Field and numerical investigations at Happisburgh, East coast of England, UK, sought to characterize beach thickness and determine geologic framework controls on coastal change. After a major failure of coastal protection infrastructure, removal of about 1 km of coastal defense along the otherwise protected cliffed coastline of Happisburgh triggered a period of rapid erosion over 20 years of ca. 140 m. Previous sensitivity studies suggested that that beach thickness plays a major role in coastal recession. These studies were limited, however, by a lack of beach volume data. In this study, we have integrated the insights gained from our understanding of the Quaternary geology of the area, a novel non-intrusive passive seismic survey method, and a 3D novel representation of the subsurface source and transportable material into a coastal modelling environment to explore the role of beach thickness on the back wearing and down wearing of the cliffs and consolidated platform, respectively. Results show that beach thickness is non-homogeneous along the study site: we estimate that the contribution to nearshore sediment budget via platform down wearing is of a similar order of magnitude as sediment lost from the beach and therefore non-negligible. We have provided a range of evidence to support the idea that the Happisburgh beach is a relatively thin layer perched on a sediment rich platform of sand and gravel. This conceptualization differs from previous publications, which assumes that the platform was mostly till and fine material. This has direct implication on the regional sediment management of along this coastline. The present study contributes to our understanding of a poorly known aspect of coastal sediment budgeting and outlines a quantitative approach that allows for simple integration of geological understanding for coastline evolution assessments worldwide.

This service improvement project was carried out at LEKMA Hospital, Ghana. Ghana has high levels of antimicrobial resistance (AMR). There is an urgent need to introduce models of care that optimize antibiotic prescribing. Methods Delayed / back-up prescribing is a strategy that could reduce antibiotic use in suspected upper respiratory tract infections. Four different models of delayed / back-up prescribing [no prescription; post-dated prescription (given to patient); post-dated prescription (forwarded to pharmacy); and follow-up appointment for reassessment after 3 days] were implemented in discussion between clinician and patient. Patients were contacted 10 days after their appointment to record compliance, check on their wellbeing, and rate their experience. Results Over a 3-month period (12/2019-02/2020), 142 patients were eligible for delayed / back-up prescribing. The most common clinical diagnoses were sore throat (102/140, 73%), common cold (22/140, 16%) and sinusitis (10/140, 7%). In total, 12 (9%) patients remained symptomatic at day 10, and only one individual in the entire cohort took antibiotics. Most patients (95%) rated their experience as good or very good. Conclusions Delayed / back-up prescribing models can lead to substantial reduction in antibiotic consumption amongst outpatient department patients with suspected upper respiratory tract infections. Delayed / back-up prescribing can be implemented safely in low and middle-income countries.

Impact in the form of innovation and commercialisation is an essential component of publicly funded research projects. PHUSICOS, an H2020 Innovation Action project, aims at demonstrating the use of nature-based solutions for mitigating hydrometeorological hazards in rural and mountainous areas. The work program is built around key innovation actions, and each WP leader specifically responsible for nurturing innovation processes, maintaining market focus and ensuring relevance for the intended recipients of the project results. Key success criteria for PHUSICOS include up-scaling and mainstreaming of NBS to reach broader market access. An innovation strategy and supporting tools for implementing this within PHUSICS has been developed and key concepts forming the basis for this strategy are presented in this research note.

The way Norway is spearheading electrification in the transport sector is of global interest, and details of its policies and emission impacts represent a reference. We used the NERVE model, a bottom-up high-resolution traffic emission model, to calculate all exhaust emissions in Norway (2009-2020). This allows us to evaluate the co-benefit of policies to target climate change mitigation and air quality. We have analyzed local municipal data with regards to traffic growth, road network influences, vehicle composition, emissions and energy consumption. Light vehicle CO2 emissions per kilometre have been reduced by 22% since 2009, mainly driven by an increaseing bio-fuel mixing and BEV share. BEVs are mostly located in and around the main cities, areas with young vehicle fleets, and strong local incentives. Beneficiaries of all BEVs incentives have been a subset of the population with strong economic indicators. The incentivized growth in the share of diesel-fuelled passenger vehicle has been turned, and together with Euro6 emission standards, light vehicle NOx emissions have been halved since peaking in 2014. BEV represent an investment in emission reductions in years to come and current sales set up for an accelerated decline in emissions despite growth in traffic.

The prevalence of back pain (BP) among children and adolescents has increased over recent years. Some authors advocate promoting back-health education in the school setting. It is therefore important to adopt a uniform suite of assessment instruments to measure the various constructs. The present study aimed to perform a cultural adaptation of a validated measurement instrument (BackPEI), beginning with a translation and cultural adaptation phase, followed by a second phase to test reliability using a test-retest design. The translation and cross-cultural adaptation were performed based on the guidelines. Reliability was tested by applying the questionnaire to 224 secondary school students, at two different times with a 7-day interval between the tests. In general, the Spanish version presented adequate agreement for questions 1–20, with only question 9 achieving a low Kappa range of .312 [-.152- .189]. The question about pain intensity did not show differences between the averages for the test (4.72 ± 2.33) and re-test (4.58 ± 2.37) (p = .333), and the responses for these two tests were highly correlated (ICC= .951 [.928- .966]; p= .0001). Psychometric testing indicated that the Spanish version of the BackPEI is well-adapted and reliable, based on the test-retest design, providing similar results to the original Brazilian version.

The aim of this study was to analyze the level of specific back-health-related physical activity and exercise knowledge. This is a cross-sectional study. A representative sample of 1500 students were recruited with a confidence level of 95% and an accepted standard error of ±2.53%. Individuals were aged between 13 and 18 years old (mean age= 15.18; SD = ±1.446). Self-reported questionnaires were used to record back-health-related physical activity and exercise knowledge concerning back care in adolescents. The level of specific knowledge of back health education related to physical activity and exercise in adolescents was low (X = 2.05, SD = ±2.264). Only 10.9% of the students passed the specific knowledge test, achieving a grade equal or superior to 5. The boys average score was higher (X = 2.17, SD = ±2.312) than the girls (X = 1.94, SD = ±2.212) with statistically significant differences (p = .048). The level of specific knowledge increased with age (F = 11.531; p < .001). High school students have a low level of specific knowledge. Physical Education teachers should apply the conceptual content properly. Knowledge is the first step towards changing behavioral habits. Back care education in the school curriculum is recommended.

Traditionally there is a gap between reactor operation and the consideration of nuclear waste in the final disposal. Fuel is produced and fuel must be disposed of in the view of the reactor operator, fuel has to be cleaned in the reprocessing and new solid fuel has to be produced in the view of the chemist. iMAGINE is designed to overcome this separation through the breakthrough development applying an optimized, integrative approach from cradle to grave of nuclear energy production as a first step to come as close as possible to the vision of zero waste nuclear power. It is described here the first time all in three the steps: reactor, fuel cycle, waste, providing the ratio behind each of the choices taken to come to the overall solution to open the discussion and thinking process on what could be achieved by a really innovative approach to integrated nuclear energy production. The opportunities regarding the handling of the remaining waste will be discussed with a view on the expectation of the final disposal community, the study ‘Nuclear waste from small modular reactors’, and the IAEA report ‘waste from innovative types of reactors and fuel cycles - a preliminary study. The aim of the is not to find answers to each of the raised points, but to identify first potential approaches and potentially promising ways to go, as well as to stimulate a discussion among experts. In the best case this could lead to a change of track for nuclear to become an even more sustainable and at least as important, trusted technology to help solve the net-zero challenge.

Background: Sickle cell disease (SCD) is a public health problem in the Democratic Republic of Congo. While reference sickle cell centers have been implemented in capital cities of African countries and have proven to be beneficial for SCD patients, they have never been set up in rural areas for families with very low sources of income. Method: A cohort of 143 children with SCD aged 10 years old (IQR (interquartile range): 6–15 years) (sex ratio male/female = 1.3) were clinically followed for 12 months without any specific intervention aside from the management of acute events, and then for 12 months with a monthly medical visit, biological follow-up, and regular prophylaxis. Results: The median age of patients at the diagnosis of SCD was 2 years (IQR: 1–5). The implementation of standardized and regular follow-ups in a new sickle cell referral center in a remote city showed an increase in the annual mean hemoglobin level from 50 to 70 g/L (p = 0.001), and a decrease in the lymphocyte count and spleen size (p < 0.001). A significant decrease (p < 0.001) in the average annual number of hospitalizations and episodes of vaso-occlusive crises, blood transfusions, infections, and acute chest syndromes were also observed. Conclusions: Creation of a sickle cell referral center and the regular follow-up of children with SCD are possible and applicable in the context of a remote city of an African country and represent simple and accessible measures that can reduce the morbimortality of children with sickle cell disease.

Disparities between fold amplitude (A) and intrusion thickness (Hsill) are critical in identifying elastic or inelastic deformation in a forced fold. However, accurate measurement of these two parameters is challenging because of the limit in separability and detectability for the seismic data. In the TZ-47 exploring area from the Tarim Basin, Northwest China, we combined wireline data and 3-D seismic data, to accurately constrain the fold amplitude and total thickness of sills that inducing the roof uplift. The measurement results show that the forced fold amplitude is 155 m and the total sill thickness is 148.4 m. When using a magma density of 2.7 g/cm3, and solid rock density of 3 g/cm3, the molten magma thickness at the time of intrusion would be 153.8 m, which is almost no difference from the forced fold amplitude. Therefore, the TZ-47 fold is a pure elastic forced fold induced by emplacement of multiple sills. Measurement solely based on seismic data may not be able to detect some thin interlayers and may result in large errors.

This paper studies an effective finite difference scheme for solving two-dimensional Heston stochastic volatility option pricing model problems. A dynamically balanced up-downwind strategy for approximating the cross-derivative is implemented and analyzed. Semi-discretized and spatially nonuniform platforms are utilized. The numerical method comprised is simple, straightforward with reliable first order overall approximations. The spectral norm is used throughout the investigation and numerical stability is proven. Simulation experiments are given to illustrate our results.

Simulator training for image-guided surgical interventions may benefit from artificial intelligence systems that control the evolution of task skills in terms of time and precision of a trainee's performance on the basis of fully automatic feed-back systems. At the earliest stages of training, novice trainees frequently focus on getting faster at the task, and may thereby compromise the optimal evolution of the precision of their performance. For automatically guiding them towards attaining an optimal speed-accuracy trade-off, an effective control system for the reinforcement/correction of strategies must be able to exploit the right individual performance criteria in the right way, reliably detect individual performance trends at any given moment in time, and alert the trainee, as early as necessary, when to slow down and focus on precision, or when to focus on getting faster. This article addresses several aspects of this challenge for speed-accuracy controlled simulator training before any training on specific surgical tasks or clinical models should be envisaged. Analyses of individual learning curves from the simulator training sessions of novices and benchmark performance data of one expert surgeon, who had no specific training in the simulator task, validate the suggested approach.

As there exist no repulsive forces in strong interaction, in a hypothetical approach, strong interaction can be assumed to be equivalent to a large gravitational coupling. Based on this concept, strong coupling constant can be defined as a ratio of the electromagnetic force and the gravitational force associated with proton, neutron, up quark and down quark. With respect to the product of strong coupling constant and fine structure ratio, we review our recently proposed two semi empirical relations and coefficients 0.00189 and 0.00642 connected with nuclear stability and binding energy. We wish to emphasize that- by classifying nucleons as ‘free nucleons’ and ‘active nucleons’, nuclear binding energy can be fitted with a new class of ‘three term’ formula having one unique energy coefficient. Based on the geometry and quantum nature, currently believed harmonic oscillator and spin orbit magic numbers can be considered as the lower and upper “mass limits” of quark clusters.

The use of smartphones, coupled with different sensors, makes it an attractive solution for measuring different physical and physiological features, allowing for the monitoring of various parameters and even identifying some diseases. The BITalino device allows the use of different sensors, including Electroencephalography (EEG) and Electrocardiography (ECG) sensors, to study different health parameters. With these devices, the acquisition of signals is straightforward, and it is possible to connect them using a Bluetooth connection. With the acquired data, it is possible to measure parameters such as calculating the QRS complex and its variation with ECG data to control the individual's heartbeat. Similarly, by using the EEG sensor one could analyze the individual's brain activity and frequency. The purpose of this paper is to present a method for recognition of the diseases related to ECG and EEG data, with sensors available in off-the-shelf mobile devices and sensors connected to a BITalino device. The data were collected during the elderly's experiences, performing the Timed-Up and Go test, and the different diseases found in the sample in the study. The data were analyzed, and the following features were extracted from the ECG, including heart rate, heart rate variability, the average QRS interval, the average R-R interval, and the average R-S interval, and the EEG, including frequency and variability. Finally, the diseases are correlated with different parameters, proving that there are relations between the individuals and the different health conditions.

We evaluated the usefulness of the novel cholesterol-triglyceride subgroup (CTS) indices that potentially reflect the metabolic status regarding risk of coronary heart disease (CHD) using a retrospective longitudinal study of the Japanese general population. We recruited 12,373 individuals from the annual users of our healthcare center. Among them, the first onset of CHD was recorded in 131 individuals between April, 2014 and March, 2020. The multivariate Cox proportional hazards regression analyses for all normalized lipid indices revealed that the CTSqnt index showed a comparable hazard ratio for the CHD outcome to non-high-density lipoprotein cholesterol (nonHDL-c) and triglycerides. The HR of the CTSqlt index was significantly lower than for CTSqnt, but still comparable to that for low-density lipoprotein cholesterol (LDL-c). In comparison with the other indices, CTSqlt is more sensitive to risk increment while the index value increases. Linear regression analyses for the CTS indices and previously known lipid indices suggest that the CTSqnt and CTSqlt indices reflect the quantity of atherogenic lipoproteins and size of smaller and denser LDLs, respectively. Furthermore, the CTSqnt/HDL-c index can be used as a comprehensive risk indicator that may represent the status of lipid metabolism determined by the CTSqlt and CTSqnt indices and thus may be useful for screening. The CTS indices can be used to evaluate the metabolic status of individuals, which may increase the risk of future CHD.

Electrospinning has gained a lot of attention in recent years due to its ability to easily produce high-quality polymeric nanofibers. However, electrospinning suffers from limited production capacity and a method to readily scale up this process is needed. One obvious approach includes the use of multiple electrospinning needles operating in parallel. Nonetheless, such an implementation has remained elusive, partly due to the uneven electric field distribution resulting from the Coulombic repulsion between the charged jets and needles. In this work, the uniformization of the electric field was performed for a linear array of twenty electrospinning needles using lateral charged plates as auxiliary electrodes. The effect of the auxiliary electrodes was characterized by investigating the semi-vertical angle of the spun jets, as well as the deposition area and diameter of the fibers. Finite element simulation was also used to analyze the impact of the auxiliary electrodes on the electric field intensity below each needle. Implementing parallel lateral plates as auxiliary electrodes was shown to help achieve uniformization of the electric field, the semi-vertical angle of the spun jet, and the deposition area of the fibers for the multi-needle electrospinning process. The high-quality morphology of the polymer nanofibers obtained by this improved process was confirmed by scanning electron microscopy (SEM). These findings help resolve one of the primary challenges that have plagued the large-scale industrial adoption of this exciting polymer processing technique.

Purpose: To evaluate seasonal variation in intra-ocular pressure (IOP) with and without short tear break-up time (SBUT, BUT ≤ 5 s). Methods: This study enrolled 176 patients who visited one of six eye clinics in Japan for IOP measurement at every season. The mean patient age was 67.9 years, including 79 males. We compared the seasonal variation in IOP (mean ± SD) across spring (Mar-May), summer (Jun-Aug), fall (Sep-Nov), and winter (Dec-Feb). Results: The IOP (mmHg) in winter and summer, respectively, was 12.8 ± 3.7 and 12.8 ± 3.1 for non-glaucoma patients without SBUT (n = 47, P = 0.964), 14.8 ± 3.4 and 13.3 ± 3.4 for non-glaucoma patients with SBUT (n = 57, P < 0.001), 14.3 ± 3.2 and 14.1 ± 3.4 for glaucoma patients without SBUT (n = 36, P = 0.489), and 13.3 ± 3.0 and 11.6 ± 2.9 for glaucoma with SBUT (n = 36, P < 0.001). Seasonal variation was largest across the seasons in the glaucoma with SBUT group, and the magnitude of seasonal variation correlated with BUT (β = 0.228, P = 0.003). Conclusions: Seasonal variation tended to be larger in patients with SBUT than those without SBUT.

Sanitation, water supply and their governance remain major challenges in many Pacific Island Countries. National sustainable development strategies (NSDSs) are promoted throughout the Pacific as overarching improved governance instruments to identify priorities, plan solutions and fulfill commitments to sustainable development. Their relevance to local village-level development priorities is uncertain. The Kingdom of Tonga provides opportunities to compare both. Tonga’s Strategic Development Frameworks (TSDFI 2011-2014 and TSDFII 2015-2025) were developed to focus government and its agencies on national outcomes. From 2007 to 2016, 136 villages throughout Tonga’s five Island Divisions (IDs) formulated Community Development Plans (CDPs) involving separately 80% of women, youth and men in each village. Censuses in 2006 and 2016 show linked improvements in water supply and sanitation systems but reveal IDs with continuing challenges. Sanitation and water are prominent in TSDFI but absent from the current TSDFII. In contrast, CDPs show in one ID, 53% of villages ranked sanitation as a priority with marked differences between IDs and between women, youth and men. CDPs’ sanitation priorities in IDs mostly correspond to sanitation and water metrics in the Censuses, but some reflect impacts of natural disasters. Explanations for differences in sanitation priorities between national and local development plans, as well as suggestions for improving NSDS processes in island countries, are advanced.

Up-conversion nanoparticles (UCNP) under near-infrared (NIR) light irradiation have been well investigated in the field of bio-imaging. However, the low up-conversion luminescence (UCL) intensity limits applications. Plasmatic modulation has been proposed as an effective tool to adjust the luminescence intensity and lifetime. In this study discrete dipole approximation (DDA) was explored concerning guiding the design of UCNP@mSiO2-Au structures with enhanced UCL intensity. The extinction effects of gold shells could be changed by adjusting the distance between the UCNPs and the Au NPs by synthesized tunable mesoporous silica (mSiO2) spacers. Enhanced UCL was obtained under 808 nm irradiation. Theoretical predictions could not be demonstrated to full extend by experimental data, indicating that better models for simulation need to better take into account inhomogeneities in particle morphologies.

Methane is a greenhouse gas and identified as a key driver of near-term climate change. Bottom-up approaches estimate annual methane loss from US natural gas production and transport at 6 Tg, but recent studies suggest this may be an underestimate. To investigate this possibility, an equipment-based emissions inventory, using EPA emission factors, was developed to calculate methane emissions from oil and gas operations in the Delaware Basin, USA. Emission factors and activity data were then updated using contemporary and region-specific measurement data. The original inventory estimated emissions at 315 Gg CH4 y-1 (gas production-normalized rate of 0.6% loss), while the updated inventory estimated emissions of 1,500 Gg CH4 y-1 (2.8% loss). The largest changes resulted from large fugitive emissions from oil production (+430 Gg CH4 y-1), updating maintenance activity emissions (+214 Gg CH4 y-1), considering flaring inefficiency (+174 Gg CH4 y-1), and the inclusion of associated gas venting (+136 Gg CH4 y-1). This study suggests that a systematic underestimate probably exists in current bottom-up inventories and identifies sources currently missing or may be incorrect. We also strongly recommend that emission factors should be validated through direct comparison against measurement campaigns that include long-tail distributions typical of oil and gas activities.

Background: Chronic non-specific low back pain (CNSLBP) is defined as back pain that lasts longer than 12 weeks. Objectives: To investigate the efficacy of manual therapy (MT) program combined with Capacitive and Resistive Electric Transfer (TECAR) therapy in individuals with CNSLBP. Method: Sixty adults with CNSLBP were randomly equally divided into three groups. The first group followed an MT protocol in the lumbar region (MT group), the second group followed the same MT protocol combined with TECAR therapy (MT + TECAR group) using a conventional capacitive electrode as well as a special resistive electrode bracelet and the third group (Control group) received no treatment. Both intervention programs included six treatments over two weeks. Pain in the last 24 hours with the Numeric Pain Rating Scale (NPRS), functional ability with the Roland-Morris Disability Questionnaire (RMDQ), Pressure Pain Threshold (PPT) in the lumbar region with pressure algometry, and mobility of the lumbo-pelvic region through fingertip-to-floor distance (FFD) test were evaluated before and after the intervention period with a one-month follow-up. Analysis of variance with repeated measures was applied. Results: In the NPRS score, both intervention groups showed statistically significant differences compared to the control group both in the second week as well as in the one-month follow-up (p < .001). Between-groups differences were also noticed between the two intervention groups in the second week (p < .05). Differences in the RMDQ score in the second week and on the one-month follow-up were detected between the intervention groups and the control group (p < .001), while differences between the two intervention groups were only detected in the one-month follow-up (p < .001). Regarding the PPT values, differences were found mainly between the MT + TECAR and the control group and between the MT + TECAR and the MT group (p < .05), with the MT + TECAR group in most cases showing the greatest improvement compared to the other two groups, which remained statistically significant in the one-month follow-up (p < .05). Finally, both intervention groups improved the mobility of the lumbo-pelvic region in both time points compared to the control group without, however, statistically significant differences between them (p> .05). Conclusion: The application of an MT protocol with TECAR therapy appeared more effective than conventional MT as well as compared to the control group in reducing pain and disability and improving PPT in individuals with CNSLBP. No further improvement was noted in mobility of the lumbo-pelvic region by adding TECAR to the MT intervention.

In the paper we show that the general relativity in recent Einstein-Palatini formulation is equivalent to a gauge field. We begin with a bit of information of the Einstein-Palatini formulation and derive Einstein field equations from it. In the next section, we consider general relativity with a positive cosmological constant in terms of the corrected curvature. We show that in terms of the corrected curvature general relativity takes the form typical for a gauge field. Finally, we give a geometrical interpretation of the corrected curvature.

Lower Back Pain (LBP) is a disease that needs immediate attention. Person with back pain shall go immediately to doctor for treatment. Injury, excessive works and some medical conditions are result of back pain. Back pain is common to any age of human for different reasons. Due to factors such as previous occupation and degenerative disk disease the chance of developing lower back pain increases for older people. It hampers the working condition of people common reason for seeking medical treatment. The result is absence from work and is unable to normal due to pain. It creates uncomfortable and debilitating situations. Hence, detecting this disease at an early stage will assist the medical field experts to suggest counter measures to the patients. Detection of lower back pain is implemented in this paper by applying ensemble machine learning technique. This paper proposes Stacking ensemble classifier as an automated tool that will predict lower back pain tendency of a patient. Experimental result implies that the proposed method reaches an accuracy of 76.34%, f1-score of 0.76 and MSE of 0.34.

In real financial market, the delayed market feedback and the delayed effect of government macro-control are inevitable. And both the delay of market feedback and the delay of macro-control effect bring about the mathematical difficulties in studying stabilization and synchronization of the hyper-chaotic financial system. However, employing Lyapunov function method, differential mean value theorem, suitable bounded hypotheses and pulse control technology results in the globally asymptotical stabilization and synchronization criteria. It is the first paper to drive the stabilization and synchronization criteria under the assumptions of the double delays. Finally, numerical examples illuminate the effectiveness of the proposed methods.

Large lithium-ion batteries (LIBs) in electric vehicles and energy storage systems demonstrate different performance and lifetime compared to small LIB cells, owing to the size effects generated by the electrical configuration and property imbalance. However, the calculation time for performing life predictions with three-dimensional (3D) cell models is undesirably long. In this paper, a lumped cell model with equivalent resistances (LER cell model) is proposed as a reduced order model of the 3D cell model, which enables accurate and fast life predictions of large LIBs. The developed LER cell model is validated via the comparisons with results of the 3D cell models by simulating a 20-Ah commercial pouch cell (NCM/graphite) and the experimental values. In addition, the LER cell models are applied to different cell types and sizes, such as a 20-Ah cylindrical cell and a 60-Ah pouch cell.

In this note, we provide some effective treatments of a general linear model with adding-up restrictions via algebraic operations of given vectors and matrices in the model, including analytic expressions of the well-known ordinary least-squares estimator (OLSE) and the best linear unbiased estimator (BLUE) of the unknown parameters in the model.

Protein translational modifications (PTMs) generate an enormous, but as yet undetermined, expansion of the expressed proteoforms. In this Viewpoint, we firstly differentiate the concepts of proteoform and peptidoform by reviewing and discussing previous literature. We show that the current PTM biological investigation and annotation largely follow a PTM site-specific rather than proteoform-specific approach. We further illustrate a potentially useful matching strategy in which a particular “modified peptidoform” is matched to the corresponding “unmodified peptidoform” as a reference for the quantitative analysis between samples and conditions. We suggest this strategy could provide directly relevant information for learning the PTM site-specific biological functions. Accordingly, we advocate for the wider use of the nomenclature “peptidoform” in the future bottom-up proteomic studies.

This paper reports an experimental investigation on compression after low-velocity impact response for two lay-up configurations of symmetric CFRP laminated composite specimens obtained by reversing their angle-ply orientation, namely [0/-45/45/90]s versus [90/45/-45/0]s, the impact velocity of the projectile up to the BVID level being subsequently considered. To this aim, a modified Compression-After-Impact (CAI) test device is proposed that involves clamping the specimen's upper and lower edges between two adjustable wide and flat anti-buckling plates through a removable bolt-nut assembly. Such a solution relies on the fact that the specimen's active length is shortened, reducing the risk of global buckling. Besides, the bolts carry part of the load with minor localized bearing damage, provided that the metallic plates act as washers by supporting the bolt-bearing region laterally, thus avoiding crashing failures at the specimens’ loaded edges. With these settings, roughly the same percent decrease in the average values of maximum compression load (i.e., 22%) was recorded for both lay-up configurations impacted up to their BVID threshold, whereas in terms of compressive stiffness behavior, a reduction of 17 % was found for [0/-45/45/90]s specimens compared to 6 % obtained for [90/45/-45/0]s specimens.

Education on Innovation and Entrepreneurship (I&E) has increased in the last two decades, specially, through MOOCs. Lately, these reusable online alternatives have tended to be revalorized by HEIs into blended learning activities, posing new challenges for instructors, specially, on how to bridge prior knowledge with in-class activities. Adopting a discursive approach to knowledge, our proposal aims to meet this challenge by identifying student’s ‘representations’, i.e., patterned constructions on disciplinary knowledge. Representations can be found across different cohorts and thus further complemented by instructors. To test this assumption and build our proposal, we analysed student’s representations in two observations. We mapped students’ representations over key I&E definitions (e.g., ‘start-up’) and, to know how prior knowledge may be complemented by instructors, we identified students’ alignment with expert disciplinary knowledge. Firstly, we found that the two cohorts tended to express representations by turning attention to several dimensions, e.g., referring to different types of features or finalities associated with concepts. Secondly, the disciplinary alignment description revealed that students tended to focus on the same components present in experts’ definitions, but with a greater level of generality. Our results have been packaged into a proposal that aims to help instructors scale their blended activities.

The conventional explanation of delayed-choice experiments seems to violate our causal intuition. This apparent violation is caused by a misinterpretation of the conventional formulation of quantum mechanics. I reanalyze these experiments using advanced and time-symmetric formulations of quantum mechanics. All three formulations give the same experimental predictions, but the advanced and time-symmetric formulations violate our causal intuition that effects only happen after causes. I explore reasons why our causal intuition may be wrong at the quantum level. I also suggest how conventional causation might be recovered in the classical limit, and speculate on cosmological boundary conditions.

To improve the voltage gain of step-up converters, cascaded technique is considered as a possible solution in this paper. By considering the concept of cascading two Z-source networks in a conventional boost converter, the converter takes the advantages of both impedance source and cascaded converters. However, by applying some modifications, the proposed converter provides high voltage gain while the voltage stress of switch and diodes are still low. Moreover, the low input current ripple of the converter makes it absolutely appropriate for photovoltaic applications in order to expand the lifetime of PV panels. After analyzing the operation principles of the proposed converter, simulation and experimental results of a 100W prototype are presented to verify the proposed converter performance.

The phenomenon of quantum erasure exposed a remarkable ambiguity in the interpretation of quantum entanglement. On the one hand, the data is compatible with the possibility of arrow-of-time violations. On the other hand, it is also possible that temporal non-locality is an artifact of post-selection. Twenty years later, this problem can be solved with a quantum monogamy experiment, in which four entangled quanta are measured at the same time. If Bell violations can be recovered from a “monogamous” quantum system, then the arrow of time is obeyed at the quantum level.

This paper presents a comprehensive review that highlights the characteristics of non-isolated step-up converters based on high boost voltage lifting techniques. The paper categorises the high boost techniques: multistage/multilevel, switched capacitor, voltage multiplier, voltage lift, switched inductor, and magnetic coupling. The paper also discusses in detail the advantages and disadvantages for each category such as cost, complexity, power density, reliability and efficiency. The number of passive and active components, voltage gain, voltage stress, switching frequency, efficiency and power rating are also compared. Although the paper considers coupling inductors in the context of the non-isolated converter, the focus of the entire article is on the non-isolated high voltage step-up techniques. The key contribution in this paper is the review of high boosting techniques rather than the DC /DC converters. This allows divergence of new ideas and new power converters that will help provide highly efficient and flexible power converters for several applications where the sending end voltage is very low as photovoltaic systems. In addition, many applications and control techniques of DC/DC converters are summarised in this paper.

Background This paper draws learnings and successes based on field implementation experience spanning four years (2016–2019) of implementing CLTS by Prince of Peace Orphans and Widows Vision, a community-based organization located in Kaberamaido district in eastern Uganda. Methods The study aimed to document, disseminate and inform from an evidence-based point of view how adaptation and collaborative engagements triggers learning from mistakes to inform iterative changes from improvements and success.This is a descriptive paper that used project documents review based on field implementation experience. Existing project reports were synthesised, collated and curated for evidence. Data were drawn from project reports and records to inform narratives in writing. Implementation of the project was executed in homogenous rural communities occupied by people of the same dialect, cultural and social settings. Results We note that success in CLTS implementation can hardly be achieved by merely following prescriptions in handbooks and guidelines but rather by devising innovative community engagement and other participatory and community-driven techniques that foster adaptive management, promote ownership, and buy-in.Having learned from our failures, we used data to inform decisions and transformatively deviated from traditional CLTS implementation and introduced high impact and innovative approaches such as the use of CLTS helpdesks and Situation room, the Pamoja approach, learning labs and iterative feedback loops, innovatively tackling slippage and carefully introducing the follow-up mandona approach. These enhanced experiential learning and ultimately resulted in sustained sanitation behaviour. Conclusions The CLTS approach as outlined in the handbook needs to be flexibly adapted to address contextual needs. Reflective and learning sessions reinforced with routine feedback loops from implementers and beneficiaries yields tremendous results, propagates experiential learning, and ultimately results in a transformative deviation from undesirable to desired sanitation behaviours. These innovative approaches once carefully blended have proved to be sustainable, are adaptable and can work in an even larger scale and in a variety of contexts.

A multicenter, prospective cohort study conducted in 5 physiotherapy clinics in the UAE from January 2021 to March 2023 to assess coronal lumbar spine radiographic parameters as a predictor of conservative therapy outcomes in patients suffering from low back and leg pain due to lumbar disc herniation (HNP). Ninety patients (mean age 44 yrs., 54% male) with lumbar HNP underwent conservative therapy. All participants received lumbar spine MRI and radiography to assess spine alignment. Interventions included specific exercises, diathermy, traction, education, a home-based exercise pro-gram, and medications. Detailed demographic data was collected. Follow-up was 6-months after discharge. A successful outcome was based on a minimum of the following four outcomes: (1) reduction of pain by 17.5 points (0–100 NRS); (2) fatigue reduction by 7.5 points; (3) distress reduction by 5 points; and (4) interference reduction by 9.5 points. At 6-month follow-up it was found that patient age, education, and radio-graphic determined lumbosacral angle measures significantly affected the odds of a successful outcome. Increasing age 1-year significantly decreased the odds of success of improving pain, fatigue (OR = 0.85, p = 0.016) and interference scores (OR = 0.89, p = 0.042) by 15%, 15%, and 11% respectively. Lower education significantly increased the odds of success for improving pain, fatigue, and interference by 26.18, 26.18, and 7.5 (p = 0.006, = 0.006, and = 0.029 respectively). Increasing (worsening) the radiographic lumbosacral angle by each 1° significantly reduced the odds of success for improving pain, fatigue, distress, and interference by 3.52, 3.52, 27.99, and 2.55, respectively (p < 0.001, < 0.001, = 0.003, = 0.001). Our findings indicate that younger age, less education, and better coronal radiological lumbar spine alignment all had a substantial impact on the likelihood of success of 6-month outcomes in patients suffering from chronic lower back pain and radiculopathy due to HNP.

In this study, a new method for synthesizing Au-NaYF4:Yb3+/Er3+-DSPE-PEG2K nanocomposites was introduced. Using a hydrothermal method, the synthesized Yb3+- and Er3+-codoped NaYF4 upconversion luminescent materials and Au nanoparticles were doped into upconversion nanomaterials and modified with DSPE-PEG2k up-conversion nanomaterials. This material is known as Ag-UCNPs-DSPE-PEG2k, it improves both the luminous intensity because of the doped Au nanoparticles and has low cytotoxicity because of the DSPE-PEG2k modified. Exciting UCNPs with a wavelength of 980nm near-infrared light will emit light with a wavelength of 520nm to further excite gold nanoparticles to convert light energy into heat. Successful synthesized gold nanoparticles was confirmed using transmission electron microscopy (TEM). The morphology of UCNPs was observed using scanning electron microscopy (SEM), and the mapping confirmed the successful doping of Au nanoparticles. Fluorescence spectra were used to compare changes in luminescence intensity before and after doping Au nanoparticles. The cytotoxicity of Au-UCNPs-DSPE-PEG2K was tested via the cell counting kit-8 (CCK-8) method, and its imaging ability was characterized using the Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) method.

This paper explores the latest developments in electrolysis technology, a key player in the transition to sustainable energy systems. Electrolysis, despite currently contributing a small share to global hydrogen production, holds immense potential for producing green hydrogen. The study delves into the efficiency of electrolysis systems, emphasizing ongoing efforts to enhance energy conversion rates. It investigates the impact of high-temperature electrolysis on reducing electricity consumption, thus making the process more efficient. The paper discusses the various challenges in the research on water electrolysis and underscores the critical role electrolysis plays in integrating renewable energy sources. The study emphasizes the need for continuous advancements in electrolysis technology to bridge existing gaps, making a compelling case for its pivotal role in the green hydrogen revolution.

In this study, a new method for synthesizing Ag-NaYF4:Yb3+/Er3+ @ SiO2 nanocomposites was introduced. Using a hydrothermal method, the synthesized Yb3+- and Er3+-codoped NaYF4 upconversion luminescent materials and Ag nanoparticles were doped into upconversion nanomaterials and coated with SiO2 up-conversion nanomaterials. This material is known as Ag-UCNPs-SiO2’ it improves both the luminous intensity because of the doped Ag nanoparticles and has low cytotoxicity because of the SiO2 coating. The morphology of UCNPs was observed using scanning electron microscopy (SEM), and the mapping confirmed the successful doping of Ag nanoparticles. Successful coating of SiO2 was confirmed using transmission electron microscopy (TEM). Fluorescence spectra were used to compare changes in luminescence intensity before and after doping Ag nanoparticles. The reason for the increase in luminescence intensity after doping with Ag nanoparticles was simulated using first-principles calculations. The cytotoxicity of Ag-UCNPs-SiO2 was tested via the cell counting kit-8 (CCK-8) method, and its imaging ability was characterized using the micro-CT method.

Recent studies have indicated that terahertz time-domain spectroscopy (THz-TDS) can stably and efficiently acquire output spectra using an affordable and compact multimode laser diode (MMLD) with delayed optical feedback as the light source. This research focused on a numerical analysis of the optimal conditions for employing an MMLD with delayed optical feedback (chaotic oscillating laser diode) in THz-TDS, utilizing multimode rate equations. The findings revealed that the intermittent chaotic output generated by the MMLD, characterized by concurrent picosecond pulse oscillations lasting several tens of picoseconds, proves to be highly effective for THz-TDS. By appropriately setting the amounts of injection current and optical feedback, and the delay time of optical feedback, intermittent chaotic oscillation can be attained within a considerably broad parameter range. Moreover, both the MMLD output spectrum and the THz-TDS output spectrum exhibit a consistently stable shape at the microsecond scale, demonstrating the attractor properties inherent in an MMLD with delayed optical feedback.

The aim of this study is to test the effectiveness and safety of AE-AE surgery combining otoendoscopy and surgical microscopy in the treatment of acquired pars flaccida cholesteatoma in stages Ib and II of the Japan Otological Society classification occupying the tympanic cavity and attic. A historical cohort study on 65 patients. Of the total, 44 patients were treated by AE-AE surgery using an otoendoscope and 21 with canal wall-up tympanomastoidectomy (CWUT). Patients in whom the AE-AE technique was performed had a lower recurrence rate (9%) compared to those treated with CWUT (38%); p=0.013. In addition, the median time to recurrence was lower in the AE-AE group (4 years [P25-75= 1.25-2-75]) than in CWUT group (2 years [P25-75= 3.25-4.75]); p=0.048. Thresholds were higher in the CWUT group compared to the AE-AE group in pre-surgery (53±16 vs 44±15; p=0.039) and post-surgery (52±18 vs 42±16 dB dB; p=0.042), but not in pre-post-surgery comparisons neither in the AE-AE technique (p= 0.89) nor in the CWUT technique (p= 0.96). We concluded that AE with otoendoscopic support is an effective and safe technique for acquired cholesteatomas occupying box and attic in stages IB and II.

Acute low back pain (LBP) stands as a leading cause of activity limitation and work absenteeism, and its associated healthcare expenditures are expected to become substantial when acute LBP develops into a chronic and even refractory condition. Therefore, early intervention is crucial to prevent progression to chronic pain whose management is particularly challenging and for which the most effective pharmacological therapy is still controversial. Current guideline treatment recommendations vary and are mostly driven by expertise with opinion differing across different interventions. Thus, it is difficult to formulate evidence-based guidance when relatively few randomized clinical trials did explore the diagnosis and management of LBP while employing different selection criteria, statistical analyses, and outcome measurements. This narrative review aims to provide a critical appraisal of current acute LBP management by discussing the unmet needs and areas of improvement from bench-to-bedside and proposes multimodal analgesia as the way forward to attain an effective and prolonged pain relief and functional recovery in patients with acute LBP.

The food system represents a key industry for Europe and particularly Germany. However, it is also the single most significant contributor to climate and environmental change. A food system transformation is necessary to overcome the system's major and constantly increasing challenges in the upcoming decades. One possible facilitator for this transformation are radical and disrup-tive innovations that start-ups develop. There are many challenges for start-ups in general and food start-ups in particular. Various support opportunities and resources are crucial to ensure the success of food start-ups. One aim of this study is to identify how the success of start-ups in the food system can be supported and further strengthened by players in the innovation ecosystem in Germany. There is still room for improvement and collaboration toward a thriving innovation ecosystem. A successful innovation ecosystem is characterised by a well-organised, collaborative, and supportive environment with a vivid exchange between the members in the ecosystem. The interviewees confirmed this, and although the different actors are already cooperating, there is still room for improvement. The most common recommendation for improving cooperation is learning from other countries and bringing the best to Germany.

Trauma is one of the most common causes of death or permanent disability in young people, so a timely diagnostic approach is crucial. In polytrauma patients, CEUS has been shown to be more sensitive than US for the detection of solid organ injuries, improving the identification and grading of traumatic abdominal lesions with levels of sensitivity and specificity similar to those seen with MDCT. CEUS is recommended for the diagnostic evaluation of hemodynamically stable patients with isolated blunt moderate-energy abdominal traumas and for the diagnostic follow-up of conservatively managed abdominal traumas. In this pictorial review we illustrate the advantages and disadvantages of CEUS and the procedure details with tips and tricks during investigation of blunt moderate-energy abdominal trauma as well as during follow-up in non-operative management.

We present a simplified computational rule for the back-propagation formulas for artificial neural networks. In this work, we provide a generic two-step rule for the back-propagation algorithm in matrix notation. Moreover, this rule incorporates both the forward and backward phases of the computations involved in the learning process. Specifically, this recursively computing rule permits the propagation of the changes to all synaptic weights in the network, layer by layer, efficiently. In particular, we use this rule to compute both the up and down partial derivatives of the cost function of all the connections feeding into the output layer.

Low back pain (LBP) is a health problem that affects 70-80% of the population in Western countries. Because of the biomechanical relationship between the lumbar region and the hip, it is thought that strengthening the muscles of this joint could improve the symptoms of people with LBP. The objective of the study is to evaluate the current evidence on the efficacy of hip strengthening exercises to reduce pain and disability in people with LBP. Clinical trials were collected from PubMed, PEDro, and Scopus databases published up to September 2022. Based on Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and using CASpe and PEDro tools for methodological quality assessment, we selected studies that included hip strengthening exercises as part of LBP treatment and measured pain and/or disability parameters. Among the 966 records identified in the search, a total of 7 studies met the established selection criteria. Overall, participants who performed hip strengthening exercises had significantly improved in pain and disability. The methodological quality of the included studies was assessed as “good”. In conclusion, the addition of hip muscle strengthening exercises iterating LBP effectively improving pain and disability.

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

The diagnosis of celiac disease (CD) may be delayed due to non-specific clinical symptoms. The aim of the study was to evaluate the clinical manifestation and diagnostic process of CD in Polish children and adults. Methods: The members of the Polish Coeliac Society (n=2 500) were asked to complete a questionnaire on socio-demographic factors, clinical and diagnostic aspects of CD. The analysis was based on 796 responses from patients with confirmed CD diagnosis, and included 224 (28.1%) children and 572 (71.9%) adults. Results: The mean duration of symptoms prior to CD diagnosis in children was significantly shorter than in adults (p < 0.001), and amounted to 3.1 and 9 years respectively. The most frequent symptoms before CD diagnosis were abdominal pain and bloating in children (70.4%), and chronic fatigue in adults (74.5%). Although almost all CD patients claimed to strictly avoid gluten after CD diagnosis, symptoms were still present in the majority of these respondents. No comorbid diseases were reported by 29.8% of children and by 11.7% of adults (p < 0.001). Conclusions: The results indicate that CD diagnosis is delayed in Poland, espe-cially in adults, and clinicians should be aware of the diversity in CD presentation.

Treating clubfoot in walking age children is debated, despite studies showing that using Ponseti casting principles can correct the mid-foot effectively. We aimed to explore techniques and approaches for management of older children with clubfoot and identify areas of management consensus. A mixed-methods cross-sectional electronic survey on delayed presenting clubfoot (DPC) was sent to 88 clubfoot practitioners (response rate 56.8%). We collected data on decision-making, casting, imaging, orthotics, surgery, re-currence, rehabilitation, multidisciplinary care and contextual factors. The quantitative data were analysed using descriptive statistics and the qualitative data were analysed using conventional content analysis. Many respondents used the Pirani score and some used the PAVER score to aid deformity severity assessment and correctability [1,2]. Ponseti casting principles were consistently applied with a stepwise approach. Con-textual factors influenced the timing of the treatment, the decision to treat a bilateral deformity simultaneously, and casting intervals. Differences were seen around orthotic usage and use of tibialis anterior tendon transfer following full correction. The survey identified consensus areas in overall principles of management for delayed presenting clubfoot and implementation of Ponseti principles, indicating these principles are well recognized as a multidisciplinary approach for older children with clubfoot. Some dif-ferences in approach may reflect different economic or social contexts. The principles can be adapted well for different geographical and healthcare contexts.

Road intersections are made of asphalt pavement, a popular road surface material used worldwide. The pavement may suffer deformities and deterioration, resulting in higher maintenance expenses and an elevated likelihood of road accidents, due to factors such as heavy vehicles and environmental variables like temperature and rainfall. To tackle these obstacles, researchers have devised several machine-learning algorithms and optimization techniques. These tools aim to forecast and scrutinize pavement deformation, with the goal of refining pavement design and maintenance approaches, as well as obtaining a more comprehensive comprehension of the factors that impact pavement effectiveness. This paper shows that heavy vehicles contribute significantly more to road erosion, and the retention and braking of vehicles greatly impact roadways. We also emphasize the statistical errors computed on the actual data range and demonstrate the results of the multilayer perceptron (MLP) model. The MLP model used the lath erosion standard to simulate future impact. Even though the model given is based on a small sample of data from one intersection, its estimates for road erosion in a year were found to be accurate when contrasted to real data. Controlling traffic flow can significantly improve road conditions, reducing erosion decay by reducing the time spent at intersections and other parameters. We conclude that machine learning can help control traffic flow, which can significantly improve road conditions, reducing vehicle time stretches at intersections.

Newborn screening (NBS) is hailed as a public health success, but little is known about long-term outcomes following a positive newborn screen. There has been difficulty gathering long-term follow-up (LTFU) data consistently, reliably, and with minimal effort. Six programs developed and tested a core set of minimal LTFU data elements. After an iterative data collection process and the development of a data collection tool, the group agreed on minimal LTFU data elements. The denominator captured all infants with an NBS diagnosis, accounting for children who moved or died prior to the follow-up year. They also agreed on three LTFU outcomes: if the child was still alive, had contact with a specialist, and received appropriate care specific to their diagnosis within the year. The six programs representing NBS public health programs, clinical providers, and research programs provided data across multiple NBS disorders. In 2022, 83.8% (563/672) of the children identified by the LTFU programs were alive and living in the jurisdiction; of those, 92.0% (518/563) saw a specialist, and 87.7% (494/563) received appropriate care. The core LTFU data elements can be applied as a foundation to address the impact of early diagnosis by NBS within and across jurisdictions.

Many pigments and dyes are not only valuable molecules in manufacturing, but also pollutants. Science has certainly been producing sustainable alternatives to counter the issue of dyes, but this is not enough. There is also a need for change in the business attitude and leadership approach of the organizations that operate in the industry. Only through the successful combination of new technologies and forward-looking decision making, it will be possible to alter the status quo and deal with the multiple environmental and supply chain challenges that these businesses are and will be facing. With a focus on colorants, this critical review article will reflect on the importance of both a biotechnological approaches and sustainable leadership to achieve a sustainable, forward-looking fashion industry.

Data from the WHO and UNICEF Estimates of National Immunization Coverage (WUENIC) 2022 revision were analyzed to assess the status of routine immunization in the WHO African Region, disrupted by the COVID-19 pandemic. In 2022, the coverage with the first and third dose of diphtheria-tetanus-pertussis containing vaccine (DTP1 and DTP3 respectively) and with the first dose of measles-containing vaccine (MCV1), in the region, was estimated at 80%, 72% and 69%, respectively (all below the 2019 level). Only 13 of the 47 countries (28%) achieved the global target coverage of 90% or above with DTP3 in 2022. From 2019 to 2022, 28.7 million zero-dose were recorded (19.0% of target population). Ten countries of the region accounted for 80.3% of all zero-dose children including the four most populous countries (Nigeria, Ethiopia, Democratic Republic of the Congo, United Republic of Tanzania). Reported administrative coverage greater than WUENIC was found in 19 countries, highlighting routine immunization data quality issues. The WHO African region has not yet recovered from COVID-19 disruptions to routine immunization. It is critical for Governments to ensure that processes are in place to prioritize investments for restoring immunization services, catching-up on vaccination of zero-dose and un-der-vaccinated children and improving data quality.

To systematically assess the effect size of different methods for patients with low back pain. PubMed, Cochrane Library, Web of Science, and Google Scholar. databases were searched in January 2023. This study has been developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. The key search terms were: “Low back pain”, “Back pain”, “SF-36”, “VAS”, “VASP”, “Roland-Morris”, “Oswestry Disability Index”, and “conservative treatment”. The risk of bias was determined for each randomized trial using the Cochrane Risk of Bias Tool, and the methodological index for non-randomized studies (MINORS). The outcomes included SF-36 Mental, SF-36 Physical, VAS, Roland-Morris, and Oswestry Disability Index. R 4.0.5 software was used, and standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated for continuous outcomes, random model. Twenty-five studies were included. Depending on the outcome being measured, the effect size of different methods in treating low back pain varies from small to large as follows: SF-36 Mental (SMD = 0.39, p &lt; 0.0001), SF-36 Physical (SMD = 0.55, p &lt; 0.0001), VAS (SMD = -0.84, p &lt; 0.0001), Roland-Morris (SMD = -0.45, p &lt; 0.0001), and Oswestry Disability Index (SMD = -0.61, p &lt; 0.0001). Our meta-analysis indicates the positive effects of applying different methods in the treatment of low back pain. PROSPERO registration number: CRD42022371282

The main purpose of this article is to consider the smoothness control of a weak solution after some moment if there is known solution regularity until this moment. The necessary tools can be varied. It is possible to control kinetic energy dissipation to fix moment or changing of velocity square or summability of acceleration square to fix at point time.

Gold-centered carbene-metal-amides (CMAs) containing cyclic (alkyl)(amino)carbenes (CAACs) are promising emitters for thermally activated delayed fluorescence (TADF). Aiming at design and optimization of new TADF emitters, we report a density functional theory study of over 60 CMAs with various CAAC ligands, systematically evaluating computed parameters in relation to photoluminescence properties. We demonstrate that the efficiency of TADF of CMAs, arising from a compromise of exchange energy and oscillator strength, is governed by the overlap of HOMO and LUMO orbitals, where HOMO is localized on amide and LUMO on Au-carbene. The S0 ground states and excited T1 states of the CMAs adopt approximately coplanar geometries of carbenes and amides, but rotate perpendicular in the excited S1 states, resulting in degeneracy or near-degeneracy of S1 and T1, accompanied with lowering of the S1-S0 oscillator strength from its maximum at coplanar geometries to near zero at rotated geometries. Based on computations, promising new TADF emitters are proposed and synthesized. Bright CMA complex (Et2CAAC)Au(carbazolide) is obtained and fully characterized to demonstrate that high radiative rates up to 106 s-1 can be obtained for the gold-CMA complexes with small CAAC-carbene ligands.

Blasting pattern optimization is an attempt to optimize blast design parameters aiming to achieve optimum fragmentation, reduce mining operating costs as well as environmental side consequences. The present study aims to propose a multi-objective optimization model, employing artificial intelligence and metaheuristics, to simultaneously minimize the mine-to-crusher operating costs and the impact of blasting consequences including fly-rock and back-break. To achieve the purpose of the study, a multi-variable regression model was developed to model total costs from drilling to crushing. In addition to the costs, multilayer perception neural networks were implemented to predict the blast-induced back-break and fly-rock as a function of collected variables such as number of holes, hole length, burden, spacing, hole slope, stemming, blasted rock per hole, powder factor, and charge per delay. High-precise estimations for both back-break and fly-rock were achieved with the average of 99% coefficient of determination for train, test and validation data sets. Then, the developed regression model and the neural networks were used in an optimization framework, employing Grasshopper algorithm, to find the optimum blast design satisfying practical constraints. The proposed model was tested on a lead-zinc open-pit mine, where 1032 blasting patterns were recorded and analyzed. The results of the optimization model provide a Pareto set of solutions, such that any of these solutions can be implemented according to the strategy of the mining operation management team. The blast pattern with the lowest cost, result in a relatively high fly-rock and back-break, while the pattern with low fly-rock and back-break raises the cost by 20.13 % compared the minimum cost blast design.

Objectives of this study were to investigate effects of repeated superstimulation on the success of ovum-pick up and in vitro production of embryos (OPU-IVP) and donor health and evaluate the efficiency of a modified SOF sequential medium in producing viable embryos. Over 1 y, six cross-bred beef heifers and three beef cows were subjected to superstimulations and OPU-IVP. Oocytes recovered were used for in vitro embryo production and the resulting embryos were transferred as fresh or frozen-thawed. Number of follicles, oocytes recovered, cleavage and blastocyst rates substantially varied among individuals. However, repeated trials did not significantly affect the efficiency of OPU-IVP. The pregnancy rates (PR) 22 to 30 d after embryo transfer for in vitro-derived fresh embryos was similar to that of fresh in vivo embryos, whereas transfer of in vitro-derived frozen embryos reduced PR compared to frozen-thawed in vivo embryos. All recipient heifers diagnosed pregnant delivered a viable calf, suggesting developmental competence of the embryos. Repeated OPU-IVP had no apparent deleterious effects, as all donors had viable calves after ET. We concluded that multiple OPU-IVP cycles can be effectively performed for a prolonged interval to maximize embryo production from elite donors without compromising their reproductive health.

In the first wave of COVID-19, up to 20% of patients had skin lesions with variable characteristics. There is no clear evidence of the involvement of the SARS-CoV-2 virus in all the cases; some of these lesions may be secondary to drug hypersensitivity. To analyze the possible cause of the skin lesions, we performed a complete allergology study on 11 patients. One year after recovery from COVID-19, we performed a lymphocyte transformation test (LTT) and Th1/Th2 cytokine secretion assays of PBMC. We included 5 nonallergic patients treated with the same drugs without lesions. Except for one patient who had an immediate reaction to azithromycin, all patients had a positive LTT to at least one of the drugs tested (azithromycin, clavulanic acid, hydroxychloroquine, lopinavir, and ritonavir). None of the nonallergic patients had a positive LTT. We found mixed Th1/Th2 cytokine secretion (IL-4, IL-5, IL-13, and IFN-γ) in patients with skin lesions corresponding to mixed drug hypersensitivity type IVa and IVb. In all cases, we identified a candidate drug as the culprit for skin lesions during SARS-CoV-2 infection, although only three patients had a positive drug challenge. Therefore, it would be reasonable to recommend avoiding the drug in question in all cases.

(1) Importance of problem: Breast cancer accounted for 685.000 deaths globally in 2020, and half of all cases occur in women with no specific risk factor beside gender and age-group. During last 4 decades we see a reduction by 40% of age-standardized breast cancer [1], which in turn means that the number of mastectomies performed for younger women increased, raising the need for adequate breast reconstructive surgery. Advances in oncological treatment have made it possible to limit the extent of what represents radical surgery for breast cancer, yet in the past decade, we see a marked trend toward mastectomy in breast conserving surgery eligible patients [2]. Prophylactic mastectomy has also registered an upward trend [3,4]. This trend together with new indication for breast reconstruction like chest feminization in transgender patients [5] have increased the need for breast reconstruction surgery. (2) Purpose: The purpose of this study is to analyze the types of reconstructive procedures, their indications, their limitations, their functional results and the safety profiles when used during the integrated treatment plan of the oncologic patient; (3) Methods: We conducted an extensive literature review of the main reconstructive techniques, especially the autologous procedures, summarized the findings and presented a few cases from our own experience for exemplification of the usage of breast reconstruction in oncologic patients. (4) Conclusions: Breast reconstruction has become a necessary step in the treatment of most breast cancers and many reconstructive techniques are now routinely practiced. Microsurgical techniques are considered the "gold standard", but they are not accessible to all services, from a technical or financial point of view, so pediculated flaps remain the safe and reliable option, along with alloplastic procedures, to improve the quality of life of these patients.

Particles and photons appear to be total opposites; the former has rest mass which requires space to exist; the latter has kinetic energy which requires time to occur (oscillate). But they do share certain properties (e.g., quantization) that remain invariant when one is transformed (swapped) for the other. This gauge invariance is developed in some detail.The symmetry between particle and photon turns out to be one of inversion. It is the equalities of special relativity that support this inversion and the accompanying invariances: mass transformed to energy; space transformed to time. The great advantage of these symmetries (inversions) is that they provide guidance for an object little understood (the photon) based upon an object well understood (the particle). On this basis, progress can be made in the understanding of some long-standing issues: wave-particle duality, time’s arrow, the constant speed of light and nonlocality.

Background: The thoracolumbar fascia (TLF) is thought to play a role in the development of LBP, but it is not yet clear which factor of TLF changes is a cause and which is an effect. Therefore, some studies used the cross-correlation function (CCR) to reveal time-dependent relationships between biomechanical and neuromotor factors. Methods: Ten patients with acute low back pain (aLBP) were matched to healthy controls. Simultaneous recording of surface electromyography (sEMG) of the erector spinae muscle (ES) and dynamic ultrasound (US) images of TLF deformation were performed during trunk extension. CCR functions and Granger causality were used to describe the relationship between the two measures. Results: CCR time lags were significant higher in the aLBP group (p = 0.04). Granger causality (GC) showed a direct effect of TLF deformation on ES activation only in the aLBP group (p &lt; 0.03). Conclusions: The results suggest that in aLBP, ES activity is significantly affected by TLF, whereas this relation-ship is completely random in healthy subjects studied with CCR and GC comparisons of dynamic US imaging and sEMG data signals. Fascia-related disturbances in neuromotor control, particularly due to altered muscle spindle functions, are suspected as a possible mechanism behind this.

Efficient commencement of clinical trials is pivotal for their successful execution. The purpose of this study was to determine and examine the factors that contribute to trial start-up delays. The study assessed 20 clinical trials' start-up stages in order to identify relevant variables. Results showed that trials with an emphasis on devices, trials that did not outsource, trials that utilized less auxiliary services, and trials that employed interventional designs had quicker start-up times than observational studies. Furthermore, approval times were substantially shortened by using a centralized Institutional Review Board (IRB) rather than a local IRB. Furthermore, compared to studies that successfully enrolled subjects, those who failed to do so required more time to complete contracts and budgets and secure IRB clearance. This study underscores the diverse impact of clinical trial features on start-up timelines. Understanding these factors is crucial for optimizing the initiation process of clinical trials.

When animals evolve sufficient intelligence and dexterity to be able to learn to fabricate utility products (UPs) like tools, the UP's they produce become part of an induced-reproduction system that intrinsically shares many life-like traits with biological organisms, including genome-like fabrication and operation information that is physically-encoded in the animal fabricator’s neural networks. When this set of life- like traits includes a sufficient capacity for system-improving cultural evolution (UP-evolvability), the UPs become ‘para-alive’, i.e., nearly alive, or a form of non-biological UP-paralife that is equivalent to the life- status of biological viruses, plasmids, and transposons. In the companion paper I focus on the evolution of UP-paralife in the context of modern, language-capable humans and its predicted evolution going forward in time (Rice 2022). Here I look backward in time and focus on the origin of UP-paralife and its subsequent coevolution with human intelligence. I begin by determining the pathways leading to the evolution of large brains in the rare lineages of biological life that have sufficient intelligence to learn to fabricate tools –a critical first step in the evolution of UP-paralife. The simplest forms of these learning- based UPs, made by species like chimpanzees and New Caledonian crows, represent only proto-UP- paralife because they lack sufficient UP-evolvability. Expanded UP-evolvability required a combination of three attributes that enabled continuous niche-expansion of the animal fabricator via a new and advanced form of UP-mediated teamwork (TW): i) self-domestication that facilitated TW among low-related individuals, ii) learned volitional words (protolanguage) that represent ephemeral UPs that coordinate TW, and iii) learned fabrication of simple flaked-stone tools with cutting and chopping capabilities (a UP to make other structural UPs) that expanded teammate phenotypes and TW capabilities. This specific triad of attributes is synergistic because each one acts as a TW-enhancer that can gradually erode different components of the three major constraints on TW operation and expansion: too much selfishness, insufficient coordination signals, and insufficient physical traits of teammates. The increase in UP- evolvability was transformative and marked the origin of UP-paralife and the initiation of coevolution between UP-paralife (cultural evolution) and the intelligence of its hominin/human symbiont (genetic evolution) that fostered 2.5 million years of: i) continuous brain size increase and niche-expansion within the genus Homo, and ii) parallel advances in the diversity, complexity and uses of UP-paralife. This coevolution also fostered evolutionary expansion of word-based communication, and eventually language, that acted in a catalyst-like manner to facilitate the evolution of increasingly complex forms of imagination, reasoning, mentalizing, and UP-generating technology. I next focus on the evolution of creativity in the human lineage –in the form of divergent thinking and creative imagination. I conclude that the evolution of this advanced cognitive feature required a preadaptation of sufficient intelligence and is the component of human cognition that was the major causal factor generating the greatly expanded diversity and complexity of UP-paralife currently associated with modern humans. Lastly, I apply my findings to the issue of the prevalence of extraterrestrial intelligent life. I conclude that any exoplanets with detected chemical life will very rarely (e.g., probability ~10-5 for a planet closely matching Earth’s characteristics) have evolved intelligence equalling or exceeding that of humans.

The objective of this study was to analyze the mental workload using EEG and eye tracking data and classify it using machine learning algorithms. The machine learning model was developed based on the simultaneous recording of eye tracking and EEG measurements during the experimental process. The experiments involved 15 university students, consisting of 7 women and 8 men. Throughout the experiments, the researchers utilized the n-back memory task and the NASA-Task Load Index (TLX) subjective rating scale to assess various levels of mental workload. The findings revealed that as the task difficulty increased, there was an increase in the diameter of both the right and left pupils, the number of fixations, the number and duration of saccades, and the number and duration of blinks. Conversely, variables related to fixation duration decreased. The EEG results indicated that theta power in the prefrontal, frontal, and front central regions increased with task difficulty. Additionally, alpha power increased in the frontal regions but decreased in the temporal, parietal, and occipital regions as the task became more challenging. Furthermore, low beta power significantly decreased in almost all brain regions as the task difficulty increased. In terms of the four-class classification problem, the mental workload level can be predicted with an accuracy rate of 76.59% using 34 selected features. This study has made a significant contribution to the literature by presenting a four-class mental workload estimation model that utilizes different machine learning algorithms.

Convolution forms one of the most essential operations for the FPGA-based hardware accelerator. However, the existing designs often neglect the inherent architecture of FPGA, which puts forward an austere challenge on hardware resource requirements. Even though some previous works have proposed approximate multipliers or convolution acceleration algorithms to deal with this issue, the inevitable accuracy loss and resource occupation easily lead to performance degradation. Toward this, we first propose two kinds of resource-efficient optimized accurate multipliers based on LUTs or carry chains. Then targeting FPGA-based platforms, a generic multiply-accumulate structure is constructed by directly accumulating the partial products produced by our proposed optimized radix-4 Booth multipliers without intermediate multiplication and addition results. Experimental results demonstrate that our proposed multiplier achieves a maximum 51% look-up-table (LUT) reduction compared to the Vivado area optimized multiplier IP. Furthermore, the convolutional process unit using the proposed structure achieves a 36% LUT reduction compared to existing methods. As case studies, the proposed method is applied to DCT transformer and LeNet to achieves hardware resource saving without loss of accuracy.

Plasmonic nanomaterials have garnered considerable attention in the scientific community due to their applicability in light-mediated technologies, owing to tunability, large light absorption cross-sections, transparency, and potential scalability. While single morphology plasmonic nanoparticles exhibit substantial absorption cross-sections, their effectiveness is limited to a narrow energy window, especially under polychromatic illumination like sunlight. Integrating plasmonics with a Fabry-Pérot nanocavity is a promising approach to broaden the absorption energy range of the photosystem. Traditionally, the fabrication of these nanocavities involves clean room processes, posing scalability challenges. This study presents a novel approach, demonstrating the successful enhancement of light absorption in a plasmonic photoelectrode system through a Fabry-Pérot nanocavity created using bottom-up solution methods. This innovative technique not only overcomes the scalability issues associated with clean room processes but also enables the production of scalable photosystems that can be rendered entirely opaque or semitransparent. Such versatility opens up a multitude of application possibilities for these photosystems.

The progress in markerless technologies is bringing clinicians tools to rapidly evaluate tests such as Timed Up and Go (TUG) without compromising the time of the assessment, yet it raises questions about the potential trade-off in accuracy compared to traditional marker-based systems, suggesting that the precision of these evaluations is not yet conclusively established. The OpenCap system is an easy tool to process 3D kinematics with two iPhone cameras placed in front of the subject. Previous research has primarily focused on walking and movement towards the cameras with the subject facing the cameras (WF) and thus has been unable to disentangle the differences in the movement directions. We have compared the OpenCap system with a standard marker-based system for both walking directions. In OpenCap, we found significantly worse results capturing walking facing away from the cameras (RW). Compared to the marker-based system, our findings indicate troubles measuring kinematic parameters but provide good accuracy in measuring spatial-temporal parameters. These insights pave the way for refining markerless assessment technologies, potentially enhancing their utility in clinical settings.

Injured peripheral nerves regenerate their axons in contrast to those in the central nervous system. However, functional recovery after surgical repair is often disappointing. The basis for the poor recovery is the progressive deterioration with time and distance, of the growth capacity of the neurons that lose their contact with targets (chronic axotomy) and the growth support of the chronically denervated Schwann cells (SC) in the distal nerve stumps. This is despite the retained capacity of chronically denervated and atrophic muscle to accept reinnervation. Progressive decline in regeneration associated genes in both axotomized neurons and denervated SCs accounts for the decline in regenerative success in association with silencing of neural activity in sensory neurons due to their disconnection from their sense organs and, in motoneurons due to loss of their synaptic contacts in the spinal cord. Whilst exogenous neurotrophic factors promote nerve regeneration, the profuse axonal outgrowth and difficulties in delivery are avoided by promoting their endogenous expression with brief (1 hour) low frequency (20Hz) electrical stimulation (ES) proximal to the injury site. ES accelerates axon outgrowth and in turn, target reinnervation in both animals and human subjects. Applying ES to intact nerve days prior to nerve injury, conditional ES (CES) increases axonal outgrowth and regeneration rate with the potential for application in nerve transfer surgeries and end-to-side neurorrhaphies. However, the additional surgery for applying CES electrodes may be a hurdle. ES is applicable in all surgeries with excellent outcomes.

Chronic Low Back Pain (CLBP), defined as pain persisting for at least 12 weeks, is a significant public health issue, with prevalence intensifying due to an ageing global population, amassing approximately 619 million cases in 2020 and projected to escalate to 843 million by 2050. Given the multitude of therapeutic modalities available for CLBP, this research sought to ascertain their respective efficacies in ameliorating pain and disability. We specifically scrutinized Multidisciplinary Biopsychosocial Rehabilitation (MBR) among adults enduring non-specific low back pain for over 12 weeks, excluding acute pain conditions and pre-study surgical interventions. MBR is an approach encompassing various modalities, including exercise, behavioral therapies, educational programs, and work conditioning aspects, necessitating a comprehensive Network Meta-Analysis (NMA) to fully grasp the extensive scope of its impact. The constructed network comprised diverse MBR modalities (behavioral, educational, and work conditioning) alongside exercise therapy (ET), minimal intervention, and usual care, serving as controls with pain and disability as outcomes. Through the analysis of 4,619 initially identified studies, 93 were included, encompassing a total of 8,059 participants. The NMA conducted substantiated that both ET and MBR modalities were notably effective in alleviating CLBP, with education-oriented MBR emerging as the most efficacious for pain mitigation and behavior-focused MBR for disability reduction. Nevertheless, the discerned differences amongst the treatments were minimal and uncertain, highlighting that no modality was definitively superior to the others. The analysis revealed low global and local inconsistency within the network, underscoring the reliability of the observed outcomes. Given the intricate nature of CLBP, embodying various facets, our findings advocate for a combined therapeutic approach to optimize treatment efficacy. Nonetheless, the presence of high study heterogeneity and potential biases necessitates cautious interpretation of the results, prompting future research.

The texture properties of cooked rice are a dominant property which can indicate the eating quality. Evaluation of back extrusion (BE) test precision and sensitivity for cooked germinated brown rice (GBR) texture in production process was investigated in this study. BE test on texture properties of cooked GBR rice show high precision of measurement of hardness, toughness and stickiness tests which indicated by the repeatability and reproductivity test but the sensitivity indicated by coefficient of variation of the texture properties. The findings of the study of the effect of different soaking and aging duration in the production of Khao Dawk Mali 105 (KDML 105) GBR on cooked GBR texture measured by BE test confirmed the developed protocol for evaluation of high precision and sensitivity of the texture measurement method. Repeatability and reproducibility of reliable measurements have a low standard deviation of the farthest different between replicates, which is considered high precision. High coefficient of variation where the relative wide variation of the absolute value of the property can be detected indicate high sensitivity which even small resolution can be detected or vice versa. But the correlation coefficient among the texture properties by BE were not related to the precision or sensitivity of the test. By these results, the original protocol for determination of precision and sensitivity of food texture measurement was successfully verified as the usable evaluation protocol for GBR texture measurement.

Bis-benzimidazole derivative (BBM) molecule, consisting of two 2-(2’-Hydroxyphenyl) benzim-idazole (HBI) halves, has been synthesized and successfully utilized as a ratiometric fluorescence sensor for the sensitive detection of Cu2+ based on enol-keto excited state intramolecular proton transfer (ESIPT). In this study, we strategically implement femtosecond stimulated Raman spec-troscopy and several time-resolved electronic spectroscopies, aided by quantum chemical calcula-tions to investigate the detailed primary photodynamics of BBM molecule. The results demonstrate that the ESIPT from BBM-enol* to BBM-keto* was observed in only one of HBI halves with a time constant of 300 fs, after that, the rotation of the dihedral angle between two HBI halves generate a planarized BBM-keto* isomer in 3 ps, leading to dynamics red shift of BBM-keto* emission.

Abstract: Background and objectives: Symptomatic walled-off pancreatic necrosis is a serious local complication of acute necrotising pancreatitis. The endoscopic step-up approach is the standard treatment for symptomatic walled-off pancreatic necrosis; however, adjunctive radiologic percu-taneous drainage for this condition is controversial. This study compared the clinical and radio-logic resolution of walled-off pancreatic necrosis achieved with the endoscopic step-up approach with or without radiology-guided percutaneous drainage. Material and Methods: This retrospective, single-center cohort study enrolled patients with symp-tomatic walled-off pancreatic necrosis who underwent endoscopic transmural drainage (ETD) followed by directed endoscopic necrosectomy (DEN) with or without radiology-guided drainage. A total of 34 patients (endoscopic approach, n=22; combined modality approach, n=12) underwent the endoscopic step-up approach (ETD followed by DEN). Baseline characteristics, clinical success, and resolution of necrosis were compared between groups. Results: All patients achieved symptom resolution from walled-off pancreatic necrosis. The mean patient age was 58.4 years, and 21 (61.8%) were men. After treatment with the endoscopic approach and combined modality approach, clinical success was achieved in 90.9% of patients within 11.5 days, and 66.7% of patients within 16.5 days, respectively. Both the total hospital stay (55 days vs 71 days; p=0.071) and time to complete radiologic resolution were shorter (93 days vs 124 days; p=0.23) in the endoscopic approach group. Conclusion: The endoscopic step-up approach resulted in the clinical resolution of symptomatic walled-off pancreatic necrosis comparable to that of the combined modality drainage. However, the endoscopic approach alone allows higher clinical success, early clinical and radiologic resolution, and a shorter hospital stay.

Opioid use disorder has increased in the world in recent years and Iran ranks first in terms of opium smoking in the world. In fact, opium smoking by traditional methods, in addition to dependence on morphine, is a behavioral addiction in Iran. The body position during opium smoking is usually non-standard and non-ergonomic. Over time, changes in muscle tissue, tendons and ligaments, and the connective tissue go from elasticity to neuromuscular plasticity. This study aims to compare sway back posture and musculoskeletal problems between opium smokers and non-drug users. In this comparative and cross-sectional study, 80 opium smokers were compared with 74 non-drug users in terms of sway angle (sway back posture), and musculoskeletal complaints (NORDIC questionnaire) and the association of possible risk factors was investigated. Data were analyzed by Kolmogorov-Smirnov, Correlation Coefficient and paired-t tests using SPSS version 23. There were significant differences between two groups in terms of sway back posture (P=0.007), and neck (<0.001), upper back (<0.001) and lower back (0.006) musculoskeletal complaints. Homelessness, the lifetime duration of opium smoking (in months), and the duration of daily opium smoking (in minutes) had significant correlation with sway back posture and musculoskeletal complaints. Homelessness was the strongest predictor and had strongest correlation. Overall, an increase in the duration of sitting in non-ergonomic positions could lead to increase in sway angle and sway back posture and increase in musculoskeletal complaints of neck, upper back and lower back due to the non-neutral posture of opium smoking. It seems that plasticity and structural and functional adaptations of the posture occurs due to opium smoking and further studies are recommended.

Background: Spinal pain is highly prevalent and in Spain it produces a very high economic cost and the scientific evidence supporting treatments shows low to moderate evidence for exercise. Therefore, the aim of this study was to assess the effectiveness of a therapeutic group exercise protocol in reducing pain intensity and disability in patients with spinal pain in primary health care setting. Methods: A total sample of 149 patients who suffered from chronic non-specific spinal pain. Patients received a therapeutic exercise protocol, including exercises of auto-mobilization of the neck and lumbar regions, as well as core stabilization exercises. Pain intensity and disability were evaluated before and after the therapeutic exercise protocol. Results: Statistically significant differences (P&lt;0.05) were shown for pain intensity and disability of patients with neck and low back pain with an effect size from moderate to large. Conclusions: A therapeutic exercise protocol may provide beneficial effects on disability and pain intensity in patients with chronic non-specific spinal pain, including neck and low back pain conditions. Clinicians should consider the use of self-administered exercise protocols, demonstrate great effectiveness, and be less costly.

Low back pain (LBP) is a common musculoskeletal complaint that can impede physical function and mobility. Current management often involves pain medication, but there is a need for non-pharmacological and non-invasive interventions. Soft tissue manipulation (STM) such as massage has been shown to be effective in human subjects, but the molecular mechanisms underlying these findings are not well understood. In this paper, we evaluated potential changes in soft tissue levels of more than thirty pro- or anti-inflammatory cytokines following instrument-assisted STM (IASTM) in rats with chronic, induced LBP using Complete Freund’s Adjuvant. Our results indicate that IASTM is associated with reduced soft tissue levels of RANTES/CCL5 and increased soft tissue levels of IL-4, which are pro-inflammatory and anti-inflammatory factors, respectively, by 120 minutes post-treatment. IASTM was not associated with tissue-level changes in CXCL5/LIX (the murine homologue of IL-8), CXCL7, GM-CSF ICAM-1, IL1-ra, IL-6, IP-10/CXCL10, L-selectin, TNF-α, or VEGF at either 30- or 120 minutes post-treatment. Combined, our findings suggest that IASTM exerts tissue-level effects that are associated with improved clinical outcomes and potentially beneficial changes in pro/anti-inflammatory cytokines in circulation and at the tissue level.

Neck circumference (NC), neck circumference to height ratio (NHtR) and neck circumference to weight ratio (NWtR) appear to be good candidates for the non-invasive management of non-alcoholic fatty liver disease (NAFLD). This study aimed to evaluate the ability of routine variables to assess and manage NAFLD in participants with obesity and NAFLD included in a 2-year nutritional intervention program. Anthropometric measurements, biochemical variables and imaging techniques were performed at different study time-points (baseline, 6, 12 and 24 months). The nutritional intervention significantly improved all anthropometric measurements as well as the glucose profile and the hepatic enzymes. NC and neck ratios combined with ALT levels and HOMA-IR showed good prediction ability for the hepatic fat content and hepatic steatosis at all the study time-points in a ROC analysis. The prediction ability of the combination panels improved when the weight loss variable was also considered. NC and neck ratios are easy anthropometric measurements that in combination with routine biochemical variables (ALT and HOMA-IR) showed good prediction ability of NAFLD. More research studies are necessary to validate the utility of these simple and easy variables as surrogate markers of NAFLD since their application could improve the prevention and management of this prevalent disease.

We develop the theory of Heyting locally small spaces, including Stone-like dualities such as a new version of Esakia duality and a system of concrete isomorphisms and equivalences. In such a way, we continue building tame topology, realising Grothendieck's ideas. We use up-spectral spaces and define the standard up-spectralification of a Kolmogorov locally small space. This research gives more understanding of locally definable spaces over structures with topologies.

Background: The currently advised follow-up scheme of PSA-testing after robot-assisted radical prostatectomy (RARP) is strict and might pose a burden to our healthcare system. We aimed to optimize the 1-year follow-up scheme for patients who undergo RARP. Methods: All patients with histologically-proven prostate cancer (PCa) who underwent RARP between 2018 and August 2022 in the Prostate Cancer Network the Netherlands were retrospectively evaluated. We excluded patients who underwent salvage RARP and patients who had &lt;1 year of PSA follow-up. Postoperative PSA-values were collected. Biochemical persistence (BCP) was defined as PSA-level &gt;0.10 ng/mL at 0-4 months after RARP, whereas biochemical recurrence (BCR) was defined as PSA-level &gt;0.2 ng/mL at any time point after RARP. We aimed to identify a group of patients who had a very low risk of BCR at different time-points after surgery. Results: Of all 1155 patients, BCP was observed in 151 (13%), of whom 79 (6.8%) had PSA ≥0.2 ng/mL. BCR further developed in 51 (4.7%), and 37 (3.4%) patients at 5-8 and 9-12 months after RARP, respectively. In 12 patients, BCR was found at 5-8 months after RARP in absence of BCP. These patients represented 1.2% (12/1004) of the entire group. In other words, 98.8% (992/1004) of patients who had an unmeasurable PSA-level at 0-4 months after RARP also had unmeasurable PSA-level 5-8 months after surgery. Limitations are the retrospective design and incomplete follow-up. Conclusions: Patients with an unmeasurable PSA-level at 3-4 months after RARP may not need to be retested until 12 months of follow-up as almost 100% of patients will not have biochemically recurrent disease at 5-8 months of follow-up. This will reduce PSA-testing substantially at the costs of hardly any missed patients with recurrent disease.

This paper gives solutions to puzzles of double Wheeler’s delayed choice experiments, a photon’s passing two paths simultaneously and wave collapse velocity measure, and shows new quantum control, new quantum oscillation and new controlling photon oscillator (that can be arranged in quantum computer and quantum network as their classical correspondences) in experiments. Furthermore, this paper obtains the measured attractive state and the new useful key technology of altering state’s evolving paths for quantum systems. We discover the reason and the technological way for the present changes the past, further show their feasible experiments of new quantum control, new quantum oscillation and new quantum oscillator. Finally, this paper achieves the collapse response time t of wave, further concretely deduces the measured collapse velocity of quantum system. In the past, the collapse velocity cannot be objectively deduced and experimentally measured.

Background and Objectives: The relevance of red flags in serious spinal pathology (SSP) evolved throughout the last years. Recently, new considerations have been proposed to expand the consideration of red flags. The purpose of this study was to determine, approve and test a model for the triage and manage-ment process of SSP based on the latest data available in the literature. Materials and Methods: The SSP model was initially built on the basis of a literature re-view. The model was further determined and approved by an expert panel us-ing a Delphi process. Finally, clinical scenario were used to test the applicabil-ity of the model. Results: After three rounds of Delphi process, panellists reached a consensus on a final version of the model. The use of clinical scenari-os by experts bring about reflexive elements both on the determined model and on the evocative SSP of the clinical cases. Conclusions: The validation of the model and its implementation in the clinical field could help assess the skills of first-line practitioners managing spinal painful patients. To this end, the devel-opment of additional clinical scenarios fitting with the determined model should be further considered.

Abstract: Sand-cement bound screed floor layers are at risk for work-related low back pain, lumbosacral radicular syndrome and knee osteoarthritis given their working technique of level-ling screed with their trunk bended and mainly supported by their hands and knees. To reduce the exposure of the physical demands of bending of the trunk and kneeling, a manually moved screed levelling machine was developed for floor layers in the Netherlands. The aim of this pa-per is to estimate the potential health gain of the manually moved screed levelling machine on the risk of low back pain (LBP), lumbosacral radicular syndrome (LRS) and knee osteoarthritis (KOA) compared to the traditional working technique. The potential health gain was assessed using the epidemiological population estimates of the Population Attributable Fraction (PAF) and the Potential Impact Fraction (PIF) combined with work-related risk estimates for these three disorders from systematic reviews. The percentage of workers exceeding these risk esti-mates was based on worksite observations among in total 28 floor layers. For LBP, 16/18 work-ers were at risk using the traditional working technique with PAF=38%, and for the manually moved screed levelling machine this was 6/10 with PIF=13%. For LRS, these data were 16/18 with PAF=55% and 14/18 with PIF=18% and for KOA, 8/10 with PAF=35% and 2/10 with PIF=26%. A manually moved screed levelling machine might have a significant impact on the prevention of LBP, LRS and KOA among floor layers in the Netherlands and a health impact assessment is a feasible approach to assess health gains in an efficient way.

(1) Background: The synthesis of core-shell magnetic mesoporous nanoparticles (MMSN) from phase transfer process is usually performed at 100-250 mg scale. At the gram scale, nanoparticles without core or with multicore systems are observed. (2) Methods: Iron oxide core nanoparticles (IO) were synthesized through thermal decomposition procedure of -FeO in oleic acid. Phase transfer from chloroform to water was then performed in order to wrap IO with mesoporous silica shell through the sol-gel procedure. MMSN were then functionalized with DTPA, and used for the separation of metal ions. Their toxicity was evaluated (3) Results: The phase transfer pro-cedure was crucial to obtained MMSN at large scale. Three synthesis parameters were rigorously controlled: temperature, time and glassware. Homogeneous dispersion of MMSN at the gram scale was successfully obtained. After functionalization with DTPA, the MMSN-DTPA were shown to have a strong affinity for Ni ions. Furthermore toxicity was evaluated in cells, zebrafish and through seahorse metabolic assays, and the nanoparticles were found nontoxic. (4) Conclusions: We developed a method of preparation of MMSN at the gram scale. After function-alization with DTPA, the nanoparticles were efficient in metal ion removal and separation, fur-thermore, no toxicity was noticed up to 125 µg.mL-1 in zebrafish.

Background and objectives: Musculoskeletal (MSK) pain significantly impacts physical activity and quality of life in the elderly, potentially influencing mortality. This study explored the relationship between MSK pain, physical activity, muscle mass, and mortality among older adults. Material and Methods: We studied 1000 participants of the Korean Longitudinal Study on Health and Aging (KLoSHA), a prospective, population-based cohort study of people aged 65 years or older. Survival status was tracked over a 5-year period. Correlations between Low back pain (LBP), knee pain, regular exercise, appendicular skeletal muscle mass (ASM), and other variables were analyzed. Logistic regression analyzes were used to identify independent risk factors for mortality. Results: Of the total participants, 829 (82.9%) survived after a 5-year period. Survivors tended to be younger, had a higher BMI, and were more active in regular exercise. In contrast, non-survivors exhibited a higher prevalence of both LBP and knee pain, along with increased instances of multiple MSK pain. Lower ASM correlated moderately with LBP and knee pain, whereas higher ASM was associated with regular exercise Lower ASM was moderately associated with LBP and knee pain, while higher ASM correlated with engagement in regular exercise. There was a moderate correlation between LBP and knee pain, both of which were associated with a lack of regular exercise. Age, sex, ASM, and regular exercise were significant predictors, even though MSK pain itself did not directly predict all-cause mortality. Conclusions: This study demonstrated the independent association between ASM, regular exercise, and mortality. Although MSK pain did not directly correlate with all-cause mortality, the non-survivor group had higher levels of both single and multiple MSK pain. Recognizing the interplay of MSK pain, physical activity, and muscle mass for older adults, the research underscores the need for holistic strategies to enhance health outcomes in older individuals with MSK pain.

Background: The annual mortality of patients with untreated chronic thromboembolism pulmonary hypertension (CTEPH) is approximately 50% unless a timely diagnosis is followed by adequate treatment. In pulmonary embolism (PE) survivors with functional limitation the diagnostic work-up starts with echocardiography. It is followed by lung scintigraphy and right heart catheterization. However, noninvasive test providing diagnostic clues to CTEPH, or ascertain this diagnosis as very unlikely, would be extremely useful since the majority of post PE functional limitations is caused by deconditioning. Methods: Patients after acute PE underwent a structured clinical evaluation with electrocardiogram, routine laboratory tests including NT-proBNP and echocardiography. The aim of study was to verify whether the parameters from echocardiographic or perhaps electrocardiographic examination and NT-proBNP concentration best determine the risk of CTEPH. Results: A total (n = 261, male n = 123) patients after PE were included into the study, in group of 155 patients (59.4%) with reported functional impairment 13 patients (8.4%) had CTEPH and 7 PE survivors had chronic thromboembolic pulmonary disease (CTEPD) (4,5%). Echo parameters differed significantly between CTEPH/CTEPD cases and other symptomatic PE survivors. Patients with CTEPH/CTEPD had also higher level of NT-proBNP (p = 0.022) but concentration of NT-proBNP above 125 pg/ml did not differentiate patients with CTEPH/CTEPD (p>0.05). Additionally, proportion of patients with right bundle brunch block registered in ECG was higher in group with CTEPH/CTED (23.5% vs. 5.8%, p = 0.034) but there were no differences between other ECG characteristics of right ventricle overload. Conclusion: Screening for CTEPH/CTEPD should be performed in patients with reduced exercise tolerance compared to pre PE period, It is not effective in asymptomatic PE survivors. Patients with CTEPH/CTED had predominantly abnormalities indicatingchronic thromboembolism in the echocardiographic assessment. NT-proBNP and electrocardiographic characteristics of right ventricle overload proved to be insufficient in predicting CTEPH/CTEPD development.

Objective: This systematic review and meta-analysis compared the patient-reported outcomes of intra-articular facet joint injections of normal saline and selected active substances to identify a more effective agent for treating subacute and chronic low back pain (LBP). Methods: The PubMed, Embase, Scopus, Web of Science, and CENTRAL databases were searched for randomized controlled trials and observational studies published in English. A research quality assessment was performed using ROB2 and ROBINS-I. A meta-analysis was conducted using a random-effects model, and the mean differences (MD) with 95% confidence intervals (CI) in efficacy outcomes, including pain, numbness, disability, and quality of life, were assessed. Results: Of the 2,467 potential studies, three were included (247 patients). The active substances and normal saline had similar therapeutic effects on pain within 1 h, after 1-1.5 months, and after 3-6 months, with MD and 95% CI of 2.43 and -11.61 to 16.50, -0.63 and -7.97 to 6.72, and 1.90 and -16.03 to 19.83, respectively, as well as the quality of life after 1 and 6 months. Conclusion: The short- and long-term clinical effects of intra-articular facet joint injections of normal saline are comparable to those of other active substances in patients with LBP.

Background: With the trend of intelligent display, the interface design of in-vehicle HUD is an expanding research field; Methods: To solve the subjectivity and uncertainty in the optimization of HUD interface design schemes, this paper proposed a hybrid scheme evaluation and optimization method based on entropy weight and VIKOR. The entropy weight method was used to reduce the subjectivity the decision-maker's weighting and obtain the objective weight of each indicator; The VIKOR method was used to obtain the best ranking of alternative schemes, and then the optimal interface design scheme was selected; Results: The evaluation of in-vehicle HUD interface design schemes were taken as an example for verification and calculation. The results showed that this method considers the subjectivity and uncertainty of the decision-making process in the optimization of design scheme, which can effectively improve the objectivity and accuracy of the evaluation results, and provide a reference for designers to optimize interface design schemes.

Circular RNAs (circRNAs) served as covalently closed single-stranded RNAs have been proposed to influence plant development and stress resistance. Grapevine is the most economically valuable fruit crops cultivated worldwide and threaten by various abiotic stresses. Herein, we reported that a circRNA (Vv-circPTCD1) processed from the second exon of a pentatricopeptide repeat family gene PTCD1 was preferentially expressed in leaves and responded to salt and drought but not heat stress in grapevine. Additionally, the second exon sequence of PTCD1 was highly conserved but the biogenesis of Vv-circPTCD1 is species-dependent in plants. It was further found that the overexpressed Vv-circPTCD1 can slightly decreased abundance of the cognate host gene and the neighboring genes were barely affected in grapevine callus. Furthermore, we also successfully overexpressed the Vv-circPTCD1, and found that the Vv-circPTCD1 deteriorated the growth during heat, salt, and drought stresses in Arabidopsis. However, the biological effects on grapevine callus were not always consistent with that of Arabidopsis. Interestingly, we found that the transgenic plants of linear counterpart sequence also conferred the same phenotypes as that of circRNA during the three stress conditions, no matter what species. Those results imply that although the sequences are conserved, the biogenesis and functions of Vv-circPTCD1 are species-dependent. Our results indicate that the plant circRNA function investigation should be conducted in homologous species, which support valuable reference for further plant circRNA studies.

As traditional supply chains face increasingly severe environmental issues and countries promote green development and sustainable development policy concepts, cultivating green supply chain operation models is gradually being highly valued by current governments and enterprises. Generally speaking, the production of green products incurs higher additional costs and thus their total production costs also increase. In this work, the product green level is related to the random demand. Under the green supply chain buy-back contract with the green product R&amp;D cost sharing between the manufacturer and the retailer, both the product green level and the order quantity need to be decided to maximize the channel profit. In order to coordinate the green supply chain, the manufacturer needs to share both the risk of good salvage and the green product R&amp;D cost with the retailer. We find that both the wholesale price and buy-back price increase in the manufacturer’s proposition of the green product R&amp;D cost, but decrease in emission reduction efficiency coefficient or carbon trading price. In addition, the product green level, the optimal order quantity and the channel profit increase in emission reduction efficiency coefficient, but decrease in the R&amp;D cost coefficient of the product green level. Interestingly, we find that if the carbon trading price is low, the manufacturer will set a low product green level and the product carbon emission trading is a cost for the supply chain. The increment of the carbon trading price leads to a higher cost such that the channel profit is decreased. However, if the carbon trading price is high, the manufacturer will set a high product green level and the product carbon emission trading is a revenue for the supply chain. The increment of the carbon trading price leads to a higher revenue such that the channel profit is increased.

. Background: Recent studies suggest that acquired brain injury with impaired consciousness in infancy is related to more severe and persistent effects and may have a cumulative effect on ongoing development. In this work, we aim to describe vocational outcome in a group of patients at 15 years from a severe brain lesion they suffered in developmental age. Methods: This study included a total of 147 patients aged 1.5 to 14 years with acquired brain lesion. Clinical, functional details (“Glasgow Outcome Scale – Extended”, “Functional Independent Measure”, Intelligence Quotient) were collected at the time of their first hospitalization and vocational outcome was determined after 15 years. Results: 94 patients (63.9%) presented with traumatic brain injury, while 53 patients (36.1%) presented with a brain lesion of other origin. Traumatic patients had a higher probability to be partly or fully productive than non-traumatic ones: 75.5% of traumatic subjects were working –taking into account limitations due to the traumatic event, versus 62.3% of non-traumatic ones. A relationship between some clinical variables and the vocational outcome was found. Conclusions: Rehabilitation should adequately emphasize “vocational rehabilitation” because a significant proportion of people experiencing a disorder of consciousness in childhood may show good social integration in adult age.

The number of long-term cancer survivors increases continually. Understanding their needs is crucial to ensure an adequate follow-up. The aim of our study was to summarize the current literature concerning needs and what in-fluences these needs. A Scoping review of systematic reviews was conducted according to the recommendations of the Joanna Briggs Institute (JBI). Four electronic databases were searched. Of 414 retrieved papers, 11 met the eligi-bility criteria. Needs were aggregated into six domains (health-related information, health system, mental, practical, relationship and physical) and 15 categories. The lack of adequate information and the lack of access and/or conti-nuity of supportive care were the most prominent needs. Female gender, younger age, a low level of family and/or social support, and higher educational level were identified as risk factors. Employment and relationship status can affect the needs both in a positive or negative way. The weeks or months after the end of the treatments are partic-ularly critical and needs can be emphasized during this period. Cancer survivors could also leave positive changes. The variety of needs affects the quality of life of cancer survivors. The current Swiss healthcare system is not de-signed to support these people. Needs assessments should be systematically provided to ensure a better awareness on the part of health professionals and to allow an individual, holistic, and integrated follow-up.

Nuclear technologies have a strong potential and a unique role to play in delivering reliable low carbon energy for a future net-zero society. However, to assure the sustainability required for the long-term success, nuclear will need to deliver innovative solutions as proposed in iMAGINE. One of the most attractive features, but also a key challenge for the envisaged highly integrated nuclear energy system is the need for a demand driven salt clean-up system. The work described provides an insight into the interplay between a potential salt clean-up system and the reactor operation in a plutonium started core in a dynamic approach. The results presented will help to optimize the parameters for the salt clean-up process as well as to understand the differences which appear between a core started with enriched Uranium and Plutonium as the fissile material. The integrated model is used to investigate the effects of the initial fissile material on core size, achievable burnup, and long term operation. Different approaches are tested to achieve a higher burnup in the significantly smaller Pu driven core. The effects of different clean-up system throughputs on the concentration of fission products in the reactor salt and its consequences are discussed for general molten salt reactor design. Finally, an investigation of how a plutonium loaded core could be used to provide fuel for future reactors through fuel salt splitting is presented with the outcome that one Pu started reactor of the same size as a uranium started core could deliver fuel for 1.5 new cores due to enhanced breeding. The results provide an essential understanding for the progress of iMAGINE as well as the basis for inter-disciplinary work required for optimizing iMAGINE.

Like the most of crops, especially sugarcane needs to be kept upright until it is harvested. Because, lodging of sugarcane has a significant negative effect on cane yield and sugar content of sugarcane. To keep sugarcane upright earthing up is an utmost intercultural operation. In Bangladesh, most of the operations for sugarcane cultivation including earthing up are generally done in traditional method using human labor which increases production costs as well as reduces the income of sugarcane growers. So, a cost effective two-wheeled tractor (2WT) mounted earthing up machine was developed in Bangladesh Sugarcrop Research Institute (BSRI), Pabna to reduce drudgery and cost of sugarcane production. Field tests were conducted in experimental sugarcane field at BSRI and technical and economic performances of the developed earthing up machine were also carried out based on the field test. Average effective field capacity and field efficiency were found 0.16 ha/hr and 77.41 %, respectively for the developed earthing up machine. The earthing up machine was not found economically viable when it is used only for earthing up operation. Besides, when the 2WT was being used as the main driver for other activities including earthing up operation, then the earthing up machine becomes economically beneficial with net cash flow, net present value, internal rate of return, benefit-cost ratio and payback period of BDT 148497/ha, BDT 23184, 3%, 3.81:1 and approximately 1 year, respectively. On the contrary, considering cost of only earthing up tool without 2WT, then it was found economically beneficial with net cash flow, internal rate of return, net present value, benefit-cost ratio and payback period of BDT 16428/ha, BDT 3053, 4.7%, 2.71:1 and approximately 2 years, respectively. Since 2WT is commonly used for versatile farming purposes. Therefore, versatile use of 2WT as prime mover for other machines including earthing up machine can make earthing up machine economically viable and beneficial for sugarcane growers.

One of the main causes of the dismal prognosis in patients who survive the initial bleeding after aneurysmal subarachnoidal hemorrhage is the delayed cerebral ischaemia caused by vasospasm. Studies suggest that cerebral magnesium and pH may potentially play a role in the pathophysiology of this adverse event. Using phosphorous magnetic resonance spectrocopy (31P-MRS) we calculated the cerebral magnesium (Mg) and pH level in 13 patients who suffered aSAH. The values between the group that developed clinically significant vasospasm (n=7) and the group that did not (n=6) were compared. The results of this study showed significantly lower cerebral Mg levels (p=0.019) and higher pH (p&lt;0.001) in cumulative group (all brain voxels together) in patients who developed clinically significant vasospasm. Further clinical studies on a larger group of carefully selected patients are needed in order to predict clinically significant vasospasm.

The aim of this study was to assess the effects of three warm-up durations on post-exercise oxidative stress biomarkers, as well as recovery from the Wingate test in 14 amateur handball players. These players completed the Wingate test three times: after 5-min, after 10-min, and then after 15-min of warm-up, spread over two weeks with an interval of one week between each session. At the end of each session of the Wingate test, blood samples were taken: at rest (PR), after warming up (PWU) and immediately at the end of the test (P0), then after 10-min (P10) and after 20-min (P20) of recovery. The measured parameters are the total antioxidant status (TAS), superoxide dismutase (SOD), glutathione reductase (GR), glutathione peroxidase (GPx), malondialdehyde (MDA), protein-bound-carbonyls (PC) and thiobarbituric acid reactive substances (TBARS). The main findings revealed that anaerobic exercise induces oxidative stress, as evidenced by changes in antioxidant status and significant increases in concentrations of the majority of oxidative stress indicators (p < 0.05). At P20, plasma GPx, SOD, GR, TBARS, and PC contents, are lower and significantly different after a 15-min warm-up than after a 10-min or 5-min warm-up. ANOVA showed a significant ‘‘warm-up×recovery’’ effect on plasma GPx, SOD, GR, TBARS, and PC contents [F(8.104)=3.61; p<0.001; η2p=0.22, F(8.104): from 1.88 to 19.97; η2p: from 0.19 to 0.61: 0.05<p<0.001], respectively. We concluded that a 15-min warm-up was more efficient than the other duration in reducing free radical rise, emphasizing the importance of warm-up length on plasma oxidative stress biomarkers.

The demand for improving the nuclear waste management has since long been identified as one of the major hurdles for widespread use of nuclear energy. Nuclear waste management, through partitioning and transmutation (P&T) has been researched since the 1990ies with partitioning being a pre-requisite for the process. Recently, an innovative approach of reactors directly operating on spent nuclear fuel, iMAGINE, has been proposed which could deliver on the aims of P&T as a side effect to more efficient nuclear energy production in the future. The results shown here confirm that it is possible to achieve the aims of P&T without prior partitioning, but it is certainly less efficient since the high concentration of MAs, required for efficient burning, are impossible to obtain in a short operational time. The proposed nuclear waste management approach will be a long-term effort when it is accomplished without partitioning/separation technologies. However, none of the analyses contradicts this effort – the key points are a) when the technology for treating the waste is possible and reliable, the time horizon will not be a major concern b) the waste management is now intrinsically linked with energy production instead of requiring dedicated costly facilities, delivering a promising economic basis c) the waste management is now associated with long-term energy production and massively improved resource utilization. In summary, the objectives of P&T are achievable without prior partitioning – this is a ground-breaking result. However, the approach will require continued nuclear energy production for a very long time. In case of a nuclear phase-out decision, a much more efficient transmutation scenario would have to be envisaged as already discussed several years ago for Germany.

In synthetic diamond plate, the intrapulse correlated dynamics of self-phase modulation and spontaneous Raman scattering by optical phonons were for the first time directly investigated for tightly focused (focusing numerical aperture NA = 0.25) positively-chirped visible-range ultrashort laser pulses with variable durations (0.3-9.5 ps) and energies, transmitted through the sample. The observed modulation of the transmitted light spectra and Stokes Raman scattering spectra for the different pulse durations were related to nonthermal excitation of nonlinear phonon polarization and its eventual picosecond-scale suppression due to thermal decay of optical phonons on the timescale of electron-phonon thermalization in the material.

Primary care pediatricians encounter a wide range of complex conditions in their daily clinical practice. It is not uncommon for their patients to get exposed to medical errors. Diagnostic errors, defined as missed, delayed, or wrong diagnosis, are of great importance as they may cause significant harm to the pediatric patient with severe disease. These errors often occur when the symptoms and signs of a disease are atypical or missing. Data on the most frequent misdiagnosed situations in pediatrics is scarce. One of these groups of conditions is that regarding cardiac diseases. The pediatric cardiology field has met rapid development over the past few decades. Primary care providers play a key role in diagnosis, management, and referral of children with heart disease, both congenital and acquired, because many common cardiac complaints are first addressed in the primary care setting. The scope of this review is to investigate the cardiac entities that are often missed by the general pediatricians. In particular, it aims to spot the most common of them, to describe their clinical presentation, their diagnostic options, red flags, and tips, and to provide the ways to avoid erroneous, delayed, or missed diagnosis.

Up-conversion luminescence (UCL) materials are of great importance due to their unique optical properties. In particular, the red UCL, falling into the optical transmittance window of biological tissues, can realize deep tissue penetration depth and high-resolution bioimaging. In this work, effective red UCL is achieved in the ternary sulfide by the introduction of Tm3+ or Ho3+ ions into Er3+ doped NaYS2 under 1550 nm excitation. The main emission peak is successfully tuned from green (NaYS2:Er3+) to highly efficient red luminescence (NaYS2:Er3+,Tm3+ and NaYS2:Er3+,Ho3+). The maximum red to green emission intensity ratio (IR/IG) increased by 31 and 80 times, respectively. The lifetime of 4I9/2(Er3+) level decreases significantly from 3432 s (NaYS2:Er3+) down to 636 (NaYS2:Er3+,Tm3+) and 423 s (NaYS2:Er3+,Ho3+), respectively. This is due to the altered energy transfer pathways, resulting in the population of 4F9/2(Er3+). The mechanisms of UCL and energy transfer processes are further supported by fluorescence decay dynamic measurements. The results show the realization of red-emissive UCL in the promising NaYS2 matrix, representing a new type of red UCL phosphors.

Graphene is a two-dimensional nanostructured material with intrinsic properties that show promising performance in various applications, including electronics, renewable energy, medicine, mechanical enforcement and others. This study reports a bottom-up approach for the conversion of cyclohexane into graphene nanoflakes, which were then deposited onto fiberglass using a non-thermal generator. The composite was characterized using transmission electron microscopy, which revealed the formation of stacked few-layer graphene with a partially disordered structure and a d-spacing of 0.358 nm between the layers. X-ray diffraction confirmed the observations from the TEM images. SEM images showed the agglomeration of carbonaceous material onto the fiberglass, which experienced some delamination due to the synthesis method. Raman spectroscopy indicated that the obtained graphene exhibited a predominance of defects in its structure. Additionally, Atomic Force Microscopy (AFM) analyses revealed the formation of graphene layers with varying levels of porosity.

Delayed discharge for non-clinical reasons is defined as a period of stay that continues after a patient has been deemed medically fit to leave the hospital but is unable to do so for non-medical reasons. This circumstance overburdens the healthcare system and constitutes a major problem for healthcare systems and the patients themselves in this situation.The aim of this study was to evaluate the delay in effective discharge for non-medical reasons in patients admitted to acute care hospitals in Spain. A scoping review was conducted in order to revise and obtain an up-to-date review. The initial search strategy identified a total of 123 references, which were successively screened to a final selection of 13 studies. To conclude, delayed discharge from hospital for non-clinical reasons is a multifactorial problem. It may be due to factors internal or external to the hospital, as well as personal factors. The main causes of the delay are similar among the studies found, as are the clinical characteristics of the patients, most of whom are elderly, frail, and more dependent due to declining functional capacities. Further studies addressing the socio-familial characteristics of the patients and the perspective of the patient and families would be necessary.

This paper proposes a novel symmetrical active-switched coupled-inductor high-step-up DC/DC converter. A new active-switched coupled inductor is used to allow much higher voltage gain of the proposed converter. The symmetrical circuit structure of the proposed converter evenly divides large input currents and reduce input current ripple by operating in interleaved mode so power density is increased. The switches also have low voltage stress. The operating principle and design considerations for the converter topology are described. The proposed converter with an input voltage of 40 V, an output voltage of 400 V and an output of 1000 W at a switching frequency of 50 kHz is implemented. The simulations and experimental results are thus depicted to verify the theoretical analysis. The highest efficiency is 95.5% at 200 W measured by using a HIOKI 3390. Consequently, the proposed converter is suitable for renewable energy generation systems that require high power, high voltage gain and high efficiency.