described the varied clinical picture when patients presented in their office. How they identified depressive symptoms apart from originally somatic complaints, formed a trusting relationship and addressed suicide ideation. They described customized interventions as well as obstacles and factors that facilitated communication: time, own personal traits, pa-tient’s disclosure and organizational barriers. Conclusions: The levels of the suicidal process among patients in general practice vary greatly. GPs adjust their appraisals to profundity understand and intervene in order to prevent a crisis to escalate into subsequent suicidal behavior.

This article presents and discusses analytical data on the scientific publication record from 1910 to 2020 on two topics: "climate" and "climate change/global warming/climate emergency". The goal is to visualize how the publication record on these two topics has evolved over time, from different classification perspectives (year, country, source and organization). Three hypotheses are tested using data collected from Web of Science and various graphical representations of the data. It is found that research output related to the Earth’s contemporary changing climate overtook that of general climate research in 2011, and the publication ratio has been expanding in the last decade. There are significant differences in the publication countries and sources between the two topics, and conversely less significant differences in terms of organizations publishing these works. Differentiation factors that affect the level of research output and engagement on the climate challenge include: island versus landlocked nations, specialized versus general scientific journals, academic versus institutional organizations. The future of the publication records is discussed, such as the emergence of new terms to refer to the climate challenge, such as “climate emergency”.

The aim of the study was to examine the prevalence of suicide thoughts and -attempts during the early stage of the COVID-19 outbreak and examine factors associated with suicide thoughts in the general Norwegian population. A sample of 4527 adults living in Norway were recruited via social media. Data related to suicide thoughts and attempts, mental health variables, pandemic-related concerns and sociodemographic variables were collected. Associations with suicide thoughts were analyzed with logistic regression analysis. In the sample, 3.6 % reported suicide thoughts during the last month, while 0.2 % had attempted to commit suicide during the same period. Lower age (OR: 0.66, p < 0.001), daily alcohol use (OR: 3.29, p < 0.001), being in the risk group for COVID-19 complications (OR: 2.38, p < 0.01), and having economic concerns related to the pandemic (OR: 2.51, p < 0.001) were associated with having suicide thoughts. In addition to known risk factors, the study suggests that aspects specific to COVID-19 may be important for suicidal behaviors during the pandemic.

This paper derives measurement and identical principles, then makes the two principles into measurement and identical theorems of quantum mechanics, plus the three theorems derived earlier, we deduce the axiom system of current quantum mechanics, the general quantum theory no axiom presumptions not only solves the crisis to understand in current quantum mechanics, but also obtains new discoveries, e.g., discovers the velocities of quantum collapse and entanglement are instantaneously infinitely large. We deduce the general Schrȍdinger equation of any n particles from two aspects, and the wave function not only has particle properties of the complex square root state vector of the classical probability density of any n particles, but also has the plane wave properties of any n particles. Thus, the current crisis of the dispute about the origin of wave- particle duality of any n microscopic particles is solved. We display the classical locality and quantum non-locality for any n particle system, show entanglement origins, and discover not only any n-particle wave function system has the original, superposition and across entanglements, but also the entanglements are of interactions preserving conservation or correlation, three kinds of entanglements directly give lots of entanglement sources. This paper discovers, one of two pillars of modern physics, quantum mechanics of any n particle system is a generalization ( mechanics ) theory of the complex square root ( of real density function ) of classical statistical mechanics, any n particle system’s quantum mechanics of being just a generalization theory of the complex square root of classical statistical mechanics is both a revolutionary discovery and key new physics, which are influencing people’s philosophical thinking for modern physics, solve all the crisises in current quantum theories, quantum information and so on, and make quantum theory have scientific solid foundations checked, no basic axiom presumption and no all quantum strange incomprehensible properties, because classical statistical mechanics and its complex square root have scientific solid foundations checked. Thus, all current studies on various entanglements and their uses to quantum computer, quantum information and so on must be further updated and classified by the new entanglements. This and our early papers derive quantum physics, solve all crisises of basses of quantum mechanics, e.g., wave-particle duality & the first quantization origins, quantum nonlocality, entanglement origins & classifications, wave collapse and so on.Key words: quantum mechanics, operator, basic presumptions, wave-particle duality, principle of measurement, identical principle, superposition principle of states, entanglement origin, quantum communication, wave collapse, classical statistical mechanics, classical mechanics

Innovation in general education governance is one of the development trends not only in Vietnam but also in the world. This is also an important measure to change and improve the quality of education, especially expand autonomy of high schools and universities. The paper focuses on some main contents: overview of general education; the experiences of some countries in the implementation of the school administration model towards the school autonomy model so that give lessons for Vietnam’s education can be learned in the context of development conditions nowadays. The results in this work would be used to classify the schools into the various groups. The data also analysts on decision-making capability, on what we called an “index of school autonomy”, expressed the possible level of school-level decision-making.

The most important conclusion from this article is that from the General Theory of Relativity (GTR) do not result any gravitational waves, but just ordinary modulation of the gravitational field intensities caused by rotating of bodies. If the LIGO team has measured anything, it is only this modulation, rather than the gravitational wave understood as the carrier of gravity. This discussion shows that using too complicated mathematics in physics leads to erroneous interpretation of results (in this case, perhaps the tensor analysis is guilty). Formally, various things can be calculated, but without knowing what such analysis means, they can be attributed misinterpreted. Since the modulation of gravitational field intensities has been called a gravitational wave in contemporary physics, we have also done so, although it is misleading. In the article it was shown, that from the Newton’s law of gravitation resulted an existence of gravitational waves very similar to these, which result from the General Theory of Relativity. The article shows differences between the course of gravitational waves that result from Newton’s gravitation, and the course of gravitational waves that result from the General Theory of Relativity, which measurement was announced by the LIGO (Laser Interferometer Gravitational-Wave Observatory) [1], [2], and [5]. According to both theories, gravitational waves are cyclical changes of the gravitational field intensities. The article proposes a method of testing a laser interferometer for gravitational wave measurement used in the LIGO Observatory. Criticism of results published by the LIGO team was also presented.

The problem of optimal scheduling in a system with parallel queues and a single server has been extensively studied in the queueing theory. However, such systems have mostly been studied by assuming homogeneous attributes of arrival and service processes, or in heterogeneous case a Markov random process was usually assumed. In this paper, we explore the possibility of combining simulation and neural network paradigms for optimal scheduling in a heterogeneous system with an arbitrary inter-arrival and service time distributions. The service of any queue by the server is exhaustive. Further routing of the server after the queue has been emptied is as instructed by the trained neural network. Any change in the queue that currently has a server is accompanied by a switching cost. The simulated annealing optimization algorithm which is used to optimize the parameters of the neural network was adapted for numerically evaluated average cost function. A Markov decision problem was formulated for the corresponding markovian queueing system to verify the results of solving the optimization problem. In addition to comparing the actual values of the average cost, the parameter values of the neural network trained on the optimal control policy of the Markov model are also used to determine the domains of parameters required for the simulated annealing defined on a finite discrete domain. Numerical analysis shows the effectiveness of this approach. Moreover, a comparison of the results for different distributions illustrates the insensitivity of the optimal control policy to the shape of the distributions for the same two first moments. Thus, the optimal control policy for an exponential model can be used as a suboptimal one for the general system.

Density distribution function of classical statistical mechanics is generally generalized as a product of a general complex function and its complex Hermitian conjugate function, and the average of classical statistical mechanics is generalized as the average of the quantum mechanics. Furthermore, this paper derives three ones of the five axiom presumptions of quantum mechanics, e.g., deduces Schrȍdinger equation by two general ways, makes the three axiom presumptions into three theorems of quantum mechanics, not only solves the crisis to hard understand, but also gets new theories and new discoveries, e.g., this paper solves the crisis of the origin of the wave-particle duality, derives operators, eigenvalues and eigenstates, deduces commutation relations for coordinate and momentum as well as the time and energy, and discovers quantum mechanics is just a generalization ( mechanics ) theory of the complex square root of ( real density function of ) classical statistical mechanics. Quantum mechanics being just a generalization theory of the complex square root of classical statistical mechanics is both new physics and revolutionary discovery, which are affecting people’s deep philosophical thinking for modern physics development, solve all the crisises of quantum mechanics, quantum information and so on, and make quantum mechanics have scientific solid bases being checked and both no basic axiom presumption and no all the quantum strange incomprehensible properties, because classical statistical mechanics and the complex square root of classical statistical mechanics have the scientific solid bases being checked. In addition, this paper discovers the reason no taking the time derivative of space coordinates in Schrȍdinger equation. Therefore, this paper gives solution to the crisis of the first quantization origin, and mainly deduces quantum physics no all the quantum current strange incomprehensible properties.

Background: Critical states present scale-free dynamics, optimizing neuronal complexity. We explored electroencephalogram (EEG) criticality in amnesic Mild Cognitive Impairment (aMCI) patients with clinical improvement in working memory, verbal memory, verbal fluency and overall executive functions after the completion of a 6-month prospective memory training. (2) Methods: We compared “before” and “after” stationary resting-state EEG records of right-handed MCI patients (n = 17; 11 females), using the method of critical fluctuations and Haar wavelet analysis. (3) Results: Significant criticality enhancement was present in frontotemporal electrodes [mean dif: 0.10; Z = 7, p = .019] and isolated electrodes T6 [mean dif: 0.204; t (10) = - 2.3, p = .044] and F4 [mean dif: 0.0194; t (10) = - 2.82; p = .018]. (4) Conclusions: EEG criticality agreed with clinical improvement, consisting a possible monitoring biomarker in MCI and Alzheimer’s disease. Further evaluation is needed in patients under cognitive training or even drug-modifying therapies.

Background: The adoption of self-care behaviors among patients with congestive heart failure (CHF) is essential for the management of their health condition. However, there is a lack of tools for estimating self-care in CHF patients. We aim to develop and validate the Hippocratic heart failure self-care scale (HHFSCS). Methods: the scale includes 22 items which are reviewed by a committee of experts. Individuals indicate the frequency at which they follow each self-behavior on a five-point Likert scale. Adult patients with CHF (n=250) from a General Hospital, in Athens, were participated in the study from June 2020 to March 2021. Reliability coefficients and Explanatory Factor Analysis (EFA), using a Varimax rotation and the Principal Components Method were used to assess the psychometric measurements. Results: The Cronbach’s alpha coefficient of the HHFSCS was 0.807. The exploratory factor analysis identified two domains that accounted for 88.44% of the variance of the scale items; however, each sub-scale could not be used as an independent scale. Finally, the test-retest showed a significant strong correlation (r=0.973, p&lt;0.001). Conclusions: The HHFSCS is a reliable and valid tool for assessing self-behaviors in CHF patients. Health professionals can use it in their clinical practice to improve the management of patient’s health conditions.

We wanted to investigate the current knowledge on the impact of diet on anti-TNF response in inflammatory bowel diseases (IBD), to identify dietary factors that warrant further investigations in relation to anti-TNF treatment response, and, finally, to discuss potential strategies for such investigations. PubMed was searched using specified search terms. One small prospective study on diet and anti-TNF treatment in 56 patients with CD found similar remission rates after 56 weeks among 32 patients with good compliance that received concomitant enteral nutrition and 24 with poor compliance that had no dietary restrictions (78% versus 67%, p = 0.51). A meta-analysis of 295 patients found higher odds of achieving clinical remission and remaining in clinical remission among patients on combination therapy with specialised enteral nutrition and Infliximab (IFX) compared with IFX monotherapy (OR 2.73; 95% CI: 1.73–4.31, p < 0.01, OR 2.93; 95% CI: 1.66–5.17, p < 0.01, respectively). In conclusion, evidence-based knowledge on impact of diet on anti-TNF treatment response for clinical use is scarce. Here we propose a mechanism by which Western style diet high in meat and low in fibre may promote colonic inflammation and potentially impact treatment response to anti-TNF drugs. Further studies using hypothesis-driven and data-driven strategies in observational, animal and interventional studies are warranted.

Anesthetics reduce cardiac functions and lower blood pressure (BP), potentially causing excessive BP reduction in dehydrated patients or those with heart conditions, such as coronary artery disease (CAD). Considering the increased prevalence of cardiovascular disease with age, anesthesiologists must be cautious about BP reduction during general anesthesia in older adults. In the present case, an undiagnosed CAD patient in a hypovolemic state experienced a significant systolic blood pressure drop to the 50s during propofol and sevoflurane anesthesia. Despite the use of vasopressors, excessive hypotension persisted, leading to anesthesia suspension. Subsequent cardiac examinations, including computed tomography heart angio and calcium score, and coronary angiogram, revealed a near total occlusion of the left main coronary artery and the formation of collateral circulation. After 5 days of hydration and anticoagulation medications and confirmation of normovolemic state, general anesthesia was attempted again and successfully induced; a normal BP was maintained throughout the surgery. Thus, it is important to conduct a thorough cardiac evaluation and maintain normovolemia for general anesthesia in older adults.

Karate is a martial art that originated in Japan It is characterized by its diverse techniques, including punches, kicks, strikes, and open hand techniques. Generally, karate practitioners shall execute techniques fast, with an impactful finishing towards the target. The present study aims to examine the effectiveness of customized gym sessions in enhancing the athletes’ general performance with a duration of 3-months’time. A total of 7 tests were monitored, i.e., anthropometric measurement, sit and reach test, stork balance stand test, T-test, counter movement jump, 20m sprint, and Yo-Yo endurance test. 4 male amateur athletes (state representative) that has practiced karate for at least 6 years, with at least 5 days training per week, were selected. The age ranges from 15 to 20 years old. The athletes were requested to have a proper rest (at least 7 hours sleeping time) five days before the actual test day. The results show that all athletes have at least maintained or improved stork balance for both legs. The balance improvement ranges from 0% up to 134.69%. However, both the T-test and 20m sprint test demonstrated a negative outcome. The time consumed to complete 20m is increased, which deteriorated the linear speed capability by 1.89% up to 8.93%. Also, 3 out of 4 athletes show that the T-test performance does not provide a satisfactory achievement. The agility of athletes was found to drop by 3.58% up to 10.60%. Interestingly, the athletes’ stamina was found to improve based on the VO2 max prediction and Yo-Yo test. The enhancement of VO2 max prediction and Yo-Yo test recorded as 0% - 7.53% and 9.09% - 20%, respectively. So far, there is no clear indicator on the flexibility of the athletes’ spine and length of the hamstring muscles, based on the sit and reach test. Short-term gym sessions with a duration of 3 months might improve the strength and body balance of athletes. However, the impact on the responsiveness and agility of athletes did not show any significant breakthrough. In future study, it is recommended that a large sample of participants should be included in the analysis.

Cholesterol is a lipid-derived substance found in lipoproteins and cell membranes. It is also one of the main sources for the production of bile acids, vitamin D, and steroid hormones. Today, foods are evaluated by consumers not only according to their taste and nutritional content but also according to their effects on consumer health. For example, many consumers choose foods according to their cholesterol level. The cholesterol in the food can directly affect the blood cholesterol level when consumed, which can lead to cardiovascular diseases. High levels of cholesterol can lead to diet-related human diseases such as cardiac arrest, paralysis, type II diabetes cerebral hemorrhage. In societies with high living standards, interest in and consumption of foods that lower or have low cholesterol levels have increased recently. Accordingly, efforts to increase the variety of foods with reduced cholesterol levels are on the rise. This has indirectly insulted in accurate measurement of cholesterol levels in blood and food being of great importance. Classical chemical, enzymatic, colorimetric, polarographic, chromatographic, spectrophotometric methods, and enzymatic, nonenzymatic, and electrochemical sensors and biosensors are used for the determination of cholesterol in foods. The purpose of this review is to reveal and explore current and future trends in cholesterol detection methods in foods. The review will summarize the most appropriate and standard methods for measuring cholesterol in biological components and foods.

The paper proposes a theoretical study that investigates the quantum effects on the gravity of black holes. The study utilizes a gravitational model that incorporates quantum mechanics derived from the classical-like quantum hydrodynamic representation. The research calculates the mass density distribution of quantum black holes, specifically in the case of central symmetry. The gravity of the quantum black hole shows contributions coming from the quantum potential energy, which is also sensitive to the presence of the background of gravitational noise. The additional energy, stored in the quantum potential fluctuations and constituting a form of dark energy, leads to a repulsive gravity in the weak gravity limit. This repulsive gravity overcomes the attractive classical Newtonian force at large distances of order of the intergalactic length.

Abstract This article examines the implementation of the Swedish national environmental quality objectives and discusses what can be learnt for the equivalent process for the set of global UN 2030 goals (SDGs), established in 2015. The empirical basis is a study on 50 large companies in Sweden and their use of these objectives in their policy formulation. The SDGs are crafted with a broader approach than the Swedish national environmental quality objectives. Therefore, the SDGs probably better reflect the agenda of the business community since they have a global character, cover the whole spectrum of important sustainability issues and provide a mutual agenda for the business community world-wide. More than 90 percent of the large companies in the study have explicitly committed themselves to the SDGs, only 1-2 years after they were published, whereas similar commitments hardly exist for the national environmental quality objectives, even 20 years after its establishment. A large majority of the large companies in this study know about the SDGs, have actively endorsed them, and started to adjust their activities accordingly. At the end, the results of these endorsements remain to be seen.

Single particle tracking (SPT) is a powerful class of methods for studying the dynamics of biomolecules inside living cells. The techniques reveal the trajectories of individual particles, with a resolution well below the diffraction limit of light, and from them the parameters defining the motion model, such as diffusion coefficients and confinement lengths. Most existing algorithms assume these parameters are constant throughout an experiment. However, it has been demonstrated that they often vary with time as the tracked particles move through different regions in the cell or as conditions inside the cell change in response to stimuli. In this work, we propose an estimation algorithm to determine time-varying parameters of systems that discretely switch between different linear models of motion with Gaussian noise statistics, covering dynamics such as diffusion, directed motion, and Ornstein-Uhlenbeck dynamics. Our algorithm consists of three stages. In the first stage, we use a sliding window approach, combined with Expectation Maximization (EM) to determine maximum likelihood estimates of the parameters as a function of time. These results are only used to roughly estimate the number of model switches that occur in the data to guide the selection of algorithm parameters in the second stage. In the second stage, we use change detection (CD) techniques to identify where the models switch, taking advantage of the off-line nature of the analysis of SPT data to create non-causal algorithms with better precision than a purely causal approach. Finally, we apply EM to each set of data between the change points to determine final parameter estimates. We demonstrate our approach using experimental data generated in the lab under controlled conditions.

ABSTRACT:This paper presents arguments for why it is important to include disability in the undergraduate medical curriculum. I, the first author am currently involved with my doctoral thesis proposal titled "Proposing clinician competency guidelines for the inclusion of disability in the undergraduate medical curriculum of South Africa. An exploratory study.” As part of my research, I conducted a literature search and developed arguments to strengthen the reasons why the research I propose in my thesis is necessary. It is important that I position myself in this research. I am a South African, Caucasian, female medical doctor, with an interest in physical rehabilitation medicine and I am a person with a physical disability. Although this research study will be conducted in South Africa, I am hopeful that the findings will be transferable to medical schools across the world.

AGI could arise within the next decades, promising a decisive strategic advantage. This paper discusses risks, associated with the development of AGI: destabilizing effects on strategic balance, underestimating risks in the interest of victory in the race, egoistically exploiting the huge benefits by a tiny minority. Further: Developed AGI could be beyond human control. Human goals could not be implemented and an intelligence explosion to superintelligence could take place leading to a total loss of control and power. If competition for AGI is non-transparent, secret, uncontrolled and not regulated, it’s possible that risks could not be managed and would lead to catastrophic consequences. The danger corresponds to that of nuclear weapons. It is crucial that the key actors of a possible AI Race agree at an early stage on the prevention and transparent regulation of a possible AI Race - similar to measures to secure strategic stability, on arms control measures, disarmament, and prevention of the proliferation of nuclear weapons. The realization that an uncontrolled AI race can lead to the extinction of humanity - this time even independent of human will – requires analogous measures to contain, prevent, regulate and secure an AI race within the framework of AGI development.

Current theories of autoimmunity are diverse, sometimes contradictory, and suffer from incompleteness. Although substantial evidence exists that adaptive and innate immunity, sex, genetic predisposition, and the microbiome all play essential roles in autoimmune disease etiologies and pathogenesis, and that antigen processing is altered during disease induction, no existing theory integrates all of these factors through a single, coherent mechanism. In an attempt to focus the field on the need to elucidate such an integrative mechanism, I propose one possibility here that, if nothing else, helps to identify the nature of the problems that need to be addressed. My theory is that autoimmune diseases are induced by normal immunological responses to unique pairs of complementary antigens, at least one of which is a molecular mimic of a host target. Each antigen in the complementary pair induces a complementary immune response (T or B cell); although each immune response is idiotypic in origin, the antigenic complementarity results in what appears to be an idiotype-anti-idiotype relationship between the responses. Additionally, because of the antigenic complementarity, each immune response mimics one of antigens, abrogating the distinction between self and non-self. If at least one of the antigens mimics a host antigen, then the resulting immunological civil war spreads to a host tissue. Complementary antigens also alter antigen processing so that antigens that would normally be proteolytically digested are presented by the major histocompatibility complex (MHC) to T and B cell receptors inducing a cross-reactive immune response. The resulting civil war is supported by the innate immune system due to the complementarity of the initiating antigens.. Complementary antigens stimulate synergistic toll-like receptors (TLR) and/or nucleotide-binding oligomerization receptors (NOD) resulting in up-regulation of cytokine production and further stimulation of the adaptive immune response. Because the immune responses (e.g., antibodies) mimic the initiating antigens, this synergistic activation of innate immunity becomes chronic. Additionally, TLR and NOD function are highly sensitive to sex hormones, some becoming up-regulated and some down-regulated in the presence of either testosterone or estrogens. This sensitivity explains how sex modifies susceptibility to autoimmune diseases. Genetic mutations in TLR, NOD and MHC further alter antigen presentation and the degree to which antigens stimulate an immune response explaining how genetics also modifies susceptibility. Finally, sex hormones also alter the host microbiome, which in turn modulates autoimmune disease risk by shaping the immunological nature of self and by mediating susceptibility to microbial infection. Moreover, it appears that the microbiome camouflages itself from the immune system by mimicking the host antigenic repertoire; the mimicry between the antigens of the microbiome and the host results in selective attacks on microbiome constituents concomitant with any autoimmune attack on host tissues. This antigenic complementarity theory thereby integrates all major elements known to affect, or be affected by, autoimmune diseases and provides a set of testable implications.

Background: Obesity among pregnant women is common, and their offspring are predisposed to obesity, insulin resistance, and diabetes. Circulating metabolites that are related to insulin resistance and are associated with this decreased tissue-specific uptake are unknown. Here, we assessed metabolite profiles in elderly women and who were either female offspring from obese mothers (OOM) or offspring of lean mothers (OLM). Metabolic changes were tested for associations with metrics for insulin resistance. Methods: 37 elderly women were separated into an elderly offspring from obese mothers (OOM; n = 17) and elderly offspring from lean/normal weight mothers (OLM; n = 20) groups. We measured plasma metabolites using 1H-NMR and also insulin-dependent tissue specific glucose uptake in skeletal muscle were assessed. Associations were made between metabolites and glucose uptake. Results: Compared to the OLM group, we found that the 22:6 docosahexaenoic acid percentage of the total long chain n-3 fatty acids (DHA/FA) was significantly lower in OOM (P = 0.015). DHA/FA associated significantly to skeletal muscle GU (P = 0.031) and M-value in the OLM group only (P = 0.050). Conclusions: DHA/FA is associated with insulin-dependent skeletal muscle glucose uptake and that this association is significantly weakened in the offspring of obese mothers.

This study aims to identify factors associated with anxiety levels of adults living in Singapore before the pandemic and during the COVID-19 outbreak. Data were collected using a cross-sectional web-based survey conducted from July to November 2020 accruing 264 eligible participants. Ordered logistic regression was used to assess Generalized Anxiety Disorder-7 (GAD-7), ranked as minimal (0-4), mild (5-9), moderate (10-14), and severe (15-21) before the pandemic and during the pandemic. About 74% of participants were female, 50% were aged 25-34, and 50% were married. The GAD-7 level went up from pre-pandemic for both moderate (from 12.5% to 16%) and severe GAD (from 2% to 11%). Alcohol consumption (AOR 1.79, 95% CI 1.04-3.06), loneliness (AOR 1.28, 95% CI 1.05-1.54), and difficulty in switching off social media (AOR 2.21, 95% CI 1.29-3.79) predicted increased GAD-7 levels. The quality of life (AOR 0.84, 95% CI 0.79-0.90) was significantly associated with decreased GAD-7 levels. The results heighten the awareness that early initiation of mental health support is crucial for the population in addition to the various financial support measures provided by the government as they are adapting to live with the COVID-19 pandemic.

We address the dynamics of two-dimensional Navier-Stokes models with infinite delay and hereditary memory, whose kernels are a much larger class of functions than the one considered in the literature, on a bounded domain. We prove the existence and uniqueness of weak solutions by means of Faedo-Galerkin method. Moreover, we establish the existence of global attractor for the system with the existence of a bounded absorbing set and asymptotic compact property.

With the development of general anesthesia techniques and anesthetic substances, brought new horizons for the expansion and improvement of surgical techniques. Nevertheless, more complex surgical procedures brought a higher complexity and longer duration for general anesthesia that led to a series of adverse events such as hemodynamic instability, under- or overdosage of anesthetic drugs, as well as an increased number of post-anesthetic events. In order to adapt the anesthesia according to the particularities of each patient, the multimodal monitoring of these patients is highly recommended. Classically, general anesthesia monitoring consists of the analysis of vital functions and gas exchange. Multimodal monitoring refers to the concomitant monitoring of the degree of hypnosis and the nociceptive-antinociceptive balance. By titrating anesthetic drugs according to these parameters, clinical benefits can be obtained, such as hemodynamic stabilization, reduction of awakening times, and the reduction of post-operative complications. Another important aspect is the impact on the status of inflammation and the redox balance. By minimizing inflammatory and oxidative impact one can achieve a faster recovery that will lead to both increased patient satisfaction and an increase in patient safety. The purpose of this literature review is to present the most modern multimodal monitoring techniques, respectively to discuss the particularities of each technique.

Pesticides have a vital contribution to the agricultural industry in Australia. However, pesticide applications may not always selective to its target organism. Exposure to pesticide has been associated with negative impacts to human health. One of the ways to reduce pesticide risk to the population and the environment is through government regulations. To put Australia pesticide regulations into perspective, comparisons were made between Australia and other nation’s pesticides regulations. The EU pesticide regulatory system was chosen for comparison with the Australian’s in the aspect of protecting the population from pesticide exposure. The comparison showed that the assessment to authorize a pesticide in Australia is based on the risk while in the EU, the assessment is based on the hazard of the pesticide. A registered active substance in Australia can be authorized for use indefinitely unless it is nominated for reconsideration while the period of registration of an active substance in the EU lasts for 10 years. In addition, no routine systematic chemical residue surveys are conducted in Australia for food commodities. The results highlight areas for improvement in the Australian pesticide regulatory system from the perspective of controlling undue exposure among the general population.

On 11th March 2020, the World Health Organization declared COVID-19 as a pandemic. Vaccination programs have advanced greatly in the global health period, despite widespread anti-vaccination attitudes and misinformation. Vaccine hesitancy of COVID-19 vaccine is currently a major issue in Saudi Arabia. This cross-sectional study was carried out from June 25, 2021 to October 2021 in order to investigate the knowledge levels of acceptance and hesitancy of COVID-19 vaccine among Saudi’s nationals. The data was collected through a close-ended structured questionnaire from a total of 565 respondents. Overall, 78.41% respondents were female, 62.48% having university level education and 61.06% were unemployed. Majority of the participants 82.30% (n=465) think that Pfizer vaccine has the highest efficiency against COVID-19. Our study concludes that majority of the participants have satisfactory knowledge about COVID-19 vaccination. Concerns over vaccine components, effectiveness of vaccine and possible side effects are among the key causes for vaccine hesitancy.

Improving access to sexual health services is critical in light of rising sexually transmitted infections (STIs). We evaluated a Hub and Spoke model for improving access to sexual health services in three general practices in Victoria, Australia. The primary outcome was the impact on HIV and STI (chlamydia, gonorrhoea, syphilis) testing. Segmented linear regression analysis was conducted to examine the trends in the total HIV/STI tests before (from January 2019 to June 2020) and post-implementation (from July 2020 to July 2021). We evaluated the feasibility and acceptability of integrating this model into the general practices using semi-structured individual interviews. There was a statistically significant rise in testing for HIV and STIs in all general practices: post-implementation, there was an increase of an average of 11.2 chlamydia tests per month (p=0.026), 10.5 gonorrhoea tests per month (p=0.001), 4.3 syphilis tests per month (p=0.010), and 5.6 HIV tests per month (p=0.010). Participants reported increases in knowledge level and confidence in offering STI testing and managing more variety of sexual health cases. This study demonstrated the feasibility of implementing a hub and spoke model to enable GPs to deliver sexual health care with support from a sexual health specialist service.

Background: The COVID-19 among humans is spreading heavily and is largely impacting the mental health of the general population, students, and health care workers worldwide. Hence, this review aims to summarize the literatures addressing the impact of the COVID-19 pandemic on the mental health of the general population, students, and health care workers. Methods: Published articles concerning mental health of the general population, students, and health care workers related to the COVID-19 outbreak have been considered and reviewed. Results and Discussion: Mental health symptoms of stress, anxiety, and depression are common psychological reactions to the COVID-19 pandemic in the general population, students, and health care workers. This collectively influences daily behavior, economy, prevention strategies and decision making from policy makers and health organizations, weakening the strategies of COVID-19 control leading to more morbidity and mental health needs at the global level. Conclusion: There is a need for more evidence-based research from other affected countries, particularly in vulnerable populations such as children and adolescents, people of lower socioeconomic status, and those residing in rural areas, so that valid strategies can be developed and COVID-19 and outbreaks of similar types in the near future can be prevented.

The outdoor sculpture of the first Portuguese king, D. Afonso Henriques (~1109 – 1185 AD), placed in Guimarães (North Portugal) is one of the most emblematic national sculptures. Created in 1887 by António Soares dos Reis, it possesses a remarkable symbolic value in the presumed birthplace of the king. In addition to the artistic and heritage importance of the monument, it is one of the few sculptures cast by a Portuguese industrial foundry in the 19th-century. This study obtained data on the sculpture's elemental composition and corrosion products, gathering important historical and technical information. For this purpose, a multi-analytical approach consisting of X-ray fluorescence (XRF), X-ray diffraction (XRD), optical microscopy (OM) and scanning electron microscopy (SEM-EDS) was carried out to characterise the bulk metal and corrosion layers. The data revealed a ternary alloy of Cu, Sn, Zn with Pb, Fe, As, Bi and Mn as minor elements. The alloy matches that of other sculptures cast in that period. In terms of corrosion, it is characterised by the presence of oxides. These results represent the first step for applying an appropriate conservation strategy for bronze sculptures with similar characteristics.

Patients with predominantly antibody deficiencies (PAD) display hypogammaglobulinemia with a high prevalence of infections, along with autoimmune manifestations, benign and malignant lymphoproliferation and granulomatous disease. It is noteworthy that PAD patients, even those with defects in the same causative genes display a variable clinical phenotype, suggesting that additional genetic polymorphisms, located in either immune-related or non-immune-related genes, may affect their clinical and laboratory phenotype. In this context, we analyzed 80 PAD patients, including 70 with common variable immunodeficiency (CVID) for SERPINA1 defects, in order to investigate their possible contribution to PAD clinical phenotype. Eight CVID patients carried heterozygous pathogenic SERPINA1 defects with normal alpha-1 antitrypsin levels. Interestingly, the presence of the Z allele (rs28929474) which was found in three patients, was significantly associated with liver disease; hepatic complications were also observed in patients carrying the p.Leu23Gln (rs1379209512) and the p.Phe76del (rs775982338) alleles. Conversely, no correlation of SERPINA1 defective variants with respiratory complications was observed, although patients with pathogenic variants exhibit a reduced probability of developing autoimmune diseases. Therefore, we recommend SERPINA1 genetic analysis in PAD, in order to identify patients with a higher risk for liver disease.

Across decades of contemporary discussion on sustainable development, a core debate has concerned the relationship between the economic, social, and environmental dimensions of sustainability. In recent years, a debate on economic growth versus degrowth has been going on discussing whether economic growth can be sustainable in environmental terms and whether economic degrowth can be sustainable in social terms. This conceptual and theoretical article has used the Sustainability Window, or ‘SuWi’ method, to theoretically determine the sustainable window of economies, as upper and lower bounds of future change in GDP, that could be deemed in line with environmental and social sustainability. All theoretically possible scenario paths of development are considered by combining the economic, environmental, and social dimensions, with the environmental and social productivities of GDP. In moving to sustainability analysis through SuWi it is noted that only four of the logically possible scenario paths could be considered theoretically 'sustainable’, and only if adhering to strict conditions. Two of the hypothesised scenarios involve economic growth and two of economic degrowth. The approach, including calculation formulas, has many potential uses in providing analysis and support to 21st century sustainability policymaking, including the United Nations Sustainable Development Goals.

Linear programming formulations of forest ecosystem management (FEM) problems proposed in the 60s have been adapted and improved upon over the years. Generating management alternatives for forest management planning is a key step in building these models. Global forests are diverse, and a variety of models have been developed to simulate management alternatives. Climate change has made forest management calculations even more complex, requiring flexibility, diverse parameters, models, and methods. Despite this complexity, consistent concepts can be applied in developing management alternatives for forest management planning. This work describes iGen, a flexible forest prescription generator that applies the AI technique Rule-Based System (AI-RBS). iGen projects the state and associated inputs and outputs for a set of management units using rules from its knowledge base. An Inference Engine uses the rules to simulate a set of prescriptions in a tree-like graph structure. Without needing IT specialists, forest managers can describe the potential development of their forest through variables, rules, formulas, functions, and procedures. A key feature of iGen is that it is not limited to, adapted to, or focused on any specific region, landscape, forest condition, projection method, or yield function. Instead, it aims to maximize generality, enabling it to address a broad range of FEM problems. This article introduces iGen, explaining its concepts, structure, and algorithms through two FEM problems: natural regeneration with shelterwood harvests and plantation/coppice. For data and iGen source programs, visit github.com/…/iGen.

Geriatric decisional capacity assessment is a complex medico-legal activity that evaluates normal subjects involved in specific civil matter like wealth transfer, access to treatment or voluntary hospitalization. Our objective was to evaluate how geriatric extrajudicial capacity exams impacted a general psychiatric unit over a decade. We also assessed the value of a surrogate biomarker (neutrophils to lymphocyte ratio) as a screening factor in the capacity assessment process. 72 cases were assessed in one psychiatric unit over a decade (2009-2018). As population was fast ageing, the total number of capacity exams per year doubled in time. None of the subjects had an active diagnostic of severe cognitive impairment or active psychiatric disease. The percentage of subjects receiving an “absence of capacity” conclusion remained constant over time (approx. 20% of all cases). 81% of the subjects within this subgroup had a clinical diagnostic of mild cognitive impairment compared to 46% in the “presence of capacity” subgroup (p&lt;0.001). The surrogate biomarker neutrophils to lymphocyte ratio was significantly higher in the “absence of capacity” subgroup, mainly related to a cognitive impairment diagnostic. The ratio has to be validated by larger studies before to be included in the capacity assessment process as an early screening tool.

Hospital Pulau Pinang is the general hospital in Malaysia which targeting energy savings of 10% within five years from 2015 and other sustainability targets such as 3-star Energy Management Gold Standard and Green Building Certification. The targets are beneficial for the hospital itself to establish the Smart Building Program to improve its energy efficiency concurrent with the green policy of the Ministry of Health Malaysia and Sustainable Development Goals by the United Nations. This paper reviews the background of Hospital Pulau Pinang energy data , energy consumption trending, energy-saving trending, and energy conservation measures taken for the hospital from 2015 to December 2021.The yearly energy consumption baseline taken in 2016 was 27,496,731.00 kWh. It reduced significantly to 21,356,063 kWh in 2021 due to energy conservation measures. As a result, Hospital Pulau Pinang has achieved energy-saving about 16% at approximately RM7.3 million reduction in operational expenditure. The main objective of this paper is to provide further potential energy savings by studying the energy reduction by implementing solar photovoltaics using the simulation method. The simulation method can predict that Hospital Pulau Pinang can achieve another 5,130,000 kWh energy savings annually. This type of simulation has never been done before at a public hospital, and it will give further enhancing strategies to the Smart Building Program itself. Furthermore, the potential of smart building can be maximized to the next level by simulation, which helps the hospital energy committee make the potential decision on the energy-saving investment.

Male breast cancers are uncommon, as men account for less than 1 percent of all breast carcinomas. Among the predisposing risk factors for male breast cancer, the following appear to be significant: a) breast/chest radiation exposure, b) estrogen use, diseases associated with hyper-estrogenism, such as cirrhosis or Klinefelter syndrome, and c) family health history. Furthermore, there are clear familial tendencies, with a higher incidence among men who have a large number of female relatives with breast cancer and d) major inheritance susceptibility. Moreover, in families with BRCA mutations, there is an increased risk of male breast cancer, although the risk appears to be greater with inherited BRCA2 mutations than with inherited BRCA1 mutations. Due to diagnostic delays, male breast cancer is more likely to present at an advanced stage. A core biopsy or a fine needle aspiration must be performed to confirm suspicious findings. Infiltrating ductal cancer is the most prevalent form of male breast cancer, while invasive lobular carcinoma is extremely uncommon. Male breast cancer is almost always positive for hormone receptors. A worse prognosis is associated with a more advanced stage at diagnosis for men with breast cancer. And randomized controlled trials which recruit both female and male patients should be developed in order to gain more consistent data on the optimal clinical approach.

Fluid mechanics of flow in hydrophobic, rectangular microchannels with finite aspect ratios is of paramount importance. In such microchannels, not only the effect of the side walls should be taken into account, but also the classical assumption of no-slip boundary condition (BC) is no longer valid at the solid-liquid interface. Accordingly, slip flow can occur in microchannels fabricated from surfaces with low wetting conditions, hydrophobic surfaces. Determining the interactions of liquid molecules adjacent to solid surface is still a challenging issue, and it is especially important in small scale domains. Herein, the fluid mechanics of flow through rectangular hydrophobic microchannels has been reconsidered by taking into account the general Navier-slip BCs at the solid-liquid interface. For fully developed incompressible flow in microchannels at low Reynolds number, partial differential equation (PDE) of the momentum equation simplifies to the classical Poisson equation. Accordingly, by analytically solving the Poisson equations with general Navier-slip BCs, the most general forms of velocity distributions, flow rate, friction factor and Poiseuille number have been obtained.

Introduction Pharmacovigilance may detect safety issues after marketing of medications, and this can result in regulatory action such as direct healthcare professional communications (DHPC). DHPC can be effective in changing prescribing behaviour, however the extent to which prescribers vary in their response to DHPC is unknown. This study aims to explore changes in prescribing and prescribing variation among GP practices following a DHPC on the safety of mirabegron, a medication to treat overactive bladder (OAB). Methods This is an interrupted time series study of English GP practices from 2014-2017. NHS Digital provided monthly statistics on aggregate practice-level prescribing and practice characteristics (practice staff and registered patient profiles, Quality & Outcomes Framework indicators, and deprivation of the practice area). The primary outcome was monthly mirabegron items as a percentage of all OAB drug items. The exposure was a DHPC issued by the European Medicines Agency in September 2015. Variation between practices in mirabegron prescribing before and after the DHPC was assessed using the systematic component of variation (SCV). Multilevel segmented regression with random effects quantified the change in level and trend of prescribing after the DHPC. Practice characteristics were assessed for their association with a reduction in prescribing following the DHPC. Results This study included 7,408 practices. During September 2015, 88.9% of practices prescribed mirabegron and mirabegron composed a mean of 8.2% (SD 6.8) of OAB items. Variation between practices was classified as very high and the median SCV did not change significantly (p=0.11) in the 6 months after the September 2015 DHPC (12.4) compared to before (11.6). Before the DHPC, there was a monthly trend of 0.294 (95%CI, 0.287, 0.301) percentage points increase in mirabegron percentage. There was no significant change in the month immediately after the DHPC (-0.023, 95% CI -0.105 to 0.058) however there was a significant reduction in trend (-0.036, 95% CI -0.049 to -0.023). Higher numbers of registered patients and patients aged ≥65 years, and practice area deprivation were associated with having a significant decrease in level and slope of mirabegron prescribing post-DHPC. Conclusion Variation in mirabegron prescribing was high over the study period and did not change substantively following the DHPC. There was no immediate prescribing change post-DHPC, although the monthly growth did slow. Knowledge of the degree of variation in and determinants of response to safety communications may allow those that do not change prescribing to be provided with additional supports.

Abstract: This article aims to better understand the mechanisms that connect climate change perceptions and general willingness to engage in pro-environmental behavior using Spanish cross-sectional data (N = 403). To do this, we first developed and validated the General Willingness for Environmental Behavior Scale (GWEBS), which includes the classical approach of voluntarily doing new actions but also actions implying not doing things (degrowth) and actions forced by social constraints. The exploratory and confirmatory factor analysis showed a good fit for the one-factor structure, which had adequate validity based on their relationship with other variables. Additionally, the GWEBS distinguished between women and men, left- and right-oriented people, and people who belonged to pro-environmental groups and people who did not. In the second place, we tested the parallel mediator role of eco-anxiety and trust in science in the relationship between climate change perceptions and the GWEBS. The results showed that eco-anxiety, fully, and trust in science partially mediated such a relationship, making them crucial to mobilize the intention to act following the perception. This study contributes to our understanding of the psychological mechanisms that eventually drive pro-environmental behaviors and provides a clear direction for future research.

Nutraceuticals have taken the spotlight during the past two decades as evidenced by the exponential publications on them. Long a part of routine in Traditional Medicine Systems, the rise of their mainstream use globally raises both safety concerns and need for better understanding of efficacious dosing. We attempt to answer these questions in this preliminary scoping review by an analysis of current literature on nutraceutical use as a personalized or prescription medicine. Using Covidence, Rayyan, and manual searches of PubMed, 598 unique publications were selected. 32 are systematic reviews, of which we overview the scope. We also overview 30 papers that address adverse drug reactions. To obtain an unbiased landscape of the 598 papers, we analyzed keywords using multiple methods. Expectedly, the most frequent keywords were probiotics and vitamins. Unexpectedly and remarkably, among the highest keyword yield was ‘COVID’. Further exploring this aspect, we review 15 pertinent papers, that not only provide robust evidence for nutraceutical benefits as part of SARS-CoV-2 treatment, but also amplify the notion that nutraceuticals are protective. Overall, the strident note is that further robust targeted research is needed in order to reap the full benefits of nutraceuticals in a safe and efficacious manner.

Background: Large-cell neuroendocrine carcinoma presents significant treatment challenges owing to its rarity and limited therapeutic options. The LANCE study was designed to explore the survival benefits of incorporating atezolizumab in chemotherapy for metastatic LCNEC. Methods: In this non-randomized study, patients with metastatic LCNEC were treated with ei-ther standard chemotherapy plus atezolizumab or standard chemotherapy alone. The primary outcomes measured were progression-free survival (PFS) and overall survival (OS), with an ex-ploratory analysis of miR375 in plasma as a potential biomarker. Results: Of the 22 screened patients, 17 met the inclusion criteria and were stratified into the atezolizumab and chemotherapy (n=10) or chemotherapy alone(n=7) groups. After a median follow-up of 23.3 months, the 12-month survival rate for the atezolizumab group was 57.1% (95% CI: 32.6%-100%) and 45.7% at 24 months (95% CI: 22.4%-93.2%). In contrast, the chemotherapy group had a 14.3% survival rate at both 12 and 24 months (95% CI: 2.33%-87.7%). The log-rank test for survival showed a statistically significant difference in the atezolizumab-treated group (chi-squared = 4, df = 1, p = 0.04). A non-significant correlation was found between disease pro-gression and elevated levels of miR375. Conclusions: This pilot study suggests that atezolizumab combined with chemotherapy may be effective in treating metastatic LCNEC. The non-significant correlation between plasma miR375 levels and disease progression suggests its biomarker potential, warranting further validation research.

Infection with human immunodeficiency virus (HIV) and induced acquired immune deficiency syndrome (AIDS) represent one of the greatest health burdens worldwide. The complex pathophysiological pathways that link highly active antiretroviral therapy (HAART) and HIV infection per se with dyslipidemia make the management of lipid disorders and the subsequent increase in cardiovascular risk essential for the treatment of people living with HIV (PLHIV). Amongst the HAART regimens, darunavir and atazanavir in terms of protease inhibitors, tenofovir disoproxil fumarate, nevirapine or rilpivirine in terms of nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors respectively, and especially integrase inhibitors, have demonstrated the most favorable lipid profile emerging as sustainable options in HAART substitution. To this day, statins remain the cornerstone pharmacotherapy for dyslipidemia in PLHIV, although important drug-drug interactions with different HAART agents should be taken into account upon treatment initiation. For those intolerant or not meeting therapeutic goals, the addition of ezetimibe, PCSK9, bempedoic acid, fibrates or fish oils should also be considered. This review summarizes the current literature on the multifactorial etiology and intricate pathophysiology of hyperlipidemia in PLHIV, with an emphasis on the role of different HAART agents, while also providing valuable insights into potential switching strategies and therapeutic options.

Interprofessional collaboration between general practitioners (GPs) and community pharmacists (CPs) is central to implement antimicrobial stewardship (AMS) programs in primary care. This study aimed to design a GP-pharmacist antimicrobial stewardship (GPPAS) model in Australian primary care. A seven-component exploratory study was conducted since 2017 to 2021 to inform a GPPAS model. We generated both secondary and primary evidence through a systematic review, a scoping review, a rapid review, nationwide surveys of Australian GPs and CPs including qualitative components and a pilot study of a GPPAS model. All study evidence was synthesised, reviewed, merged and triangulated to design a prototype GPPAS model using a Systems Engineering Initiative for Patient Safety theoretical framework. Secondary evidence informed effective GPPAS interventions, and primary evidence captured interprofessional issues, challenges and future needs to implement GPPAS interventions by GPs and CPs. A GPPAS model framework involving GP-pharmacist team-based five GPPAS sub-models were successfully designed to foster AMS education, antimicrobial audits, diagnostic stewardship, delayed prescribing, and routine review of antimicrobial prescription by improved GP-CP collaboration. A GPPAS model could be used as a guide to collaboratively optimise antimicrobial use by GPs and CPs. Implementation studies on GPPAS model and sub-models are required to integrate GPPAS model into GP-pharmacist interprofessional care models in Australia.

This work is mainly focused on improving the differential evolution algorithm with the utilization of shadowed and general type 2 fuzzy systems to dynamically adapt one of the parameters of the evolutionary method. In this case, the mutation parameter is dynamically moved during the evolution process by using a shadowed and general type-2 fuzzy systems. The main idea of this work is to make a performance comparison between using shadowed and general type 2 fuzzy systems as controllers of the mutation parameter in differential evolution. The performance is compared with the problem of optimizing fuzzy controllers for a D.C. Motor. Simulation results show that general type-2 fuzzy systems are better when higher levels of noise are considered in the controller.

Background.Nurse gives professional nursing service to patients according to competence owned. Based on these services in the end of every year, nurses are given incentives for medical services as financial incentive. Purpose. To analyze the impact of competence training and incentives medical services’ distribution upon the achievement of nurse’s performances in General Hospital of W. Z. Johannes Kupang. Matterial and method. Observational survey research with cross sectional design. Population. Nurses in General Hospital of W. Z. Johannes Kupang. Technique. Total sampling technique with number of samples 183 respondents. Inclusive criteria of samples are willing to be interviewed, nurse’s status, permanent offices without limitation from particular working unit or poly in hospital. Independent variable: (1) competence training; (2) Incentives for medical services. Dependent variable; Nurse’s performance achievement. Variables are measured by using Lickert scale. Information are recorded through questionnaire. Analyzes using linier regression. Result. There are impacts of competence training (α=.000;ß=.489)and distribution of incentives for medical services(α=.012; ß=.152)upon nurse’s performances achievement in General Hospital of Prof.W. Z. Johannes Kupang. Conclusion.The training of nursing service status that could increase competences among nurses with affair incentives for medical services’ distribution simultaneously end up in the increasing of nurse’s performances achievement in a hospital

Background: This study explored maternal gut, breast milk and infant gut microbiomes as possi-ble mediators of the observed effects of a relaxation intervention which reduced maternal stress and promoted infant weight gain. Methods: A randomized controlled trial was conducted in healthy Chinese primiparous mother-infant pairs. Mothers were randomly assigned to interven-tion group (IG, listening to relaxation meditation) or control group (CG). Outcomes were differ-ences in microbiome composition and diversity in maternal gut, breast milk and infant gut at 1- and 8-weeks between IG and CG, assessed by 16S rRNA gene amplicon sequencing of fecal and breastmilk samples. Results: 38 mother-infant pairs were included in this analysis (IG=19, CG=19). Overall microbiome community structure in the maternal gut was significantly different between IG and CG at 1-week and the difference was more significant at 8 weeks (Bray-Curtis distance R2=0.04 vs. R2=0.13). Post-intervention, the α-diversity was significantly lower in IG breast milk (observed features: CG=295 vs. IG=255, p=0.032); the Bifidobacterium genera presented higher relative abundance. In parallel, significantly higher α-diversity was observed in IG infant gut (observed features: CG=73 vs. IG=113, p

The paper focuses on the application of a multilevel, integrative and territorial approach to the protection of cultural heritage through planning instruments in Serbia. It points out the problems of the sectoral approach and discusses international recommendations that can be integrated into the planning methodology. The case study is the area of Djerdap National Park, which has an already established international and national importance. The research suggests that the cultural heritage in the area, with the exception of the Roman limes, is still recognized at the level of individual localities. The study emphasizes the importance of aligning all levels of governance to safeguard the whole spatial entity rather than focusing solely on its particular areas. The interna-tional and national importance of the planning area contributes to the strengthening of awareness of heritage and its institutional protection. However, the vitality of the area, which is key to its sustainable development, comes from the local level. Planning documents contribute to the inte-gration of local values and local communities into development programs and projects.

This study finds that in northern Jordan, breeder indicators present challenges to the sustainability and growth of sheep and goat farming, while economic indicators suggest a combination of financial stability alongside hurdles related to profitability and resource ownership. Breeder age plays a role in the management of livestock herds, due to factors such as experience, resources, or adherence to traditional practices. Experience significantly affects breeders' decisions on male insemination replacements, likely due to skill. Crop cultivation influences breeders' returns by reducing feeding costs, while strategic lamb sales management boosts individual animal profitability. Winter raises animal mortality due to cold stress. Other animals in herds increase kid mortality by spreading diseases. Breeder experience significantly affects lamb survival, stressing its role in care. Increasing sheep proportion enhances lamb production and reduces lamb mortality while managing rams and selling lambs positively affects herd health and productivity. A larger goat herd proportion positively correlates with kids sold but inversely with breeding males and overall kids, implying trade-offs affecting herd productivity and mortality rates. Sheep herds (92.5%) show slightly better reproductive success than goats (90.6%), implying superior long-term viability. Flock excels in birth, survival, and sales, but low sheep and lamb%. Improvement is needed for sustainability, and the potential is high. Goat breeding shines in birth, sales, and overall success, but needs attention to kid survival and other sustainability issues. In conclusion, despite challenges, there are promising opportunities to enhance sheep and goat farming in Jordan. Effective management, informed by breeders' experience and economics, is crucial. Empowering small-scale herders and implementing targeted interventions like winter mortality solutions and selective breeding is vital for sustainable growth.

This paper discovers that current canonical variational principle and canonical Noether theorem of (in)finite freedom systems for different physics systems have neglected doublet extreme value processes of the general extreme value functional that both is derived by variational principle and is necessarily be taken in deriving all ( quantum ) physics laws in phase space, but which have not been done for over one century since Noether's showing her distinguished theorem, which lead to the crisis deriving all (quantum) physics laws (necessary) in phase space. We discover there is the hidden logic cycle that people assume canonical equations, and then they finally deduce canonical equations by the equivalent relation in the whole processes in all current references. We correct the current key mistake concepts that when physics systems take the variational extreme values, the appearing processes of the physics systems are real physics processes, otherwise, are virtual processes in all current references. The real physics should be what after taking the physics systems' variational extreme values, the physics systems' general extremum functional needs to further take the general extremum functional's minimum absolute extremum zero, otherwise, the appearing processes of physics systems still are virtual processes. Conservation current equations and conservation currents, in phase space, of general canonical variational principle and general canonical Noether theorem are, respectively, deduced for the first time. Using the general extremum functionals' doublet extreme value processes, the hidden logic cycle and the crisis in current canonical variational principle and current canonical Noether theorem are solved. Consequently, the new mathematical pictures, classical and quantum new physics in phase space and the new mathematical and physical doublet extremum processes for (in)finite freedom systems are discovered. General canonical variational principle and general canonical Noether theorem naturally are given, which would rewrite all the different sciences in phase space, as key tools of studying and dealing with them.

In schizophrenia, a single latent trait underlies psychosis, hostility, excitation, mannerism, negative (PHEMN) symptoms, formal thought disorders (FTD) and psychomotor retardation (PMR). Schizophrenia is accompanied by a breakdown of gut and blood-brain-barrier (BBB) pathways, increased tryptophan catabolite (TRYCAT) levels, bacterial translocation, and lowered natural IgM and paraoxonase (PON)1 activity. The aim of this study was to examine the factor structure of schizophrenia symptom domains and the biomarker correlates of these factors. We recruited 80 patients with schizophrenia and 40 healthy subjects and assessed the IgA/IgM responses to paracellular/transcellular (PARA/TRANS) ratios, IgA responses to TRYCATs, natural IgM to malondialdehyde and Gram-negative bacteria, and PON1 enzymatic activity.Direct Hierarchical Exploratory Factor Analysis showed a bifactorial oblique model with a) a general factor which loaded highly on all symptom domains, named overall severity of schizophrenia (“OSOS”); and b) a single-group factor (SGF) loading on negative symptoms and PMR. We found that 40% of the variance in the OSOS score was explained by IgA/IgM to PARA/TRANS ratio, male sex and education while 36.9% of the variance in SGF score was explained by IgA to PARA/TRANS, IgM to Gram-negative bacteria, female sex (positively associated) and IgM to MDA, and PON1 activity (negatively associated). Schizophrenia phenomenology comprises two biologically-validated dimensions, namely a general OSOS dimension and a single-group negative symptom dimension, which are associated with a breakdown of gut/BBB barriers, increased bacterial translocation and lowered protection against oxidation, inflammation and bacterial infections through lowered PON1 and natural IgM.

Glycosidic linkage analysis was conducted on the unfractionated polysaccharides in the alcohol-insoluble residues (AIRs) prepared from six red seaweeds (Gracilariopsis sp., Prionitis sp., Mastocarpus papillatus, Callophyllis sp., Mazzaella splendens, and Palmaria palmata) using GC-MS/FID analysis of partially methylated alditol acetates (PMAAs). The cell walls of P. palmata primarily contained mixed-linkage xylans and small amounts of sulfated galactans and cellulose. In contrast, the unfractionated polysaccharides of the other five species were rich in galactans displaying diverse 3,6-anhydro-galactose and galactose linkages with varied sulfation patterns. Different levels of cellulose were also observed. This glycosidic linkage method offers advantages for cellulose analysis over traditional monosaccharide analysis that is known for underrepresenting glucose in crystalline cellulose. Relative linkage compositions calculated from GC-MS and GC-FID measurements showed that anhydro sugar linkages generated more response in the latter detection method. This improved linkage workflow presents a useful tool for studying polysaccharide structural variations across red seaweed species. Furthermore, for the first time, relative linkage compositions from GC-MS and GC-FID measurements, along with normalized FID and total ion current (TIC) chromatograms without peak assignments, were analyzed using principal component analysis (PCA) as a proof-of-concept demonstration of the technique's potential to differentiate various red seaweed species.

Background: Educating college students about the importance of good sleep habits could lead to the adoption of healthier sleep routines, including sufficient sleep duration and sleep quality. The current pre-post study examines the impact of completing a sleep education program called “Sleep 101” on (1) sleep hygiene practices, (2) sleep quality, and (3) weekday and weekend sleep behaviors among college students. “Sleep 101” is an interactive online course developed to educate college students about the importance of sleep by addressing basic sleep physiology, the impact of sleep on mood, academic and physical performance, the interactions between sleep and various substances, and common sleep disorders. Methods: 338 college students were recruited from a midsized public university in the US and invited to participate in “Sleep 101”, of which 25 participants completed the baseline and post-intervention questionnaire. The Sleep Hygiene Index (SHI) was utilized to evaluate sleep hygiene practices, while standard questions were employed to assess weekday and weekend sleep behaviors and overall sleep quality. Results: Those who completed the study demonstrated a significant increase in weekday sleep duration and were less likely to engage in negative prior bedtime activities. In addition, 40% of those who completed baseline and post-intervention assessments noticed improvements in their sleep quality. Conclusion: These findings suggest that a brief online program is beneficial in improving sleep behaviors among college and could be a scalable approach to addressing current sleep issues and preventing future sleep problems in college students.

In this paper, we establish the necessary and sufficient conditions for solving a dual split quaternion matrix equation AXB=C, and present the general solution expression when solvability is achieved. As an application, we delve into the necessary and sufficient condition for the existence of Hermitian solution to this equation by using a newly defined real representation method. Furthermore, we obtain the solutions for the dual split quaternion matrix equations AX=C and XB=C. Finally, we provide a numerical example to demonstrate the findings of this paper.

Background Although the management of the majority of patients with IBS is dealt with by General Practitioners, randomized clinical trials and treatment guidelines are developed mostly in academic settings. Probiotics are one of the most investigated treatment modality for this condition. Scarce information is available as regards GPs attitude in this regard. Methods A literature search was performed to identify papers specifically dealing with probiotic treatment of IBS in the general practice setting. Moreover, the preliminary results of a survey on this topic conducted by the authors among general practitioners in a province in northern Italy are reported. Results Five papers specifically addressing probiotic treatment of IBS in general practice were found. The response rate varied from 4 to 100%. The prescription rate of probiotics by GPs in IBS varied from <10 to 46%, regardless of the patients’ bowel habits. Physicians’ satisfaction with this treatment varied from 20 to 93%. The variability of these results probably depends on factors such as differences in the interpretation of the available data on probiotics use in IBS and traditional/ cultural differences. Moreover, compliance with patient satisfaction, may play a role. Conclusions The reported data on the treatment of IBS with probiotics in general practice is scarce and inhomogeneous, thus it does not allow firm conclusions. It is suggested that the involvement in research on the use of probiotics in IBS of physicians working in general practice would be useful in order to pursue more reliable and useful results, since the majority of the IBS population is followed in general practice and may differ from the one represented in academic clinical trials.

Abstract: this study aimed to evaluate the benefits of applying 5 cmH2O of CPAP using a pediatric helmet during the recovery phase from general anesthesia in brachycephalic dogs. Brachycephalic dogs undergoing various surgical procedures were included in the study, and a total of 64 subjects were randomly assigned to receive either standard oxygen supplementation (NO-CPAP group) or oxygen supplementation combined with CPAP (CPAP group). The study evaluated arterial blood pH, blood gas partial pressures of O2 and CO2, arterial blood O2 saturation, and related parameters during recovery. The dogs were monitored, and helmet tolerance was assessed using predefined criteria. Of the initially assessed 69 dogs, 64 were enrolled, 32 in the CPAP group and 32 in the NO-CPAP group. Fifteen dogs in the NO-CPAP group were excluded based on predetermined criteria. The CPAP group showed significant improvements in PaO2, PaO2/FiO2, P(A-a)O2, F-Shunt, and respiratory rate compared to the NO-CPAP group (p < 0.001). The incidence of reintubation and helmet intolerance was higher in the NO-CPAP group (18% and 15.6%, respectively) than in the CPAP group (0%). This study highlights the potential benefits of incorporating CPAP, delivered through a pediatric helmet, in the perioperative management of brachycephalic dogs. Keywords: Brachycephalic; dog; CPAP; oxygenation; anesthesia

The patient's satisfaction level concerning hospitalization has certain particularities, related to the geographical area, medical/non-medical assistance, the age, incomes, morbidity and mortality of the population. The objective of this study is to emphasize the degree of patients' satisfaction, depending on the specialty of the hospitalization department: surgical, medical, oncological, psychiatry, and to evidence the factors influencing the reliability and accuracy of patients' answers, such as: the patient's health condition upon admission, the duration of the admission, the level of physical pain and the emotional state. Patients and methods: The research was conducted between April and December 2021 on patients hospitalized in two public hospitals from the north-west of Romania, both of them being independent Legal Entities: the Municipal Clinical Hospital of Oradea (MCHO) and the County Clinical Emergency Hospital of Oradea (CCEHO). Results: The lowest score of PSS recorded in these two analyzed public hospitals from the north-western of Romania was appointed for the Pharmaceutical availability of patients medical treatment (2.24), attitude of the staff (2.56) and the quality of nursing care offered (2.58). Conclusions: The hospital management’s focus has been set to improve the communication skills among medical staff, to evidence their compassion, politeness, and to ensure the availability of essential drugs.

Difference in two quantum states defined for a point in space time is represented by space time curvature and the superposition of these quantum states will affect the momentum of mass existed at that point. Analogy of the same with Einstein’s General relativity field equation and Einstein’s gravitational constant , indicated an equation containing ‘Hubble’s constant H , Einstein’s gravitational constant ‘H’ and Siva’s constant ‘K’. Its output is a quadratic equation. Solution to this quadratic equation predicted a fundamental force particle. This solution gives the diameter of that particle. From the fundamental principles, the diameter of this force particle gives the coupling constant of that fundamental force. Prediction and review of this particle may provide us new insights in to quantum physics and standard model of particle physics. From the first principles, it is discussed that this particle can be claimed as a force carrying particle of a fundamental force related to dark matter. This work has provided simple explanation to reconcile quantum nature of space time with smooth space time of General Relativity. This has demanded the necessity to introduce a new postulate in quantum mechanics which is beyond Hilbert space and Dirac notation. A new perspective of uncertainty principle in quantum mechanics has been elaborated.

We suggest that despite McLuhan’s claim not to have a theory of communication that in fact the body of his work does indeed constitute a theory of media and their effects which I have called his General Theory of Media (GToM) that also includes his Laws of Media (LoM). Both McLuhan’s GToM and his LoM are described. A comparison is made of three notions of law: i. McLuhan’s notion of law as used in his Laws of Media; ii. the notions of the Law in the legal sense and iii. the notion of law as formulated in scientific laws. McLuhan’s understanding of media is used to analyze some of the negative effects of social media suggesting that laws need to be formulated to prevent the misuse of social media that are antithetical to democracy and the invasion of the privacy of the individual users of these apps. McLuhan’s Laws of Media are then used to provide insights into the nature of scientific laws, the Law in the legal sense and his own Laws of Media.

This paper presents a new analytical method for obtaining new deformations compatibility equations or, new Saint-Venant’s identities, into the relative coordinate system with projected deformations by applying the hypothesis of the lineal shell theory in general flexion state. The method proposed generalizes the compatibility conditions established by A.L. Goldenveizer for the shell theory. On the other hand, the new equations include the deformations compatibility equations by other authors: Flügge, Saint-Venant, Love-Kirchhoff, Timoshenko, Goldenveizer, and Reissner-Mindlin. The results showed an increase of knowledge in general shell theory, and provide inverse and semi-inverse solutions, whose systems solution correspond to the hyper-statics degrees of the physical model, and not to their degrees of freedom.

The profile of secondary metabolites occurring in apple cuticular layer is not only characteristic for particular apple cultivar, but also dynamically reflects various external factors in growing environment. In this study, the possibility to authenticate apple samples based on analysis of their cuticular layer extracts was investigated. Ultra-high-performance liquid chromatography coupled to high resolution tandem mass spectrometry (UHPLC-HRMS/MS) was employed for obtaining metabolomic fingerprints. In total, 274 authentic apple samples, four cultivars harvested within the seasons 2020 to 2022 in the Czech Republic and Poland were analysed. The generated complex data processed by univariate and multivariate statistical methods enabled to build classification models for discrimination of apple cultivars as well as their geographical origin. The models showed very good performance in differentiation of Czech and Polish samples for three of four cultivars: ‘Gala’, ‘Golden Delicious’ and ‘Idared’, moreover, the validity of the models was verified over harvest seasons. The diagnostic markers, besides metabolites of triterpene biosynthetic pathway, mainly represented wax esters. ‘Jonagold’, which is known to be susceptible to mutations, was the only cultivar for which the unambiguous classification of geographical origin was not possible.

Background/Objectives: Community-acquired pneumonia (CAP) is a common emergency presentation in Australia, with the choice of admitting specialty unit often influenced by pneumonia severity and comorbidities. However, it remains unclear whether there are between-specialty differences in patient characteristics and outcomes. We sought to address this issue by investigating the characteristics and outcomes of CAP patients admitted to General Medicine (GM) versus Respiratory units.Methods: This retrospective observational study utilised data from the two largest metropolitan hospitals in South Australia, encompassing all non-COVID-19-related CAP admissions throughout 2021 to 2023. Hospital length of stay (LOS), in-patient and 30-day mortality, and 30-day readmission rates were assessed by propensity-score-matching (PSM) with using 14 variables.Results: Of the 3,004 cases of non-COVID-19 CAP admitted across the two hospitals during the study period, 2,673 (71.8%) were admitted under GM units and 331 (9.1%) under Respiratory units. GM patients were, on average, a decade older, presented with a significantly higher burden of comorbidities, exhibited a greater prevalence of frailty and had higher pneumonia severity compared to those admitted under a Respiratory unit, (P

Purpose – Extend the Blade Element Momentum Theory (BEMT) such that rotors with pronounced cone and axis angle (tilt or yaw) can be calculated. Derive an equation for the speed ratio (lambda) as a function of Tip Speed Ratio (TSR), radius, blade, cone and axis angle. This converts the BEMT into an Unsteady BEMT or UBEMT. Present the Wagner rotor as one such rotor geometry. --- Methodology – Literature review and calculations. --- Findings – The UBEMT can be used to calculate highly unconventional rotor geometries. --- Research Limitations – Although the aerodynamic coefficients used in the UBEMT are from measurements in steady flow conditions, they can be used with success. --- Practical Implications – Also conventional Horizontal Axis Wind Turbines (HAWT) with noticeable cone and axis angle should be calculated with the UBEMT. The accuracy of power calculations of these HAWTs can be slightly improved. --- Originality – Analytic equations for rotors with cone and axis angle have barely been discussed.

Research into professionalization in health and safety has recently gained in interest. Graduate training is one of the factors that determines or conditions the role of the safety professional, thus intervene in the professionalization process. This article is the result of a workshop and the discussions of nine academic directors of safety education programs about quality evaluation. This article introduces the issue with a historic overview of safety education, presents a synthesis of nine selected education programs, discusses quality evaluation of health and safety education programs, propose a quality evaluation frame and finally, proposes a process for designing a quality safety education program with an associated model of the learning objectives. The outcomes are interesting for everyone who is interested in health and safety education and quality evaluation and will give insights into how safety professionals are educated.

The temporary immersion system bioreactor named GreenTray®[2], [3]presents advantages over the existing ones. Firstly, there is no need to use forceps to move the shoots or plantlets in or out of the recipient, neither the use of scalpel to divide them. Secondly, the basis of the shoot can remain in the GreenTray® and can sprout again in several cycles of growth. These two characteristics reduce the costs in the process of micropropagation. Besides, shoots or plantlets development is enhanced by the aeration of the recipient, thus enriching with CO2 the recipient atmosphere. The chapter describes and provides images and values of interest in (1) the micropropagation process of some commercial Prunus or Pyrus rootstocks; (2) the plantlet growth under autotrophic conditions; and (2) the inoculation of plants with pathogens that reproduce in vitro the symptoms observed in vivo, using the GreenTray® bioreactor.

Strawberry root rot caused by Neopestalotiopsis clavispora is one of the main diseases of strawberry and significantly impacts the yield and quality of strawberry fruit. There are now no effective control techniques available except for fungicide sprays, which may directly impact consumers. Biological control is becoming an alternative method for the control of plant diseases to replace or decrease the application of traditional synthetic chemical fungicides. Trichoderma is widely used as a biological agent for controlling strawberry root rot. In order to provide resources for screening the highly effective biocontrol fungus for controlling strawberry root rot caused by Neopestalotiopsis clavispora, the biocontrol mechanism,the control effects of Trichoderma asperellum CMT10 against strawberry root rot and growth-promoting effects on strawberry seedlings were investigated by plate culture, microscopy observation and root drenching methods.The results showed that CMT10 had obvious competitive, antibiotic and hyperparasitism effects on Neopestalotiopsis clavispora CMGF3. The CMT10 could quickly occupy nutritional space, and the inhibition rates of CMT10 against CMGF3 in confrontation culture on 7 d was 65.49%. The inhibition rates of volatile metabolite and fermentation metabolite produced by CMT10 against CMGF3 were 79.67% and 69.84%, respectively. The mycelium of strain CMT10 can act as hyperparasites by making contacting, winding and penetrating hyphae of CMGF3. Pot experiment showed that the biocontrol efficacy of CMT10 on strawberry root rot caused by Neopestalotiopsis clavispora was 63.00%. CMT10 had obvious promotion effect on strawberry growth, the plant height, root length, total fresh weight, root fresh weight, stem fresh weight and root dry weight, with the promotion rates were 20.09%, 22.39%, 87.11%, 101.58%, 79.82% and 72.33%, respectively. Overall, this study showed the ability of Trichoderma asperellum CMT10 to control strawberry root rot and their potential to develop as novel biocontrol agents to replace chemical fungicides for eco-friendly, sustainable agriculture.

Primary cutaneous B-cell lymphomas (PCBCLs) are B-cell lymphomas that can occur in the skin without evidence of extracutaneous involvement. The 2005 WHO/EORTC classification of cutaneous lymphomas and its 2018 update have distinguished three main categories based on clinicopathological, immunohistochemical and genetic characteristics: primary cutaneous marginal zone lymphoma (PCMZL), primary cutaneous follicle centre lymphoma (PCFCL), and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT). PCMZL and PCFCL are clinically indolent, while PCDLBCL-LT is an aggressive lymphoma. Due to its low incidence and lack of prospective studies, it is difficult to establish a standard treatment for each subgroup. The objective of our study was to describe the clinical and pathological characteristics of 103 patients with cutaneous B-cell lymphoma from 12 centres belonging to the Spanish Lymphoma Oncology Group. The median age was 53 years (40-65). According to skin extension, 62% had single site lymphoma, 17% had regional lymphoma and 20% had multifocal lymphoma. Histology: 66% had PCMZL, 26% had PCFCL, and 8% had PCDLBCL-LT. Twenty-three percent of the patients were treated exclusively with surgery, 26% with radiotherapy only, 21% with surgery plus radiotherapy, 10% with polychemotherapy, and 5% with rituximab monotherapy. Overall, 96% of patients achieved a complete response, and 44% subsequently relapsed, most of them relapsing either locally or regionally. The 10-year OS was 94.5% for the entire cohort, 98% for the PCMZL cohort, 95% for the PCFCL cohort and 85.7% for the PCDLBCL-LT cohort. Our data are comparable to those of other published series, except for the high frequency of PCMZL. The expected heterogeneity in therapeutic management has been observed.

Pancreatic cancer (PC) is the most lethal type of cancer, it has the lowest 5-year survival rate among all other types of cancers. More than half of PC cases are diagnosed at an advanced stage due to PC’s insidious and non-specific symptoms. Surgery remains the most efficacious treatment option currently available, but only 10-20% of PC cases are resectable upon diagnosis. As of now, the sole biomarker approved by the United States Food and Drug Administration (US-FDA) for PC is carbohydrate antigen 19-9 (CA19-9); however, its use is limited use for early diagnosis. An in-creasing number of studies have investigated a combination of biomarkers. Lately, there has been considerable interest in the application of a liquid biopsy, including the utilization of microRNAs (miRNAs), circulating tumor DNA (ctDNA), and circulating tumor cells (CTCs). Screening for PC is indicated for high-risk patients; studies on new diagnostic models combined with biomarkers for early detection have also shown promising results for the ability of these models and biomarkers to aid clinicians in deciding on whether to start screening. This review seeks to provide a concise overview of the advancements in existing biomarkers and explore novel strategies for the early detection of PC.

Apis mellifera, especially weak ones, are highly vulnerable to Carpoglyphus lactis mites, which can rapidly infest and consume stored pollen, leading to weakened colonies and potentially colony collapse. This study aimed to ascertain and investigate the prevalence of this mite in honeybee colonies across 9 provinces in the Republic of Korea (ROK). A total of 615 honeybee colonies were collected, from 66 apiaries during the spring and 58 apiaries during the summer of 2023. A 1,242 bp segment of the the Cytochrome c oxidase subunit 1 (COI) gene was amplified using the polymerase chain reaction method. The detection levels of C. lactis in the honeybees were compared between winter and summer. Based on the COI sequence analysis, the nucleotide sequence similarity of C. lactis mites isolated in the ROK with those from China (NC048990.1) was found to be 99.5%, and with those from the United Kingdom (KY922482.1) was 99.3%. This study is the first report of C. lactis in Korean apiaries. The findings in this study demonstrate a significantly higher detection rate in winter, which is 4.1 times greater than that in summer (p &lt; 0.001). Furthermore, the results underscore the usefulness of molecular diagnostic techniques for detecting C. lactis mites.

COX II containing a dual core CuA active site is one of the three core subunits of mitochondrial Cco, which plays a significant role in the physiological process. In this report, the full-length cDNA of COXⅡ gene was cloned from Sitophilus zeamais, which had an ORF of 684 bp encoding 227 amino acids residues. The predicted COXⅡ protein had a molecular mass of 26.2 kDa with pI value of 6.37, and multiple sequence alignment and phylogenetic analysis indicated that Sitophilus zeamais COXⅡ had high sequence identity 78.51% with the COXⅡ of other insect species, especially similarity to sitophilus oryzae. This gene was subcloned into the prokaryotic expression vector pET-32a, and induced by IPTG in E.coli Transetta (DE3) expression system. Finally the COXⅡ with 6-His tag was purified using affinity chromatography with Ni²⁺-NTA agarose. WB showed the recombinant COXⅡ was about 44 kD, and the concentration of fusion protein was 50μg/mL. UV-spectrophotometer and infrared spectrometer analysis showed that recombinant COXⅡ could catalyze the oxidation of substrate Cytc, and influenced by AITC. It was found that AITC could form a hydrophobic region with COXⅡ protein via molecular docking, besides, a sulfur atom of AITC structure could form a length of 2.9 Å hydrogen bond with Leu-31. These results will provide valuable information for elucidating the role of COXⅡ in Sitophilus zeamais responses to AITC, meanwhile, it will helpful to carry out a point mutation in AITC binding sites for the future research.

The properties of the annual, semiannual and triennial oscillations (AO, SAO and TO) in the middle atmosphere have been investigated using the TIMED/SABER temperature data. The Lomb-Scargle and wavelet spectra were used to determine the dominant oscillations in the background temperature field. The AO is prominent at the mid-latitudes. The AO amplitudes present an asymmetry between the two Hemispheres, being larger in the mesosphere than in the stratosphere. The SAO dominates the tropical regions, with three amplitude maxima at altitudes of 45, 75, and 85 km. The SAOs in the upper mesosphere (75 km) are out of phase with those in the mesopause (85 km) in the tropical regions, which can generate an enhancement of 11 K at each equinox, contributing to the lower mesospheric inversion layer. The TO is significant in the tropical region, with amplitude being maximum at 35, 45 and 85 km. Result shows that there may be potential interaction by the TO with SAO at 85km at the equator. The relation between ENSO and TO has also been discussed. The ENSO signal may modulate the amplitude of the TO, mainly in the lower stratosphere. The real origin of the TO may lie in the wave-mean-flow interaction.

This paper is focused on typical rural settlements in the Stara Planina Mountain area in Serbia. They are distinguished by their authenticity, identity and character, and they have still not been destroyed by inappropriate development as is the case in some other mountain areas in Serbia, where the effects of urbanization, globalization and homogenization are obvious. Consequently, there is a need to prevent these effects in mountain areas where there is a threat of disbalance between development and the inherited natural and cultural values. The paper starts from several important concepts that relate contemporary approaches to cultural heritage preservation, place morphology and planning future development. The concept definitions from recent documents from related fields are used. These concepts are then applied to the area of Stara Planina Mountain and its rural settlements. The necessity for an integrative approach to planning this area with significant natural and anthropogenic potential is pointed out, including its integration into international programs of sustainable development.

Literature pertaining to youth development has identified the importance of understanding the physical, intellectual and emotional needs of adolescent youth. The purpose of this study was to compare the use of a ‘traditional’ and ‘progressive’ coaching style to train a general male youth population to improve sprint and jump performances, whilst assessing enjoyment to comment on long term application. Maximal sprint times, sprint kinematics, unilateral jump distances and repetitive tuck jump scores were measured alongside anthropometric variables to characterise performance. Results revealed significant (p>0.05) pre/post differences in anthropometric variables across all maturation groups, and each of the maturational levels displayed a tendency to favour a particular coaching or control condition. Pre-PHV groups responded most effectively to the progressive style of coaching, displaying improvements in horizontal jump performances, and -0.7 to -2.7% improvements in all sprint times, despite also showing the largest increase in tuck jump scores (25.8%). The circa-PHV group produced their greatest improvements in the traditional intervention, as displayed through significant improvements (p<0.05) in 20m sprint times and dominant-leg horizontal jump performance, whilst also revealing the greatest deterioration in tuck jump scores (14.2%). Post-PHV displayed the greatest improvements in the control setting, suggesting the natural benefits gained through adolescent development were greater than the influence of the training interventions. In conclusion, it is suggested that matching coaching strategies and delivery techniques to the period of biological maturation may have implications for both performance and athlete safety.

The research reported on this paper was aimed at improving the overall efficiency of a PDO certified artisanal cheese production process. Being a PDO certified foodstuff by the EU, it is considered to have properties and qualities determined by the geographical environment in which is made, with its production taking place in a specific and determined geographical location, in this case the Serra da Estrela region. In that sense, the authors conducted a mapping according to a systemic perspective of the processes involved in the context of manufacturing and distribution of certified Serra da Estrela cheese. Numerous methods were used throughout the process, such as a systemic design analysis, and techniques derived from ethnographic methods, which led to the collection of data in the field and consequently provided the immersion of the researcher in genuine work situations. Critical points were identified and emphasized in the systemic map with the purpose of encouraging initiatives to address and overcome the gaps and inefficiencies detected. The systemic design analysis triggered the development of design work. Observations following an ethnographic approach identified ergonomic risks in cheese making during the process of cutting excess chips, fostering the emergence of musculoskeletal disorders at the wrist. A tool that fits best to the task at hand was developed. A prototype of the new tool enabled collecting feedback from use in the work context, in order to inform product development. The domains of agricultural production and microbiology, considering the specific microorganisms developed trough the ripening process of the cheese, turned out to be aspects of high importance for the issue under focus, contributing to a broader understanding of the ripening process and its risks, simultaneously improving the efficiency and success of cheese production. If it were not for the systemic analysis, which served as a link between the boundaries of distinct domains such as the risk of microorganism contamination, ergonomics, energy efficiency, legislation and regulation policies, transportation challenges and economic viability, approached throughout the research. Simultaneously creating bridges between them, the various problems might not have been detected in the first place, as they are usually addressed in specialized disciplines, predetermined by the restrictions of each specific area of knowledge. As a consequence of the development of this research, which was based on an analysis that sought to establish possible connections between various disciplines and tried to constantly maintain a holistic perspective, making new connections and observing the issues from a new angle, apart from the already established methodologies. All this allowed to lay out the seeds for the development of a plan to tackle the critical points identified by the systemic analysis reported in this paper.

Promoting green development has become an important way to optimize the ecological and economic structure and promote sustainable development. The Yangtze River Economic Belt is an important economic corridor in China, and it remains to be examined whether the implementation of environmental regulations has enhanced the green total factor productivity (GTFP) of cities. This paper calculates the green total factor productivity of 107 cities within the Yangtze River Economic Belt by using the super-efficient SBM model and the GML index with Chinese city panel data from 2007-2019 and measures the intensity of environmental regulations through textual analysis. The bidirectional fixed-effects model constructed in this paper suggests an inverted U-shaped relationship between environmental regulation and GTFP, which is confirmed by a series of robustness tests. Green technology innovation and advanced industrial structure play a mechanism role in this. In regions with lower levels of green technology and industrial structure, the inverted U-shaped relationship between environmental regulation and green total factor productivity is more significant. In addition, the phenomenon of GTFP rising and then falling because of environmental regulation is more obvious in cities in the middle and upper reaches of the Yangtze River and outside the urban agglomerations. Therefore, when formulating environmental regulation policies, it is necessary to balance the relationship between economic development and environmental protection and harmonize the environment and economic development of the entire Yangtze River Basin.

The wetlands in northeastern Bangladesh are home to some of the most prolific and valuable ecosystems on the planet, offering a wide range of benefits to both the local and wider communities. A limited number of research on this topic have been carried out in various wetlands in coastal hilsa, but none have been located in the northeastern region of Bangladesh. Thus, the goal of this study was to better understand the most commercially relevant species (anadromous hilsa) in northeastern Bangladesh as well as to assess the wetland ecosystem services more thoroughly with the contribution of their fish genetic resources. In addition to laboratory studies, fieldwork was done in the fishing settlements along the Surma River, Hakaluki Haor, and Tanguar Haor. The study classified 77 fish species into 21 subcategories of ecosystem services, of which 56% were not threatened, 17% were vulnerable, and 10% were highly endangered. The species Hilsa was found to be the most economically significant, accounting for 1% of the GDP overall. The study determined if the hilsa stock of the examined wetlands maintains a single or several subpopulations in comparison to other parts of the country when they migrate from saline water to northeastern Bangladesh (freshwater). But when compared to other groups, the FST score was between 0.000 to 0.017, indicating that the populations are identical and that there is genetic material sharing between them. Additionally, these statistics imply that the Sylhet haor and adjacent river systems contain a single stock of Hilsa fish. Nevertheless, a number of stresses and risks, including overexploitation, illicit and destructive fishing, siltation, and natural disasters like flash floods, have been linked to changes in the supply of hilsa and other ecosystem services. This study also emphasizes the necessity of policy attention and research to address the concerns.

We present a novel approach to quantum theory construction that involves maximizing the Shannon entropy of quantum measurements relative to their initial preparation. By constraining the maximization problem with a phase that vanish under measurements, we obtain quantum mechanics (vanishing U(1)-valued phase), relativistic quantum mechanics (vanishing Spin^c(3,1)-valued phase), and quantum gravity (also a vanishing Spin^c(3,1)-valued phase, but with a dilation constraint replacing the normalization constraint). The first two cases are equivalent to established theory, whereas the later case yields a quantum theory of accelerated reference frames, in which a quantized version of the Einstein field equation lives. Specifically, the spacetime interval is promoted to an observable, effectively building the metric tensor from the underlying quantum structure. Moreover, the SU(3)xSU(2)xU(1) gauge symmetries of the Standard Model arise naturally without additional assumptions. Finally, the solution is consistent only with 3+1 spacetime dimensions, as it encounters obstructions in all other dimensional configurations. This framework integrates quantum mechanics, relativistic quantum mechanics, quantum gravity, spacetime dimensionality, and particle physics gauge symmetries from a simple entropy maximization problem constrained by a vanishing phase.

Lifestyle interventions halt the progression of prediabetes to frank type 2 diabetes (T2D). However, the feasibility of a diabetes prevention program promoting tailored interventions on a national scale and conducted by primary care physicians is unclear. To explore this issue, general practitioners dislocated in ten different regions throughout Italy enrolled random subjects without known metabolic diseases to identify individuals with prediabetes and prescribe them an intervention based on physical activity. Using a simple stepwise approach, people referring to their primary care physician for any reason were screened for their diabetes risk with a web-based app of the Findrisc questionnaire. Those at risk for T2D, i.e. with a Findrisc score > 9, were invited to come back after overnight fasting to measure fasting glycaemia (FG). Those with 100 ≤ FG < 126 mg/dL were considered as people with prediabetes and compiled the Physical Activity Readiness Questionnaire (PAR-Q) to then receive a personalized prescription of physical activity. Overall, 5928 people were enrolled and compiled the questionnaire. Of these, 2895 (48.8 %) were at risk for T2D. Among these, FG was measured in 2168 subjects (participation rate 75%). The numbers of individuals with undetected prediabetes and T2D according to FG were 755 and 79 (34.8% and 3.6% of those assessing FG), respectively. Of the 755 subjects in the prediabetes range, 739 compiled the PAR-Q and started a personalized program of physical activity (participation rate 97%). Physicians involved in the study reported a mean of 6 minutes to perform the screening. Overall, these data suggest the feasibility of a national diabetes prevention program developed by general practitioners using a simple stepwise approach starting from a web-app to intercept individuals with prediabetes.

New or in-service truss bridges, with or without upper bracing systems, may display instability phenomena such as general lateral torsional buckling of the upper chord. The buckling of structural elements, particularly in the case of steel bridges, can be associated with the risk of collapse or temporary/permanent withdrawal from service. Buckling poses a significant danger as it often occurs at lower load values compared to those considered during the design phase. Additionally, this phenomenon can manifest suddenly, without prior warning, rendering intervention for its prevention impossible or futile. In contemporary times, most research and design calculation software offer the capability to establish preliminary values for buckling loads, even for highly intricate structures. This is typically achieved through linear eigenvalue buckling analyses, often followed by significantly more complex large displacement nonlinear analyses. However, interpreting the results for complex bridge structures can be challenging, and their accuracy is difficult to ascertain. Consequently, the objective of this paper is to introduce an original method for a more straightforward estimation of the buckling load of the upper chord in steel truss bridges. The method utilizes the theory of beams on an elastic foundation. The buckling load of the upper chord was determined using both the finite element method and the proposed methodology, yielding highly consistent results.

Background: Patients with chronic obstructive pulmonary disease (COPD) often suffer from acute exacerbations. Our objective was to describe recurrent exacerbations in a GP based Swiss COPD cohort, and develop a statistical model for predicting exacerbation. Methods: In a questionnaire-based COPD cohort, demographic and medical data were recorded for 24 months. Data set was split into training (75%) and validation (25%) datasets. A negative binomial regression model was developed using the training dataset to predict the exacerbation rate within 1 year. An exacerbation prediction model was developed, and the overall performance was validated. A nomogram was created to facilitate the clinical use of the model. Results: Of the 229 COPD patients analyzed, 77% of patients had no exacerbation during the follow-up. The best subset in the training dataset found that lower forced expiratory volume, high scores on the MRC dyspnoea scale, exacerbation history, being on combination therapy of LABA+ICS or LAMA+LABA at baseline were associated with a higher rate of exacerbation. When validated, the area-under-curve (AUC) was 0.75 for one or more exacerbations. Calibration was accurate (predicted 0.34 exacerbations vs observed 0.28 exacerbations). Conclusion: Nomograms built from these models can assist clinicians in the decision-making process of their COPD care.

There is a need for multimodal strategies to keep research participants informed about study results. Our aim was to characterize preferences of genomic research participants from two institutions along four dimensions of general research result updates: content, timing, mechanism, and frequency. Methods: We conducted a web-based cross-sectional survey that was administered from 6-25-2018 to 12-5-2018. Results: 397 participants completed the survey, most of whom (96%) expressed a desire to receive research updates. Preferences with high endorsement included: update content (brief descriptions of major findings, descriptions of purpose and goals, and educational material); update timing (when the research is completed, when findings are reviewed, when findings are published, and when the study status changes); update mechanism (email with updates, and email newsletter); and update frequency (every three months). Hierarchical cluster analyses based on the four update preferences identified four profiles of participants with similar preference patterns. Very few participants in the largest profile were comfortable with budgeting less money for research activities so that researchers have money to set up services to send research result updates to study participants. Conclusion: This work provides evidence of a need for funders to incentivize researchers to communicate results to participants.

This work investigates the utility of the National Oceanic and Atmospheric Administration’s National Water Model (NWM) for water management operations by assessing the total inflow into a select number of reservoirs across the Central and Western U.S. Total inflow is generally an unmeasured quantity, though critically important for anticipating both floods and shortages in supply over a short-term (hourly) to sub-seasonal (monthly) time horizon. The NWM offers such information at over 5,000 reservoirs across the U.S., however, its skill at representing inflow processes is largely unknown. The goal of this work is to understand the drivers for both well performing and poor performing NWM inflows such that managers can get a sense of the capability of NWM to capture natural hydrologic processes and in some cases, the effects of upstream management. We analyzed the inflows for a subset of Bureau of Reclamation (BoR) reservoirs within the NWM over the long-term simulations (retrospectively, seven years) and for short, medium and long-range operational forecast cycles over a one-year period. We utilize ancillary reservoir characteristics (e.g. physical and operational) to explain variation in inflow performance across the selected reservoirs. In general, we find that NWM inflows in snow-driven basins outperform those in rain-driven, and that assimilated basin area, upstream management, and calibrated basin area all influence the NWM’s ability to reproduce daily reservoir inflows. The final outcome of this work proposes a framework for how the NWM reservoir inflows can be useful for reservoir management, linking reservoir purposes with the forecast cycles and retrospective simulations.

Background: dementia is a significant health issue worldwide. Mild cognitive impairment (MCI) can transform into dementia over time. General practitioners may be the first to notice the cognitive deficit, so they may need a screening test in the event of suspicion, which they must be able to use under great time pressure. We examined the usability of the Hungarian Test Your Memory (TYM-Hun) self-administered dementia test in general practice, and with the results of the received tests, we tried to draw conclusions regarding the population. Methods: In the four Hungarian cities with medical universities, general practitioners filled out 368 questionnaires with their clients over 50 years of age. Results: the total scores of the test showed a significant correlation with education and the type of occupation, while a significant negative correlation with age. We found the clock drawing test and recall indicates cognitive decline the earliest. Based on the TYM-Hun results, the prevalence levels for MCI and dementia are slightly higher in Hungary than globally. Conclusion: the test can sensitively indicate MCI and early-stage dementia as a screening test, and two of its subtests can raise the possibility of cognitive impairment at an earlier age than the others.

The fundamental challenge for the structural design of complicated shapes and lightweight structures such as Tensile Membrane Structures (TMS) is a reliable estimation of lateral loading such as wind load. Wind pressure coefficients can’t be correctly calculated by standards for a large range of intricate forms of structures. Computational Fluid Dynamics (CFD), a strong computational technique for evaluating wind pressure distribution on complicated geometry, can be used to determine wind-related parameters. The average wind related-distributions for the tensile membrane surface are validated with a few contributions from prior studies, which are important to validate with benchmarks in experimental wind tunnel experiments. For the double-curved surface, the results show good agreement between experimental tests and CFD simulations. In this study, CFD simulation was used to calculate the mean surface pressure coefficient (Cp) for generic shapes and tensile membrane forms using the steady Reynolds-Averaged Navier-Stokes (RANS) technique. Wind force coefficients and the effect of wind directions are also explored across a wide range of classical and tensile forms. The purpose of the current research is to look at the effect of wind assault angle on the Cp distribution for tensile membrane structures and general shapes.

The workforce crisis of primary care is reflected in the increasing number of general medical practices (GMP) with vacant general practitioner (GP) position, and the GPs’ ageing. Our study aimed to describe the association between this crisis and premature mortality. Age-sex-standardized mortality for 18-64 years old adults were calculated for all Hungarian GMPs annually in the period from 2006 to 2014. The relationship of premature mortality with GPs’ age and vacant GP position were evaluated by standardized linear regression controlled for list size, urbanization, geographical location, clients’ education, and type of the GMP. The clients’ education was the strongest protective factor (beta=-0175; p<0.001), followed by urban residence (beta=-0.149; p<0.001), and the bigger list size (beta1601-2000=-0.054; p<0.001; beta2001-X=-0.096; p<0.001). The geographical localization influenced significantly also the risk. Although, GMP with a GP aged older than 65 years (beta=0; p=0.995) did not affected the risk, GP vacancy was associated with higher risk (beta=0.010; p=0.033), but the corresponding number of attributable cases was 23.54 for 9 years. The vacant GP position is associated with significant but hardly detectable increased risk of premature mortality without considerable public health importance. Nevertheless, employment of GPs aged more than 65 does not impose premature mortality risk elevation.

In this paper, we introduce a specialized, fully automated experimental arrangement designed for assessing the effectiveness of augmented and virtual reality technologies in healthcare setting and explore its design principles focusing on depth sensor characterization. The main goal of this project is to establish a robust benchtop platform for the quantitative evaluation of extended reality technologies in a controlled environment, emphasizing the practical assessment of augmented reality head-mounted devices. We outline a design concept and considerations for an experimental configuration aimed at creating a realistic testing environment. This apparatus comprises an observation platform mounted on a three-degree-of-freedom motorized system and a test phantom stage. Focusing on real-case scenarios, we utilized a range of sensors, including readily available range-sensing cameras and commercial augmented reality headsets, such as the Intel RealSense L515 LiDAR camera, mounted on the motion control system. The setup enabled automated data collection and facilitates controlled assessments and validation of various facets of augmented reality technologies, including object, hand, and head tracking, as well as static and dynamic image registration. This paper describes the system architecture, the process of automated data collection, and presents several evaluation studies conducted with this setup, providing insights into the quality and temporal noise associated with static or moving objects or observers in augmented reality applications.

Background: Early postoperative airway management after laryngo-tracheal surgery is crucial. Acute respiratory failure due to glottis’ oedema may occur, requiring reintubation. This can prolong ventilatory assistance, jeopardizing the anastomosis. To date, only judicious steroid administration and fluid management are available to avoid more invasive procedures. High-Flow-Oxygen-Therapy(HFOT) is a noninvasive O2 support method providing humidification, warmed air, Positive-End-Expiratory-Pressure(AIRVO2). No data exist about HFOT use to prevent early complications after laryngo-tracheal surgery. Methods: Between Sept.2020-Sept.2022, 107 consecutive patients underwent laryngo-tracheal surgery received HFOT(Group A). Data and long-term results were compared with those of 80 patients operated between Sept.2018-Aug.2020(Group B), when HFOT was not available. All patients were operated in a single center. No pre- or post-operative settings changed, except for HFOT introduction. We analyzed and compared the risk for “delayed” reintubation (unexpected reintubation within the first 24-48 hours after extubating/laryngeal mask removal) in the two groups. Results: No patients reported HFOT-related adverse events. Control group(B) presented “delayed” reintubation in 37% (p= 0.027), Intensive Care Unit admission in 67%(p=0.005) and longer hospital stay(p=0.001) compared to HFOT group(A). Minor complications rate was 3% in both group and overall mortality was 0%. Re-stenosis was described in 4.6% of HFOT group, without a statistically significant difference (p=0.7006). Conclusions: Our study is the first to investigate HFOT use in patients undergoing laryngo-tracheal surgery, potentially representing a consistent innovation in the peri-operative management of these patients. With the limit of a retrospective series, we would suggest HFOT use for preventing post-operative reintubation rate, possibly reducing ICU admission and hospital stay.

To conduct high-precision and high-resolution numerical simulation of complex flow structures in turbomachinery, a high-order finite volume weighted essentially non-oscillatory (WENO) scheme for the large eddy simulation (LES) is improved and embedded into the three-dimensional viscous unsteady CFD solver NUAA-Turbo. Firstly, the spectral characteristics and unsteady convergence of the improved WENO scheme are studied. Compared with the classical WENO scheme, the improved WENO scheme has better dissipation and dispersion characteristics and faster convergence speed. Then, the coefficient CW of the Wall-Adapting Local Eddy-viscosity (WALE) model is calibrated by decaying homogeneous isotropic turbulence (DHIT) test case. Finally, the scheme is applied to conduct high-precision LES calculations of turbulent boundary layer flow, supersonic compression corner flow, and low-pressure turbine cascade separation flow. The numerical simulation results show that this WENO scheme has excellent shock wave capture ability and turbulence resolution and can capture more flow field details with less mesh size, greatly reducing the computational cost and laying a foundation for large-scale engineering application of LES.

To secure logic circuits against the illegal copying the insertion of the so-called key bit inputs using XOR/XNOR gates has been proposed in . The inserted gates modify (lock) the behavior of the original circuit and only the correct choice of the secret key bits guarantees the equivalent behaviour of the locked circuit to the original circuit. To break this kind of security, i.e. to find the secret key bits, there was a SAT solver based attack proposed in . The aim of this work is to experimentally verify this attack on several locked circuits with various number of primary inputs and outputs and with various number of gates. Except for the random placement of the key gates we evaluate also the positioning with chaining elimination. The obtained and presented results show that we were able to unlock 10 of 11 circuits within few minutes on a common PC.

Intermetallic compounds are increasingly being expected to utilize in tribological environments, but to date the works are hindered by insufficient ductility at low and medium temperature. This paper presents a novel multiphase intermetallic alloy with the chemical composition of Mo-40Ni-13Si (at.%). Microstructure characterization reveals that a certain amount of ductile Mo phases formed during the solidification process of ternary Mo-Ni-Si alloy melt, which is undoubtedly beneficial to the ductility improvement of intermetallic alloy. Tribological properties of the designed alloy, including wear resistance, friction coefficient and metallic tribological compatibility, were evaluated under dry sliding wear test conditions at room temperature. Results suggested that the multiphase alloy possesses an excellent property for room-temperature wear applications, which is attributed to the unique microstructural features and thereby good combination in hardness and ductility. The corresponding wear mechanism is also reported by observing the worn surface, subsurface and wear debris of alloy, which to be found is soft abrasive wear.

With the integrated development of the Internet, wireless sensor technology, cloud computing, and mobile Internet, there has been a lot of attention given to research about and applications of the Internet of Things. A Wireless Sensor Network (WSN) is one of the important information technologies in the Internet of Things; it integrates multi-technology to detect and gather information in a network environment by mutual cooperation, using a variety of methods to process and analyze data, implement awareness, and perform tests. This paper mainly researches the localization algorithm of sensor nodes in a wireless sensor network. Firstly, a multi-granularity region partition is proposed to divide the location region. In the range-based method, the RSSI (Received Signal Strength indicator, RSSI) is used to estimate distance. The optimal RSSI value is computed by the Gaussian fitting method. Furthermore, a Voronoi diagram is characterized by the use of dividing region. Rach anchor node is regarded as the center of each region; the whole position region is divided into several regions and the sub-region of neighboring nodes is combined into triangles while the unknown node is locked in the ultimate area. Secondly, the multi-granularity regional division and Lagrange multiplier method are used to calculate the final coordinates. Because nodes are influenced by many factors in the practical application, two kinds of positioning methods are designed: the unknown node is in the positioning unit or not. When the unknown node is on the side of the positioning unit, we use the method of vector similarity. Moreover, we use the centroid algorithm to calculate the ultimate coordinates of unknown node. When the unknown node is not on the side of the positioning unit, we establish a Lagrange equation containing the constraint condition to calculate the first coordinates. Furthermore, we use the Taylor expansion formula to correct the coordinates of the unknown node. In addition, this localization method has been validated by establishing the real environment.

The electroencephalogram (EEG) is a record of brain activity. Brain Computer Interface (BCI) technology formed by the EEG signal has become one of the hotspots at present. How to extract the feature signal of EEG is the most basic research of BCI technology. In this paper, A new method of recognizing fatigue, conscious, concentrated state of human brain is proposed by the combination of discrete wavelet transform and the neural network based on EEG signal. First of all, the law signal is preprocessed by the wavelet denoising method because the law EEG signal contains a large number of high frequency noise, which is decomposed into multi-layer high frequency signal and low frequency signal. thus, δ wave, θ wave, α wave, β wave are obtained by the wavelet transform. And then, frequency band energy of the different wave is regards as the feature signal of EEG. In the experiment, the feature signal is classified by radial basic function (RBF) and annealed chaotic competitive learning network (ACCLN). RBF and ACCLN networks are trained with 500 sets of sample data and are tested by 100 sets of samples in different mental states. The experimental results show that the average accuracy of RBF network under three conditions are 88.75%, 88.25%, 88.5%, respectively, and the correct rate of ACCLN network is 97%, 98%, 98%, respectively.

Early discharge after childbirth has led to a rise in neonatal readmission, becoming a major concern in recent decades. Our research aimed to identify the risk factors and incidence of neonatal readmission, as well as explore preventive measures. Our study at the Clinical Hospital of Pediatrics in Ploiești, Romania included 108 neonates admitted during the neonatal period. This accounted for 2.06% of all admissions (5226). The most prevalent cases were malnutrition (25%), fever (20.3%) and bronchiolitis (17.5%). Diarrhea and infectious gastroenteritis were also observed (14.8%), along with acute rhinoconjunctivitis (9.2%) and late onset sepsis (3.7%). No deaths were recorded. The most significant characteristics identified were number of children (p&lt;0.001) and age at maternity discharge (p&lt;0.001). By following the prevention rules, malnutrition, feeding errors, and infections can be avoided. This includes practicing proper hand hygiene for both mothers and medical staff, as well as educating and demonstrating to mothers the benefits of breastfeeding. In addition, all newborns discharged from the maternity ward should benefit from follow-up at 7-10 days of life. Our results confirm the effectiveness of a multidisciplinary team and endorse promoting breastfeeding. Implementing quality control measures and regularly evaluating the surveillance program will help improve its effectiveness.

Wearable technology has been proposed as a potential tool to change the way of human life, such as the smart bracelet and the Google Glass. In the wearable technology, the inertial sensor has great significance in tracking the object movements. The paper focused on detecting the movements of user’s finger based on the inertial sensor to give the control signals. Firstly, the attitude matrix, which represented the transformation relation of carrier coordinate system and the navigation coordinate system, was obtained. Secondly, the attitude matrix was expressed based on the quaternions. Thirdly, the finger gesture was processed by the attitude matrix to get the attitude angle. Finally, the robot was controlled by attitude angle to make the moving action. The experimental results showed the detection of the finger movement is effective.