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.

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.

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 < 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.

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.

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.

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.

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.

Previous studies have quantified repolarization variability using time-domain, frequency-domain and non-linear analysis in mouse hearts. Here, we investigated the relationship between these parameters and ventricular arrhythmogenicity in a hypokalaemia model of acquired long QT syndrome. Methods: Left ventricular monophasic action potentials (MAPs) were recorded during right ventricular regular 8 Hz pacing during normokalaemia (5.2 mM [K+]), hypokalaemia modelling LQTS (3 mM [K+]) or hypokalaemia with 0.1 mM heptanol in Langendorff-perfused mouse hearts. Results: During normokalaemia, mean APD was 33.5±3.7 ms. Standard deviation (SD) of APDs was 0.63±0.33 ms, coefficient of variation was 1.9±1.0% and the root mean square (RMS) of successive differences in APDs was 0.3±0.1 ms. Low- and high-frequency peaks were 0.6±0.5 and 2.3±0.7 Hz, respectively, with percentage powers of 38±22 and 61±23%. Poincaré plots of APDn+1 against APDn revealed ellipsoid morphologies with SD along the line-of-identity (SD2) to SD perpendicular to the line-of-identity (SD1) ratio of 4.6±1.1. Approximate and sample entropy were 0.49±0.12 and 0.64±0.29, respectively. Detrended fluctuation analysis revealed short- and long-term fluctuation slopes of 1.62±0.27 and 0.60±0.18, respectively. Hypokalaemia provoked ventricular tachycardia in six of seven hearts, prolonged APDs (51.2±7.9 ms), decreased SD2/SD1 ratio (3.1±1.0), increased approximate and sample entropy (0.68±0.08 and 1.02±0.33) and decreased short-term fluctuation slope (1.23 ± 0.20) (ANOVA, P<0.05). Heptanol prevented VT in all hearts studied without further altering the above repolarization parameters observed during hypokalaemia. Conclusion: Reduced SD2/SD1, increased entropy and decreased short-term fluctuation slope are associated with ventricular arrhythmogenesis in hypokalaemia. Heptanol exerts anti-arrhythmic effects without affecting repolarization variability.

Carcinoembriogenic antigen (CEA) is a routine marker for follow-up of colo-rectal cancers. We aimed to determine whether a CEA increase within the normal range can be linked to a recurrence risk. We included 78 consecutive patients with colo-rectal cancer, who underwent curative surgical treatment with or without chemo- or radiotherapy. As reference, we used the smallest value of the CEA during follow-up. A total of 34/78 patients (43.6%) had fluctuations of CEA of at least 1.1 ng/ml, with or without increases above 5 ng/ml. In 27/34 patients (79.4%) increases of CEA were explained either by recurrence (15/34 patients, 44.1%), adjuvant chemotherapy (7/34 patients, 20.6%) or benign pathology (5/34 patients, 14.7%). In 5 of 22 recurrences (23%) a CEA increase of at least 1.1 ng/ml, but below 5 ng/ml preceded the clinical relapse by a median of 8 months (range 3-22 months). The 4-year disease-free survival was 89% in patients with postoperative CEA <2.5 ng/ml, and 55% in patients with CEA >2.5 ng/ml. CEA increase by at least 1.1 ng/ml within the normal range, after curative treatment of colorectal cancer can be either an early sign of relapse or can be usually explained by other pathological processes.

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.

The objective of parsing is to transform a natural language sentence it in to a standard order. and in a same way a sentence is tokenized with an appropriate format. There are certain English grammar evaluation rules and the parsing approach which is to be followed for the proper formation of a particular sentence syntactically and semantically using the parsing approach. A sentence in English language is the main element in the semantic parser, which creates a parse tree with the help of applying semantic dating technique to a number of phrases. A parser divides a token into smaller components by applying sets of guidelines that characterize and a series of the tokens to determine its structure of the language, which specified by grammar. The illustration provides easy records on grammatical connections, which can simply know and put into practice with those who have no prior knowledge of the language, such as those who need to obtain textual family members. The semantic family members represent the relationships of a number of the words in the sentence. We advocate utilizing our parser to acquire the tagged sets as well as a context-free layout grammatical representation for the source form. All pronouns, adverbs, singular, plural, nouns, verbs, people, adjectives, tenses and other words are kept in a database.

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.

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.

Many children have suspected delayed language development and need extensive support from parents and the health care team. This study aimed to investigate suspected delayed language development and factors associated with suspected delayed language development among early childhood in Southern Thailand. Children aged 24 to 60 months were recruited as study samples using stratified random sampling conducted in 23 districts and simple randomized seven sections (425 children). Instruments comprised demographic data of the children and families, The preschool temperament questionnaire, and the Language Development Screening questionnaire using developmental surveillance and promotion manual. I was collecting data from July 2020 to January 2021. Data analysis used descriptive statistics and logistic regression. The results showed that 40.9 percent suspected delayed development. Daily screen time exceeding 2 hours per day (A.O.R. = 17.30, 95% CI: 7.35-40.72), and regarding a child's temperament, moderate-to-difficult temperament (A.O.R. = 9.56, 95% CI: 5.12-17.85) were significantly associated with a suspected delay of language development. The study suggested two-way communication and appropriate responses will help develop children's language.

The present decade has witnessed numerous investigations focussed on the determination of the mechanical properties of Fly ash composites. These composites have attracted attention, especially in the form of reinforcements owing to their excellent tensile and compressive properties coupled with impact and hardness response. A number of techniques viz. in-situ deposition, hand-up lay and compo-casting techniques have been reported to fabricate these composites. However, in the context of these composites, a systematic structure-property correlation has not been established till date. The present review is aimed at highlighting the current state of research in the avenue of Fly ash composites from two different viewpoints, viz. (i) fabrication technique and (ii) mechanical properties of the fabricated composites. Moreover, the necessity of establishing systematic structure-property correlation in these materials has also been briefly discussed from the author’s viewpoint.

With the development of the city, a large number of water networks in the built-up areas of Bangkok have been filled and hardened, resulting in poor urban flooding and aggravating flooding, causing loss of life and property of citizens. In this paper, on the basis of combing the current water networks and open space potential flood storage points in the built-up areas of Bangkok, the complex network diagram of the water system in the built-up areas of Bangkok is constructed by combining the theory of complex networks and analyzing the attribute parameters of the network and the characteristic parameters of the open space storage nodes and water system paths, and finding that the water system network in the built-up area of Bangkok has complex network characteristics such as robustness, clustering and hierarchy. By exploring the key storage points and water system connection paths, the researchers initially constructed a flood safety pattern in the built-up area of Bangkok with 145 key nodes and 127 river paths as the backbone, and conceptualized the development study of the flood safety pattern in both horizontal and vertical directions. The urban flood safety pattern based on complex network theory proposed in this paper provides a case reference and methodological ideas to scientifically solve the game conflict between the demand for construction land for urban development and the construction area of urban open space storage points and water storage network under the increasingly severe flooding situation.

Low back pain is a common problem in the active population, and the second reason for visiting a physician. In patients with lumbar disc protrusion, the nucleus pulposus bulges against the disc and the latter protrudes into the spinal column, but the annulus fibrosus remains intact. The purpose of this study was to prove that starting an early complex rehabilitation treatment results into pain and disability reduction, and increased muscle strength and mobility in patients with lumbar disc protrusions. We performed a prospective cohort study, enrolling 60 patients (25 men and 35 women) aged between 26 to 76 years, diagnosed with lumbar disc protrusion. Patients in the experimental group registered significant improvements in all studied variables (pain, mobility, muscle strength, disability) after 6 months of treatment. The results of our study suggest that, in the lumbar disc disease, a combined rehabilitation program may be more effective in terms of pain and disability reduction, if it starts early after diagnosis. The current study proves the importance of combining electrotherapy with hydrotherapy and physical therapy. Patients who received this treatment combination showed an extremely significant improvement in pain relief, and reduction of functional disability after 6 months of treatment.

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.

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.

Historically, the evaluation and assessment of the clinical response to treatment for canine back pain is subjective and relies on owner and clinician assessment of pain. This study evaluated the use of sequential infrared thermal images as a measure of the response of canine patients with back pain to a prescribed series of photobiomodulation therapy (PBMT) treatments. Qualifying participants had histories of pain and dysfunction associated with spinal osteoarthritis or intervertebral disk disease, or of non-specific uni- or bilateral back pain along the paravertebral epaxial muscles. Each patient was initially thermally imaged prior to PBMT treatment and then received multiple PBMT treatments delivered to the appropriate spinal area on days 1, 2, 3, and 4. Participants were reimaged on day 7. Thermal images provided an objective measure of superficial temperature changes over the area of PBMT treatment of each patient after the PBMT regimen. The temperature correlated with statistically significant changes in Colorado State University Canine Chronic Pain Scale scoring (CPS) and owner assessment using the Canine Brief Pain Inventory (CBPI), which includes a Pain Severity Score (PSS) and Pain Interference Score (PIS). The correlation of objective thermal imaging data with more subjective outcome measures suggests thermal imaging may be a valuable additional tool in monitoring therapy outcome.

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.

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.

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.

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.

Mangrove vegetation plays a vital role in habitat and nursing ground for different organisms and prevents coastal erosion caused by wave and tide action. In recent years the mangrove vegetation in Chattogram coast, Bangladesh, has been interrupted by other infrastructural development, which has a destructing effect on the surrounding environment. Land surface temperature analysis of an area helps learn about different environmental conditions, weather, and climate. It is also essential to monitor the rising temperature and global warming, the biggest threat to humanity. NDBI and NDVI are the efficient process for monitoring vegetation and build up areas of a geographical location. This study focused on those analyses to understand the importance of mangrove vegetation in the Salimpur area and surrounding coastal areas of Chattogram by studying the relationship between NDVI and NDBI, NDVI and LST, NDBI, and LST. The outcome indicates that a higher vegetation index results in lower land surface temperature during different periods, negatively correlated. This study also found a strong positive correlation between buildup index (NDBI) and land surface temperature (LST), which means Land Surface temperature was found higher in Buildup areas. The vegetation areas are greatly affected by the buildup areas. The correlation between buildup areas and vegetation areas was strongly negative, which means an increase of NDBI decreases NDVI, and a decrease of NDBI increases NDVI.

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.

Background and objective. Globally, disposing of unused medicines has become a source of concern, as pharmaceutical waste enters the ecosystem, posing a threat to human health and the environment. This study aimed to assess the disposal practice of unused medication among pharmacists in Libya. This study also seeks to determine if pharmacists plan to have their pharmacies serve as assembly points for potential take-back initiatives. Methods. A random sample of 150 pharmacists from various government and private pharmacies in Tripoli participated in a self-administered questionnaire about their disposal practices, and knowledge on pharmacies serving as collection points for ideal disposal of unused medicines. Descriptive statistics were used to interpret the data. Results. A total of 128 pharmacists completed the survey. The majority of respondents said that throwing discarded drugs in the trash bin was their preferred method of disposal (53.1%), followed by discarding via burn and drug wholesalers (17.2%, 14.8%, respectively). Only 2.1% of the respondents disposed unused medicines according to the WHO guidelines of drug disposal. Moreover, about 65.6% had poor knowledge about Take-Back program. Conclusion. Failure to follow the WHO guidelines for drug disposal raises the risk of contamination of our environment and the likelihood of humans and animals ingesting harmful pharmaceutical wastes.

While Spinal Cord Stimulation (SCS) provides satisfaction to almost 2/3 of Persistent Spinal Pain Syndrome-Type 2 (PSPS-T2) patients implanted for refractory chronic back and/or leg pain when not adequately addressed the back pain component, leaves patients in a therapeutic cul-de-sac. Peripheral Nerve field Stimulation (PNfS) has shown interesting results addressing back pain in the same population. Far from placing these two techniques in opposition, we suggest that these approaches could be combined to better treat PSPS-T2 patients. We designed a RCT (CUMPNS), with a 12-month follow-up, to assess the potential added value of PNfS, as a salvage therapy, in PSPS-T2 patients experiencing a “Failed SCS Syndrome” in the back pain component. Fourteen patients were included in this study and randomized into 2 groups (“SCS + PNfS” group/n=6 vs “SCS only” group/n=8). The primary objective of the study was to compare the percentage of back pain surface decrease after 3 months, using a computerized interface to obtain quantitative pain mappings, combined with multi-dimensional SCS outcomes. Back pain surface decreased significantly greater for the ”SCS+PNfS” group (80.2% ± 21.3%) compared to the “SCS only” group (13.2% ± 94.8%) (p=0.012), highlighting the clinical interest of SCS+PNfS, in cases where SCS fails to address back pain.

As fossil-fueled heating in the building sector is responsible for 16 % of Germanys total CO2 emissions, it is of great importance to use climate-neutral alternatives for the decarbonization of this sector. Options for the climate-neutral heating of buildings include electricity or hydrogen as energy carriers, both explicitly considered by German policy. In this paper, bottom-up studies are conducted to investigate the role of hydrogen for the climate-neutral energy supply of ten selected residential buildings in comparison to electricity-based systems. Based on a selection of as different typical buildings as possible for single- (SFH) and multi-family houses (MFH) of different construction years, demand profiles are simulated for each building and the respective cost-optimal supply system is determined. For the construction of this system, the electricity-based technologies available are electric heater and heat pump as well as the hydrogen-based technologies hydrogen boiler and fuel cell combined heat and power (CHP) system. Based on the results of the optimization, sensitivity analyses are performed. These analyses aim to identify threshold values of the hydrogen price for the use of hydrogen in building energy systems as well as to make the quantities of hydrogen consumed visible.The identified threshold values show the significant role of hydrogen-operated CHP in MFH if the hydrogen price reaches 0.17 €/kWh_H2 in 2050 at an electricity price of 0.31 €/kWh_el. So, hydrogen-based energy systems represent an economically viable alternative to electricity-based systems with heat pumps. We identify electricity to hydrogen price ratios for the economically viable use of hydrogen in the examined buildings that range from 1.67 to 2.82. According to these ratios, the economically reasonable use of hydrogen in buildings can be derived. For the individual building groups for the year 2050, a ratio of 2.5 can be determined for SFH and 1.8 for MFH, that is favored by the use of CHP which also supplies electricity to the buildings. However, the role hydrogen will finally play in German residential buildings in the future depends to a large extent on political decisions on distribution issues and price signals.

This study presents three forms of interdisciplinary expertise in the healthcare design context to approach a particular multifaceted problem around the current healthcare for older adult patients with chronic low-back pain (LBP). Using an interdisciplinary co-design framework, first, our design approach performs the role of an initiator to define the problem by exploring the current context of healthcare. Second, it facilitates the experiences of experts and patients to reach the roots of the problem by functioning as a mediator. Third, our approach fulfills the primary role of healthcare design in producing new meanings considering the principles of patient-centeredness. These roles significantly contributed to the design of healthcare innovations. Our framework transformed the distributed disciplinary knowledge developed while tackling the multifaceted problem into new forms of expertise for collaboration in healthcare innovation.

The multidimensionality of chronic pain forces us to look beyond isolated pain assessment such as pain intensity, which does not consider multiple key parameters, particularly in patients suffering from post-operative Persistent Spinal Pain Syndrome (PSPS-T2). Our ambition was to provide a novel Multi-dimensional Clinical Response Index (MCRI), including not only pain intensity but also functional capacity, anxiety-depression, quality of life and objective quantitative pain mapping assessments, the objective being to capture patient condition instantaneously, using machine learning techniques. Two hundred PSPS-T2 patients were enrolled in a real-life observational prospective PREDIBACK study with 12-month follow-up and received various treatments. From a multitude of questionnaires/scores, specific items were combined using exploratory factor analyses to create an optimally accurate MCRI; as a single composite index, using pairwise correlations between measurements, it appeared to better represent all pain dimensions than any other classical score. It appeared to be the best compromise among all existing indexes, showing the highest sensitivity/specificity related to Patient Global Impression of Change (PGIC). Novel composite indexes could help to refine pain assessment by changing the physician’s perception of patient condition on the basis of objective and holistic metrics, and by providing new insights to therapy efficacy/patient outcome assessments, before ultimately being adapted to other pathologies.

Nociceptive innervation of the thoracolumbar fascia (TLF) has been investigated over decades, however these studies have not been compiled or collectively appraised. The purpose of this scoping review was to assess current knowledge regarding nociceptive innervation of the TLF to better inform future mechanistic and clinical TLF research targeting low back pain (LBP) treatment. PubMed, ScienceDirect, Cochrane and Embase databases were searched in January 2021 using relevant descriptors encompassing fascia and pain. Eligible studies were: (a) published in English; (b) preclinical and clinical (in vivo and ex vivo) studies; (c) original data; (d) included quantification of at least one TLF nociceptive component. Two-phase screening procedures were conducted by a pair of independent reviewers, data were extracted and summarized from eligible studies. The search resulted in 257 articles of which 10 met inclusion criteria. Studies showed histological evidence of nociceptive nerve fibers terminating in low back fascia, suggesting a TLF contribution to LBP. Noxious chemical injection or electrical stimulation into fascia resulted in longer pain duration and higher pain intensities than injections into subcutaneous tissue or muscle. Pre-clinical and clinical research provides histological and functional evidence of nociceptive innervation of TLF. Greater knowledge of fascial neurological components could impact LBP treatment.

Cancer is one of the leading causes of death and morbidity with a complex pathophysiology. Traditional cancer therapies include chemotherapy, radiation therapy, targeted therapy, and immunotherapy. However, limitations such as lack of specificity, cytotoxicity, and multi-drug resistance pose a substantial challenge for favorable cancer treatment. The advent of nanotechnology has revolutionized the arena of cancer diagnosis and treatment. Nanoparticles (1-100nm) can be used in the treatment of cancer owing to their specific advantages such as biocompatibility, reduced toxicity, more excellent stability, enhanced permeability and retention effect, and precise targeting. Nanoparticles are classified into several main categories. The nanoparticle drug delivery system is particular and utilizes tumor and tumor environment characteristics. Nanoparticles not only solve the limitations of conventional cancer treatment but also overcome multidrug resistance. Additionally, as new multidrug resistance mechanisms are unraveled and studied, nanoparticles are being investigated more vigorously. Various therapeutic implications of nano-formulations have created brand new perspectives for cancer treatment. However, a majority of the research is limited to in vivo and in vitro studies, and the number of nano-drugs that are approved has not much amplified over the years. In this review, we discuss numerous types of nanoparticles, targeting mechanisms along with approved nanotherapeutics for oncological implications in cancer treatment. Further, we also summarize the current perspective, advantages, and challenges in clinical translation.

Background In this study, we describe our clinical experience with the fifth-generation of a breast implant with a smooth, fine surface from a Korean manufacturer (BellaGel^Ò SmoothFine; HansBiomed Co. Ltd., Seoul, Korea) in Asian women. Methods We analyzed 223 women (mean age=35.28±9.45 years and mean follow-up period=12.03±2.48 months), comprising 118 bilateral cases and 109 unilateral ones, who received breast augmentation using the BellaGel^Ò SmoothFine at our hospital between June 4, 2018 and February 28, 2019. For safety assessment, we analyzed frequencies of postoperative complications and overall survival of the BellaGel^Ò SmoothFine. Results Postoperatively, complications (12 cases, 5.38%) include asymmetry (3 cases, 1.35%), hematoma (2 cases, 0.90%), hypertrophic scars (2 cases, 0.90%), wound disruption (2 cases, 0.90%), rippling (1 case, 0.45%), capsular contracture (1 case, 0.45%), stretch deformities with skin excess (1 case, 0.45%). In addition, time-to-events were calculated as 10.94±0.64 months (95% CI 9.69-12.19) and the survival rate reached 0.290±0.168 (95% CI 0.094-0.901) at 12 months postoperatively. Conclusions Here, we describe our clinical experience with the BellaGel^Ò SmoothFine. Our results are of significance in that this is the first report about the fifth-generation of a breast implant with a smooth, fine surface from a Korean manufacturer in Asian women.

This study mainly experimentally investigates and explores the effects of local low-frequency vibrations on the starting-up and heat transfer characteristics of the pulsating heat pipe. A micro motors with the vibration frequency of 200 Hz were imposed on the external surface of evaporation, condensation and adiabatic section of the pulsating heat pipe, respectively, and the starting-up temperature and the average temperatures along the evaporation section as well as the thermal performances of the vibrating heat pipe were experimentally scrutinized under the local vibrations of different positions. The following important conclusions can be achieved by the experimental study: 1) The effect of vibrations at the evaporation section and at the adiabatic section on the starting-up time of pulsating heat pipe is more significant than that at the condensation section. 2) The vibrations at different positions can reduce the starting-up temperature of the pulsating heat pipe. The effect of the vibrations at the evaporation section is the best as the heating power is lower, and the effect of the vibration at the adiabatic section is the best as the heating power is higher. 3) The vibrations at the evaporation section and at the adiabatic section can reduce the thermal resistance of the pulsating heat pipe. However, the vibrations at the condensation section have little effect on the thermal resistance of the pulsating heat pipe. 4) The vibrations at the evaporation section and at the adiabatic section can effectively reduce the temperature of evaporation section of the pulsating heat pipe, but the vibrations at the condensation section have no effect on the temperature of evaporation section of the pulsating heat pipe.

Abstract: Spatially explicit, fine-grained datasets describing historical urban extents are rarely available prior to the era of operational remote sensing. However, such data are necessary to better understand long-term urbanization and land development processes and for the assessment of coupled nature-human systems, e.g., the dynamics of the wildland-urban interface. Herein, we propose a framework that jointly uses remote sensing derived human settlement data (i.e., the Global Human Settlement Layer, GHSL) and scanned, georeferenced historical maps to automatically generate historical urban extents for the early 20th century. By applying unsupervised color segmentation to the historical maps, spatially constrained to the urban extents derived from the GHSL, our approach generates historical settlement extents for seamless integration with the multi-temporal GHSL. We apply our method to study areas in countries across four continents, and evaluate our approach for two U.S. study sites against historical settlement extents derived from the Historical Settlement Data Compilation for the US, HISDAC-US, achieving Area-under-the-Curve values >0.9. Our results are largely in agreement with model-based urban areas from the HYDE database, and demonstrate that the integration of remote sensing derived observations and historical cartographic data sources opens up new, promising avenues for assessing urbanization, and long-term land cover change in countries where historical maps are available.

Low back pain (LBP) is a leading cause of disability. It significantly impacts the patient’s quality of life, limits their daily living activities, and reduces work productivity. To reduce the burden of LBP, several pharmacological and non-pharmacological treatment options are available. This review summarizes the role of heat therapy in the management of LBP. First, we outline the common causes of LBP, then discuss the general mechanisms of heat therapy on (LB)P, and finally review the published evidence regarding the impact of heat therapy in patients with acute or chronic non-specific LBP. This review demonstrates that continuous, low-level heat therapy provides pain relief, improves muscular strength, and increases flexibility. Therefore, this effective, safe, easy-to-use, and cost-effective non-pharmacological pain relief option is still relevant in modern clinical practice.

The goal of newborn screening is to improve health outcomes by identifying and treating affected newborns. This manuscript provides an overview of a data tool to facilitate the longitudinal collection of health information on newborns diagnosed with a condition through NBS. The Newborn Screening Translational Research Network (NBSTRN) developed the Longitudinal Pediatric Data Resource (LPDR) to capture, store, analyze, visualize, and share genomic and phenotypic data over the lifespan of NBS identified newborns to facilitate understanding of genetic disease, and to assess the impact of early identification and treatment. NBSTRN developed a consensus-based process using clinical care experts to create, maintain, and evolve question and answer sets organized into common data elements (CDEs). The LPDR contains 24,172 core and disease-specific CDEs for 118 rare genetic diseases, and the CDEs are being made available through the NIH CDE Repository. The number of CDEs for each condition average of 2,200 with a range from 69 to 7,944. The LPDR is used by state NBS programs, clinical researchers, and community-based organizations. Case level, de-identified data sets are available for secondary research and data mining. The development of the LPDR for longitudinal data gathering, sharing, and analysis supports research and facilitates the translation of new discoveries into clinical practice.

Aim To perform a comprehensive analysis of discordances between contrast-enhanced CT (ceCT) and 18F-FDG PET/CT in the evaluation of the extra-cerebral treatment monitoring in patients with stage IV melanoma. Materials and methods We conducted a retrospective monocentric observational study over a 3 years period in patients referred for 18F-FDG PET/CT and ceCT in the framework of therapy monitoring of immune checkpoint or tyrosine kinase inhibitors (ICIs or TKIs) as of January-2017. Imaging reports were analysed by two physicians in consensus. Anatomical site responsible for discordances, as well as induced changes in treatment were noted. Results Eighty patients were included and 195 couples of scans analysed. Overall, discordances occurred in 65 cases (33%). Eighty percent of the discordances (52/65) were due to 18F-FDG PET/CT scans upstaging the patient. Amongst these discordances, 17/52 (33%) led to change in patient’s management, the most frequent being radiotherapy of a progressing site. ceCT represented 13/65 (20%) of discordances and induced changes in patients’ management in 2/13 cases (15%). The more frequent anatomical site involved was subcutaneous for 18F-FDG PET/CT findings and lung or liver for ceCT. Conclusions Treatment monitoring with 18F-FDG

Back pain is a common symptom that affects all age groups across the globe, when left untreated may eventually lead to disability. A convenient sample selection method was used in this study due to the global Covid-19 pandemic lockdown which was effective in Turkey during the investigation period. Thus, virtual data collection and health education including some health risks were employed. A total population of two hundred adult women was involved in the study but one hundred and twenty-one responses were collected. Findings show that, for socio-demographic characteristics, the pain was found highest in women between the ages of 41-50 and obese/overweight individuals. Although, there was no significant difference recorded in the marital status category. Moreover, statistical mean differences were detected between the scales for ODI (4.18) and BPFS (6.09). Also, p<0.05, paired sample t-test was 0.001 ODI and 0.001 BPFS after the training exercise. This suggests that exercise training is inversely correlated with pain severity which implies that training has a significant influence on pain intensity. Thus, it could be concluded that there is a relationship between the training exercise and ODI/BPFS.

In this research paper, a novel high step up dc-dc converter with a coupled inductor and voltage doubler circuits is proposed. The converter achieves a high step up voltage gain with an appropriate duty ratio and low voltage stress on the power switches. Also, the energy which is stored in the leakage inductor of the coupled inductor can be recycled to the output. The operating principles and the steady state analysis of the proposed converter are discussed in detail. Finally, a prototype circuit of the proposed converter is implemented in the laboratory in order to verify the performance of the proposed converter.

Temporary pavilions play an important role as experimental fields for architects, designers and engineers, apart from providing exhibition spaces. Novel structural and formal solutions applied in pavilions also can give them unusual appearance that attracts eyesight of spectators. In this article authors explore the possibility of combination of structural novelty, visual attractiveness and low-cost by a design and construction of a temporary pavilion. For that purpose, an innovative structural system and design approach was applied, i.e. membrane structure designed in Rhino and Grasshopper environments with the use of Kiwi!3D IsoGeometric analysis tool. The designed pavilion, named Obverse/Reverse, was built in Opole, Poland, for the occasion of World Architecture Day in July 2019. Design and construction was performed by the authors in cooperation with students’ organisation Humanisation of Urban Environment from the Faculty of Architecture Wroclaw University of Science and Technology. The Rresultant pavilion proved the possibility of obtaining a low-budgets but visually attractive architectural solution with the adaption of parametrical design tools and some scientific background with innovative structural systems.

The clinical significance of carbon-ion radiotherapy (CIRT) for adenocarcinoma (AC) of the uterine cervix has been assessed in several single-institutional studies. To validate the significance, we conducted a multi-institutional survey of CIRT for locally advanced AC (LAAC) of the uterine cervix. We retrospectively analyzed the clinical outcomes of patients with stage IIB–IVA LAAC of the uterine cervix who underwent chemo-CIRT or CIRT alone between April 2010 and April 2016. Patients received 74.4 Gy (relative biological effectiveness [RBE]) in 20 fractions of CIRT or 55.2 Gy (RBE) in 16 fractions of CIRT plus 3 sessions of brachytherapy. Patients aged ≤70 years with adequate bone marrow and organ function were administered cisplatin weekly (40 mg/m2 per week for up to 5 weeks). Fifty-five patients were enrolled in this study. The median follow-up period was 67.5 months. The 5-year overall survival (OS) and local control (LC) rates were 68.6% and 65.2%, respectively. Multivariate analysis showed that the initial tumor response within 6 months was significantly associated with LC and OS. The present study represents promising outcomes of CIRT or chemo-CIRT for LAAC of the uterine cervix, especially in the cases showing initial rapid regression of the tumor.

We present an overview over eight brightly luminescent Cu(I) dimers of the type Cu2X2(PN)3 with X = Cl, Br, I and P^N = 2-diphenylphosphino-pyridine (Ph2Ppy), 2-diphenylphosphino-pyrimidine (Ph2Ppym), 1-diphenylphosphino-isoquinoline (Ph2Piqn) including three new crystal structures (Cu2Br2(Ph2Ppy)3, 1-Br, Cu2I2(Ph2Ppym)3, 2-I, and Cu2I2(Ph2Piqn)3, 3-I). However, we mainly focus on their photo-luminescence properties. All compounds exhibit combined thermally activated delayed fluorescence (TADF) and phosphorescence at ambient temperature. Emission color, decay time, and quantum yield varies over large ranges. For deeper characterization, we select Cu2I2(Ph2Ppy)3, 1-I, showing a quantum yield of 81 %. DFT and SOC-TDDFT calculations provide insight into the electronic structures of the singlet S1 and triplet T1 states. Both stem from metal+iodide-to-ligand charge transfer transitions. Evaluation of the emission decay dynamics, measured from 1.2 ≤ T ≤ 300 K, gives ∆E(S1-T1) = 380 cm-1 (47 meV), a transition rate of k(S1→S0) = 2.25×106 s-1 (445 ns), T1 zero-field splittings, transition rates from the triplet substates, and spin-lattice relaxation times. We also discuss the interplay of S1-TADF and T1-phosphorescence. The combined emission paths shorten the overall decay time. For OLED applications, utilization of both singlet and triplet harvesting can be highly favorable for improvement of the device performance.

Recently, we have witnessed a booming development of composites and multi-dopant metal oxides to be employed as novel photocatalysts. Yet the practical application of photocatalysis for environmental purposes is still elusive. Concerns about the unknown fate and toxicity of nanoparticles, unsatisfactory performance in real conditions, mass transfer limitations and durability issues have so far discouraged investments in full-scale applications of photocatalysis. Herein, we provide a critical overview of the main challenges that are limiting large-scale application of photocatalysis in air and water/wastewater purification. We then discuss the main approaches reported in the literature to tackle these shortcomings, such as the design of photocatalytic reactors that retain the photocatalyst, the study of degradation of micropollutants in different water matrices, and the development of gas-phase reactors with optimized contact time and irradiation. Furthermore, we provide a critical analysis of research-practice gaps such as treatment of real water and air samples, degradation of pollutants with actual environmental concentrations, photocatalyst deactivation, and cost and environmental life-cycle assessment.

(1) Background: Although manual therapy for pain relief has been used as an adjunct in treatments for chronic low back pain (CLBP), there is still the belief that a single session of myofascial release would be effective. This study aimed to investigate whether a single session of a specific technique reduces pain and disability. (2) Methods: This was a crossover clinical trial in which 41 participants over 18 years old with CLBP were randomly enrolled into 3 situations - experimental, placebo, control, in a balanced and cross-over manner. The subjects underwent a single session of myofascial release on thoracolumbar fascia and compare it with the control and placebo. Outcome were pain and functionality, evaluated using the numerical pain rating scale (NPRS), pressure pain threshold (PPT) and Oswestry (ODI). (3) Results: There was no effects between-, within-tests, and interaction for all the outcomes, i.e., NPRS (η 2 = 0.32, F = 0.48, p = 0.61), PPT (η2 = 0.73, F = 2.80, p = 0.06), ODI (η 2 = 0.02, F = 0.02, p = 0.97). (4) Conclusion: A single trial of thoracolumbar myofascial release technique was not enough to reduce pain and disability in subjects with CLBP.

A novel stationary phase for affinity separations is presented. This material is based on sintered borosilicate glass readily available as semi-finished filter plates with defined porosity and surface area. The material shows fast binding kinetics and excellent long-term stability under real application conditions due to lacking macropores and high mechanical rigidity. The glass surface can be easily modified with standard organosilane chemistry to immobilize selective binders or other molecules used for biointeraction. In this paper, the manufacturing of the columns and their respective column holders by 3D printing is shown in detail. The model system protein A/IgG was chosen as an example to examine the properties of such monolithic columns under realistic application conditions. Several specifications, such as (dynamic) IgG capacity, pressure stability, long-term performance, productivity, non-specific binding, and peak shape, are presented. It could be shown that due to the very high separation speed, 250 mg antibody per hour and column can be collected, which surpasses the productivity of most standard columns of the same size. The total IgG capacity of the shown columns is around 4 mg (5.5 mg/mL), which is sufficient for most tasks in research laboratories. The cycle time of an IgG separation can be less than 1 minute. Due to the glass material's excellent pressure resistance, these columns are compatible with standard HPLC systems. This is usually not the case with standard affinity columns, limited to manual use or application in low-pressure systems. The use of a standard HPLC system also improves the ability for automation, which enables the purification of hundreds of cell supernatants in one day. The sharp peak shape of the elution leads to an enrichment effect, which might increase the concentration of IgG by a factor of 3. The final concentration of IgG can be around 7.5 mg/mL without the need for an additional nanofiltration step. The purity of the IgG was > 95% in one step and nearly 99% with a second polishing run.

Nanoprecipitation by liquid anti-solvent precipitation is one of the most versatile methods to produce pure drug nanoparticles (PDNPs) owing to the ability to optimize the properties of the product. Nevertheless, nanoprecipitation shows broad particle size distribution and low physical stability, leading to high batch-to-batch variability and challenging the bench-to-bedside translation. Microfluidics has emerged as a powerful tool to produce PDNPs in a simple, reproducible, and cost-effective manner with excellent control over NP size. In this work, we designed and fabricated T- and Y-shaped Si-made microfluidics device and used it to produce pure NPs of three kinase inhibitors of different lipophilicity and water-solubility, namely imatinib, dasatinib and tofacitinib, without the use of colloidal stabilizers. PDNPs display sizes in the 90-350 nm range (dynamic light scattering) and a rounded shape (high-resolution scanning electron microscopy). Analysis by X-rays diffraction and differential scanning calorimetry confirmed that this method results in highly amorphous NPs. In addition, we show that the flow rate of solvent, the anti-solvent, and the channel geometry of the device play a key role in the size of the generated NPs.

Utilization of Bidirectional Reflectance Distribution Function (BRDF) model parameters obtained from the multi-angular remote sensing is one of the approaches for the retrieval of vegetation structural information. In this research, the potential of multi-angular vegetation indices, formulated by the combination of multi-spectral reflectance from different view angles, for the retrieval of forest above ground biomass was assessed. This research was implemented in the New England region with the availability of a high quality forest inventory database. The multi-angular vegetation indices were generated by the simulation of the Moderate Resolution Imaging Spectroradiometer (MODIS) BRDF/Albedo Model Parameters Product (MCD43A1 Version 6) based BRDF parameters. The effects of seasonal (spring, summer, autumn, and winter) composites of the multi-angular vegetation indices on above ground biomass, angular relationship of the spectral reflectance with above ground biomass, and the interrelationships between the multi-angular vegetation indices were analyzed. Among the existing multi-angular vegetation indices, only the Nadir BRDF-adjusted NDVI ( and Hot-spot incorporated NDVI ( showed significant relationship (more than 50%) with the above ground biomass. This research proposed two more sensitive vegetation structural indices, Fore-scattering Back-scattering NDVI and Vegetation Structure Index (VSI). The Fore-scattering Back-scattering NDVI showed higher sensitivity (R² = 0.62, RMSE = 52.46) towards the above ground biomass than existing multi-angular vegetation indices. Furthermore, the VSI performed in the most efficient way explaining 64% variation of the above ground biomass, suggesting that the right choice of the spectral channel and observation geometry should be considered for improving the estimates of the above ground biomass. In addition, the right choice of seasonal data (summer) was found to be important for estimating the forest biomass while other seasonal data were either insensitive or pointless. The promising results shown by the VSI suggest that it could be an appropriate candidate for monitoring vegetation structure from the multi-angular satellite remote sensing.

(1) Background: The aim of the present study was to evaluate the effect of different types of warm-ups on the strength and skin temperature of Paralympic powerlifting athletes; (2) Methods: The participants were 15 male Paralympic powerlifting athletes. It was analyzed the effects of three different types of warm-up (without warm-up (WW), traditional warm-up (TW), or stretching warm-up (SW)) on static and dynamic strength tests as well as in the skin temperature, which was monitored by thermal imaging; (3) Results: show no differences in the dynamic and static indicators of the force in relation to the different types of warm-up. No significant differences were found in relation to the Peak Torque (p = 0.055, F=4.560, η2p= 0.246 medium effect), and 1-Repetition Maximum (p = 0.139, F=3.191, η2p = 0.186, medium effect) between the different types of warm-up. In the thermographic analysis, there was a significant difference only in the Pectoral muscle clavicular portion between the TW (33.04 ± 0.71ºC) and the WW (32.51 ± 0.74ºC) (p = 0.038). The TW method also presented slightly higher values than the SW and WW in the Pectoral Muscles Sternal portion and in the Deltoid anterior portion, but with p-value &gt; 0.05; (4) Conclusions: that the types of warm-up studied do not seem to interfere with the performance of Paralympic Powerlifting athletes. However, the thermal images showed that traditional warm-up best meets the objectives expected for this preparation phase.

Composite materials are widely used in the dental field in clinics as biomaterials. For example, it has been used as a biomaterial to repair caries and restore masticatory function, and as a cement to adhere the restoration to the tooth substrate. In order to demonstrate its function, dental biomaterials are measured their mechanical strength. From such basic research, we explained the potential of dental biomaterials, especially flexural strength and modulus of elasticity. Mechanical properties of dental biomaterials similar to those of the tooth, thermal stimulation, and aesthetic elements in the oral cavity. In this part, we will introduce the commercialized products of composites suitable for the characteristics and tooth quality, and provide the reader with the characteristics from the flexural characteristics of the composite materials used in clinical dentistry. In clinical performance, it might be advisable to delay polishing when composite biomaterials are used for luting materials, filling materials and core build-up materials since improved the flexural strength and the flexural modulus of elasticity were displayed after 1-day storage. And it is thought that flexural strength or characteristics is a significant important mechanical property of oral biomaterials.

Aim To perform a comprehensive analysis of discordances between contrast-enhanced CT (ceCT) and 18F-FDG PET/CT in the evaluation of the extra-cerebral treatment monitoring in patients with stage IV melanoma. Materials and methods We conducted a retrospective monocentric observational study over a 3 years period in patients referred for 18F-FDG PET/CT and ceCT in the framework of therapy monitoring of immune checkpoint or tyrosine kinase inhibitors (ICIs or TKIs) as of January-2017. Imaging reports were analysed by two physicians in consensus. Anatomical site responsible for discordances, as well as induced changes in treatment were noted. Results Eighty patients were included and 195 couples of scans analysed. Overall, discordances occurred in 65 cases (33%). Eighty percent of the discordances (52/65) were due to 18F-FDG PET/CT scans upstaging the patient. Amongst these discordances, 17/52 (33%) led to change in patient’s management, the most frequent being radiotherapy of a progressing site. ceCT represented 13/65 (20%) of discordances and induced changes in patients’ management in 2/13 cases (15%). The more frequent anatomical site involved was subcutaneous for 18F-FDG PET/CT findings and lung or liver for ceCT. Conclusions Treatment monitoring with 18F-FDG

Bounce Back Loan is amongst a number of UK business financial support schemes launched by UK Government in 2020 amidst pandemic lockdown. Through these schemes, struggling businesses are provided financial support to weather economic slowdown from pandemic lockdown. £43.5bn loan value has been provided as of 17^th Dec2020. However, with no major checks for granting these loans and looming prospect of loan losses from write-offs from failed businesses and fraud, this paper theorizes prospect of applying spatiotemporal modelling technique to explore if geospatial patterns and temporal analysis could aid design of loan grant criteria for schemes. Application of Clustering and Visual Analytics framework to business demographics, survival rate and Sector concentration shows Inner and Outer London spatial patterns which historic business failures and reversal of the patterns under COVID-19 implying sector influence on spatial clusters. Combination of unsupervised clustering technique with multinomial logistic regression modelling on research datasets complimented by additional datasets on other support schemes, business structure and financial crime, is recommended for modelling business vulnerability to certain types of financial market or economic condition. The limitations of clustering technique for high dimensional is discussed along with relevance of an applicable model for continuing the research through next steps

It is well known that low back pain (LBP) prevalence is high during the course of school age children’s lives. However, literature concerning the initial onset of back pain between ages of 3 and 11 years remains scarce. The present study aimed to analyze the prevalence of LBP in kindergarten and primary school students. 278 (9.9±2.1 years old; 52.2% girls) students from two public kindergarten and primary schools in Valencia, Spain participated in this cross-sectional study. The Nordic questionnaire on LBP was used to ask questions related to the duration of LBP symptoms over time. The lifetime prevalence of LBP was 47.5% (n = 132), a last year prevalence of 44.2% (n = 123), and a last week prevalence of 18.8% (n = 50) was reported. Boys and girls reached lifetime prevalence of 52.3% (n = 64) and 47.7% (n = 82) (χ2 = 1.978, p = .099), respectively. By age group, lifetime episodes of LBP also showed a higher prevalence with increasing age (χ2 = 32.637; p &lt; .001). In summary, our findings suggest that LBP increases with age. In addition, our results further strengthen the evidence that LBP onset could start as young as 10-years-old.

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.

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.

Background: Low-level physical activity (PA) among Chronic Low Back Pain (cLBP) is associated with various biopsychosocial factors. This research aimed to study the predictors of PA behavior among cLBP patients. Methods: In the present study 300 eligible patients with cLBP who referred to comprehensive health service centers in the Shahid Beheshti University of Medical Sciences (SBUMS) in Tehran, Iran were random selected.To diagnose the predictors of PA behavior, all the Theory of Reasoned Action (TRA) constructs were examined as risk factors to see if they influence on the probability of PA behavior occurrence and were interpreted through odds ratio (OR). SPSS version 19 was used to analyze the data. Results: Totally 280 cLBP patients with mean age of 57.07 ±13.09 years old participated in the study. This study showed that motivation to comply significant predictor the cLBP patients for subjective norm OR (%95CI): 2.095(0.116-2.792), p-value<0.001), intention was significant predictor for perform the PA behavior OR (%95CI): 1.431(0.138-1.538), p-value <0.001), behavior beliefs could predictor for attitude OR (%95CI): 1.276(0.106-1.355), p-value= 0.002). attitude, normative beliefs, subjective norm ,and evaluation outcome behavior could predictors the cLBP patients for intention to perform the PA behavior OR (%95CI): 1.188(0.032-1.312), p-value<0.001)., OR (%95CI): 1.158(0.076-2.208), p-value=0.003) ., OR (%95CI): 1.104(0.076-1.128), p-value<0.001) ., OR (%95CI): 0.814(0.301-1.440), p-value=0.007). Conclusions: This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm). This study showed that the cLBP patients who were normative beliefs and evaluation regarding PA behavior could effect on the intention to engage in greater PA than those via other constructs (attitude and subjective norm).

Scientists who are interested in building research programs at primarily-undergraduate institutions (PUIs) have unique considerations compared to colleagues at research-intensive (R1) institutions. Maintaining a research program at a PUI holds unique challenges that should be considered before prospective faculty go on the job market, as they negotiate a job offer, and after they begin a new position. In this article we describe some of the considerations that aspiring and newly hired faculty should keep in mind as they plan out how they will set up a laboratory as a new Principle Investigator (PI) at a PUI. Anyone hoping to start a research program at a PUI should understand both the timeframe of interviews, job offers, and negotiations and the challenges and rewards of working with undergraduate researchers. Once a job is offered, candidates should be aware of the range of negotiable terms that can be part of a start-up package. Space and equipment considerations are also important, and making the most of shared spaces, existing infrastructure, and deals can extend the purchasing power of start-up funds as a new PIs builds their lab. PUIs’ focus on undergraduate education and mentorship leads to important opportunities for collaboration, funding, and bringing research projects directly into undergraduate teaching laboratories. A major focus of any new laboratory leader must be on building a productive, equitable, and supportive laboratory community. Equitable onboarding, mentorship plans, and formalized expectations, can all help build a productive and sustainable laboratory research program. However, important considerations about safety, inclusion, student schedules, and a PI’s own professional commitments are also extremely important concerns when working with undergraduates in research. A successful research program at a PUI will bring students into meaningful scientific inquiry and requires insights and skills that are often not the focus of scientific training. This article aims to describe the scope of setting up a new laboratory as a way to alleviate some of the burden that new and prospective faculty often feel.

Sedation is a ubiquitous practice in ICUs and NCCUs. It has the benefit of reducing cerebral energy demands, but also precludes an accurate neurologic assessment. Because of this, sedation is intermittently stopped for the purposes of a neurologic assessment, which is termed a neurologic wake-up test (NWT). NWTs are considered to be the gold-standard in continued assessment of brain-injured patients under sedation. NWTs also produce an acute stress response that is accompanied by elevations in blood pressure, respiratory rate, heart rate, and ICP. Utilization of cerebral microdialysis and brain tissue oxygen monitoring indicates that this is not mirrored by alterations in overall cerebral metabolism, and seldom affects oxygenation. The hard contraindications for the NWT are preexisting intracranial hypertension, barbiturate treatment, status epilepticus, and hyperthermia. However, hemodynamic instability, sedative use for primary ICP control, and sedative use for severe agitation or respiratory distress are considered significant safety concerns. Despite ubiquitous recommendation, it is not clear if additional clinically relevant information is gleaned through its use, especially with the contemporaneous utilization of multimodality monitoring. Various monitoring modalities provide unique and pertinent information about neurologic function, however, their role in improving patient outcomes and guiding treatment plans has not been fully elucidated. There is a paucity of information pertaining to the optimal frequency of NWTs, and if it differs based on type of injury. Only one concrete recommendation was found in the literature, exemplifying the uncertainty surrounding its utility. The most common sedative used and recommended is propofol because of its rapid onset, short duration, and reduction of cerebral energy requirements. Dexmedetomidine may be employed to facilitate serial NWTs, and should always be used in the non-intubated patient or if propofol infusion syndrome (PRIS) develops. Midazolam is not recommended due to tissue accumulation and residual sedation confounding a reliable NWT. Thus, NWTs are well tolerated in most patients and remain recommended as the gold-standard for continued neuromonitoring. Predicated upon one expert panel, they should be performed at least one time per day. Propofol or dexmedetomidine are the main sedative choices, both enabling a rapid awakening and consistent NWT.

Long-term, high-accuracy mapping of built-up land dynamics is essential for understanding urbanization and its consequences for the environment. Despite advances in remote sensing and classification algorithms, built-up land mapping using early satellite imagery (e.g., from the 2000s and earlier) remains prone to uncertainty. We mapped the extent of built-up land in the North China Plain, one of China’s most important agricultural regions, from 1990 to 2019 at three-year intervals. Using dense time-stack Landsat data, we applied discrete Fourier transformation to create temporal predictors and reduce mapping uncertainties for early years. We improved overall accuracy by 8% compared to using spectral and indices predictors alone. We implemented a temporal correction algorithm to remove inconsistent pixel classifications, further improving accuracy to a consistently high level (>94%) across years. A cross-product comparison showed that our study achieved the highest levels of accuracy across years. Total built-up land in the North China Plain increased from 37,941 km² in 1990–1992 to 131,578 km² in 2017–2019. Consistent, high-accuracy built-up land mapping provides a reliable basis for policy planning in one of the most rapidly urbanizing regions of the planet.

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.

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.

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.

Acceptance of SNAP benefits has increased in farmers’ markets (FM) over the years. However, getting SNAP recipients to take up the opportunity of extra dollars for healthy food options remains a challenge. Thus, we tracked the use of the Double-up Food Buck (DUFB) program among SNAP recipients who visit participating FMs in Utah to understand the unique characteristics of the program users. Our results identified varying types of program users (multiple and single market shoppers, more frequent and less frequent shoppers). While our findings indicate a higher DUFB transaction in token value among frequent users, larger markets are more likely to have higher DUFB transactions with a higher number of market visits compared to smaller ones. In conclusion, while all types of users may add to the total revenue generated by participating FM, additional initiatives are required to encourage frequent visits and uptake of the program for better access to healthy foods.

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.

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.

Background: Although National Licensing Examinations (NLEs) may be a costly process, they can predict better performance for many following years. The current licensing requirements will not entail and new requirements will be requested. Therefore, this study suggests a framework for the development of the Medical Licensing Exam by exploring the opinions of Egyptian medical practitioners and educators regarding the exam format and criteria. Objective and methods: to describe the needed steps to develop the EMLE through a two-phase exploratory mixed-method study that had been conducted among the Egyptian medical sectors: medical practitioners and educators. Results: There were 50 clinical and academic educators shared in the online discussion about EMLE development. Then, a survey was carried out on 266 participants with various working places in which 198 of the participants were staff in the Higher Education Ministry and 68 physicians in the Ministry of Health. The input from both had contributed to the development of the following framework that is divided into two main sections; the Exam Logistics and the Exam Set up. The exam Logistics included the exam committee, prerequisites for the exam, the admission criteria and fees, and the validity of the license. While the Exam Set up included exam setting, structure, standard-setting, pass marks and reset policy. Conclusion: A Multidisciplinary team resources for the exam setting. Fairness and objectivity were highlighted through several factors; development of the exam blueprint, types of assessment methods, post-exam analysis, and standard-setting. Finally, the reset policy, fees, and validity of the license were recommended with a student-centered perspective that was suggested for the exam committee.

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.

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.

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.

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 &lt; .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.

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.

Artificial Intelligence is dominated by Artificial Neural Networks (ANNs). Currently, the Batch Gradient Descent (BGD) is the only solution to train ANN weights when dealing with large datasets. In this article, a modification to the BGD is proposed which significantly reduces the training time and improves the convergence. The modification, called Instance Eliminating Back Propagation (IEBP), eliminates correctly-predicted-instances from the Back Propagation. The speedup is due to the elimination of unnecessary matrix multiplication operations from the Back Propagation. The proposed modification does not add any training hyperparameter to the existing ones and reduces the memory consumption during the training.

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.

Western Anatolia comprises a vast amount of various volcanic successions spanning from Eocene to Upper Miocene periods. These units mainly display southward younging in broad sense and display large amounts of chemical variation that spanned from basalt to rhyolite. The southward younging of magmatism and chemical variations have been largely attributed to the retreat and roll-back of the Hellenic slab and the western escape of the Anatolian microplate. However, there is still a lack of high precision data to pinpoint the exact nature of the magmatism and lithospheric tectonics. In this contribution we investigated a poorly known region along the Western Anatolia along Manisa district called Karakılıçlı volcanic field. We investigated two different volcanic sections (Kalpakkaya and Çamlık hill) that display the best volcano-sedimentary features in terms of geochronology and geochemistry. Samples acquired from the bottom, middle and upper portions of these sections display Early-Middle Miocene ages of 17.64±0.20, 17.22±0.15, 16.16±0.17 and 16.36±0.13, 15.79±0.71 and 13.61±0.20 Ma respectively. The results indicate that the volcanism in the region generated by the melting of the mantle and/or lithospheric mantle by slab retreat and roll-back of the Hellenic slab and evolved in the shallow magma chambers/mushes by fractional crystallization, magma mixing and crustal assimilation.

South America has become the new epicenter of the coronavirus, especially in Brazil where the disease continues to spread exponentially across the country. This text aims to analyze the psychosocial factors of Covid-19 on back to school strategies in Brazil from a bioecological perspective. At the microsystem level, the population is experiencing different levels of stress and fear; at the mesosystem level, changes in routines, separation from family and friends, and closure of schools; and at the macrosystem level, national guidelines to control the pandemic, institutional standards on a national and international scale. Therefore, the main focus for the success of school return must be in the prevention of contagion and with physical and psychological health, and should not only consider the demands of curricula, financial or administrative management. For this reason, it is paramount that greater female representativeness is increased in decision-making levels of the meso and macrosystem, regarding the resumption of school and academic activities in the pandemic period, since the number of female leaders in decision-making, is still insufficient.

Development of rovers and development of infrastructure which enables them to probe other planets (such as Mars) have sparked a lot of interest recently specially with increasing public attention in Moon and Mars program by National Aeronautics and Space Administration. This is designed to be achieved by various means such as advanced spectroscopy and artificial intelligent techniques such as deep learning and transfer learning to enable the rover to not only map the surface of planet but to get a detailed information about its chemical makeup in layers beneath (deep learning) and in areas around point of observation (transfer learning). In this work, which is part of a proposal, later approach is explored. A systematic strategy is presented which make use of aforementioned techniques developed for metallic glass matrix composites as benchmark and helps develop algorithms for chemistry mapping of actual Martian surface on Perseverance Rover launching shortly.

Central nervous system (CNS) uses vision, vestibular, and somatosensory information to maintain body stability. Research has shown that there is more lumbar proprioception error among low back pain (LBP) individuals as compared to healthy people. In this study, two groups of 20 healthy people and 20 non-specific low back pain participants (LBP) took part in this investigation. This investigation focused on somatosensory sensors and in order to alter proprioception, a vibrator (frequency of 70Hz, amplitude of 0.5 mm) was placed on the soleus muscle area of each leg and two vibrators were placed bilaterally across the lower back muscles. Individuals, whose vision was occluded, were placed on two surfaces (foam and rigid) on force plate, and trunk angles were recorded simultaneously. Tests were performed in 8 separate trials; the independent variables were vibration (4 levels) and surface (2 levels) for within subjects and 2 groups (healthy and LBP) for between subjects (4×2×2). MANOVA and multi-factor ANOVA tests were done. Linear parameters for center of pressure (COP) (deviation of amplitude, deviation of velocity, phase plane portrait (PPP), and overall mean velocity) and nonlinear parameters for COP and trunk angle ((recurrence quantification analysis) RQA and Lyapunov exponents) were chosen as dependent variables. Results indicated that NSLBP individuals relied more on ankle proprioception for postural stability. Similarly, RQA parameters for the COP on both sides and for the trunk sagittal angle indicated more repeated patterns of movement among the LBP cohort. Analysis of short and long Lyapunov exponents showed that people with LBP caused no use of all joints in their bodies (non-flexible), are less stable than healthy subjects.

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 this study, a motion control problem for the vessels towed by tugboats or towing ships on the sea is considered. The towed vessels including barge ships are need to have assistance of tugboats. Combining two vessels, some work purposes in the sea or harbor area can be completed. In this study, the authors give newly developed mathematical model and control system strategy. Especially, the system model fully presenting the physical characteristics of two vessels are derived. For controlling the system effectively, it is considered that the towed vessel has no power propulsion system but the rudder is activated to improve the maneuverability. Considering the strong nonlinearities included in the vessel dynamics, the modelled system is presented by nonlinear system without linearization of nonlinear parameters. Thus, the control system for the towed vessel is designed based on the nonlinear control scheme. Exactly, the back-stepping control method is applied to its motion control. Also, the PID control method is applied for comparing with the proposed control strategy.

Perovskite based solar cells have achieved tremendous progress reaching record efficiency in the past 5 years. Numerous new processes and chemistry have been reported and contribute to the perovskite rapid progress. Continuous efficiency improvements are still necessary for perovskite solar cells, and an exploratory data analysis on devices performance over multiple studies could boost the technology development. Such analysis could identify patterns or provide insights that are not obvious in a single study. Here we present a high quality dataset containing only independently certified Pb-based perovskite solar cells summarizing their efficiency, relevant I-V metrics, manufacturing processes and materials used. Analysis over the dataset provides insights on how aperture size, perovskite deposition methods and materials used in each functional layer affect the final solar cell efficiency and I-V metrics. Future directions are also suggested for efficiency improvements.

The time series of daily new cases of Covid-19 infection in different zones of Italy, several European countries and New York City were analyzed in order to characterize the large fluctuations contained in them. The comparison shows that the time series share a similar evolution, although with delays of one or two weeks, with Italy that precedes the other countries. Correlation analysis indicates a strict resemblance between the time series of the first differences, which emphasize accelerations and slowdowns of the epidemic (e.g., correlation coefficient r=0.70 for Italian vs. worldwide data). According to Fourier analysis the signals have a dominant oscillatory component at a period of seven days, with minima located near the weekends. Some of the possible causes of this time modulation are discussed. In particular, it is hypothesized a delayed or missed recognition of a significant fraction of the new cases during the weekend, with possible consequences for the evolution of the epidemic.

In our recent works we reported that physical and chemical characteristics of serum can vary in relation to the psychic activity of an individual depending on whether it is oriented to stress or relaxation. We wandered if these observations could be accompanied by an appreciable modification of the Ph, electric conductivity and Delayed Luminescence of the same serum samples. Our preliminary data may suggest that the serum pH could significantly increase during a Relaxation Response intervention while electric conductivity seems to decrease. Moreover, Delayed Luminescense could vary in the same subject according to the Relaxation Response practice. According to our proof of concept study, we postulate the appearance of a coherent system within the blood samples analyzed after the Relaxation Response. Further researches and some technical development are needed to support our preliminary findings.

Cortical actomyosin flows, among other mechanisms, scale up spontaneous symmetry breaking and thus play pivotal roles in cell differentiation, division, and motility. According to many model systems, myosin motor-induced local contractions of initially isotropic actomyosin cortices are nucleation points for generating cortical flows. However, the positive feedback mechanisms by which spontaneous contractions can be amplified towards large-scale directed flows remain mostly speculative. To investigate such a process on spherical surfaces, we reconstituted and confined initially isotropic minimal actomyosin cortices to the interfaces of emulsion droplets. The presence of ATP leads to myosin-induced local contractions that self-organize and amplify into directed, large-scale actomyosin flows. By combining our experiments with theory, we found that the feedback mechanism leading to a coordinated, directional motion of actomyosin clusters can be described as asymmetric cluster vibrations, caused by intrinsic non-isotropic ATP consumption, in conjunction with spatial confinement. By tracking individual actomyosin clusters, we identified fingerprints of vibrational states as the basis of directed motions. These vibrations may represent a generic key driver of directed actomyosin flows under spatial confinement in vitro and in living systems.

With increasing interest in the use of additive manufacturing techniques in the construction industry, static rheological properties of fresh concrete have necessarily come into focus. In particular, the knowledge and control of static yield stress (SYS) and its development over time are crucial for mastering formwork-free construction, e.g. by means of layered extrusion. Furthermore, solid understanding of the influences of various concrete constituents on the initial SYS of the mixture and the structural build-up rate is required for purposeful material design. This contribution is concentrated on the effect of aggregates on these rheological parameters. The volume fraction of aggregates was varied in the range of 35 to 55 % by volume under condition of constant total surface area of the particles. The total surface area per unit volume of cement paste was equal to 5.00, 7.25 and 10.00 m²/l, conditioned on the constant volume fraction of aggregates. Both variations were enabled by changing the particle size distributions of the aggregates while holding the cement paste composition constant for all concrete mixtures. To characterise the SYS and the structural build-up, constant shear rate tests with a vane-geometry rotational rheometer were performed. It was found that in the ranges under investigation the variation in volume fraction had a more pronounced effect on the static rheological properties of concrete than did the variation in surface area. An accurate mathematical description of the relationship between the initial SYS of concrete and the relative volume fraction of aggregate based on the Chateau-Ovarlez-Trung model was proposed. Challenges in deriving a similar relationship for the structural build-up rate of concrete were highlighted.

We propose a novel tensor-based formalism for inferring causal structures from time series. An information theoretical analysis of transfer entropy (TE), shows that TE results from transmission of information over a set of communication channels. Tensors are the mathematical equivalents of these multi-channel causal channels. A multi-channel causal channel is a generalization of a discrete memoryless channel (DMC). We consider a DMC as a single-channel causal channel. Investigation of a system comprising three variables shows that in our formalism, bivariate analysis suffices to differentiate between direct and indirect relations. For this to be true, we have to combine the output of multi-channel causal channels with the output of single-channel causal channels. We can understand this result when we consider the role of noise. Subsequent transmission of information over noisy channels can never result in less noisy transmission overall. This implies that a Data Processing Inequality (DPI) exists for transfer entropy.

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.

Low back pain (LBP) is a pandemic and costly musculoskeletal condition in the United States. Patients with LBP may endure surgery, injections, and expensive visits to emergency departments. Some suggest that using physical therapy or chiropractic in the earlier stage of LBP reduces the utilization of expensive health services and lowers the treatment costs. Nevertheless, there is no consistent evidence to declare which one of these methods is a cost-effective treatment within a short (less than a year) period of time. The purpose of this study was to investigate the cost-effectiveness of chiropractic versus physical therapy in the United States. A decision tree analytic model was used for estimating the economic outcomes. The findings showed that in the chiropractic group, the total average cost was $48.56 lower than the physical therapy group, and daily adjusted life years (DALY) was 0.0043 higher than the physical therapy group. Chiropractic care was shown to be a cost-effective alternative compared with physical therapy for adults with at least three weeks of low back pain over six months.

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.

Photoelectrochemical systems have the potential to contribute to de-carbonation of the energy system because solar energy can be directly converted to hydrogen which can be burnt without the release of greenhouse gases. However, meaningful deployment of photoelectrochemical (PEC) technology in the global energy system, even when highly efficient scaled up devices become available, shall only be a reality when their safe and reliable operation can be guaranteed over serveral years of service life. The first part of the review discusses the importance of hermetic sealing of up scaled PEC device provided by the casing and sealing joints from a reliability and risk perspective. The second part of the review presents a survey of fully functional devices and early demonstrators and uses this to establish the extent to which the state of the art in PEC device design address the issue of hermetic sealing. The survey revealed that current material choices and sealing techniques are still unsuitable for scale –up and commercialization. Accordingly, we examined possible synergies with related photovoltaic and electrochemical devices that have been commericalised and derived therefrom, recommendations for future research routes that could accelerate the development of hermetic sealings of PEC devices.

Instead of simplified steady-state models, with modern computers, one can solve the complete aero-thermodynamics happening in gas turbine engines. In the present article, we describe a mathematical model and numerical procedure to represent the transient response of a PT6A gas turbine engine operating at off-design conditions. The aero-thermal model consists of a set of algebraic and ordinary differential equations that arise from the application of the mass, linear momentum, angular momentum, and energy balances in each engine's component. The solution code has been developed in Matlab-Simulink using a block-oriented approach. Transient simulations of the PT6A engine start-up have been carried out by changing the original Jet-A1 fuel with biodiesel blends. Time plots of the main thermodynamic variables are shown, especially those regarding the structural integrity of the burner. Numerical results have been validated against reported experimental measurements and GasTurb simulations. The computer model has been capable to predict acceptable fuel blends, such that the real PT6A engine can be substituted to avoid the risk of damaging it.

Globally, karst aquifers store large amount of precious water and create beautiful karst springs in many places. However, most of the karst springs flow declined, and some of the karst springs dried up with the effects of extensive groundwater development and climate variation. In order to obtain better understanding of factors contributing to the drying-up of karst springs, this study introduced grey system models to quantify spring flow taking Jinci Springs (China) as an example, which dried up in May 1994. Based on the characteristics of Jinci Springs flow, the spring flow was divided into two stages: the first stage (1954-1960), when the spring flow was affected only by climate variation; and the second stage (1961-1994), when the flow was impacted by both climate variation and anthropogenic activities. Results showed that the Jinci Springs flow had strong relations with precipitation occurring one year and three years earlier in the first stage. Subsequently, a grey system GM (1, 3) model with one-year and three-year lags was set up for the first stage. By using the GM (1, 3) model, we simulated the spring flow in the second stage under effects of climate variation only. Subtracting the observed spring flow from the simulated flow, we obtained the contribution of anthropogenic activities to Jinci Springs cessation. The contribution of anthropogenic activities and climate variation to Jinci Springs cessation was 1.46 m³/s and 0.62 m³/s, respectively. Finally, each human activity causing spring flow decline was estimated. The methods are useful to describe the karst hydrological processes under the effects of anthropogenic activities and climate variation.

Although urbanization has contributed to improving living conditions, it has had negative impacts on the natural environment in the urbanized areas. Urbanization has changed the urban landscape and resulted in increasing land surface temperature (LST). Thus, studies related to LST in various urban environments have become a popular research topic. However, few LST studies focusing on the mountain landscapes (i.e. hill stations) have been carried out. The primary objective of this study is to investigate changes in the landscape and their impacts on LST intensity (LSTI) in the tropical mountain city of Nuwara Eliya, Sri Lanka. The study utilized annual median temperatures extracted from Landsat data collected from 1996 to 2017 based on the Google Earth Engine (GEE) interface. The fractions of built-up (BL), forest (FL), and agricultural (AL) land were calculated using land use and cover maps based on the urban-rural zone (URZ) analysis. The urban-rural margin was demarcated based on the fraction of BL (<10%) and LSTI was measured using the mean LST difference in the urban-rural zone. In addition, the mixture of land use types was calculated using the AL/FL and BL/FL fraction ratios, and grid-based density analysis. The result shows that the BL in all URZ rapidly developed, while AL decreased during the period 1996 to 2017. There was minimal change in the forest area of the Nuwara Eliya owing to the government forest preservation policies. The fraction of the BL increased from 32.4% in 1996 to 58.7% in 2017 in the city center zone (URZ₁) resulting in increased mean LST by 4.7 °C. Furthermore, the increase of the BL/FL fraction ratio and the decrease of the AL/FL fraction ratio were positively correlated with the mean LST. Grid-based analysis showed an increasing positive relationship between mean LST and density of BL. This indicated that BL density has been a crucial element in increasing LST in the study area. The results of this study will be a useful indicator to introduce improved landscape and urban planning in the future to minimize the negative impact of LST on urban sustainability.

The art work of this present paper is to show properly conditions and aspects to reach stability in the process control, as also to avoid instability, by using digital PID controllers, with the intention of help the industrial community. The discussed control strategy used to reach stability is to manipulate variables that are directly proportional to their controlled variables. To validate and to put the exposed principles into practice, it was done two simulations of a continuous fermentation tank process start-up with the yeast strain S. Cerevisiae NRRL-Y-132, in which the substrate feed stream contains different types of sugar derived from cane bagasse hydrolysate. These tests were carried out through the resolution of conservation laws, more specifically mass and energy balances, in which the fluid temperature and level inside the tank were the controlled variables. The results showed the facility in stabilize the system by following the exposed proceedings.

Much remains to be understood for delayed ultraweak photon emission (UPE) from organism in association with oxidative burst following external perturbation, a phenomenon that has been experimented for over three decades. Delayed UPE often decays hyperbolically; yet, it is not uncommon to have delayed UPE that reveals first-order kinetic patterns characterized by single-exponential, double exponential, or multi-exponential changes. Some delayed UPEs also presented transient patterns that are characteristic of second-order responses. A soliton-based photon-storage model has addressed the hyperbolic decaying pattern of delayed UPE; however, there are questions outstanding regarding modeling other non-hyperbolic kinetics as well as the large range of temporal scales of delayed UPE that can vary from 8.5 microseconds to many hours. This work proposes an alternative, phenomenological model-framework for interpreting the various kinetic patterns of delayed UPE following stress. The delayed UPE is considered to be governed by two sequential phases: a stress-transfer phase that transforms the external stress to photo-genesis for emitting photons, and a photon-diffusion phase that transmits the photons emitted by the photo-genesis to the surface of organism for being detected as delayed UPE. Time-resolved photon diffusion analysis reveals that any delayed UPE in organism with a delay time >100ns cannot be addressed by the inherent temporal spread that realistic tissue scattering will cause. A slow stress-transfer phase is thus required to explain the delay time-scales of delayed UPE at a minimum of 8.5 µs as reported experimentally. The stress-transfer phase is hypothesized to carry the following types of responses: single or multiple 1st-order low-pass, single 2nd-order low-pass with various damping factors, and single 2nd-order band-pass with various damping factors. A single 1st–order low-pass response with a time-varying kinetic rate is also analyzed. The responses of these modeled pathways to bolus and step inputs demonstrate that a kinetic pattern other than the exact single-exponential one may have multiple causes.

Background: Although transcatheter arterial chemoembolisation (TACE) is the standard of care for intermediate-stage hepatocellular carcinoma (HCC), this is a largely heterogeneous disease that includes a subgroup of patients who do not benefit from TACE. The treatment strategy for this subgroup of patients currently remains an unmet need in clinical practice. Here, we performed a proof-of-concept study that lenvatinib may be more favourable treatment option over TACE as an initial treatment in intermediate-stage HCC patients with large or multinodular tumours exceeding the up-to-seven criteria. Methods: This proof-of-concept study included 642 consecutive patients with HCC initially treated with lenvatinib or conventional TACE (cTACE) between January 2006 and December 2018. Of these patients, 176 who received lenvatinib or cTACE as an initial treatment and met the eligibility criteria [unresectable, beyond the up-to-seven criteria, no prior TACE/systemic therapy, no vascular invasion, no extrahepatic spread and Child-Pugh A liver function] were selected for the study. Propensity score matching was used to adjust for patient demographics. Results: After propensity-score matching, outcome of 30 patients prospectively treated with lenvatinib (14 in clinical trials, 1 in early access program and 15 in real world setting) and 60 patients treated with cTACE as the initial treatment was compared. The change of ALBI score from baseline to the end of treatment were -2.61 to -2.61 for 30 patients in lenvatinib group (p = 0.254) and -2.66 to -2.09 in cTACE group (p < 0.01), respectively. The lenvatinib group showed a significantly higher objective response rate (73.3% vs. 33.3%; p < 0.001) and significantly longer median progression-free survival than the cTACE group (16.0 vs. 3.0 months; p < 0.001). Overall survival was significantly longer in the lenvatinib group than in the cTACE group (37.9 vs. 21.3 months; hazard ratio: 0.48, p < 0.01). Conclusion: In patients with large or multinodular intermediate-stage HCC exceeding the up-to-seven criteria with Child-Pugh A liver function, who usually do not benefit from TACE, lenvatinib provides more favorable outcome than TACE.

Consideration of climate change in Environmental Impact Assessment (EIA) is a rather novel topic, which became partly mandatory through the revised EU Directive on EIA. Through a mixed-methods approach involving key-actors from EIA practice, decision making and climate adaptation planning, this study presents a transdisciplinary point of view on barriers and opportunities to tackle climate change adaptation in environmental assessment of large-scale projects. It is based on both a retrospective ex-post evaluation of existing practices in Austria and Germany as well as prescriptive examination and development of outcomes for practice through the development of a climate-fit toolkit that supports the incorporation of climate change impacts into EIAs. The scenario analysis applied with a back casting approach provided the opportunity to look beyond limitations related to legal compliance and partly lack of data identified by previous research. Three scenario narratives were elaborated based on nine key impact factors based on literature review, content analysis of EIA documents and interviews with EIA actors. The groups of actors carried out a prioritization of actions towards consideration of climate change in EIA. Finally, the actors were involved in co-production of an online tool-kit for Austrian and German EIA practice.

There is limited information on Tamarind production, trade and value added products in Kenya. Of late, there is growing interest in the domestic and export markets due to its multiple uses. The objective of this paper is to review existing literature to identify the missing value chain links which may help catalyse the scaling up of production and commercialization of Tamarind. Selected literature and interviews with traders and extension staff in the Coastal Counties were used to collect information for this study. Tamarind fruits are mainly collected in the wild in semi-arid areas of the country and marketed through informal channels. Mombasa is the terminal market for tamarind from Kenya and Uganda, from where domestic consumers and exporters obtain their supplies. Globally, virtually every part of tamarind tree (pulp, seed, leaves, flowers, bark and roots) has either nutritional, industrial or medicinal value. Tamarind fruit contains substantial levels of carbohydrates, proteins, vitamins, minerals and essential amino acids making it potentially useful in addressing wide spread malnutrition. Its anti-oxidant, anti-inflammatory, anti-microbial, anti-fungal and anti-diabetic properties gives tamarind wider application in conventional and traditional medicine. The findings suggest that scaling up the production and commercialization of tamarind in the country requires both public and private sector investment. The structure of this partnership should consist of the following value chain links: An efficient Seed / seedling system as a source of planting materials; production hubs by farmer associations, government institutions and private farms; aggregation centres for assurance of volumes and quality; processing, value addition and product diversification; an efficient distribution systems of wholesalers and retailers, particularly supermarkets; exporters and consumers. The agenda for further research should include breeding and availing early maturing cultivars demanded by the export market, quality management andvalue addition technologies.