Background: A significant proportion of SARS-CoV-2-infected patients develops respiratory failure. Thromboembolism is also prevalent in coronavirus disease 2019 (Covid-19). Vitamin K plays a role in coagulation and possibly also in lung diseases. We therefore hypothesized that vitamin K is implicated in Covid-19 pathogenesis. Methods: 134 Covid-19 patients and 184 controls were included. Inactive vitamin K-dependent matrix Gla protein (i.e.dp-ucMGP) and prothrombin (i.e. PIVKA-II) were measured, which are inversely related to respectively extrahepatic and hepatic vitamin K status. Desmosine was measured to quantify elastic fiber degradation. Lung involvement and arterial calcifications severity were assessed by computed tomography. Results Dp-ucMGP was elevated in Covid-19 patients compared to controls (P=0.001). Higher dp-ucMGP was found in Covid-19 patients with poor compared to better outcomes (P=0.002). PIVKA-II was normal in 81.8%, mildly elevated in 14.0% and moderately elevated in 4.1% of Covid-19 patients not using vitamin K antagonists. Dp-ucMGP in Covid-19 patients was correlated with desmosine (P<0.001), thoracic aortic calcification (P<0.001) but not with pneumonia severity. Conclusions: Extrahepatic vitamin K status was severely reduced in Covid-19 patients, as reflected by elevated inactive MGP, and related to poor outcome. Procoagulant prothrombin activity remained preserved in the majority of Covid-19 patients, which is compatible with the increased thrombogenicity that is frequently observed in severe Covid-19. Impaired MGP activation was linked to accelerated elastic fiber degradation and premorbid vascular calcifications. A trial should assess whether increasing MGP and protein S activity by vitamin K administration improves Covid-19 outcomes.

To address global warming, there is a worldwide effort to establish carbon-neutral energy plans. Given the characteristics of renewable energy generation, a diverse 'Energy Mix' consisting of various energy sources such as wind and solar power is crucial. In particular, the wind power is expected to continue expanding globally due to its sustainable nature. Furthermore, the expan-sion of offshore wind farm is making essential and a rapidly growing industry sector to be achieving carbon neutrality with limited land for construction. To facilitate the construction and operation of offshore wind farms, specialized vessels with dynamic positioning (DP) systems are essential such as Wind Turbine Installation Vessels (WTIVs) and Service Operating Vessels (SOVs). The purpose of this study is to predict and analyze the scale and structural changes in the fleet capacity of DP vessel, which is essential for offshore wind power construction as the offshore wind power industry develops using System Dynamics (SD) modeling. Specifically, this study aims to construct a demand forecasting model for DP vessel used in offshore wind farm con-struction based on SD methodology. The study aims to identify influencing factors by analyzing dynamic changes in system configurations over time and establishing causal relationships based on feedback structures. Instead of traditional time series analysis methods, causal relation-ship-based simulations were conducted for quantitative analysis. The results provide insights into the changes in the DP vessel market structure due to the emergence of the new industry and highlight areas that require improvement throughout the industry.

For the generation of representative volume elements a statistical description of the relevant parameters is necessary. These parameters usually describe the geometric structure of a single grain. Commonly, parameters like area, aspect ratio and slope of the grain relative to the rolling direction are applied. However, usually simple distribution functions like log normal or gamma distribution are used. Yet, these do not take the interdependencies between the microstructural parameters into account. To fully describe any metallic microstructure though, these interdependencies between the singular parameters need to be accounted for. To accomplish this representation, a machine learning approach was applied in this study. By implementing a Wasserstein generative adversarial network, the distribution, as well as the interdependencies could accurately be described. A validation scheme was applied to verify the excellent match between microstructure input data and synthetically generated output data.

Apathy in patients with Parkinson's disease (PD) is one of the least studied manifestations of a wide range of neuropsychiatric disorders (PND). The frequency of apathy in PD, according to various researchers, is 17–80%. Structural and neurochemical changes associated with PD are considered as the leading pathophysiological factors of apathy. Possible general pathophysiological mechanisms of apathy and hypokinesia, depression, executive (frontal) cognitive functions, sleep disorders in PD are discussed. The basis of the pathophysiological commonality of apathy, hypokinesia, and executive functions is probably bilateral disturbances in the functional connections of the stratum and dorsolateral, medial parts of the prefrontal cortex. The combination of apathy and depression in PD may be due to dysfunction of the structures of the limbic system and the medial orbital prefrontal cortex responsible for motivational determined behavior. The variability of the relationship between apathy and hypokinesia, depression, cognitive impairments, sleep disorders at different stages of PD may be associated with the phenomenological heterogeneity of apathy.Apathy worsens the quality of life, makes a significant contribution to disorders of both household and social adaptation of PD patients. It is promising to study the possibility of correcting apathy using dopaminergic therapy. Against the background of the appointment of pramipexole (1.5-3.0 mg / day) to 20 patients with PD (middle stage, according to Hen-Yar-2.5) to correct movement disorders after 4-6 weeks of therapy, a statistically significant positive dynamics of apathy were noted. According to the total assessment of the scale of apathy SE Starkstein (AS). As a result of the study, no statistically significant correlation was found between the dynamics of the total apathy indicator and the dynamics of motor symptoms of PD according to the unified rating scale for assessing PD (“Motor functions”), which, we believe, indicates an independent effect of pramipexole therapy in relation to motivational disorders.

Amidst the burgeoning global concerns surrounding skin cancer, the quest for precise and efficient diagnostic methodologies has intensified. Conventional diagnostic approaches relying on subjective visual inspection by dermatologists often grapple with subjectivity and resource constraints. This predicament underscores the critical role of Artificial Intelligence (AI) in revolutionizing diagnostic paradigms by significantly enhancing accuracy and accessibility. This study embarks on an extensive exploration of skin cancer classification, specifically targeting the intricate task of 8-class skin cancer classification. Employing cutting-edge deep learning models on the ISIC2019 dataset, a comprehensive analysis was conducted utilizing a diverse array of pre-trained ImageNet architectures and Vision Transformer models. To counteract the inherent class imbalance in skin cancer datasets, a pioneering "Naturalize" augmentation technique was introduced, leading to the creation of indispensable tools—the Naturalized 2.4K ISIC2019 and groundbreaking Naturalized 7.2K ISIC2019 datasets—catalyzing advancements in classification accuracy. The pivotal role of AI in mitigating the risks of misdiagnosis and under-diagnosis in skin cancer becomes evident through this research. AI’s proficiency in analyzing vast datasets and discerning subtle patterns augments the diagnostic prowess of dermatologists significantly. Integration of AI-powered systems in skin cancer diagnosis holds immense promise in facilitating early detection and substantially improving patient outcomes. The meticulous evaluation employed quantitative measures such as confusion matrices, classification reports, and visual analyses using Score-CAM across diverse dataset variations. Astonishingly, the culmination of these endeavors culminated in an unprecedented achievement—100% average accuracy, precision, recall, and F1-Score—within the groundbreaking Naturalized 7.2K ISIC2019 dataset. This remarkable feat underscores the transformative potential of AI-driven methodologies, exemplifying their prowess in redefining the landscape of skin cancer diagnosis and management. In summary, this research represents a pivotal stride towards redefining dermatological diagnosis, showcasing the remarkable impact of AI-powered solutions in surmounting the challenges inherent in skin cancer diagnosis. The attainment of 100% across crucial metrics within the Naturalized 7.2K ISIC2019 dataset serves as a testament to the transformative capabilities of AI-driven approaches in reshaping the trajectory of skin cancer diagnosis and patient care.

In this paper, we redefine the boundaries of blood cell classification, expanding from 5 to 11 distinct blood cell types using the challenging 11-class PBC dataset. This shift enables a deeper understanding of blood cell diversity, overcoming previous limitations in medical image analysis. Our approach combines state-of-the-art deep learning techniques, including pre-trained ConvNets, ViTb16 models, and custom CNN architectures. We employ transfer learning, fine-tuning, and ensemble strategies, such as CBAM and Averaging ensembles, to achieve unprecedented accuracy and interpretability. Our fully fine-tuned EfficientNetV2 B0 model sets a new standard, with a macro-average precision, recall, and F1-score of 91%, 90%, and 90%, respectively, and an average accuracy of 93%. This breakthrough underscores the transformative potential of 11-class blood cell classification for more precise medical diagnoses. Moreover, our groundbreaking "Naturalize" augmentation technique produces remarkable results. The 2K-PBC dataset generated with "Naturalize" boasts a macro-average precision, recall, and F1-score of 97%, along with an average accuracy of 96% when leveraging the fully fine-tuned EfficientNetV2 B0 model. This innovation not only elevates classification performance but also addresses data scarcity and bias in medical deep learning. Our research marks a paradigm shift in blood cell classification, enabling more nuanced and insightful medical analyses. The "Naturalize" technique’s impact extends beyond blood cell classification, emphasizing the vital role of diverse and comprehensive datasets in advancing healthcare applications through deep learning.

Deep Learning (DL) has made significant advances in computer vision with the advent of Vision Transformers (ViT). Unlike Convolutional Neural Networks (CNNs), ViTs use self-attention to extract both local and global features from image data, and then use residual connections to feed these features directly into a fully networked multilayer perceptron head. In hospitals, hematologists prepare peripheral blood smears (PBSs) and read them under a medical microscope to detect abnormalities in blood counts such as leukemia. However, this task is time-consuming and prone to human error. This study investigates the transfer learning process of Google ViT and ImageNet CNNs to automate the reading of PBSs. The study used two online PBS datasets, PBC and BCCD, and transferred them into balanced datasets to investigate the influence of data amount and noise immunity on both neural networks. The PBC results show that Google ViT is an excellent DL neural solution for data scarcity. The BCCD results show that Google ViT is superior to ImageNet CNNs in dealing with unclean, noisy image data because it is able to extract both global and local features and use residual connections, despite the additional time and computational overhead.