Early-life adversity can profoundly impact individual development, yet some demonstrate resilience. Longitudinal studies tracking individuals over extended periods have aided our understanding of resilience and growth following adverse childhood experiences. This paper reviews insights from influential studies like the Kauai Longitudinal Study, the Adverse Childhood Experiences (ACE) Study, and the Dunedin Study. It explores key findings on risk and protective factors, adaptation trajectories, and long-term outcomes associated with resilience. Theoretical frameworks and methodological considerations are discussed. The paper examines how this research informs interventions, policies, and support systems for fostering resilience. It highlights the need for diverse samples, integrating biological and environmental factors, and investigating intergenerational impacts. By synthesizing longitudinal research, this paper elucidates complex pathways to resilience and positive development despite early adversity, offering insights for research and supporting vulnerable populations.

Degradation is an inevitable companion in the operation of solid oxide fuel cell (SOFC) systems since it directly deteriorates the reliability of the system’s operation and the system’s durability. Both are seen as barriers that limit the extensive commercial use of SOFC systems. Therefore diagnosis and prognosis are valuable tools that can contribute to raising the reliability of the system operation, efficient health management, increased durability and implementation of predictive maintenance techniques. Remaining useful life (RUL) prediction has been extensively studied in many areas like batteries and proton-exchange membrane fuel cell (PEM) systems, and a range of different approaches has been proposed. On the other hand, results available in the domain of SOFC systems are still relatively limited. Moreover, methods relying on detailed process models and models of degradation turned out to have limited applicability for in-field applications. Therefore, in this paper, we propose an effective, data-driven approach to predicting RUL where the trend of the health index is modelled by an adaptive linear model, which is updated at all times during the system operation. This allows for a closed-form solution of the probability distribution of the RUL, which is the main novelty of this paper. Such a solution requires no computational load and is as such very convenient for the application in ordinary low-cost control systems. The performance of the approach is demonstrated first on the simulated case studies and then on the data obtained from a long-term experiment on a laboratory SOFC system. From the tests conducted so far it turns out that, the quality of the RUL prediction is usually rather low at the beginning of the system operation, but then gradually improves while the system is approaching the end-of-life (EOL), making it a viable tool for prognosis.

The colpodellids consist of free-living predatory protists phylogenetically related to pathogenic Apicomplexan parasites such as Plasmodium species, Cryptosporidium sp. and Toxoplasma gondii. Among the colpodellids, Colpodella species prey on bodonids, algae, and ciliates. Voromonas pontica preys on Percolomonas species. In the past decade, Colpodella species have been reported to cause opportunistic infections in humans and animals, and having the potential for zoonotic infections in humans due to the presence of Colpodella species in ticks. In the reported cases, transmission and pathogenic stages of Col-podella were not identified by light microscopy. In the colpodellid V. pontica, cyst stages of both the pred-ator and its prey Percolomonas cosmopolitus have not been identified by light microscopy. In this study we evaluated the dye components used for Sam-Yellowe’s trichrome staining, from different major vendors to determine the consistency and reproducibility of the staining protocol to aid the use of the staining proto-col for diagnosis. We show that although slight variations in the color of the stained cells are obtained, life cycle stages of Colpodella ATCC 50594 could be clearly identified, regardless of the vendor used. For the first time, Sam-Yellowe’s trichrome staining series, could identify cysts of V. pontica and its prey, demonstrating that the staining protocol can identify life cycle stages of other colpodellids. Sam-Yellowe's trichrome staining will aid molecular diagnosis of infections caused by colpodellids in human and ani-mals, identify colpodellids in ticks and flies and from environmental samples, when used for staining.

This paper investigates the relationship between public spaces and quality of life (QoL) for older adults, aiming to identify knowledge gaps within the context of population ageing and urbanization. Recognizing the growing importance of sustainable urban development, the research explores how cities can foster active ageing and improve QoL through accessible and inclusive public spaces. A scoping literature review identifies five key QoL domains for older adults: autonomy, meaningful activities, positive social relationships, leisure opportunities, and health. The review highlights areas requiring further investigation, including the interplay between environmental design and social connections, intergenerational perspectives on public space liveliness, the influence of context on QoL and the built environment, and the value of qualitative research in this field. By contributing to the understanding of QoL in relation to public spaces through the lens of Person-Environment fit theory, this study aims to inform urban design, landscape architecture, and policymaking in the creation of age-friendly communities with inclusive public spaces.

This article presents multiple novel and compelling arguments to systematically disprove two widely accepted notions: one is that entropy is a measure of disorder, and the other is Schrödinger's notion of negative entropy (negentropy). These two notions have been cited hundreds of times annually in scientific literature for decades. To mathematically describe the second law of thermodynamics, the concept of entropy was created and defined in the 1860s as heat energy divided by thermodynamic temperature, and the entropy of an object increases when it absorbs heat. This is the uncontroversial and fundamental nature of entropy, which is pivotal to current thermodynamics and from which multiple facts are deduced. These facts consistently disprove the above two notions. Some biological facts, such as the one that life orderliness is encoded and provided by inherited genes rather than entropy decline, can also disprove Schrödinger's negentropy notion. Moreover, this article further clarifies the reasoning errors of the two notions. It also shows that the tendency of many natural or social systems to become more disordered over time does not result from the second law of thermodynamics.

The prevalence of diagnosed cases of autism has increased rapidly, which raise interest in studying the variables related to the well-being of these families. The purpose of this paper is to review recent literature on other variables related to family well-being such a parenting styles. We conducted a systematic review using PRISMA check list and bias assessment ESTROBE with the aim of analyzing if the concepts of autism, well-being and parenting style are related. We screened 753 references, 16 full text articles and abstracts were read. It was identified that authoritative parenting style, those based on warmth, establishing relationships and emotional bonding, and low expressed emotion were positively related to family well-being. On the other hand, authoritarian, permissive and overprotective styles, as well as critical, punishing and training-based were negatively associated with well-being and quality of family life.

Maternal unbalanced diets cause adverse metabolic programming and affect the offspring's liver microRNA profile. The liver is a site of β-carotene (BC) metabolism and a target of BC action. We studied the interaction of maternal Western diet (WD) and early-life BC supplementation on the epigenetic remodeling of offspring’s liver microRNAs. Mouse offspring of WD-fed mothers were given daily a placebo (controls) or BC during suckling. The liver miRNAome was analyzed in recently weaned animals by microarray hybridization. BC impacted the liver miRNAome differently in male and female offspring, with no overlap in differentially expressed (DE) miRNAs between sexes and more impact in females. Bioinformatic analysis of DE miRNA predicted target genes revealed enrichment in biological processes/pathways related to metabolic processes, regulation of developmental growth and circadian rhythm, liver homeostasis and metabolism, insulin resistance, and neurodegeneration, among others, with differences between sexes. Fifty five percent of the overlapping target genes in both sexes identified were targeted by DE miRNAs changed in opposite directions in males and females. The results identify sex-dependent responses of the liver miRNA expression profile to BC supplementation during suckling and may sustain further investigations regarding the long-term impact of early postnatal life BC supplementation on top of an unbalanced maternal diet.

The most important prognostic factors in curatively treated prostate cancer at the initial diagnosis are T and N stage, histological subtype, Gleason score, initial PSA, PSA density and percentage of core biopsy positivity. Newer, but non-standard prognostic factors are urine PCA3 and genetic markers of prostate cancer. A simple, but seemingly underestimated standard test is serum Calcium (Ca) level, which has been shown by a previous study group to be a good predictor of lethal prostate cancer, but there is scarce evidence regarding the prognostic value of calcium levels at diagnosis. We aimed to determine whether a Ca level in the upper part of normal values has a prognostic value in curatively treated prostate cancer. We have retrospectively included 84 consecutive patients with prostate cancer, who underwent curative radiotherapy (primary or adjuvant; external beam RT with or without brachytherapy). We have performed statistical analysis of available prognostic factors. Ca level at diagnosis was found to be a statistically significant predictor of disease-free survival.

This paper presents a comprehensive simulation study of Automated Guided Vehicles (AGVs) in a fabricated production environment for toy car assembly. This paper uses Petri Nets for modeling and the General Petri Net Simulator (GPenSIM) for model implementation on MATLAB and simulation. The primary focus of this research is to analyze the operational efficiency of AGVs under varying conditions, particularly examining the impact of battery charge reduction rates and the strategic placement of charging stations within the production line. By employing Colored Petri Nets (CPN) within GPenSIM, we have developed a detailed and dynamic model that captures the intricate movements and interactions of AGVs in a simulated manufacturing setting. By presenting an approach to simulating AGVs in a production environment, this paper specifically focuses on two critical operational parameters: the battery charge reduction rate of AGVs and the number of charging stations available in the production line. Unlike previous studies that have primarily concentrated on general path planning or bottleneck detection in manufacturing systems, this paper delves into the intricate balance between AGV operational efficiency and the logistical constraints imposed by battery life and charging infrastructure.

INTRODUCTION: Breast sensibility following reconstruction surgery, though often overlooked, holds significant importance due to its widespread occurrence and profound effects on patients’ well-being and safety. Our objective is to compare the sensory outcomes between DIEP flap microsurgery reconstruction and implant-based reconstruction. Additionally, we explored the potential influence of sociodemographic and clinical factors on sensory recovery, along with assessing temperature discrimination abilities and evaluating quality of life. MATERIAL AND METHODS: We conducted an ambispective descriptive-analytical study, involving women who underwent mastectomy with reconstruction using either DIEP flap and implants at our hospital between 1990 and 2021. Data were collected from medical records, patient histories, physical examination, and validated quality of life questionnaires (BREAST-Q). RESULTS: A total of 99 women with breast reconstruction were included, 47 with DIEP flap and 52 with implants. Sensory recovery in implant-based reconstruction was found to be superior to DIEP flap reconstruction (5.03 and 5.18 respectively, p-value <0.005). A direct correlation was observed between sensory improvement and thermal discrimination (Spearman coefficient 0.9, p-value <0.001). Factors such as radiotherapy, delayed reconstruction with DIEP flap, and height with implants were associated with poorer sensory recovery in the breast. Women experiencing better breast sensibility reported higher satisfaction with their surgeon, medical team, and psychosocial quality of life. CONCLUSION: Women reconstructed with implants or DIEP abdominal flap exhibit suboptimal overall sensory recovery of the reconstructed breast, with slightly better outcomes observed in women reconstructed with implants.

In 2011, commercial aviation contributed approximately 3.5% of global anthropogenic climate change through the emission of greenhouse gases during flight and operational non-CO2 climate effects. Over the last few years, numerous aviation-related organisations have set goals to reduce aviation’s climate impact. These goals, however, lack alignment, are poorly or ambiguously defined, or are internally inconsistent. This increases uncertainty about what aviation should work towards, how various stakeholders can contribute, and introduces problems with respect to accountability. In order to address this issue, this paper presents a comprehensive definition of a climate neutral air transport system as an “air transport system of which the climate effects of all its greenhouse gases and non-carbon dioxide effects throughout the entire life-cycle of each element of the system is balanced”. The proposed definition spans relevant system and encompasses all life cycle phases. To achieve a climate neutral air transport system by 2050, all life-cycle greenhouse gas emissions and non-CO2 climate effects remaining after in-sector reduction should be neutralised, as should all remaining non-CO2 climate forcing from emissions prior to 2050. Clarity on governance is furthermore needed, as the goal and associated targets proposed should be adopted globally.

Undernutrition and micronutrient deficiencies such as anemia are considered significant public health challenges in Bangladesh, which enhancing fish consumption is a well-established food-based intervention to address these. This paper documents the establishment of community-based fish chutney production and reports the impact of its consumption on mid-upper arm circumference (MUAC) and hemoglobin (Hb) levels among targeted 150 pregnant and lactating women (PLW) in rural Bangladesh. A fish chutney was developed using locally available ingredients followed by a series of laboratory tests, including nutrient composition, shelf-life and food safety. A community-based fish chutney production process was designed to: 1) supply locally available ingredients for processing; 2) establish two fish drying sites; 3) initiate a community-based production site, and 4) distribute fish chutney to PLW by six women nutrition field facilitators for one year. Then a pre- and post-intervention study was designed for a selected 150 PLW to receive 30g of fish chutney daily for 12 months. Differences in mean mid-upper arm circumference (MUAC) and hemoglobin (Hb) levels pre- and post-consumption were analyzed using one-way analysis of variance. Consumption of 30g of fish-chutney resulted in significant increases of the mean values of Hb levels and MUAC among the targeted PLW.

.Bacground: Sepsis remains a major health challenge worldwide, characterized by a dysre-gulated host response to infection, leading to high mortality and morbidity in intensive care units (ICUs). The Fibrosis 4 (FIB-4) index, originally developed to assess liver fibrosis in hepatitis C patients, has recently been explored for its potential prognostic value in sepsis patients. Method: This study retrospectively analyzed 309 sepsis patients admitted to the Internal Me-dicine and Anaesthesia ICUs between December 12, 2021, and December 15, 2023, to inves-tigate the relationship between FIB-4 levels, Acute Physiology and Chronic Health Evaluation (APACHE), and Sequential Organ Failure Assessment (SOFA) and clinical outcomes. Results: The study found that higher FIB-4 measurements were statistically significantly asso-ciated with increased 28-day mortality, with a cut-off value of 4.9 providing a sensitivity of 54.92% and specificity of 74.25%. Logistic regression analysis indicated that elevated Conclusion:FIB-4 levels were a significant predictor of early mortality, suggesting that the FIB-4 index could serve as a valuable prognostic tool in assessing the severity and prognosis of sepsis patients.

Aims: This study aims to evaluate the impact of family-centered empowerment on Jordanian adolescents with type 1 diabetes (T1DM), focusing on their HbA1c levels, self-efficacy, and quality of life (QOL). Background: Poor glycemic management in adolescents with type 1 diabetes increases complications. Improved control is linked to various variables, but few studies focus on Middle Eastern populations. Methods: An experimental study involved 68 adolescents with T1DM visiting Jordanian Royal Medical Services' clinics. Two sets of participants were created: control (n = 34) and intervention (n = 34). Data was collected through face-to-face interviews and medical records. Results: The study found significant differences in self-efficacy scores between the intervention and control groups, with the intervention group experiencing a significant decrease in HbA1c readings and a significant difference in QOL between pre-program and post-program phases. Discussion: Family empowerment can significantly improve the lives of Jordanian teenagers with type 1 diabetes. This strategy leads to improved glycemic management, increased self-efficacy, and improved quality of life. Future treatments and health policies should recognize and value the critical role families play in the care of this population. Conclusion: The study suggests that patients with T1DM should receive continuous care education sessions, including self-care training, to improve their health. Nurses should also incorporate these training into treatment plans and educational programs for adolescents to enhance their QOL.

1) Background: Capturing patients’ medical histories significantly influences clinical decisions. Errors in this process lead to clinical errors, increase costs and dissatisfaction among physicians and patients. Physicians in developing countries are overloaded with patients and cannot always follow the proper history-taking procedure. The challenges are acknowledged; however, a comprehensive understanding of the status and the remedies remained unexplored. 2) Objective: This paper aims to investigate the workload, history-taking challenges, and the willingness of the physicians to accept digital solutions. 3) Methods: A cross-sectional online survey was conducted on 104 physicians across Bangladesh, featuring 22 questions regarding their professional environment, workload, digitization status of health records, challenges in history-taking, and attitudes toward adopting digital solutions for managing patient histories; 4) Results: 92.67% of the physicians face workloads, 88.46% struggle in medical history-taking, and only 4.81% use digital medical records. About 70% struggle to complete the necessary history-taking steps, emphasizing the urgent need for solutions. An AI-based Smart Health Gantt Chart (SHGC) system has been introduced for their instant feedback. 93.27% of physicians expressed their willingness to use such a system. 5) Conclusions: The proposed SHGC has the potential to enhance healthcare efficiency in developing nations, benefit physicians, and improve patient-centered care.

Health-Related Quality of Life (HRQoL) encompasses the comprehensive evaluation of an indi-vidual's health and well-being across multiple dimensions. Mindfulness, recognized as a scientifi-cally supported strategy for anxiety management, plays a role in enhancing both physical and mental health. The Gut-Brain Axis (GBA) serves as the bidirectional communication link between the gastrointestinal system and the central nervous system. This study aims to explore the associa-tion between Mindfulness and factors influencing the GBA in both healthy individuals and those with Inflammatory Bowel Diseases (IBD). A cross-sectional investigation involved 338 adults, in-cluding 50 IBD patients, utilizing validated Greek scales for Mindfulness (MAAS-15), Mediterra-nean Diet (14-MEDAS), and HRQoL (EQ-5D-5L). The questionnaire gathered demographic, an-thropometric, and lifestyle data. Among healthy participants, EQ-5D-5L showed a moderate cor-relation with the MAAS-15 scale (r=0.389, p

As the world attempts to decarbonise the food industry and limit greenhouse gas (GHG) emissions, plant-based meat analogues (PBMAs) have emerged as a sustainable alternative to traditional meat. This study implemented a life cycle assessment (LCA) to rigorously compare the environmental impacts of a beef burger (BB), produced with British beef, against a meat analogue (MA) equivalent with a publicly available recipe. For the LCA, a cradle-to-fork system boundary was utilised, alongside a functional unit of a single 100 g burger patty. Results from the LCA revealed that the BB patty had more than double the total environmental impact than the MA equivalent, as well as possessing a global warming impact that was 62% higher. A simple extrapolation illustrated that if the UK population switched from beef to meat analogue patties, 3 million tonnes of CO2e could be saved annually, corresponding to 0.74% of the country’s yearly territorial GHG emissions. Scenario analyses displayed how the environmental impact of the MA patty remained stable regardless of changes in exportation, ingredient origin or soy protein sourcing. Moreover, sensitivity analysis conducted with an alternative characterisation method corroborated initial findings, whilst uncertainty analysis ensured that nearly all conclusions generated from the original comparison were robust. Future studies should conduct peer-reviewed LCAs on PBMA patties with commercial recipes based on other plant-based proteins, as well as fully understanding any potential health implications of long-term PBMA consumption.

The theories of Evolution and Big Bang have brought a major impact upon the scientific and societal perception upon the origins, abilities and roles of mankind on Earth. It is conclusively evident that Mother Nature and the physical realm is autonomous and all phenomena in the world occur without an imposition against the “free will” of such events and patterns. Nevertheless, this extent of freedom does not imply that life on Earth represents an accident and has no purpose. By careful analysis of ancient religious texts, it can be suggested even otherwise, that it is especially free will that is offered as a gift from outside of the physical dimensions of existence, with the purpose of a continuous edification and improvement of the overall life conditions and of the human perception. It may be that the multi-generational focus on improvement and progress have been misattributed as a long-term evolution of species, that humans came from animal ancestors and that there is a blurred line associating humans with animals. Furthermore, it may be that scientists based their suggestions that no outside Creator would have brought the Earth into existence on physical perspectives, when the extra-dimensional process of Creation implies that all elements of the physical existence undergo a process of Creation from the outside, where time, space and physical matter do not exist, in spite of such elements possibly reflecting unseen elements of the meta-physical world. Finally, there is the following example that deserves attention within the scientific community; just because all living cells - human, animal and plant - contain DNA chromosomes, ribosomes, mitochondria and a plasma membrane, it does not indicate that humans are animals, just as this does not indicate that plants are animals. In Science, there is a golden statement, that correlation does not imply causation. This example is in complete agreement with the verses of the Book of Genesis in the Holy Scriptures regarding the origins of life; namely, that animals could have been created by an Author of all life on Earth so that man would experience companionship. An improved scientific perception of the timeline of life on Earth may be reached via an approach that combines molecular biology with quantum physics, given that the three layers of Science - Biology, Chemistry and Physics - together with their foundational layer of Mathematics, are in fact situated in a relationship of complete harmony.

Mothers of children with a specific clinical condition such as type 1 diabetes mellitus (T1DM) may experience higher levels of stress predisposing them to a poorer perception of quality of life and alterations in nutritional status. The aim of this research was to evaluate the relationship between nutritional status and quality of life perception of mothers caring for children with Type 1 Diabetes Mellitus. This research was conducted from July to September 2022, with mothers of children aged 5 to 10 years with diabetes. Data were collected through an online questionnaire including soci-oeconomic information, anthropometric data, clinical data of the children, and the WHO-QOL-abbreviated quality of life questionnaire. For statistical analysis, Statistical Package for Social Science 24 was used. Fifty-five mothers of children with diabetes were evaluated. Over 33% of the mothers were overweight and reported a regular perception of quality of life. Higher BMI was associated with poorer perception of quality of life in the psychological and self-assessment domains, and longer diagnosis time was associated with better perception of quality of life in the physical, psychological, and environmental domains. Therefore, it is understood that actions aimed at improving the quality of life of these mothers are necessary.

The article discusses early diagnosis and intervention for developmental delays in children, emphasizing the role of specialized services and personnel in supporting recovery and development. It presents findings from a pilot project initiated in Bucharest, aiming to assess the incidence of developmental delays in children aged 1-3 years in selected kindergartens, including ASD. The study involved children, parents, and specialists, utilizing systematic behavior observation (SBO) and semi-structured interviews. Results indicate that out of 613 evaluated children, 81 received specialized control recommendations, with 4 cases showing potential risk of ASD. Additionally, 8 children were diagnosed with autism. The incidence of autism in children aged 1-3 years was 1 in 51. Although exploratory, these findings suggest a model of good practice for future early diagnosis campaigns nationally. Conclusively, the study underscores the importance of early diagnosis and intervention for developmental delays, advocating for a responsive community and emphasizing the significance of national-level efforts to address these issues effectively.

The current state-of-the-art does not provide a universal and rapid method of determining the state of health (SOH) of a battery or a supercapacitor without carefully examining the degradation of hundreds of full charge/discharge cycles. Lithium-ion batteries, sodium-ion batteries and supercapacitors of different cell chemistries were studied by impedance spectroscopy during lifetime tests. Faradaic and capacitive charge storage are distinguished by the relationships between stored electric charge and capacitance. For batteries, impedance spectroscopy is best applicable in the flat region of the voltage-charge curve. An approximately linear correlation between pseudocapacitance and Ah capacity is observed as long as overcharge and deep discharge are avoided. The correct calculation of quantities related to complex impedance and differential capacitance is outlined – which may also be useful as an introductory text and tutorial for newcomers to the field. Novel diagram types are proposed for the purpose of instant performance and failure diagnosis of batteries and supercapacitors.

(1) Background: Breast cancer is the leading malignancy worldwide and in Ghana it has a poor overall survival. However, approximately 50% of cases are early stage disease and with advances in breast cancer treatment and improvement in survival, quality of life (QOL) becomes as im-portant as treatment of the disease. (2) Methodology: This was a cross-sectional study of survivors who had breast conserving surgery (BCS), mastectomy only (M) and mastectomy with breast re-construction (BRS) from 2016 to 2020 at a tertiary hospital in Ghana, comparatively assessing their QOL using EORTC QLQ C-30 and EORTC QLQ BR-23. (3) Results: The study participants had an overall Global Health Status (GHS) median score of 83.3 [IQR: 66.7-91.7] with no significant differences between the surgery types. The BRS group had a statistically significant lower median scores for the Functional scale (82.8 and 51.0) and the highest scores for the Symptomatic scale (15.7 and 16.5). Body image was significantly lowest for the BRS group 83.3 [68.8-91.7] and highest 100 [91.7-100] for the BCS group (p < 0.001). (4) Conclusion: There is a need to develop support systems tailored at improving the QOL of breast cancer survivors taking into consideration the type of surgery performed.

Sleep and stress significantly affect emotions, productivity, and overall well-being, crucial for optimal health and performance. However, limited research examines how Nepalese nurses' quality of life relates to their sleep quality and stress levels. This study aims to assess this relationship among nurses in private hospitals in Kathmandu. Three private hospitals were selected for this cross-sectional analytical study. Eligible nurses were chosen through purposive sampling, and data were analysed using IBM SPSS v25, employing Chi-square tests and logistic regression analysis. Research revealed a high rate of poor sleep quality (83.9%) among individuals with a mean age of 24.33 ± 3.08 years. Initially, significant associations were found with the factors like bachelor's degree, no tobacco use, absence of insomnia, good sleep quality, and low stress with good quality of life. After adjustment, the association with bachelor's degree [AOR:2.025, CI at 95%: 1.021-4.016, p

Systemic AL amyloidosis is a challenging disease for which many patients are considered frail in daily clinical practice. However, no study has so far addressed frailty and its impact on the outcome of these patients. We built a simple score to predict mortality based on three frailty-associated variables: age, ECOG performance status (&lt;2 vs. 2) and NT-proBNP (&lt;8500 vs. 8500 ng/L). Four-hundred and sixteen consecutive newly diagnosed patients diagnosed at ten sites from the Spanish Myeloma Group were eligible for the study. The score was developed in a derivation cohort from a referral center, and it was externally validated in a multicenter cohort. On multivariate analysis the three variables were independent predictors of survival. The score was able to discriminate four groups of patients in terms of overall survival and early mortality in both cohorts. Comorbidity was also analyzed with the Charlson comorbidity index, but it did not reach statistical significance in the model. A nomogram was created to easily estimate the mortality risk of each patient at each time point. This score is a simple, robust, and efficient approach to dynamically assess frailty-dependent mortality both at diagnosis and throughout the follow-up. The optimal treatment for frail AL amyloidosis patients remains to be determined but we suggest that the estimation of frailty-associated risk could complement current staging systems, adding value in clinical decision-making in this complex scenario.

The endometrium, the inner mucosal lining of the uterus, undergoes complex molecular and cellular changes across the menstrual cycle in preparation for embryo implantation. Transcrip-tome-wide analyses have mainly been utilized to study the endometrial receptivity, the prerequisite for successful implantation, with most of the studies, so far, comparing the endometrial transcriptomes between (i) secretory versus proliferative endometrium or (ii) mid-secretory versus early-secretory endometrium. In the current study, we provide the complete transcriptome description of the endometrium across the entire menstrual cycle and, for the first time, comprehensively characterize the proliferative phase of the endometrium. Our temporal transcriptome analysis includes five time points: mid-proliferative, late-proliferative (peri-ovulatory phase), early-secretory, mid-secretory, and late-secretory phases. Thus, we exhaustively unveil the transitions between the consecutive proliferative and secretory phases, highlighting their unique gene expression profiles and possible distinct biological functions. Transcriptome analysis reveals many differentially expressed genes (DEGs) across the menstrual cycle, most of which are phase-specific. As an example of the coordinated gene activity, the expression profile of his-tone-encoding genes within the HIST cluster on chromosome 6 showed an increase in cluster activity during the late-proliferative and a decline during the mid-secretory phase. Moreover, numerous DEGs are shared among all phases. In conclusion, in the current study, we delineate the endometrial proliferative phase-centered view of transcriptome dynamics across the menstrual cycle. Data analysis highlights significant transcriptomic and functional changes occurring during the late-proliferative phase – an essential transition point from the proliferative to the secretory phase. Future studies should explore how the biology of the late-proliferative phase endometrium impacts the achievement of mid-secretory endometrial receptivity or contributes to molecular aberrations leading to embryo implantation failure.

Rheumatoid arthritis (RA) is a complex illness with both hereditary and environmental compo-nents. Globally, in 2019, 18 million people had RA. RA is characterised by persistent inflammation of the synovial membrane that lines the joints, cartilage loss, and bone erosion. Phenolic molecules are the most prevalent secondary metabolites in plants, with a diverse spectrum of biological ac-tions that benefit functional meals and nutraceuticals. These compounds have received a lot of at-tention recently because they have antioxidant, anti-inflammatory, immunomodulatory, and anti-rheumatoid activity by modulating tumour necrosis factor, mitogen-activated protein kinase, nu-clear factor kappa-light-chain-enhancer of activated B cells, and c-Jun N-terminal kinases, as well as other preventative properties. This article discusses dietary polyphenols, their pharmacological properties, and innovative delivery technologies for the treatment of RA, with a focus on their possible biological activities. Nonetheless, commercialization of polyphenols may be achievable only after confirming their safety profile and completing successful clinical trials.

The study investigated the application of Wastewater-Based Epidemiology (WBE) as a tool for monitoring SARS-CoV-2 prevalence in a city in Northern Italy from October 2021 to May 2023. Starting from a widely applied deterministic model, this study proposed a variation to take into account population characteristics and virus biodegradation in the sewer network. The model calculated virus loads and corresponding COVID-19 cases over time in different areas of the city and was validated with healthcare data while considering viral mutations, vaccinations, and testing variability. The correlation between the predicted and reported cases was high across the three waves that occurred in the considered period, demonstrating the model’s capacity to predict relevant fluctuations in the number of cases. Population characteristics did not substantially influence the predicted and reported infection rates. Conversely, biodegradation significantly reduced the virus load reaching the wastewater treatment plant, resulting in a 30% reduction in the total virus load produced in the study area. This approach can be applied for comparing virus load values across cities with varying population demographics and sewer network structures, enhancing the comparability of WBE data for effective surveillance and intervention strategies.

Deep Neural Network (DNN) inference demands substantial computing power, resulting in significant energy consumption. A large number of negative output activations in convolution layers are rendered zero due to the invocation of the ReLU activation function. This results in a substantial number of unnecessary computations that consume significant amounts of energy. This paper presents ECHO: Energy-efficient Computation Harnessing Onilne Arithmetic - A MSDF-based accelerator for DNN inference, designed for computation pruning, utilizing an unconventional arithmetic paradigm known as online/ most-significant digit first (MSDF) arithmetic which performs computations in a digit-serial manner. The MSDF digital serial computation of online arithmetic enables overlapped computation of successive operations leading to substantial performance improvements. The online arithmetic, coupled with a negative output detection scheme, facilitates early and precise recognition of negative outputs. This, in turn, allows for the timely termination of unnecessary computations, resulting in a reduction of energy consumption. The implemented design has been realized on the Xilinx Virtex-7 VU3P FPGA and subjected to a comprehensive evaluation through a rigorous comparative analysis involving widely used performance metrics. Experimental results demonstrate promising power and throughput improvements compared to contemporary methods. In particular, the proposed design achieved an average improvement in power consumption of up to 81%, 82.9%, and 40.6% for VGG-16, ResNet-18, and ResNet-50 workloads compared to the conventional bit-serial design, respectively. Furthermore, significant average speedups of 2.39×, 2.6×, and 2.42 were observed when comparing the proposed design to conventional bit-serial designs for VGG-16, ResNet-18, and ResNet-50 models respectively.

This research addresses a gap in the literature by conducting a comprehensive analysis of patients’ level of satisfaction with dental care. Methods: By combining quantitative and qualitative survey methods with the PSQ questionnaire this study aims to augment ongoing initiatives to enhance dental patients’ experiences by painting a more comprehensive depiction of patients' level of satisfaction; Results: When asked about their overall level of satisfaction 77,1% of the patients said they received excellent services from the office personnel and 72,2% said they trust their doctors; Conclusions: Assessing patient satisfaction in the realm of dental services quality is crucial for enhancing service quality and accuracy, benefiting both patients and dentists, and ultimately improving public health.

Quality of life (QoL) assessments are integral to cancer care, yet their effectiveness in providing essential information for supporting survivors varies. This study aimed to elucidate key indicators of QoL among colorectal cancer survivors from the perspective of healthcare professionals, and to evaluate existing QoL questionnaires in relation to these indicators. Two studies were conducted: a Delphi study to identify key QoL indicators and a scoping review of questionnaires suitable for colorectal cancer survivors. Fifty-four healthcare professionals participated in the Delphi study's first round, with 25 in the second. The study identified two primary QoL domains (Physical and Psychological) and 17 subdomains deemed most critical. Additionally, a review of 12 questionnaires revealed two instruments assessing the most important general domains. Findings underscored a misalignment between existing assessment tools and healthcare professionals' clinical priorities in working with colorectal cancer survivors. To enhance support for survivors' QoL, efforts are needed to develop instruments that better align with the demands of routine QoL assessment in clinical practice.

Dolichandrone spathacea is a rare and endangered semi-mangrove plant species with an extremely small population, naturally distributed only in Zhanjiang City and the east coast of Hainan Island, China. Regrettably, the present situation of the D. spathacea population in China has not yet been carefully investigated. In this study, we aim to evaluate the current resource status and population dynamic characteristics of D. spathacea on Hainan Island, China, in order to propose sustainable conservation and management strategies for future ecological restoration of its natural population. Our results show that D. spathacea on Hainan Island can be divided into four populations. All the D. spathacea populations present a state of overall dispersion, local concentration, and occasionally sporadic existence, and they exist in geographical isolation. The young, middle, and old D. spathacea plants account for 20.42%, 66.20%, and 13.38%, respectively, indicating that the overall age class of the D. spathacea population on Hainan Island belongs to a declining type. Furthermore, instead of temporal structure, we chose diameter at breast height (DBH) to establish a static life table, draw a population survival curve, and quantify the future development trend through population dynamic analysis and time-series prediction. These results directly point out that the D. spathacea population on Hainan Island is sensitive to external disturbances and possesses two main increases in mortality rate—namely, in its juvenile and mature stages—due to weak vitality, competition, and anthropogenic interferences, which are the most important reasons for its endangered status. Depending on the current conditions of the D. spathacea population, we should conserve and expand mature trees in situ, preserve their germplasm resources, rehabilitate their habitats to promote provenance restoration, and conduct artificial cultivation and spreading planting in order to realize the sustainable conservation and management of D. spathacea.

For a long time, a company's Product Development Process (PDP) was seen as supporting the operations department, although PDP decisions and mistakes have a considerable impact on market performance. This is critical even in agriculture where bad habits and practices in the PDP can lead rural producers to great losses. Therefore, this research investigated the effect on the market performance of rural products (banana) in the southern region of Brazil, based on two analyses: (i) how sustainability practices support the PDP phases and (ii) how the phases of the Product Life Cycle Assessment (LCA) mediate sustainability practices and PDP phases. This study presents a quantitative analysis using Confirmatory Factor Analysis (CFA) and hierarchical ordinary least squares (OLS) regression of data obtained from a survey of 110 rural producers who directly participate in the banana production and planning process in southern Brazil. Our results shows that sustainability practices support the PDP, and we confirm that the product development and post-development phase has an effect on market performance. In addition, we identified that in the pre-development phase of the PDP, dealing with rural products (bananas), the maturity stage of the LCA mediates sustainability. In the PDP development phase, we concluded that rural families that develop economic and environmental practices with their products in the market growth phase may have reduced results. As for the post-development phase of the PDP, we conclude that when companies invest in environmental and social practices, there is a complete mediation of the effect, where these practices lose strength if the product is in the introduction and maturity phases in the market. As originality, our study contributed to demonstrate value on the product life cycle for the product development process in agriculture using sustainability practices through a systemic approach, filling the gap in the literature due to the lack of research on these areas seen in an integrated way.

Based on our recent thermodynamic formulation of the Friedmann equation, we demon- strate how the age of the universe must be approximately 14.6 billion years. This is about 800 million years older than predicted by the Λ-CDM model and therefore greatly alleviates the early galaxy formation problem.

Here we will electrically-quantum model the neutron and proton as a three-phase alternating current electric generator, for this, we will use the theory of three-phase electric generators and vector or phasor diagrams. We will use this model to hypothesize how the quarks that form neutrons and protons with a combined mass of 10 MeV/c², can generate, through quarks-antiquarks-gluon interactions, a mass of 939.56 MeV/c² for the neutron and a mass of 938.27 MeV/c² for the proton. Using quantum mechanics and the theory of the generalization of the Boltzmann constant in curved space-time we will calculate the number of quarks-antiquarks-gluons and gravitons inside a neutron. We will also analyse βˉ decay using vector diagrams, we will calculate the tension of the string T₀ and the length of the string ℓs between quarks-antiquark and finally, we will model a black hole using a neutron equivalent model. In version 2 of this article, we will update the vector diagrams of the βˉ decay and theoretically calculate the energy of the W⁻ boson, the Z⁰ boson, and the Θ angle, Θ = arc cos (W⁻/Z⁰). We will demonstrate, through vector diagrams, that quarks-antiquarks-gluon interactions are the cause of the origin of the W⁻ boson and the Z⁰ boson. We will also demonstrate how the fine structure constant α originates. It is important to make clear, in future updates, we will describe the relationship that exists between the theory described in this paper and the Isospin theory, flavour and colour theory

Objective: The COVID-19 pandemic inferred on neuro-oncological patients (PTS) and the caregivers regarding tumor care and emotional functioning. This study aimed to understand how COVID-19 affects their psychological state and relations between PTS and health personnel in neuro-oncology. Methods: A cross-sectional study on neuro-oncological PTS and their caregivers. Results: A total of 162 PTS and 66 caregivers completed the questionnaire. The 37.5% of PTS perceived greater risk of contracting the COVID-19 compared to the general population. On the 0-10 scale, PTS tumor-related anxiety score was 5.8 and COVID-related 4.6. The caregivers reported 7.7 and 5.5 respectively. The QoL was described at least as good in 75% of both PTS and caregivers; the caregivers’ care burden increased in 22.7% during the pandemic, with no correlation with QoL. Future perception often changed both in PTS and in the caregivers. Cancer treatment schedule was changed in 18.5%, including for PTS decision. However, the 93.5% of PTS was satisfied with the overall care. Conclusion: A considerable proportion of PTS and caregivers still perceived the tumor disease as more burdensome than the pandemic, and perceived their future as more uncertain. Such data rinforce the need to build a proficient alliance between PTS and health personnel.

Lung cancer is one of the leading causes of cancer-related mortality globally. Pulmonary nodules are one of the risk factors and their discovery rate has been increasing. Based on the nodule size and growth rate, their malignancy propensity is determined; however, it is very challenging to distinguish between benign and cancerous nodules. Many tumour-associated antigens (TAA) have been studied as blood biomarkers for lung cancer, most commonly the Cytokeratin 19 fragment (CYFRA 21-1), squamous cell carcinoma antigen (SCC Ag), carbohydrate antigen (CA19-9) and carcinoembryonic antigen (CEA). Due to their low sensitivity, TAAs are not recommended as tools for the early detection of lung cancer. However, cancer testis antigens (CTAs) are highly specific for carcinomas but their expression is more commonly associated with advanced stages of cancer and poor prognosis. Despite the fact that TAAs may provide useful insights for the diagnosis and prognosis of early lung cancer, their potential to do so has yet to be demonstrated.

The assessment of concrete structures' durability in chlorine environments is significantly impacted by the uncertainty inherent in existing durability models. It introduce an integrated approach for updating these models, based on detection information of existing structures. This approach narrows the gap between theoretical predictions and observed structural durability. Specifically, we refine the probability model of critical chloride content by analyzing steel bar corrosion sample proportions, using Bayesian theory for greater accuracy. The enhanced model enables more reliable life expectancy prediction, forming a solid foundation for maintaining and strengthening existing structures.This method was demonstrated through a case study of a reinforced concrete industrial building with a service life of 12 years.

(1) Introduction: The COVID-19 pandemic presented unique challenges for patients and healthcare providers, especially for those working with obesity and related health problems. E-health has emerged as a crucial tool for the follow-up of users undergoing bariatric surgery during this period, allowing remote monitoring of users' health status and providing access to virtual consultation with health professionals. This study aims to analyze the impact of the use of telemedicine during the COVID-19 pandemic on the results of bariatric surgery and user satisfac-tion with this follow-up. (2) Method: Observational study with retrospective data collection. The variables were divided into several groups: health data, associated comorbidities, quality of life, quality of sleep and satisfaction with telemedicine monitoring. (3) Results: Surgery significantly affected weight loss, in general more than 75% loss of excess weight. Comorbidities, like the qual-ity of life, were reversed over time, with 50% of subjects maintaining excellent levels. Although most users were satisfied with the monitoring, the variables had no relationship. (4) Conclusions: The follow-up assured by telemedicine did not alter the results of bariatric surgery, which may allow us to infer that it may be an option to consider for regular monitoring of the post-bariatric surgery process.

Objective: To examine variations in end-of-life care for breast cancer, heart failure, and dementia patients. Data and methods: Data from four Norwegian health registries were linked using a personal identification number. Longitudinal trends over 365 days and the type of care on the final day of life were analyzed using descriptive techniques and logistic regression analysis. Results: Patients with dementia were most commonly placed in nursing homes, while patients with heart failure and breast cancer were more frequently hospitalized. Breast cancer and heart failure patients had a higher likelihood of dying at home. The presence of general practitioners increased the probability of home-based end-of-life care for cancer patients, while non-physician healthcare workers increased the likelihood of home-based care for the other patient groups. Conclusion: Diagnoses, individual characteristics, and service availability are all associated with the place of death in end-of-life care.

The catastrophic failure of two dams in Libya in the night of 10th and 11th September 2023, resulted in a significant amount of water and debris destroying a large part of the city of Derna, which is located downstream of the two dams. The flood caused more than 6000 fatalities and the dis-placement of thousands of people from the city. The dams failed due to heavy rainfall caused by the Medicane Daniel, resulting in intense precipitation and the dams overspilling after reaching full capacity. This paper analyses the consequences of the dam breach by modelling the flow discharge and the flooding of the city of Derna. The analysis compares the computed quantities with the findings of the post-event satellite image analysis from UNOSAT and Copernicus, the field reports, and information gathered from the social media through AI detection. The results allows to better understand the dynamics of the dam breach, its initial parameters and an assessment of the accu-racy of the results.

Introduction: Identifying the complexity of palliative care needs is a key aspect of referral to specialised multidisciplinary early palliative care (EPC) teams. The PALCOM scale is an instrument consisting of five multidimensional assessment domains, developed in 2018 and validated in 2023, to identify the level of complexity in patients with advanced cancer. Objectives: The main objective of this study was to determine the degree of instability (likelihood of level change or death), health resource consumption and survival of patients according to the level of palliative complexity assigned at the baseline visit during a 6-month follow-up. Method: An observational, prospective, multicentre study was conducted using pooled data from the development and validation cohort of the PALCOM scale. The main outcome variables were: a) instability ratio (IR), defined as the probability of level change or death; b) emergency department visits; c) days of hospitalisation; d) hospital death; e) survival. All variables were analysed monthly according to the level of complexity assigned at the baseline visit. Results: A total of 607 patients with advanced cancer were enrolled. According to the PALCOM scale, 20% of patients were classified as low complexity, 50% as medium and 30% as high complexity. The overall IR was 45% in the low complexity group, 68% in the medium complexity group and 78% in the high complexity group (p

Prenatal maternal feeding plays an important role in fetal development and has potential to cause long-lasting epigenetic modifications. MicroRNAs (miRNAs) are non-coding, single-stranded RNAs that serve as one epigenetic mechanism. Though miRNAs have crucial roles in fetal programming, growth, and development, there are limited data regarding maternal diet and sheep miRNA expression. Therefore, weanalyzed high and low maternal dietary protein for miRNA expression in sheep fetal longissimus dorsi. Pregnant ewes were fed an isoenergetic high-protein (HP, 160–270 g/day), low-protein (LP, 73–112 g/day), or standard protein diet (SP, 119–198 g/day) during pregnancy. miRNA expression profiles were evaluated using the Affymetrix GeneChip miRNA 4.0 Array. Twelve up-regulated, differentially expressed miRNAs (DE miRNAs) were identified targeting 65 genes. The oar-3957-5p miRNA was highly up-regulated in LP and SP compared to HP. Previous transcriptome analysis identified integrin and non-receptor protein tyrosine phosphatase genes targeted by miRNAs detected in the current experiment. A total of 28 GO terms and 10 pathway-based gene sets were significantly (padj &lt; 0.05) enriched in target genes. Most genes targeted by identified miRNAs are involved in immune and muscle disease pathways. Our study shows dietary protein intake during pregnancy affects fetal skeletal muscle epigenetics via miRNA expression.

Tack is one of the most important factors affecting the operability of prepregs, but it is still very difficult to obtain the change of prepreg tack with time at different temperatures. In this paper, a newly designed T-peel device is used to test the tack decay rate of prepregs at different temperatures. The obtained decay rate deviates less than 8.9% from the manufacturer's data. The maximum deviation of the ratio of tack decay speeds calculated by the Arrhenius equation from the experiments is not higher than -9.7%. It is proved that the present method can obtain the decay rate of tack of prepregs at different temperatures. This method is also applicable to the other two types of prepregs. The article proposes the handling life unit, an operational life measurement unit for prepregs, and establishes that the relationship between tack and remaining shelf life reduces prepreg management costs.

In this work, satellite data from the Clouds and Earth’s Radiant Energy System (CERES) and Moderate Resolution Imaging Spectroradiometer (MODIS) instruments is analyzed to determine how the global absorbed sunlight and global entropy generation rate have changed during the time period from 2002 to 2023. The data is used to test hypotheses derived from the Maximum Power Principle (MPP) and Maximum Entropy Production Principle (MEP) about the evolution of earth’s surface and atmosphere. The results indicate that the amount of absorbed sunlight has increased over the last 20 years but rising surface temperatures have caused the entropy generation rate to remain approximately constant despite that decrease in albedo. The results are simpler to explain using the MPP but do not completely rule out the MEP. Given the acceptance of the MPP or MEP, some extensions and nuances are discussed.

The relationship between perception of anxiety and quality of life in caregivers of children with autism was verified. To verify quality of life, the Short Form Healthy Survey Item was used; perception of anxiety was assessed using the Beck Anxiety Inventory. 80 caregivers of children with autism participated, with 68.7% of caregivers being mothers. Of the total number of caregivers, 68.8% had a severe level of anxiety. Regarding quality of life, they demonstrated greater impairment in Limitation due to physical aspects, Limitation due to emotional aspects, Vitality and Pain. Caregivers with severe anxiety levels had worse quality of life in the domains of pain (p = 0.012), social aspects (p =&lt; 0.001), limitation due to emotional aspects (p = 0.001) and mental health (p =&lt; 0.001). However, in the functional capacity domain, caregivers with a moderate level of anxiety had a better physical capacity score (p = 0.001). There was a negative correlation between the general anxiety score and the general physical (p = 0.029) and general emotional component of quality of life (p =&lt; 0.001). It was found that caregivers of children with ASD present losses related to psychological factors, quality of life and the lack of social support.

Exploiting the existing optical fiber network’s terrestrial infrastructure offers unexpected solutions to global challenges. We aim to expand the current network by incorporating a streaming telemetry system to integrate earthquake early detection. The purpose is to analyze and interpret alteration of light’s polarization induced by seismic events, particularly Primary earthquake waves that precede destructive Surface waves. This analysis facilitates the development of an early warning system and implementation of earthquakes countermeasures to mitigate humanitarian and economic impact. Consequently, we have developed a Python-based Waveplate Model designed to monitor light’s polarization changes within optical fibers buried underground. The model incorporates real ground displacement data from a 4.9 magnitude earthquake that struck in Marradi region, central Italy. We propose a novel approach of a smart sensing grid of optical network empowered by machine learning, trained on a large number of polarization evolution extracted from two distinct sensing fibers to identify the pattern of polarization change occurring during Marradi earthquake. Test Results demonstrate that this method can detect Primary waves within one second time-frame, achieving an accuracy rate of 99.5%. This system therefore affords nearby regions 52 seconds to take emergency response, and an extended margin of 62 seconds in more distant areas.

High seismic activity in the Himalayas and the increasing urbanization of its surrounding areas in the northern Indian region pose significant threats to both lives and properties. To mitigate the risk of seismic events, an earthquake early warning system can be used in the region. This system would be particularly beneficial to cities and towns in the mountainous and foothill regions that are located near earthquake sources. The government and the science and engineering community have re-sponded to this call by establishing the Uttarakhand State Earthquake Early Warning System (UEEWS). The system became fully operational on August 4, 2021, after being launched by the government of Uttarakhand. The UEEWS includes 170 accelerometers in the seismogenic part of the Uttarakhand region of the Himalayas. Ground motion data is transmitted to a central server through a dedicated private telecommunication network 24 hours a day, seven days a week.The system is designed to issue warnings for moderate to high-magnitude earthquakes via a mobile application installed on users' devices and sirens installed in government-owned public buildings. The UEEWS has successfully issued alerts for light earthquakes that occurred in the instrumented region and warnings for moderate earthquakes that occurred in the vicinity of the instrumented area. This paper provides an overview of the design of the UEEWS, details of the instrumentation, adaptation of attributes and their relation to earthquake parameters, the operational flow of the system, and information about the dissemination of warnings

The lexical analysis of seminal policy-to-diplomacy documents from the socio-environmental discourse of the last fifty year agendas allowed examining the evolution of five themes: resources/waste, pollution, social and economic development, justice, and health. Contextual affinities were strongest between resources, pollution, and health and are linked to societal trends and pressures. On those grounds, the central role of resource stewardship according to nature’s physical limits is highlighted, and dedicated concepts, analytical frameworks, and methodologies with different degrees of sustainability are analyzed. To reframe the identified social and economic problems, the work proposes criteria and choices that (1) allow to compare the dynamics of socioecological states across the planet, (2) help matching the pace of socioecological change by addressing path dependencies through participation and engagement of communities, and (3) enable stakeholders to make trade-offs and take decisions in specific social, economic, political, and cultural contexts. The prioritization of resource justice and responsibility becomes a societal project : from Wellfare State to commonfare communities.

Background: Features of post-traumatic stress disorder and anxiety may be present in Pulmonary Embolism (PE) patients along with impaired Quality of Life (QoL). We aim to evaluate health related QoL, anxiety and satisfaction with life, during the pandemic, in patients with a PE. Methods: Patients with PE were enrolled during their follow-up. All participants completed the Short Form 36 (SF-36) questionnaire, the State Trait Anxiety Inventory (STAI) X1 and X2 form, and the Satisfaction with Life Scale (SWLS). Results: 92 PE patients were included (mean age±SD=62.50±15.33 years, 56.5% males). Most of the mean values of the SF36 subscales were above the normative value except for “physical role functioning”) (45.92±42.41). “Emotional role functioning” (51.26±43.31) and “general health perceptions” (GH) (54.02±18.79) were slightly above the normative value of 50. Mean STAIX1 levels were 37.05±11.17 and mean STAIX2 levels were 39.80±10.47. Mean SWLS levels were 23.31±6.58. According to multiple linear regression analysis, mental healthscore (MH) and GH were predictive of SWLS(F (10,76) = 10.576, p

This is growing recognition of early onset gastrointestinal (GI) malignancies in young adults

Keywords: Biomass pyrolysis, Chemical Looping Combustion, Life Cycle Assessment, Environmental Impacts, Carbon Footprint.

Banana plantation is an important type of agro-ecosystem in the tropics, and it is important to carry out a quantitative assessment of the carbon footprint of the banana growing process for the development of low-carbon agriculture to cope with global warming. The carbon footprint of two banana cultivation processes was assessed using the life cycle assessment method through field trials and farmer surveys in Chengmai County, Hainan Province, China. The results showed that: (1) N2O emissions caused by the application of nitrogen fertilizers and compound nitrogen fertilizers were the largest source of carbon emissions from banana plantation farmland, and the production and transportation of common compound fertilizer were the second largest source of carbon emissions. Banana fruits and plants were the main contributors to carbon fixation in banana plantation ecosystems, with about 24.72 t CO2 eq hm-2 for Musa paradisiaca AA, and 34.66 t CO2 eq hm-2 for M. AAA Cavendish var. Brazil. (2) The annual carbon emissions of Musa paradisiaca AA and M. AAA Cavendish var. Brazil farmland systems were 35.40 t CO2 eq·hm-2 and 43.83 t CO2 eq·hm-2, respectively, and the annual carbon fixation was 38.23 CO2 eq·hm-2 and 48.17 CO2 eq·hm-2, respectively. The banana plantations had a negative carbon footprint per unit area, showing a net carbon sink function. (3) Banana is a plant with high carbon emission and strong carbon fixation capacity. Scientific management in the field can achieve the decrease of agricultural inputs, high quality and abundant agricultural products, and the reduction of carbon footprint of farmland.

In recent years, marine natural products have become one of the most important resources of novel lead compounds for critical diseases associated with age. Spirulina, a dietary supplement made from blue-green algae (cyanobacteria: scientific name Arthrospira platensis), is particularly rich in phycocyanin, a phycobiliprotein, which accounts for up to 20% of this cyanobacterium’s dry weight and is considered responsible for its anti-cancer, anti-inflammatory and antioxidant activities. Although the anti-aging activity of phycocyanin has been investigated, how exactly this compound works against aging remains elusive. Aim of our research is to use the yeast Saccharomyces cerevisiae as a model organism to investigate the anti-aging properties of phycocyanin from A. platensis. Our results show that phycocyanin has a powerful anti-aging effect, greatly extending the chronological life span of yeast cells in a dose-dependent way, being the effect pronounced also when cells were grown in SD medium under calorie restriction conditions (0.2% glucose). Both ROS and accumulation of dead cells were followed by staining chronologically aged cells with dihydrorhodamine 123 (DHR123) and propidium iodide (PI). Interestingly, we found that most of the aged phycocyanin treated cells, which were unable to form colonies, were actually ROS+/PI–. Finally, we show that the moment in which phycocyanin is added to the culture does not substantially influence its effectiveness in counteracting chronological aging.

In this follow-up study, we aimed to assess the effectiveness of the “I do not smoke, I exercise”, anti-smoking preventive health education program. The program was based on the Theory of Planned Behavior supplemented with life-skills teaching and targeted at high school students. The intervention comprised ten one-hour online sessions, administered by physical education instructors. The study cohort comprised 222 students (109 boys, 113 girls) from 11 secondary schools, with an average age of 16.42 ± 1.36 years. Data collection involved pre- and post-intervention self-assessment questionnaires. The examined variables included attitudes towards smoking, intention to smoke, subjective norm, perceived behavioral control (PBC), knowledge about smoking, smoking behavior, exercise behavior, attitudes toward the program's implementation, and satisfaction with the program. Separate paired samples t-test revealed a significant improvement in students' knowledge about smoking, perceived behavioral control, and overall program satisfaction following the intervention. However, no significant changes were observed in the remaining variables. These findings suggest that the health education smoking prevention intervention incorporates techniques and strategies that influence the Perceived Behavioral Control variable, emphasizing students' strong interest in educationally theorized programs integrating technology into their design. Future studies should consider further examination of tobacco control strategies within the high school context.

Background: Ankle fractures, comprising about 10% of musculoskeletal injuries, pose a significant healthcare burden with an increasing incidence, particularly among an aging population. This study focuses on isolated Danis-Weber type B fractures. Recent trends lean towards surgical intervention for anatomical restoration, quicker recovery, albeit with associated complications. This report aims to assess the safety and efficacy of NewClip narrow locking plate system with early weight bearing in treating isolated fibular fractures. Methods: The study includes patients with Danis-Weber type B fractures surgically treated with NewClip narrow locking plate system. Exclusions involved nondisplaced fractures, open fractures, or those requiring additional fixation.Results: Fifteen patients were enrolled in this study. Minor complications, including wound swelling, were observed in two cases. The Visual Analogue Scale (VAS) for pain exhibited a steady decline postoperatively, with almost complete resolution by the third month. At three months, the FAOS demonstrated excellent results, and final follow-up at twelve months revealed complete osseous healing without complications.Conclusions: The use of this type of plates in treating isolated fibular fractures with early weight bearing shows promising results in terms of fracture healing, pain resolution, and functional outcomes warranting further investigation with larger cohorts.

The question of whether the early visual cortex (EVC) is involved in visual mental imagery remains a topic of debate. In this paper, I propose that the inconsistency in findings can be explained by the unique challenges associated with investigating EVC activity during imagery. During perception, the EVC processes low-level features which means that activity is highly sensitive to variation in visual details. If the EVC has the same role during visual mental imagery, any change in the visual details of the mental image would lead to corresponding changes in EVC activity. Within this context, the question should not be whether EVC is ‘active’ during imagery but how its activity relates to specific imagery properties. Studies using methods that are sensitive to variation in low-level features reveal that imagery can recruit the EVC in similar ways as perception. However, not all mental images contain a high level of visual details. Therefore, I end by considering a more nuanced view which states that imagery can recruit the EVC, but that does not mean that it always does so.

Agriculture is an industry that heavily relies on the environment. The increasing frequency of ex-treme disasters attributable to climate change has adversely affected agricultural land and dis-rupted the stability of the supply of agricultural products. Therefore, we implemented a research program focused on current strategies for adapting to agricultural meteorological disasters. The primary goal was to actively promote disaster prevention information and techniques through information platforms and applications and to provide refined forecasting and an early warning system to enhance preparedness for and recovery from agricultural disasters. This initiative can transform passive mitigation into dynamic action by disseminating crucial information to farmers. We integrated meteorological data and crop characteristics to develop disaster prevention strate-gies for the predisaster, during-disaster, and postdisaster stages to empower farmers to implement autonomous disaster prevention, ensuring their profitability and minimizing the impact of disas-ters. This paper presents an agricultural disaster prevention system involving cross-disciplinary collaboration to establish an early warning system for crop disasters. However, the effectiveness of the early warning system relies on the availability of complete meteorological and crop infor-mation, necessitating high-density agricultural meteorological stations, refined weather forecast services, historical crop damage data, and ongoing research and development on disaster preven-tion technology. In the system, a diversified social media interface is used to provide local farmers with weather forecast information. When impending disasters are identified, the platform acti-vates disaster prevention measures to reduce agricultural losses. This article paper introduces Taiwan’s agricultural disaster prevention system as a complete disaster prevention strategy.

Until recently, no disease-specific health-related quality of life (HRQoL) instrument existed for pediatric traumatic brain injury (TBI). In this revalidation study, the psychometric properties and the validity of the final German version of the 35-item QOLIBRI-KID/ADO questionnaire were examined in 300 children and adolescents. It is the first self-reported TBI-specific instrument for measuring pediatric HRQoL in individuals aged 8–17 years. The six-factor model fits the data adequately. Internal consistencies were excellent for the total score and satisfactory to excellent for the scale scores. Intraclass correlations indicated good test-retest reliability. Construct validity was supported by overlaps between the QOLBRI-KID/ADO and the PedsQL, which measures generic HRQoL. Discriminant validity indicated that HRQoL was significantly lower in older children and girls, and in those with anxiety, depression, and post-concussion symptoms than in comparison groups, replicating the results of the questionnaire’s first development study. Our results suggest that the QOLIBRI-KID/ADO is a valid and reliable multidimensional instrument for assessing disease-specific HRQoL after pediatric TBI in clinical and research settings, which can additionally be used across the lifespan in combination with the adult version. This may help to improve care, treatment, daily functioning and HRQoL after TBI.

In the dynamic interplay between people and their physical environments, the Global South stands as a mosaic undergoing a multitude of transformative influences in architecture and urbanism where examining social sustainability becomes imperative. While prevailing attention remains on environmental and economic sustainability, this study addresses a persistent gap in the urban literature by focusing on the dynamic and manifold nature of social sustainability. Positioning itself within the context of sustainable development, the study links the pursuit of social aspects of sustainability with selected unique urban contexts from the Global South. Five cases that include Alexandria (Egypt), Tripoli (Libya), Basra (Iraq), Lilongwe (Malawi), and Accra (Ghana) are discussed through multi-layered investigations that involve attitude surveys, interviews, focus groups, participatory systematic observations, and behavioral mapping, engaging directly with inhabitants and stakeholders. Uncovering people-place narratives in the identified contexts, the cases are developed into five knowledge typologies that serve as practical tools for planning and design decision-making, policy formulation, and academic discourse. Discussions are conceived to demonstrate the transformative role people-place narratives play in fostering a more sustainable and equitable urban future. Conclusions are drawn to offer practical insights for stakeholders involved in various capacities in shaping the urban landscape of the Global South.

This study explores the pivotal biofilm life cycle, essential for comprehending intricate processes in biofilm formation and dispersal. With profound implications for medicine, environmental science, and industrial applications, the life cycle involves initial attachment, irreversible attachment, maturation, and dispersion. Employing bibliographic analysis, the paper unravels critical aspects, unveiling key keywords, prominent research countries/regions, and significant research organizations. This comprehensive approach provides insights into the current biofilm research landscape, identifying gaps for future exploration. Biofilm's influence extends to medical conditions, environmental ecosystems, and industrial challenges, accentuating the urgency of understanding its life cycle. The study also delves into global research distribution and influential organizations, guiding collaborative efforts. As a forward-looking initiative, it proposes future research opportunities, aiming to steer advancements and address challenges in biofilm science. Ultimately, this analysis contributes to the ongoing progress of biofilm research, fostering interdisciplinary collaboration and inspiring future initiatives.

Photovoltaic (PV) technologies are developing rapidly as a result of their ability to reduce energy consumption from conventional sources as well as the growth of global energy expenditures. Nevertheless, several impact categories during the PV panel life cycle occur and some principal sectors are affected. These impact categories are assessed by applying life cycle analysis (LCA) techniques through various software programs, databases and methods. Such analyses of energy technologies are crucial, as they can reveal the occurrence of hazardous emissions at distinct life cycle stages. In the present paper, a PV panel impact assessment through life cycle analysis is carried out. More precisely, a combination of PV technologies—monocrystalline, multicrystalline, copper indium gallium selenide (CIGS), amorphous, and ribbon—is studied. The impact categories of ozone depletion, human toxicity, particulate matter, ionising radiation, photochemical ozone formation, acidification, eutrophication, and ecotoxicity, as well as the sectors of human health, ecosystem quality, and environment, are assessed using the openLCA software, the ecoinvent database, the eco-indicator 99, IMPACT 2002+, ReCiPe, and TRACI methods.

Agriculture is an important sector of European Union in societal , economic and environmental dimensions. Sustainability of the sector require improvements in its key operations. Weeding is one of the crucial operation having impact on farms’ productivity, safety for farmers, food security and environmental state. To achieve EU policy goals of sustainable agriculture there are needed new technical and organizational solutions. One of the advanced techniques are laser based weeding technique. It is important to understand well the impacts of introduction of these tech-niques to the markets and agricultural practice in sustainability context. For that reason Social Life Cycle Assessment was performed. The method was based on participatory approach. The as-sessment was carried in three perspectives: general society, farmers, and business perspective re-lated to agriculture. Expert interviews based on questionnaires and workshops were realized to get the opinions on the impacts of a new laser technique on particular aspects of its implementation. The results show generally positive impact in all perspectives, especially in the perspective of farmers.

A proposed low-temperature forging method aims to enhance stainless steel bearings by creating a martensitic subsurface layer, significantly boosting bearing fatigue life due to increased surface hardness. This technique induces beneficial residual stresses, particularly in axial bearings, streamlining their construction and improving machine elements. Challenges persist, especially with radial bearings, but simplicity in axial bearing forging promotes compact, resource-efficient facility construction. Future research will focus on applying this technique to axial bearing washers, potentially replicating success in other bearing components. Despite the energy ex-penditure for cooling during forging, the substantial increase in bearing fatigue life offsets this, enhancing overall longevity and reliability of critical machine components. Integration of this forging technique into bearing fabrication appears seamless, offering a promising trade-off be-tween energy use and enhanced performance.

Synchronous electrical cardioversion is a relatively common procedure in the emergency department (ED), often performed for unstable supraventricular tachycardia (SVT) or unstable ventricular tachycardia (VT). However, it is also used for stable cases resistant to drug therapy, which carry a risk of deterioration. In addition to the inherent risks linked with procedural sedation, there is a possibility of malignant arrhythmias or bradycardia, which could potentially result in cardiac arrest following this procedure. Here, we present a case of complete heart block unresponsive to transcutaneous pacing and positive inotropic and chronotropic drugs for 90 minutes, resulting in multiple cardiac arrests. The repositioning of the transcutaneous cardio-stimulation electrodes, one of them placed in the left latero-sternal position and the other at the level of the apex, led to immediate stabilization of the patient. Extubation of the patient was performed the following day, while full recovery and discharge within 7 days, after insertion of a permanent pacemaker.

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

Addressing the pressing challenge of global warming, reducing greenhouse gas emissions in the transportation sector is a critical imperative. Battery and fuel-cell electric vehicles have emerged as promising solutions for curbing emissions in this sector. In this study, we conducted a comprehensive life cycle assessment (LCA) for typical passenger vehicles, heavy duty trucks and city buses using either proton-exchange membrane fuel cells or Li-ion batteries with different cell chemistries. To ensure accuracy, we supplemented existing studies with data from the literature, particularly for the recycling phase, as database limitations were encountered. Our results highlight that fuel cell and battery systems exhibit large emissions in the production phase. Recycling can significantly offset some of these emissions, but a comparison of the technologies examined revealed considerable differences. Overall, battery electric vehicles consistently outperform fuel cell electric vehicles regarding absolute greenhouse gas emissions. Hence, we recommend prioritizing battery electric over fuel cell vehicles. However, deploying fuel cell electric vehicles could become attractive in a hydrogen economy scenario where other factors, e. g. the conversion and storage of surplus renewable electricity via electrolysis, become important.

(1) Background: Sleep disordered breathing represent a growing public health concern, especially among children and adolescents. Full-night polysomnography is considered the gold standard for diagnosing obstructive sleep apnea. Our goals are to identify personal and environmental risk factors for the onset and persistence of sleep respiratory disorders. We also want to investigate the differences in neuropsychological profiles; (2) Methods: This is an observational, retrospective cohort study. We collected information on adenoidectomy or adenotonsillectomy. We reviewed the clinical history and preoperative visits and collected data through a telephone questionnaire. Pediatric Sleep Questionnaire (PSQ) and the Pediatric Quality of Life Inventory (PedsQL) are questionnaires used for screening sleep respiratory disorders in children. The data were statistically analyzed it using SPSS version 22.0 for Windows (SPSS Inc., Chicago, IL); (3) Results: The study involved 138 patients, but only 100 parents participated. A higher percentage of patients with sleep disordered breathing were observed to have mothers who smoked during pregnancy. A smaller proportion of patients with sleep disordered breathing had a habit of using a pacifier. A rise in physical results is associated with a reduction in the PSQ at follow-up (p=0.051). An increase of overall academic achievement is associated with an average decrease in the PSQ at follow-up (p&lt;0.0001). A more significant proportion of patients undergoing adenotonsillectomy were observed to have a history of prematurity and cesarean birth (4) Conclusions: These results provide essential information on the effectiveness and effects of adenotonsillectomy intervention compared to adenoidectomy intervention and the factors associated with SDB in children undergoing these interventions.

Assessment of health-related quality of life (HRQoL) after pediatric traumatic brain injury (TBI) has been limited in children and adolescents due to a lack of disease-specific instruments. To fill this gap, the Quality of Life after Traumatic Brain Injury for Children and Adolescents (QOLIBRI-KID/ADO) was developed for the German-speaking population. Reference values from a comparable general population are essential for comprehending the impact of TBI on health and well-being. This study examines the validity of the German QOLIBRI-KID/ADO in a general pediatric population in Germany and provides reference values for use in clinical practice. Overall, 1997 children and adolescents aged 8-17 years from the general population and 300 from the TBI population participated in the study. The questionnaire was tested for reliability and validity. A measurement invariance (MI) approach was used to assess the comparability of the HRQoL construct between both samples. Reference values were determined by percentile-based stratification according to factors that significantly influenced HRQoL in regression analyses. The QOLIBRI-KID/ADO demonstrated strong psychometric properties. The HRQoL construct was measured largely equivalently in both samples, and reference values could be provided. The QOLIBRI-KID/ADO was considered reliable and valid for assessing HRQoL in a general German-speaking pediatric population, allowing for clinically meaningful comparisons between general and TBI populations.

Hearing loss that arises from various causes at different stages of life has a direct impact on individuals' physical and mental well-being. This paper aimed to evaluate the employment, workplace adaptation, productivity, and professional success of individuals who have hearing loss and whose hearing loss is corrected with a cochlear implant. In this cross-sectional study, the data was collected between November 2022 and March 2023 with the participation of individuals with cochlear implants living in several settlements in all regions of Türkiye. A total of 142 participants with severe hearing loss who were corrected with a cochlear implant were included in this study. The survey method was used to collect data for the study. The questionnaire consisted of 32 questions and was distributed to the participants online. In the first part of the questionnaire (1-10 questions), general characteristics of implant patients were investigated. In the second part (11-32 questions), the positive or negative effects of implantation on the work life of the participants were evaluated. Almost half of the research group (49.3%, n = 70) consisted of women, and the mean age of the participants was determined to be 35.8 ± 14.8. There was no significant difference between gender, educational status, implanted side, working time, working style (physical, desk), and factors affecting work life (p > 0.05). Professional satisfaction and success at work increased significantly more in those with acquired hearing loss (p = 0.010). Post-implantation workplace compliance, success, and productivity were found to be higher in those with acquired hearing loss (p = 0.013). It was observed that hearing loss had a greater negative impact on the work life of married people (p = 0.006). Cochlear implantation greatly enhances workplace satisfaction, increases self-confidence, and has a positive impact on the future of profoundly deaf individuals.

Background:Caregiving for individuals with neurological disease involves providing physical, emotional, and social support, which can be a challenging and stressful experience. This study aims to compare the caregivers' burden, including the impact on mental and physical health, social support, and quality of life, in different neurodegenerative disorders. Methods:Fifty-five primary caregivers (F=41;mean age=53.07±12.29) of patients with Parkinson's Disease (PD=26), Multiple System Atrophy (MSA=16), and Amyotrophic Lateral Sclerosis (ALS=13), took part in the study. Standardized screening scales for the quality of life (EQ-5D/EQ-VAS and PQoL), levels of the caregiving burden (CBI and FSQ), and the assessment of the anxiety-depressive axis (HADS) were administered. Results: The mean CBI score was higher for caregivers of MSA patients (28.81±21.90) and ALS (25.15±16.23) than for caregivers of PD patients (16.08±10.34; p=0.036). Critical burden (cut-off>36) was present in the caregivers of MSA (31.3%), ALS (23.1%), and PD (19.2%) patients. Caregivers of patients with ALS had a worse perception of quality of life (EQ-5D total score) than caregivers of patients with MSA and PD (p

Background: Circulating rare cells participate in breast cancer evolution as systemic components of the disease and thus, are a source of theranostic information. Exploration of cancer-associated rare cells is in its infancy. We determined the validity of a rare-cell detection platform and demonstrated the usefulness of a certain rare cell subset as a novel approach to characterize the breast cancer system. Methods: Linearity of the Rarmax® platform was established using a spike-in approach. The platform includes red blood cell lysis, leukocyte depletion and high-resolution fluorescence image recording. Rare cell analysis was conducted on 28 samples (before and after surgery) from 14 patients with breast cancer, 20 healthy volunteers and 9 non-cancer control volunteers. In-depth identification of rare cells, including circulating tumor cells, endothelial-like cells, erythroblasts and inflammation-associated cells, was performed using a phenotype and morphology-based classification system. Results: The platform performed linearly over a range of 5-950 spiked cells, with an average recovery of 84.6%. Circulating epithelial and endothelial-like cell subsets have been demonstrated to be associated with or independent of cancer with tumor presence. Furthermore, certain cell patterns may be associated with treatment-related adverse effects. The sensitivity in detecting tumor-presence and cancer-associated abnormality before surgery was 50% and 85.7%, respectively and the specificity was 100% and 96.6%, respectively. Conclusion: The present study supports the idea of a cancer-associated rare cell abnormality to represent tumor entities as well as systemic cancer. The latter is independent of the apparent clinical cancer.

Advances in gastric cancer screening and endoscopic technology have made it possible to detect and treat gastric cancer at an early stage. As a result, about 40% of all gastric cancers have now been resected by endoscopic treatment in Japan. In endoscopic diagnosis, magnifying endoscopic observation using band-limited light such as narrow band imaging (NBI) has significantly improved the accuracy of gastric cancer diagnosis. At the same time, in endoscopic treatment, endoscopic submucosal dissection (ESD) has contributed to increase explosively the number of gastric cancers which could be resected endoscopically. In recent years, the construction of algorism for endoscopic diagnosis and treatment with a view to personalized medicine has been explored, and endoscopic use for gastric cancer managements is expected to develop further in the future. Keywords (5 words):

Reconstructing the Tree of Life remains a central goal in biology. Early methods, relying on small numbers of morphological or genetic characters, often yielded conflicting evolutionary histories, undermining confidence in the results. Investigations based on phylogenomics, which use hundreds to thousands of loci for phylogenetic inquiry, have provided a clearer picture of life's history, but certain branches remain problematic. To resolve difficult nodes on the Tree of Life, two recent studies tested the utility of synteny, the conserved collinearity of orthologous genetic loci in two or more organisms, for phylogenetics. Synteny exhibits compelling phylogenomic potential while also raising new challenges. We identify and discuss specific opportunities and challenges that bear on the value of synteny data and other rare genomic changes for phylogenomic studies. Synteny-based analyses of highly contiguous genome assemblies mark a new chapter in the phylogenomic era and the quest to reconstruct the Tree of Life.

The Glasgow Declaration called for scientifically based measurements of CO2 emissions in the tourism industry to achieve the goals of the Paris Agreement. Despite the economic and employment downturn caused by COVID-19, there are limited cases of environmental assessments related to tourism. This study estimates the carbon footprint of the tourism industry in major G20 countries before and after COVID-19. Understanding the characteristics of inbound tourism and domestic tourism is important as they impact different markets. GHG emissions from tourism mainly stem from transportation, but the type of travel and country differences also make souvenirs, accommodation, and food and beverages significant emission factors. The pandemic has greatly impacted the tourism industry. In 2020, GHG emissions from both domestic and inbound tourism significantly decreased, affecting the number of tourists. In some countries, measures against COVID-19 influenced these figures, and although signs of recovery were observed in 2021, the reduction rates varied by country. These emission reductions should be the goals pursued by the tourism industry in the post-COVID-19 era, requiring efforts to achieve sustainable tourism.

Background: Exercise is an accepted intervention to improve the quality of life (QoL) of breast cancer patients. Exercise programs have been developed and all have shown satisfactory results in improving QoL. There is a lack of research comparing different prescription modalities. The aim of this study is to evaluate the effectiveness of physical exercise (in-person, home-based, prescription) on QoL in breast cancer patients actively undergoing treatment; Methods Quasi-experimental study with randomized assignment to three groups (in-person: guided and supervised in-person exercise program; home-based exercise: guided and supervised exercise program with streaming monitoring; recommendation: exercise recommendation). Quality of life was measured using the QLQ-C30 questionnaire. Baseline and 24-week analysis. Results: The total sample analyzed was n=80. QoL improved significantly at 24 weeks in the face-to-face and home-based exercise groups, but not in the advice group. Exercise in all modalities improved fatigue, nausea, vomiting, appetite, and constipation. QoL at 24 weeks depended on active chemotherapy, tumor type, and assigned exercise group (r2 = 0.503; p &lt; 0.001). Conclusions: QoL in breast cancer patients undergoing active treatment improves after a 24-week exercise program, especially in face-to-face and home-based exercise. Home-based exercise, streaming-based recommendation is a viable option for exercise recommendation.

The aim of the study is to explore how sharing status updated and receiving Likes on Facebook, as a form of positive social feedback, correlates with current and perceived changes in Quality of Life (QoL) Sample consisted of 1577 adult Facebook users (76.3% females; 65.9% aged 18-24, 21.9% aged 25-30, 12.3% aged &gt; 30 years old). The study employed a longitudinal approach, collecting Facebook data from adult users over a 12-month period using the Graph API. Data were divided into 12 monthly segments. Two monthly indicators were calculated: the percentage of textual status updates and the average number of Likes per post. Current and perceived changes in Quality of Life (QoL) were administered as self-report measures. The findings indicated a positive correlation between the frequency of textual Facebook posts and the average received Likes. Furthermore, receivign more Likes was positively associated with a higher current QoL, and perceived improvements in QoL correlated with an increase in Likes over time. The study suggests that online positive social feedback, measured through Likes on Facebook, is associated with both current QoL and perceived improvements in QoL among adult Facebook users. This highlights the potential impact of online social interactions on individual well-being.

Qualtra, an innovative 10 MW geothermal power plant proposal, employs a closed-loop design to mitigate emissions, ensuring no direct release into the atmosphere. A thorough assessment utilizing energy and exergy analysis, Life Cycle Assessment (LCA), Exergo-economic and Exergo Environmental Analysis (EevA) was conducted. The LCA results, utilizing the ReCiPe 2016 midpoint methodology, encompass all the spectrum of environmental indicators provided. The technology implemented makes it possible to totally avoid direct atmospheric emissions from the Qualtra plant, so the environmental impact is mainly due to indirect emissions over the life cycle. The results obtained for the Global Warming Potential indicator is about 6.6 g CO2/kWh, notably lower compared to other conventional systems. Contribution analysis reveals that the construction phase dominates, accounting for over 90% of the impact in all LCA MidPoint categories. At the component level, a single score calculation incorporating normalization and weighting was executed. The resulting single score is then used into Exergo-Environmental Analysis (EEvA), highlighting the well system as the most impactful contributor, constituting approximately 45% of the total impact. Other substantial contributions to the environmental impact include the condenser (21%), the turbine (17%), and the HEGeo (14%). The Exergo-Economic analysis assesses cost distribution across major plant components, projecting an electricity cost of about 8.3 c€/kWh.

Suicide is an important public health problem, fundamentally affecting the younger population and responding to multiple biological, psychological, and social causes. The objective of this study was to characterize changes suicide mortality, suicide methods and years of potential life lost during 2005 and 2019 in Paraguay. This observational, descriptive study used data from the Vital Statistics Information Subsystem of the Ministry of Public Health and Social Welfare. The average mortality rate from suicide was 4.9 per 100,000 inhabitants, with an increase from 4.2 between 200-2009 to 5.8 during 2014 and 2019. Suicide was more common in men (75%) than in women. In men, the highest mortality rate was observed among the 20-24 years-old whereas in women the age most affected were the 15–19-year-old age group. The most used method for suicide was strangulation. The most frequent places of suicide occurrence were at home (73%). The seasonality of suicide occurrence showed a slight increase in the spring-summer months compared with autumn winter (53% vs 47%). The rate of potential years of life lost statistically significantly increased from2005 to 2019. Public health measures need to be implemented to investigate the underlying reasons and to implement interventions in the population to decrease suicide mortality in Paraguay.

Mirror Therapy (MT) and Cognitive Therapeutic Exercise (CTE) are two neurorehabilitation techniques based on neuroplasticity and designed to enhance the functionality of the upper limb. Therefore, the aim is to assess the effectiveness of the combination of CTE and MT with task-oriented training (TOT) on fine and gross motor skills of the affected hand, as well as the functionality of the affected upper limb, autonomy, independence, and quality of life (QoL) in patients with acute stroke. This longitudinal and multicenter study involved a sample of 120 participants selected randomly and consecutively. Three groups were formed, including a control group (CG) and two treatment groups, one with MT and the other with CTE. The functionality of the upper limb, fine and gross motor skills, the quantity and quality of use of the affected upper limb, autonomy, and QoL were evaluated using various scales validated in the Spanish population at the baseline, after 20 treatment sessions, and at three months of follow-up. ANCOVA analysis was conducted, revealing statistically significant differences between assessments in the CG compared to the experimental groups (GEs), indicating a notable improvement in overall functionality, fine and gross motor skills, autonomy, and QoL in the latter. However, there were no significant differences between the GEs. Therefore, the application of either of these experimental combinations is crucial for the motor recovery, functionality, and improvement of the quality of life of individuals who have suffered a stroke.

End-of-life electric vehicle (EV) batteries can be reused to reduce their environmental impact and economic costs. However, the growth of a second-life market is limited by the lack of information on the characteristics and performance of these batteries. As the volume of end-of-life EVs may exceed the amount of batteries needed for stationary applications, investigating the possibility of repurposing them in mobile applications is also necessary. This article presents an experimental test that can be used to collect the data necessary to fill a battery passport. The proposed procedure can facilitate the decision making process regarding the suitability of a battery for reuse at the end of its first life. Once the battery passport has been completed, the performance and characteristics of the battery are compared with the requirements of several mobile applications. Mobile charging stations and forklift trucks were identified as relevant applications for the reuse of high capacity prismatic cells. Finally, a definition of a state of health (SoH) is proposed to track the suitability of the battery during use in the second life application considering not only energy but also power and efficiency of the battery. This SoH shows that even taking into account accelerated ageing data, a repurposed battery can have an extended life of 11 years at 25~°C. It has also been shown that energy fade is the most limiting performance for lifetime and that cell-to-cell variation should be tracked as it has been shown to have a significant impact on battery life.

Neurodevelopmental disorders are characterized by an amalgam of genetic and epigenetic faults implicating neuronal protein-related loss-of-function and gain-of-function respectively, hence their inclusion into the category of complex diseases. Neurodevelopmental disorders are regarded as autism spectrum disorder due to this reason; that the risk factors and phenotype constitute a spectrum of faults and protein overactivity. One example of an epigenetic factor leading to the onset of neurodevelopmental delays constitutes a set of immune response-based dysregulations, as well as the excessive growth of the adaptive immune memory of the fetus or the baby following significant infectious disease during pregnancy, as well as in babies aged 0-2, given the existence of profound links between developmental immunity and developmental neurology. Given that genetic information very likely represents a form of energy, the intake of excessive pathogen-related information may transiently overload the adaptive immune memory similarly to the manner functional pathogens do whilst inducing significant illness, and if events as such occur during important stages of neuro-immunological development, then there could often be irreversible effects upon the rate of development in neurological networks that normally have a major importance in the modulation of the related cognitive and behavioral phenotype. The full extent of evidence may only be obtained via a thorough study of the applications of physical laws into biology and medicine, given the foundational role of the physical matter in the development and maintenance of life. A common misconception is that neurodevelopmental delays are characterized solely by an accumulation of protein loss-of-function incidences in the central nervous system area, rather than a disruption of neuronal region developmental rates. For example, an overexpression of neuronal proteins related to cognition factors that is accompanied by an underexpression of proteins related to social behavior is phenotypically manifested in people with sharper rational thinking and poorer communication skills, with an impact on the abilities of decision-making as well, and this tends to be regarded as a classical example of the clinical manifestation of neurodevelopmental delays. More severe forms of autism spectrum disorder tend to implicate a more generalistic impact upon the developmental rates of key human behaviors, including those related with the development and maintenance of social and intimate relationships. Likewise, more severe implications upon regular developmental rates tend to bring a major impact upon the healthy function of related functions. As a result, lower functioning forms of neurodevelopmental delays bring fresh concerns with regards to a possible uncanny increase of incidences of deviated sexuality during years of adulthood, and in the worst cases, such deviations may lead to the planning and development of criminal activity, particularly in individuals who are or become prone to breaking the moral code that established the civilized society. What holds the concerns valid is the exponential increase in the number of lower functioning autism cases throughout the world and the major signs that such an increase will continue with a full force. One major solution to this potential future problem would be a much higher investment into awareness of the exact genetic and environmental factors that directly or indirectly result in the onset of lower-functioning autism and of the current research efforts to develop the matching support for people found in situations as such. The most important aim of future research with regards to such a scenario would be a separation of disease and disability with choices made to step into more severe forms of disease and into areas that are outside of the established moral circle.

Direct assessments of executive function (EF) are increasingly used in research and clinical settings, with a central assumption that they assess “universal” underlying skills. Their use is spreading globally, raising questions about the cultural appropriateness of assessments devised in Western, industrialized countries. We reviewed multidisciplinary evidence and theory to identify sets of cultural preferences that may be at odds with the implicit assumptions of EF assessments. These preferences relate to motivation and compliance; cultural expectations for interpersonal engagement; contextualized vs. academic thinking; cultural notions of speed and time; the willingness to be silly, be incorrect, or do the opposite; and subject-matter familiarity. In each case, we discuss how the cultural preference may be incompatible with the assumptions of assessments, and how future research and practice can address the issue. Many of the cultural preferences discussed differ between interdependent and independent cultures and between schooled and unschooled populations. Adapting testing protocols to these cultural preferences in different contexts will be important for expanding our scientific understanding of EF from the narrow slice of the human population that has participated in the research to date.

Homochirality is an obvious feature of life on Earth. On the other hand, extraterrestrial samples contain largely racemic compounds. The same is true for any common organic synthesis. Therefore, it has been a perplexing puzzle for decades how these racemates could have formed enantiomerically enriched fractions as a basis for the origin of homochiral life forms. Numerous hypotheses have been put forward as to how preferentially homochiral molecules could have formed and accumulated on Earth. In this article, it is shown that homochirality of the abiotic organic pool at the time of formation of the first self-replicating molecules is not necessary and not even probable. It is proposed to abandon the notion of a molecular ensemble and to focus on the level of individual molecules. Although the formation of the first self-replicating, most likely homochiral molecule is a seemingly improbable event, on a closer look, it is almost inevitable that homochiral molecules have formed simply on a statistical basis. In this case, the non-selective leap to homochirality would be one of the first steps in chemical evolution directly out of a racemic “ocean”. Moreover, most studies focus on the chirality of the primordial monomers with respect to an asymmetric carbon atom. However, any polymer with a minimal size that allows folding to a secondary structure, would spontaneously lead to asymmetric higher structures (conformations). Most of the functions of these polymers would be influenced by this inherently asymmetric folding. To summarize, simple and universal mechanisms may have led to homochiral self-replicating systems in the context of chemical evolution. A homochiral monomer pool is deemed unnecessary and probably never existed on primordial Earth.

The creation of protonated water nanoclusters from amorphous water-ice under laboratory conditions suggests the possible ejection of such nanoclusters from ubiquitous amorphous water-ice-covered cosmic dust to interstellar space. The quantum properties of these quintessential water entities introduce a tantalizing prospect that bridges the origins of dark matter, dark energy, and life in the universe. The quantum-entangled diffuse Rydberg electronic states inherent to cosmic water nanoclusters make them plausible candidates for baryonic dark matter. Moreover, they exhibit the capacity to absorb, through the microscopic dynamical Casimir effect, virtual photons originating from zero-point-energy vacuum fluctuations occurring above the water-nanocluster vibrational frequency cutoff. This selective interaction leaves only vacuum fluctuations below these frequencies with gravitational significance, cancelling the vacuum-energy catastrophe and yielding a shared genesis for dark matter and dark energy. Moreover, this theory extends its implications to the origins of life itself, proposing that RNA protocells on Earth and habitable exoplanets may have emerged from the interactions between cosmic water nanoclusters and prebiotic organic molecules, thus yielding an anthropic narrative. Collectively, these findings coalesce into a cosmological framework depicting a cyclic universe, with cosmic water nanoclusters constituting a quintessence scalar field, instead of adhering to the multiverse concept based on cosmic inflation theory. Recent observations of CMB birefringence support this quintessence.

Early-onset colorectal cancer (EOCRC) is defined as a diagnosis of colorectal cancer (CRC) in individuals younger than 50 years of age. While overall CRC rates in the United States (US) decreased between 2001 and 2018, EOCRC rates have increased. This research project aims to evaluate the feasibility and acceptability of Time-Restricted Eating (TRE), Mindfulness, or TRE combined with Mindfulness among young to middle-aged adults at risk of EOCRC. Forty-eight participants will be randomly assigned to one of four groups: TRE, Mindfulness, TRE &amp; Mindfulness, or Control. Data on feasibility, adherence, and acceptability will be collected. Measures assessed at baseline and post-intervention will include body weight, body composition, dietary intake, physical activity, sleep behavior, circulating biomarkers, hair cortisol, and gut microbiome. Effects of the intervention on the following will be examined: 1) acceptability and feasibility; 2) body weight, body composition, and adherence to TRE; 3) circulating metabolic, inflammation, and oxidative stress biomarkers; 4) intestinal inflammation; and 5) the gut microbiome. TRE combined with Mindfulness holds promise for stress reduction and weight management among individuals at risk of EOCRC. The results of this pilot study will inform the design and development of larger trials aimed at preventing risk factors associated with EOCRC.

With the proliferation of electric vehicles (EVs) and the consequential increase in EV battery circulation, the need for accurate assessment of battery health and remaining useful life (RUL) is paramount, driven by environmentally friendly and sustainability goals. This study addresses this pressing concern by employing data-driven methods, specifically harnessing deep learning techniques to enhance RUL estimation for lithium-ion batteries (LIB). Leveraging the Toyota Research Institute Dataset, consisting of 124 lithium-ion batteries cycled to failure and encompassing key metrics such as capacity, temperature, resistance, and discharge time, our analysis substantially improves RUL prediction accuracy. Notably, the Convolutional-LSTM-Deep Neural Network (CLDNN) model and the Transformer-LSTM (Temporal-Transformer) model have emerged as standout Remaining Useful Life (RUL) predictors. The CLDNN model, in particular, achieved a remarkable Mean Absolute Error (MAE) of 84.012 and a Mean Absolute Percentage Error (MAPE) of 25.676. Similarly, the Temporal-Transformer model exhibited notable performance with an MAE of 85.134 and a MAPE of 28.7932. These impressive results were achieved through the application of Bayesian hyperparameter optimization, further enhancing the accuracy of predictive methods. These models were benchmarked against existing approaches, demonstrating superior results with an improvement in MAPE ranging from 4.01% to 7.12%.

The global focus on geopolymer binder production has increased due to the adoption of waste materials and industrial byproducts. Given the gradual decline of the availability of fly ash and ground granular blast furnace slag (GGBFS) resulting from the decarbonization process in electricity and steel productions, waste clay brick powder (WCBP), could be a viable substitute of these pozzolanic by-products. This research is dedicated to thoroughly investigate the techno-eco-efficiency performance of WCBP when utilized as a geopolymer precursor. The favorable mechanical characteristics exhibited by fly ash-GGBFS-WCBP-based geopolymer binder emphasize the importance of assessing its sustainability alongside its technical viability. The study employed life cycle analysis (LCA), following ISO 14040-44 standards, and using the Simapro software, to evaluate the environmental implications of the use of WCBP-based geopolymer mixtures. Human toxicity emerged as the primary impact. Moreover, the analysis of life cycle costs highlighted key financial factors, with around 65-70% attributed to alkaline activators of the total cost. The production of alkaline activators was identified as a critical point for both environmental impact and economic considerations due to energy consumption. While WCBP-rich samples exhibit a 1.7-0.7% higher environmental impact compared to the control mix (CM), their high mechanical strength and cost-effectiveness make them technologically and economically efficient geopolymer mixes. In conclusion, the portfolio analysis for techno-eco-efficiency affirms that mixes containing 40%, 30%, and 20% WCBP are more efficient than those using 10% and 0% WCBP, respectively.

1) Background: Patients with neurological disorders are particularly at risk of falling and requiret functional rehabilitation. HUBER® is a motorised rotating platform that allows simultaneous work on balance, stability and strength with continuous adaptation and immediate feedback. This study aimed to measure the impact of rehabilitation with the HUBER® on the physical performance and quality of life of patients with neurological diseases requiring functional rehabilitation. 2) Methods: 32 subjects were enrolled in CHU Liège CNRF and randomly divided into 2 groups. The first group received classical rehabilitation combined with two training sessions per week on the HUBER® for 8 weeks. The second group received their usual treatment. This randomized control trial has been registered on clinicaltrials.gov under the number NCT04687293. Physical performance and quality of life were evaluated at different time. 3) Results: There was no significant difference between the 2 groups after enrolment. In terms of physical performance, an improvement in SPPB chair stand test (p=0.021) and total SPPB (p=0.003) was observed in the HUBER® group. In terms of quality of life, a higher improvement was observed overall in the HUBER® group (p&lt;0.05 between groups). 4) Conclusion: The HUBER® showed promising results in functional rehabilitation of patients with neurological pathologies, as a complement to classical rehabilitation management by physiotherapy.

Keywords: early childhood; education; quality; measurement; monitoring; majority world; Item Response Theory; psychometrics

Different severe energy crises episodes occurred in the world in the last five decades. Energy crises lead to deterioration of international relations, economic crises, changes in monetary systems and social problems in countries. This paper aims to show the essential determinants of energy crises by developing a binary logit model which estimates the predictive ability of thirteen indicators in a sample that covers the period from January 1973 to December 2022. The empirical results show that the energy crises are mainly due to energy supply-demand imbalances (petroleum stocks, fossil energy production-consumption imbalance and changes in energy imports by country groups), energy investments (oil and natural gas drilling activities), economic and financial disruptions (inflation, dollar index, index of global real economic activity) and geopolitical risks. Additionally, the model is capable of accurately predicting the world energy crisis event months with 99% probability.

The Standard Model (SM) of particle physics successfully describes electromagnetic, weak, and strong forces but omits gravity. We introduce the Kinematrix Field Theory (KFT), integrating gravity into this fundamental force framework through a novel particle, the kinematon. This gauge boson, existing in both massless and massive forms, advances the SM's scope to address enigmas like dark matter and neutrino masses. We detail the mathematical structure of the KFT and establish Feynman rules for kinematon interactions with fermions and gauge bosons. The KFT, synergizing with the Higgs mechanism and general relativity, aspires to a unified quantum theory of gravity. We explore the kinematon's phenomenological implications and potential experimental signatures, forecasting significant advancements in fundamental physics and setting a course for future explorations in the SM.

The treatment of cancer and associated healthcare procedures often impose a detrimental effect on patients’ quality of life. Symptoms stemming from treatment often hinder patients’ social interactions, emphasizing the crucial role of social support in preserving quality of life and alleviating stress. Moreover, patient resilience serves as a valuable asset in mitigating stress levels and upholding an optimal quality of life amidst the challenges posed by the illness. This study aims to explore the correlation between diverse sources and forms of social support, resilience, and their impact on the quality of life and stress levels among patients undergoing cancer immunotherapy. This study involved thirty patients undergoing immunotherapy at Costa del Sol Hospital in Marbella. Resilience correlated with improved cognitive functioning and diminished symptoms. Informational support from healthcare providers and emotional support from friends were linked to symptom alleviation, such as reduced appetite and insomnia. Moreover, emotional support from friends emerged as a predictor for decreased perceived stress. Interventions targeting the improvement of quality of life and reduction of stress among cancer patients should prioritize assessing support needs and involving the patient's social network, especially during the treatment phase.

Over recent years, the swine industry has witnessed the withdrawal of antibiotics and continuous regulation of zinc and copper oxides in the early-life nutrition of piglets. Due to this development, alternative ingredients or additives from plant sources have been tremendously explored. Therefore, this study's objective was to evaluate the effect of dietary supplementation with tannins on weaned piglets’ growth performance, serum antioxidant capacity, and immune status using a meta-analysis approach. With only the inclusion of non-challenged weaned piglets, a total of 16 studies with parameters of interest were deemed eligible after a two-step screening process following a comprehensive literature search in the scientific databases of Web of Science, Scopus, ScienceDirect, PubMed, and Google Scholar. Two main categories of data, including the study’s characteristics and response variables (growth performance, serum antioxidant, and immune indices), were extracted. Applying the random-effects models, Hedges’ g effect size of supplementation with tannins was calculated using the R software to determine the standardized mean difference (SMD) at a 95% confidence interval. Sub-group analysis and meta-regression further explored heterogeneity (PSMD 0.05, I2 50%, n ≥10). Supplementation with tannin reduced average daily gain (p = 0.20) and feed conversion ratio (p 0.01); however, it increased average daily feed intake (p = 0.07) and final body weight (p 0.01). Meta-regression models indicated that tannin dosage and supplementation duration were directly associated with tannins' effectiveness on productive performance. In the serum, the concentration of glutathione peroxidase, superoxide dismutase, and total antioxidant capacity were elevated (p 0.01) in response to tannins supplementation, while malondialdehydes was reduced (p 0.01). Likewise, decreased immunoglobin A (p = 0.47) and increased immunoglobin M and G levels (p 0.01) were detected. In conclusion, dietary supplementation with tannins, particularly with chestnut and grape seed proanthocyanidins, increases the productivity of weaned piglets. At the same time, it is a possible nutritional strategy to mitigate oxidative stress and stimulate gut health. Thus, supplementing chestnut and grape seed proanthocyanidin tannins in the early phase of swine production could be used to alleviate the incidence of diarrhea.

Emotional intelligence can contribute to quality of life and as a health predictor. The aim of this study is to analyze emotional intelligence, quality of life and the correlation factors associated in patients undergoing chronic hemodialysis. A quantitative, observational, cross-sectional design was performed, and one hundred and thirty-eight multi-centers hemodialysis patients were recruited. A battery of questionnaires, including Trait Meta-Mood Scale (TMMS-24), Kidney Disease Quality of Life-Short Form (KDQOL-SF), and an ad-hoc sociodemographic questionnaire, were answered. Sex differences existed when assessing the three dimensions of emotional intelligence: ranked by order, the highest scores in males were in clarity, repair, and attention. However, in females were in repair, clarity, and attention. Males had higher scores than females in emotional role (p=0.045). Younger participants had better scores in all physical functions (p=0.001) and vitality (p=0.038) than older. Moreover, those who had a higher level of education presented better physical function (p=0.027) and higher scores in emotional wellbeing (p=0.036). Finally, in females, emotional attention (p=0.046) and repair (p<0.001) were strongly associated with general health perception. The assessment of emotional intelligence considering sex differences in patients undergoing chronic hemodialysis can be an indicator of quality of life including the use in health interventions.

Interior permanent magnet motors (IPMSMs) are extensively used as traction motors today because of their exceptional torque and power density, and wide constant power operating range. Under real-world usage, an IPMSM rotor undergoes varying electromagnetic, thermal, and mechanical loads. Under such conditions, fatigue life-based design criteria should be utilized over stress-based design criteria to ensure the structural integrity of the rotor. Moreover, the driving dynamics can change the rotor temperature continuously, which affects the electromagnetic, mechanical, and fatigue properties of rotor material. This paper proposes a robust thermo-mechanical rotor fatigue simulation workflow considering the significant loads acting on an IPMSM rotor and the temperature variation throughout a drive cycle. It discusses an accelerated fatigue life estimation approach based on peak valley extraction to reduce the simulation time significantly for stress and fatigue analysis. Then, it presents a method for stress-life curve generation for a variable loading. It also presents a sensitivity study with a median S-N curve, and a 90%-reliability 95%-confidence (R90C95) S-N curve.

Background: Neonatal sepsis associated with severe morbidity and mortality defines the systemic condition arising from the bacterial, viral, fungal origin associated with hemodynamic and clinical alterations. Symptomatology can be different, from subclinical to severe, focal or systemic disease. The causal agent comes from maternal flora or can be of community/hospital origin. Material and method: Our retrospective study evaluated 121 newborns (both preterm and term), divided into three groups: early onset sepsis (35), late onset sepsis (39), and control group (47), from 0 to 28 days old. Blood samples and cultures were collected at admission, after 24 hours, and 72 hours. Results: The two-sample Wilcoxon signed rank test revealed a statistically significant difference between the initial and final measures of lactate dehydrogenase (LDH) and ferritin within the early onset sepsis (EOS) and late onset sepsis (LOS) groups. No significant differences were observed for those two variables within the control group. There were significant differences for first and last measurements of C-Reactive Protein (CRP) (p = 0.029), leukocyte count (p = 0.002), and platelets (TR) (p = 0.00001). Conclusions: Ferritin is a potential biomarker that can be associated with systemic response and sepsis in both cases of early and late onset sepsis.

The modern age offers many challenges in terms of health related physical condition, such as new technologies, fast and stressful lifestyle, unhealthy diets, alarming statistics on physical activity, etc. Additionally, the COVID-19 pandemic accentuated the existing problems, being necessary to answer the following questions: what is the fitness level of the population? and how important are physical exercises in human life? The purpose of this paper is to monitor the fitness level of a group of students, with the help of a new fitness test system, providing individualized feedback, guidance, or motivation to the subjects. Thus, we applied the new EFB system (European Fitness Badge), that evaluates certain components of physical condition in relation to health (endurance, strength, coordination, flexibility), on a group of 180 students, 78 male (43.3%) and 102 female (56.7%), with the average age m = 23.59 ± 7.38 years, from different specializations within the U.A.V. Arad. The subjects were divided into two groups: beginners - TP1 (N-93) and advanced - TP2 (N-87). The results showed significant differences in most components of overall fitness depending on the test profile (basic or advanced), demografic factors (sex and age), and student’s major (sport, economics, psychology, etc.), a stronger association between ABSI and overall fitness than BMI, and that test profile acts as mediator between demografic factors (sex and age) and fitness abilities. In conclusion this study evidenced tendencies toward differences between the groups of subjects based on the test profile. Also the advanced profile participant scores were higher than those of the basic profile participants. The results reflect as well a lower BMI and ABSI indexes for the advanced profile participants.

This research investigates the impact of social media monitoring on Online Reputation Management (ORM) within Zimbabwe’s life assurance industry. Employing a mixed-methods approach, data was collected through questionnaires from 464 participants, yielding a response rate of 92.8%. Ethical considerations were meticulously addressed, with informed consent and confidentiality safeguards. Data analysis involved organizational and statistical techniques, including Structural Equation Modeling (SEM) for theoretical exploration. Descriptive statistics unveiled demographic insights and patterns in social media platform usage. Internal consistency assessments, Exploratory Factor Analysis (EFA), and Principal Component Analysis (PCA) informed the refinement of research instruments. The SEM analysis established significant relationships and moderation effects, providing empirical support for several hypotheses. Findings indicate that employees’ attitudes toward social media monitoring positively influence ORM, while perceived behavioural control exhibits a non-significant impact. Intriguingly, management commitment, though positively related to ORM, moderates the relationship with a negative effect. The study contributes to the understanding of ORM determinants, emphasizing the need for nuanced strategies considering both individual and organizational factors. The recommendations underscore the importance of management commitment and employee training for effective social media utilization. Future research avenues include exploring training interventions, delving into the dynamics of perceived behavioural control, and investigating emerging social media platforms’ impact on ORM.

The present study focuses on the investigation of fatigue, social support and quality of life that characterizes social workers. Furthermore, the study aims to highlight the effect of demographic and occupational characteristics on the above factors. A total of 400 social workers with an average age of 39.05 years took part in the research. Most were women, single, residents of cities of more than 100,000, and health care workers. Participants were asked to answer online questionnaires (FAS for fatigue, MSPSS for social support and GHQ-28 for quality of life). From the analysis of the data, it was found that the level of fatigue of the social workers is at low levels. At the same time, the level of occurrence of negative symptoms is also low, with physical symptoms appearing more often than the rest. Participants receive a high level of support from their environment, and more so from the "significant other" in their life. Finally, it was found that the fatigue, social support and quality of life of social workers is affected by the age of the social workers, the total years of service, gender, marital status, place of residence, employer and position of responsibility.

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