Lung cancer remains the leading cause of cancer-related death worldwide. The involvement of lymph nodes by the tumor has a strong impact on survival of patients. For this reason, lymphadenectomy plays a crucial role in the staging and prognosis of NSCLC, to define the most appropriate therapeutic strategies concerning the stage of the disease. To date, the benefit, in terms of survival, of the different extents of lymphadenectomy remains controversial in the scientific community. It is recognized that metastatic involvement of mediastinal lymph nodes in lung cancer is one of the most significant prognostic factors, in terms of survival, and it is therefore mandatory to identify patients with lymph node metastases who may benefit from adjuvant therapies, to prevent distant disease and local recurrences. The purpose of this review is to evaluate, the role of lymphadenectomy in early-stage NSCLC in terms of efficacy and accuracy, comparing systematic, sampling and lobe-specific lymph node dissection and analyzing the existing critical issue, through a search of the most relevant articles published in the last decades.

Definitive surgical resection is the preferred treatment for early-stage non-small-cell lung cancer (NSCLC). Research into genetic alterations, including epidermal growth factor receptor (EGFR) mutation, in early stage NSCLC remains insufficient. Here, we investigated the prevalence of genetic alterations in early-stage NSCLC and the association between EGFR mutation and recurrence after complete resection. Between January 2019 and December 2021, 659 patients with NSCLC who underwent curative surgical resection at a single regional cancer center were recruited. We compared the clinical and pathological data between the recurrence and non-recurrence groups. Multivariate logistic regression was used to predict the risk factors for recurrence. Among the 659 enrolled cases, the most common histology was adenocarcinoma (74.5%), followed by squamous cell carcinoma (21.7%). The prevalence of EGFR mutation was 43% (194/451). Among them, L858R point mutation and exon 19 deletion was 52.3% and 42%, respectively. ALK rearrangement was found at 5.7% (26/453), and ROS1 fusion was found at 1.6% (7/441). The recurrence rate of the entire population was 19.7%. In multivariate analysis, the presence of EGFR mutation, stage II or III (vs. stage I), and pathologic subtype (presence of solid type) were associated with recurrence. Among the recurred group, 86.5% of the patients with EGFR mutation experienced distant recurrence compared to only 66.7% of wild-type (p = 0.016), with no significant difference in median disease-free survival (p = 0.983). In conclusion, the prevalence of EGFR mutation, ALK rearrangement, and ROS1 fusion was 43.0%, 5.7%, and 1.6%, respectively in patients with early-stage NSCLC who underwent curative resection. Along with stage II/III and solid pathologic subtype, EGFR mutation was an independent risk factor for recurrence. In the recurrence group, the rate of distant metastasis was higher in patients with EGFR mutation than in those with wild-type.

Background: Early-stage interventions in a potential pandemic are important tounderstand as they can make the difference between runaway exponential growththat is hard to turn back and stopping the spread before it gets that far. COVID-19 is an interesting case study because there have been very different outcomesin different localities. These variations are best studied after the fact if precisionis the goal; while a pandemic is still unfolding less precise analysis is of value inattempting to guide localities in the early stages to learn lessons of those that pre-ceded them. Methods: I examine three factors that could differentiate strategy: asymptomaticspread, differences in use of the Bacillus Calmette-Guerin (BCG) tuberculosis vac-cine and cloth face masks.Results:Differences in disease progression as well as the possibility of alternativestrategies to prevent COVID-19 from entering the runaway phase or damping itdown later can be elucidated by a study of asymptomatic infection. A study todemonstrate not only what fraction are asymptomatic but how contagious they arewill also inform policy on universal mask wearing. Conclusions: While a COVID-19 outbreak is at a level that makes accurate trace-and test possible, investigation of asymptomatic transmission is viable and shouldbe attempted to enhance understanding of spread and variability in the disease aswell as policy options for slowing the spread.

(1) Background: Endoscopic submucosal dissection (ESD) has been widely accepted as the standard method for treating early-stage cancer or precancerous lesions in the upper gastrointestinal tract, however it may be difficult in patients with liver cirrhosis due to coagulation dysfunction or presence of gastroesophageal varices. We aimed to demonstrate the safety and efficacy of ESD in these population. (2) Methods: We retrospectively collected the clinical data and analyzed. Patients inclusion criteria: 1) patients with liver cirrhosis; 2) patients who underwent ESD; 3) patients diagnosed of early-stage cancer or precancerous lesions in the upper gastrointestinal tract. (3) Results: Eight patients were enrolled from April 2019 to April 2023, of whom 3 were male and 5 female, with age ranging from 43 to 70 years old. Seven lesions were located in the stomach, and the other one lesion in the esophagus. ESD was performed successfully in all patients, and the resected lesion size ranged from 2 to 6 cm. Only one patient encountered postoperative complication, chest pain and fever. No recurrence of noticed during a follow-up of 6 to 36 months. (4) Conclusions: ESD is safe and effective for treating upper gastrointestinal early-stage cancer or precancerous lesions in patients with liver cirrhosis.

Aim: To improve risk stratification in early-stage endometrial cancer (EC), we performed mo-lecular classification, and L1CAM immunohistochemistry (IHC) for additional risk assessment. Method: We analyzed archival tumor tissue from 247 early-stage EC patients. POLE mutations were detected using a Droplet digital polymerase chain reaction assay and Sanger sequencing, while the mismatch repair (MMR) status was determined by MMR protein IHC and MSI test. Additionally, we conducted IHC of p53 and L1CAM. Results: The 247 ECs were categorized into four subgroups: POLE-mutated (13.0%), MMR-deficient (27.9%), p53-abnormal (8.5%), and non-specific molecular profile (NSMP, 50.6%). We further subcategorized NSMP subgroup into NSMP-L1CAMneg (44.9%) and NSMP-L1CAMpos (5.7%), which we refer to as the molecu-lar-L1CAM classification. The molecular-L1CAM classification was an independent prognostic factor for recurrence-free survival (RFS) and overall survival (OS) (p <0.001, each). Similarly, the simplified L1CAM-p53 categorization, for practical use, remained an independent prognostic factor for RFS and OS (p <0.001, p =0.003, respectively). Conclusion: Integrating the molecu-lar-L1CAM classification or the simplified L1CAM/p53 categorization can enhance risk stratifi-cation in early-stage EC, providing valuable prognostic information to guide treatment deci-sions and improve patient outcomes.

BACKGROUND: The National Lung Screening Trial (ILST) and the NELSON study showed that lung cancer-specific mortality can be reduced by 20-24% using low-dose computed tomography (LDCT) screening in high-risk populations, due to an increase in early-stage diagnoses. RESEARCH QUESTION: How much lung cancer-related direct costs may be reduced using a LDCT screening programme based on the ILST protocol in a public healthcare system?STUDY DESIGN AND METHODS: Cost analysis of lung cancer screening (LCS) vs. usual care in the framework of the retail price of the Catalan public healthcare system. The LCS group included costs of screening (ILST protocol), treatment cost according to weighted average distribution of TNM staging in the NLST and NELSON trials, lung cancer detection rate (CDR) and smoking cessation intervention. The usual care group included treatment costs based on distribution of TNM staging registered in the Spanish index hospital. RESULTS: In the usual care group, treatment costs were €91,959. In the 5-year duration of the LCS programme, the average expected costs per subject were €1,342 (range €1,054-1,832 depending on malignancy in detected nodules) for screening and €32,431 for treatment, with an expected reduction of €952 based on an average CDR of 1.6%. The decrease in cost resulting from stage shift offsets 70.6% of the costs of the screening programme. INTERPRETATION: Baseline 5-year LCS costs are low according to the ILST protocol. In the Catalan public healthcare system, the expense reduction from the stage shift due to the LCS programme compensates a substantial part of its costs.

The effect of aqueous extracts of the biomass of the adult Ulomoides dermestoides beetle on the delayed effects of the defoliant paraquat causing parkinsonism in experimental mice was evaluated. The motor activity of the animals was analyzed in behavioral tests using a rotarod and a vertical pole. The number of tyrosine hydroxylase-immunopositive neurons in the ventral part of the substantia nigra of the midbrains of experimental and control mice was studied by immunohistochemistry. In the model in vitro system with SH-SY5Y human neuroblastoma, the effect of the extracts on cell proliferation was examined in the absence and presence of the neurotoxin MPP⁺. The isolation of biologically active substances from raw biomass using cavitation effects made it possible to obtain extracts with protective properties in the model of an early stage of Parkinson's disease used in this study.

The purpose of interdisciplinary communication during the early architectural design stage is to achieve the early integration of knowledge in different professional fields, which can help architects to choose correct design development strategies during the early architectural design stage. However, because there is too little information at the early design stage, and design solutions are still rapidly changing and developing, the uncertainties at this stage make it difficult for consultants in other disciplines to provide their views and analysis. In spite of this situation, the emergence of generative modeling is changing design procedures and methods of communication and cooperation for architectural teams, and has brought about a shift in the way architects transmit design information from "what" (declarative information) to "how" (procedural information). Generative modeling is like an aircraft's dashboard: It can provide a basis for interdisciplinary communication, provide interdisciplinary knowledge packages, and bring about a shift in interdisciplinary communication that will reduce the architectural team's communication needs and cost. This study uses a real design case to show the feasibility of generative modeling. Employing generative modeling as a basis, architects can enhance the efficiency of design change and multi-disciplinary communication during the early design stage, integrate specialized knowledge in relevant fields, use this knowledge to formulate design criteria for the next stage, and effectively transmit design decisions. As a consequence, the changes to the cost structure of design revisions and communication between different disciplines has initiated a paradigm shift toward multi-disciplinary communication in architectural design.

：Sleep stage on the whole night is not steady. Sleepers generally pass through three to five cycles. In each cycle, there are occur four typical sleep stages, such as wake stage (WS), light stage (LS), deep sleep (DS), rapid eye movement sleep stage (REM). According to the natural routine, in this paper, we investigate the stage transition and analyze the feature of stage transition using the local cluster Algorithm (LCA). Two-cycle sleep model (TCSM) is proposed to automatically classify sleep stages using over-night continuous heart rate variability (HRV) data. The generated model is based on the characteristics of the nested cycle's sleep stage distribution and the transition probabilities of sleep stages. Experiments were conducted using a public data set including 400 healthy subjects (female 239, male 161) and the model’s classification accuracy was evaluated for four sleep stages: WS, LS, DS, REM. The experimental results showed that based on the TCSM model, the segmentation classification of pure sleep is 5.2% higher than that of the traditional method, and the accuracy of segmentation classification is 11.2% higher than the traditional sleep staging accuracy. The experimental performance is promising in terms of the accuracy, sensitivity, and specificity rates compared with the ones of the state-of-the-art methods. The study contributes to improve the quality of sleep monitoring in daily life using easy-to-wear HRV sensors.

The etiology of exaggerated fibrous capsule formation around silicone mammary implants (SMI) is multifactorial but primarily induced by immune mechanisms toward the foreign material silicone. The aim of this work was to enlighten the disease progression from implant insertion and immediate tissue damage response reflected in (a) the acute wound proteome, and (b) the adsorption of chronic inflammatory wound proteins at implant surfaces. An intra-individual absolute quantitation TMT-liquid chromatography-tandem mass spectrometry approach was applied to profile wound proteome formed around SMI the first five days post-implantation. Compared to plasma, the acute wound profile resembled a more complex composition comprising plasma-derived and locally differentially expressed proteins (DEPs). DEPs were subjected to functional enrichment analysis, which revealed the dysregulation of signaling pathways mainly involved in immediate inflammation response and ECM turnover. Moreover, we found time-course variations in protein enrichment immediately post-implantation and adsorbed to SMI surfaces after 6-8 months. Characterization of the expander-adhesive proteome by label-free approach uncovered a long-term adsorbed acute wound and the fibrosis-associated proteome. Our findings propose a wound biomarker panel for the early detection and diagnosis of excessive fibrosis that could potentially broaden insights into the characteristics of fibrotic implant encapsulation.

Malaria is a parasitic infection that is a great public health concern and is responsible for high mortality rates worldwide. Different strategies have been employed to improve disease control, demonstrating the ineffectiveness of controlling vectors, and parasite resistance to antimalarial drugs requires the development of an effective preventive vaccine. There are countless challenges to the development of such a vaccine directly related to the parasite's complex life cycle. After more than four decades of basic research and clinical trials, the World Health Organization (WHO) has recommended the pre-erythrocytic Plasmodium falciparum (RTS, S) malaria vaccine for widespread use among children living in malaria-endemic areas. However, there is a consensus that major improvements are needed to develop a vaccine with a greater epidemiological impact in endemic areas. This review discusses novel strategies for malaria vaccine design taking the target stages within the parasite cycle into account. The design of the multi-component vaccine shows considerable potential, especially as it involves transmission-blocking vaccines (TBVs) that eliminate the parasite's replication towards sporozoite stage parasites during a blood meal of female anopheline mosquitoes. Significant improvements have been made but additional efforts to achieve an efficient vaccine are required to improve control measures. Different strategies have been employed, thus demonstrating the ineffectiveness in controlling vectors, and parasite resistance to antimalarial drugs requires the development of a preventive vaccine. Despite having a vaccine in an advanced stage of development, such as the RTS, S malaria vaccine, the search for an effective vaccine against malaria is far from over. This review discusses novel strategies for malaria vaccine design taking into account the target stages within the parasite’s life cycle.

COVID-19 is an infectious disease, growth of which depends upon the linked stages of the epidemic, the average number of people one person can infect and the time it takes for those people to become infectious themselves. We have studied the COVID-19 time series to understand the growth behaviour of COVID-19 cases series. A structural break occurs in the COVID-19 series at the change time form one stage to another. We have performed the structural break analysis of data available for 207 countries till April 20, 2020. There are 42 countries which have recorded five breaks in COVID cases series. This means that these countries are in the sixth stage of growth transmission and show a downward pattern in reporting in the daily cases, whereas countries with two and three breaks, record the rapid growth pattern in the daily cases. From this study, we conclude that the more the breaks in the series, there is more possibility to determine the constant or decreasing rate of daily cases. It is well fitted using lognormal distribution as this distribution is archived at its highest peak after some period and then suddenly it decreases at a longer time period. This can be seen in various countries like China, Australia, New Zealand and so on.

Many countries have implemented free early childhood education to solve the affordability and accessibility problems without considering the sustainability of policy; thus, they have to discontinue the policy. The city of Nanjing, China, is no exception. This case study adopted a mixed-methods approach to understanding how and why the policy was formulated, implemented, and failed in the city, using the “policy cycle” framework. Altogether 232 kindergarten principals and teaching/research staff were randomly sampled and surveyed, and 5 kindergarten principals and 5 teaching/researcher staff were interviewed. The results indicated that there were many obstacles to the policy’s sustainability, including the conflict of interest, the inefficient policy implementation, the insufficient funding, and more social inequality issues. And the policymakers made mistakes in the five domains of the policy cycle: the context of influence, the context of policy text production, the context of practice, the context of outcomes, and the context of political strategy. Finally, the lessons for a more sustainable policy decision process are discussed.

The aims of study was to evaluate the effects of rates, sources and timing of nitrogen application under cover of transgenic corn yield cultivated in Amazon Biome. The experiments were conducted in Parauapebas city, State of Pará, Brazil, in two years (2016/2017 and 2017/2018). The experimental design was randomized blocks, in a 5x2x2 factorial scheme, consisting of five rates of N (0; 45; 90; 135; and 180 kg ha-1), two nitrogen sources (urea and ammonium sulfate) and two application times of N (phenological stages V4 and V8), with four replications. The factor N rates promoted adjustment of linear equation (leaf area index, mass of thousand grains, and yield) and quadratic equation (dry mass of leaf index). Nitrogen fertilization promoted significant increases in mass of thousand grains and yield, obtaining the best results with 180 kg ha-1 of N applied at V4 phenological stage. Based on results obtained in two years of corn cultivated under conditions of Amazon Biome, the application of N at V4 phenological stage at rates of 121 to 131.39 kg ha-1 of N showed the best results for vegetative growth, while 180 kg ha-1 of N, regardless of source used, urea or ammonium sulfate, promoted greater grain weight and greater yield.

Introduction: We investigated the potential effect of smoking on pathological staging in clinically low-risk patients. Material-Methods: Data of 59 patients who were diagnosed with a bladder tumor for the first time and had a single lesion radiologically and endoscopically smaller than 3 cm were investigated, retrospectively. A total of 33 patients who currently smoke or smoked were classified as ever smokers group and 26 patients who did not ever smoke were classified as never smokers group. Pathological diagnoses of the patients in both groups were compared. Results: A total of 9 patients (27.3%) in ever smokers group and 18 patients (69.2%) in never smokers group had Ta disease (p<0.05). Morover, 19 patients (57.6%) in ever smokers group and 5 patients (19.2%) in never smokers group had T1 disease (p<0.05). The number of patients with low grade (LG) tumor were 8 (24.2%) and 19 (73.1%) in ever smoking and never smoking groups, respectively (p<0.05). The number of patients with high grade (HG) tumor were 25 (75.8%) and 7 (26.9%) in ever smoking and never smoking groups, respectively (p<0.05). Ta HG was detected in 9 (27.3%) patients in ever smoking group. In contrast, no patients in never smoking group had Ta HG disease (p<0.05). The number of patients with T1 HG was 17 (51.5%) in ever smoking group and 2 (7.69%) in never smoking group (p<0.05). Conclusion:Smoking seems to associate with pathologically worse stage and grade in patients with primary, single, < 3cm bladder cancer.

The aim of this study was to determine the relationship between levels of leisure-time sports and physical activity and the stages of change in high school students with goal orientations. Methods: The sample consisted of 2168 students randomly selected to participate in a longitudinal study in Costa Rica (423), Mexico (408) and Spain (1337), with 1052 being boys, 1037 girls and 79 who did not specify sex, aged between 11 and 16 years old (M = 12.49, SD = .81). We used a questionnaire to ask students about their leisure-time sports and physical activity, about stages of change and to measure achievement goals. Results: The results show that students are more active in Costa Rica, most of them being in the stage of active change. Conclusions: We found significant differences in achievement goals in all three countries, which shows that students in active stages have higher values than those in the inactive stage.

AbstractWe investigated the effect of cigarette smoking on pathological staging in clinically low-risk patients. Data of 59 patients who were diagnosed with bladder tumor for the first time and had a single lesion radiologically and endoscopically smaller than 3 cm were investigated retrospectively. 33 patients who smoked were classified as Group I, and 26 patients who did not smoke were classified as Group II. Pathological diagnoses of the patients in both groups were compared. The mean age of the patients were 64.8 (20–86) years. In Group II, 5 (19.2%) were female and 21 (80.8%) were male (p < 0.05). Nine patients (27.3%) in Group I and 18 patients (69.2%) in Group II had Ta disease (p < 0.05). Nineteen patients (57.6%) in Group I and 5 patients (19.2%) in Group II had T₁ disease (p < 0.05). The number of patients with low grade (LG) tumor were 8 (24.2%) and 19 (73.1%) in Group I and in Group II, respectively (p < 0.05). The number of patients with high grade(HG) tumor were 25 (75.8%) and 7 (26.9%) in Group I and in Group II, respectively (p < 0.05). TaHG was detected in 9 (27.3%) patients in Group I. In contrast, no patients in Group II had TaHG disease (p < 0.05). The number of patients with T₁HG was 17(51.5%) patients in Group I and 2 (7.69%) patients in Group II (p < 0.05). Smoking is associated with pathologically HG and stage in patients with first time bladder tumor which is single and smaller than 3 cm.

Allergic diseases are becoming a major healthcare issue in many developed nations, where living environment and lifestyle are most predominantly distinct. Such differences include urbanized, industrialized living environments, overused hygiene products, antibiotics, stationary lifestyle, and fast-food based diets tend to reduce microbial diversity and lead to impared immune protection, which further increase the development of allergic diseases. In the same time, studies also showed that modulating microbiomes can ameliorate allergic symptoms. Therefore, in this paper, we aimed to review recent findings on the potential role of the human microbiome in the gastrointestinal tract, surface of skin and respiratory tract for the development of allergic diseases. Furthermore, we addressed a potential therapeutic or even preventive strategy for such allergic diseases by modulating the human microbial composition.

Landslides are natural disasters that normally cause misery over the Mount Elgon region, especially in Bududa district. A landslide early warning system was developed in collaboration with the community and this study investigated it’s effectiveness in disseminating warnings to the community. The data were collected from 82 respondents (mean age 43) and 4 focus group discussions (one per village). Majority of the respondents lost crops (35.9%); land (29.8%); lives and livestock (6.9%). The frequent occurrence of landslides is due to the changes in landuse patterns; settlement on steep slopes; and prolonged rainfall of low intensities. The study found that, 93.2% of respondents have ever received the warnings and alerts. 78.8% of those who received the warnings evacuated. The use of radios to disseminate warnings is the most efficient communication channel (44.4%) followed by using the clan members (19.5%). Only 40% of the women received the early warning through radios, an indicator that this channel puts women at a disadvantage. The main challenges regarding utilization of early warning system were: poor timing (29.9%); poor coordination (20.7%); and poor sensitization (18.4%). There is need to strengthen the community networks, and with continuous sensitization, the effectiveness of the landslides early warning will improve and this is expected to enhance the resilience of the community to landslides.

Several lines of evidence indicate that high proliferative bias in eutopic endometrium during secretory phase is a hallmark of endometriosis and that high occurrence of implantation failure in patients resulting in infertility is often associated with endometriosis. ErbB family of proteins, which regulate the proliferation capacity in mammalian cells, appear as potential group of proteins to cause higher proliferation and endometrial hostility to implantation process in endometriosis. However, we have no concrete knowledge regarding the involvement of ErbB family in human endometrium during the ‘implantation window’, i.e., days 20-24 of a typical ovulatory cycle in endometriosis associated infertility. In the present study, the cellular profiles of immunopositive ErbBs-1 to -4 in endometrium of endometriosis-free, infertile women (Group 1; n=11), and in eutopic endometrium of infertile women diagnosed with stage IV ovarian endometriosis (Group 2; n=13) during mid-secretory phase were examined and compared using standardized WERF EPHect guidelines. Computer-aided standardized combinative analysis of immunoprecipitation in different compartments revealed an overexpression of ErbB-1 in the epithelial, stromal and vascular compartments along with marginally higher ErbB-3 expressions (P< 0.06) in the vascular compartment and ErbB-4 expression (P< 0.05) in the glandular epithelium and stroma in endometrium during the window of implantation of women with primary infertility associated with stage IV ovarian endometriosis compared with disease-free endometrium from women. A global overexpression of ErbB-1 in the endometrium during implantation window may induce anomalous proliferative, inflammatory and angiogenic activities in it, which antagonizes endometrial preparation for embryo implantation.

Early marriage is a phenomenon that has an impact on various aspects of life which then affects human development. This study aims to conduct a literature review on the implications of early marriage on human development. The method used in this study is the SLR (Systematic Literature Review) method. Data collection was carried out by documenting all literature that met the research inclusion requirements. The literature obtained as many as 25 articles from the Google Scholer database with the help of Harzing's Publish or Perish application. From this literature study, it was found that the phenomenon of early marriage has implications for the human development index based on health indicators and life expectancy, education, and welfare. Another finding is that women are the most disadvantaged from the impact of early marriage. Things that can be done to deal with the phenomenon and impact of early marriage include formal and non-formal education, strengthening access to health and education services, creating empowerment programs, and strengthening regulations and legal protection.

Samarinda City is one of the most attractive cities in Borneo Island (Indonesia) and also as a capital city of EastBorneo Province. The expansion of urban areas becomes essential due to rapid population and housing demand. Base on the statistical report, the annual population growth rate is 0.018% from the year 2016-2017 with a total population of 843446 inhabitants. Many natural disasters occur in some areas in this city, especially flooding. This natural disaster occurs almost every year, many people suffered and forced to evacuate. In 2018 there is 3 flood event with 28311 people was suffered and evacuated, and 5170 houses were flooded [1]. During the flood event, it was very possible to gain damages to their property and make traffic stuck. One common way to reducing the damages is using Early Warning Systems (EWS). Early warning is a major element for disaster risk reduction, including damages. To prevent and mitigate the impact of a disaster, many countries had taken action to build various methods of a public warning system. An effective early warning system focused on people-centered and comprises the following element, such as risk knowledge, technical monitoring and service, communication and dissemination of warnings, and community response capability [2]. Related to the existing condition which Samarinda is a Muslim-dominated city and obviously has a lot of a number of mosques. This is a good potency to develop an early warning system because every mosque has a loudspeaker for echoing Adzan (Muslim prayer-calling). With this existing condition, the loudspeaker can be utilized as a flood outdoor-voice warning announcer. The aim of this study is to briefly introduce the strategy of dissemination early warning by utilizing mosques. The hope of early warning dissemination is giving enough time to the people to evacuate their property to reduce damages and possibly to giving information to avoiding traffic stuck (in a certain location)due to flooding. The results of this study can be used as input for decision-makers to develop effective flood management strategies and policies, especially in the case of an early warning system where not well-developed in Samarinda.

Slow-roll inflation may simultaneously solve the horizon problem and generate a near scale-free fluctuation spectrum $P(k)$. These two processes are intimately connected via the initiation and duration of the inflationary phase. But a recent study based on the latest {\it Planck} release suggests that $P(k)$ has a hard cutoff, $k_{\rm min}\not=0$, inconsistent with this conventional picture. Here we demonstrate quantitatively that most---perhaps all---slow-roll inflationary models fail to accommodate this minimum cutoff. We show that the small parameter $\epsilon$ must be $\gtrsim 0.9$ throughout the inflationary period to comply with the data, seriously violating the slow-roll approximation. Models with such an $\epsilon$ predict extremely red spectral indices, at odds with the measured value. We also consider extensions to the basic picture (suggested by several earlier workers) by adding a kinetic-dominated or radiation-dominated phase preceding the slow-roll expansion. Our approach differs from previously published treatments principally because we require these modifications to---not only fit the measured fluctuation spectrum, but to simultaneously also---fix the horizon problem. We show, however, that even such measures preclude a joint resolution of the horizon problem and the missing correlations at large angles.

The recent measurement of a cutoff k_min in the fluctuation power spectrum P(k) of the cosmic microwave background may vitiate the possibility that slow-roll inflation can simultaneously solve the horizon problem and account for the formation of structure via the growth of quantum fluctuations in the inflaton field. Instead, we show that k_min may be interpreted more successfully in the R_h=ct cosmology, as the first mode exiting from the Planck scale into the semi-classical Universe shortly after the Big Bang. In so doing, we demonstrate that such a scenario completely avoids the well-known trans-Planckian problem plaguing standard inflationary cosmology, with some additional clues that may motivate further development of Kaluza-Klein cosmologies, string theories and supergravity.

Understanding the nature of the Dark Matter (DM) is one of the current challenges in modern astrophysics and cosmology. Knowing the properties of the DM particle would shed light on physics beyond the Standard Model and even provide us with details of the early Universe. In fact, the detection of such a relic would bring us information from the pre-Big Bang Nucleosynthesis (BBN) period, an epoch from which we have no data, and could even hint at inflationary physics. In this work, we assume that the expansion rate of the Universe after inflationary is governed by the kinetic energy of a scalar field ϕ, in the so-called “kination” model. We assume that the ϕ field decays into both radiation and DM particles, which we take to be Weakly Interacting Massive Particles (WIMPs). The present abundance of WIMPs is then fixed during the kination period through either a thermal “freeze-out” or “freeze-in” mechanism, or through a non-thermal process governed by the decay of ϕ. We explore the parameter space of this theory with the requirement that the present WIMP abundance provides the correct DM relic budget. Requiring that BBN occurs during the standard cosmological scenario sets a limit on the temperature at which the kination period ends. Using this limit and assuming the WIMP has a mass m_χ = 100 GeV, we obtain that the thermally-averaged WIMP annihilation cross section has to satisfy the constraints 3.5 × 10⁻¹⁶ GeV⁻² ≲ (σv) ≲ 1.4 × 10⁻⁵ GeV⁻² in order for having at least one of the production mechanism to yield the observed amount of DM. This result shows how the properties of the WIMP particle, if ever measured, can yield information on the pre-BBN content of the Universe.

Recently, due to the miniaturization of electronic products, printed circuit boards (PCBs) have also become smaller. This trend has led to the need for high-precision electrical test equipment to check PCBs for disconnections and short circuits. The purpose of this study is to improve the position repeatability of the platform unit up to ±2.5 μm in a linear stage type test equipment. For this purpose, the causes of position errors of the platform unit are analyzed. The platform unit holding the PCB is driven by a single-axis linear ball screw drive system offset from its geometric center due to design constraints. The yaw rotation of the platform is found to have a dominant effect on position repeatability. To address this problem, the methods of adding balancing weights to the platform unit and adjusting the stiffness of LM Guides are proposed. This reduces the yaw rotation by moving the centers of mass and stiffness closer to the linear ball screw actuator. In the verification tests, the position repeatability was decreased to less than ±1.0 μm.

In this paper, mineralogical and elemental geochemical characteristics of massive sulfide samples collected from Jade hydrothermal field, located in the Izena depression in the central graben of Okinawa Trough, were analyzed by means of optical microscopy, scanning electron microscopy and electron probe. The results show that the sulfide in Jade hydrothermal area can be divided into Zn-Cu-Pb rich massive sulfide and Zn-Fe rich massive sulfide. The former is composed of sphalerite, galena, anglesite, chalcopyrite and pyrite, and its formation stage can be divided into pyrite stage, sphalerite-chalcopyrite stage, anglesite stage and colloidal pyrite stage. The latter is mainly composed of sphalerite, pyrite, marcasite and a small amount of galena, which can be divided into galena stage, pyrite stage, sphalerite stage, pyrite and marcasite stage. Cu and Zn in pyrite may exist in the form of microinclusions, while Ag and Pb may exist in pyrite in the form of fine galena inclusions containing Ag. Fe and Cu may enter sphalerite in the form of ion replacement. Zn may enter chalcopyrite in the form of ion replacement, and As and Pb may be inclusions in chalcopyrite as As-bearing galena inclusions. Consistent with the previous understanding, the metal elements in the hydrothermal liquid system in Jade hydrothermal field mostly migrate with the hydrothermal fluid as sulfur complexes, and when the hydrothermal fluid mixes with seawater, the physical and chemical conditions of the fluid change, resulting in sulfide mineral precipitation. However, the chemical structure of chalcopyrite is still controversial, which restricts the understanding of the substitution mechanism of trace elements during chalcopyrite precipitation.

The taxonomy of trilobites Abadiella Hupé, 1953 and Parabadiella Zhang, 1966 from the lower Cambrian of Gondwana has long been a controversy. Based on newly-collected and formerly-reported materials, 94 trilobite cranidia within 21 species are selected for morphometric analyses: principal components analysis (PCA) and canonical variates analysis (CVA). The integrated morphological characters are successfully accounted for by two principal components in PCA. The further validations for the presupposed qualitative groupings are indispensable to detect and calibrate the ultimate taxonomic results in CVA. By this way, all specimens distributed in a consistent morphospace in PCA and the short distances between them demonstrate their close morphological affinity, supporting their congeneric status within Abadiella. Additionally, three morphotypes were recognized from all selected specimens and they were eventually revised and incorporated into A. bourgini Hupé, 1953, A. huoi Zhang, 1966, and A. yunnanensis Luo, 1981, through stepwise test-calibration to get a high correct rate as far as possible in CVA. From this, it is certain that A. huoi is conspecific in South Australia and South China. Its occurrence allows to correlate the Australian A. huoi Range Zone to the identical zone in South China (in platform), having an approximately consistent stratigraphic range in the two regions. In comparison with A. huoi, A. bourgini was reported from fewer localities in South China. Nevertheless, its presence in the Daguinaspis Zone of Issendalenian Stage in Morocco permits a correlation with Chinese and Australian A. huoi Zone. As an auxiliary marker for A. huoi, the occurrence of A. bourgini in Morocco, South Australia and South China reinforce the correlation potential and resolution in species-level for the Cambrian Stage 3 in Gondwana region.

Breast cancer (BC) is a heterogeneous disease representing a substantial economic burden. In order to develop policies that successfully decrease this burden, the factors affecting costs need to be fully understood. Evidence suggests that early detection in Stage I has a lower cost than late detection. We aim to provide conservative estimates of BC's stage-wise medical costs from German healthcare and the payer's perspective. To this end, we conducted a literature review of articles evaluating stage-wise costs of BC in Germany through PubMed, Web of Science, and Econ Lit databases supplemented by Google Scholar. We developed a decision tree model to estimate BC related medical costs in Germany using available treatment and cost information. The review generated seven studies; none estimated the stage-wise costs of BC. The studies were classified into two groups: (1) case scenarios (five studies) and two studies based on administrative data. The first sickness funds data study (Gruber, Stock, et al. 2012) used 1999 information to approach BC attributable cost; their results suggest a range between €3,929 and €11,787 depending on age. The second study (Kreis, Plöthner, et al. 2020) used 2011-2014 data and suggested an initial phase incremental cost of €21,499, an intermediate phase cost of €2,620, and a terminal phase cost of €34,513 per incident case. Our decision tree model based BC stage-wise cost estimates were €21,523 for Stage I, €25,679 for Stage II, €30,156 for Stage III, €42,086 for Stage IV. Alternatively, the modeled cost estimates are €20,284 for the initial phase of care, €851 for the intermediate phase of care, and €34,963 for the terminal phase of care. Our estimates for phases of care are consistent with recent German estimates provided by Kreis and Plöthner et al. Furthermore, the data collected by sickness funds are collected primarily for reimbursement purposes, where the German ICD-10 classification system defines a cancer diagnosis. As a result, claims data lack the clinical information necessary to understand stage-wise BC costs. Our model-based estimates fill the gap and inform future economic evaluations of BC interventions.

Investigation of sea-level positions during the highly-dynamic Marine Isotope Stage 3 (MIS 3: 29-61 kyrs BP) proves difficult because: i) in stable and subsiding areas, coeval coastal sediments are currently submerged at depths of few to several tens of meters below present sea level; ii) in uplifting areas, the preservation of geomorphic features and sedimentary records is limited due to the erosion occurred during the Last Glacial Maximum (LGM) with sea level at depth of -130 m, followed by marine transgression that determined the development of ravinement surfaces. This study discusses previous research in the Mediterranean and elsewhere, and describes new fossiliferous marine deposits laying on metamorphic bedrock of Cannitello (Calabria, Italy). Radiocarbon ages of marine shells (about 43 kyrs cal BP) indicate that these deposits, presently between 28 and 30 meters above sea level, formed during MIS 3.1. Elevation correction of the Cannitello outcrops (considered in an intermediate-to-far-field position with respect to the ice sheet) with the local vertical tectonic rate and Glacial Isostatic Adjustment (GIA) rate allows to propose a revision of the eustatic depth for this highstand. Our results are consistent with recently proposed estimates based on a novel ice sheet modelling technique.

In this research paper, a high gain transformer less inverter modeling which is used for the smart grid technology or as the stand alone for home appliances is proposed. The proposed transformer less topology provides a higher voltage gain, low cost, small size and simple control stand alone transformer less inverter for home appliances. The above inverter is modeled by using software which is known as MATLAB/ Simulimk.

Many marine species use different habitats at different stages of their life cycle. Functional connectivity, the degree to which the seascape facilitates or impedes movement between habitat patches, is poorly studied in marine systems. We reviewed the scientific literature to explore the various barriers preventing functional connectivity between marine habitats and how the removal of these barriers may restore connectivity. To our knowledge, this is the first systematic review to investigate functional connectivity between life cycle habitats for a range of marine species. A total of 4,499 records were identified and screened, leaving 69 publications eligible for review. The results highlighted a range of distances between nursery and adult habitats that limited functional connectivity for a number of species, predominantly reef fishes. For some species, adults were absent on reefs >9km from the closest nursery habitat, suggesting a threshold for connectivity. Similarly, increased distance between spawning and settlement habitats decreased settling success of larvae of various taxa. Pelagic larval duration, seascape topography and climate change were also shown to impact functional connectivity during the larval phase. The removal and mitigation of barriers preventing functional connectivity, including dams and habitat fragmentation, restored connectivity between disconnected life cycle habitats, but the efficacy of these approaches differed between species and studies. The results of this review deepen our understanding of marine functional connectivity between life cycle habitats via larval, juvenile, and adult dispersal. These findings have implications for the design and management of marine reserve networks.

Deadwood represents a source of nutrients, carbon and water for metabolism within forest ecosystem. Nutrients are mobilized due to the decomposition of wood, which is a long-term process that can be best studied by analysing environmental data on a temporary scale. Our study provides physico-temporal data on the downed logs of three major tree species in European temperate forests: Abies alba Mill., Fagus sylvatica L. and Picea abies (L.) Karst. Time since death was obtained using tree censuses (repeated for 40 years) and dendrochronology for each single downed log, the oldest being 75 years old. Standard laboratory methods were used for the determination of wood density and moisture changes. F. sylvatica was decomposed rapidly in the initial phase – mass loss was 50% during the 5 years after death, while A. alba and P. abies lost 13% and 16%, respectively. Downed logs of F. sylvatica contained 391 kg of water per m³, while these of P. abies 279 kg. A log-transformed linear model was created that shows the dependence of time since death on mass loss. According to the model, F. sylvatica had the shortest total decomposition time (39 years), followed by A. alba (58 years) and P. abies (86 years).

Studies have shown that nearly half of rural toddlers in China have cognitive delays due to an absence of stimulating parenting practices, such as early childhood reading, during the critical first three years of life. However, few studies have examined the reasons behind these low levels of stimulating parenting, and no studies have sought to identify the factors that limit caregivers from providing effective early childhood reading practices (EECRP). This mixed-methods study investigates the perceptions, prevalence and correlates of EECRP in rural China, as well as associations with child cognitive development. We use quantitative survey results from 1,720 caregiver-child dyads across 100 rural villages/townships in northwestern China and field observation and interview data with 60 caregivers from these same sites. The quantitative results show significantly low rates of EECRP despite positive perceptions of early reading and positive associations between EECRP and cognitive development. Qualitative results suggest that low rates of EECRP in rural China are not due to the inability to access books, financial or time constraints, or the absence of aspirations. Rather, the low rate of book ownership and absence of reading to young children is driven by the insufficient and inaccurate knowledge of EECRP among caregivers, which leads to their delayed, misinformed reading decisions with their young children, ultimately contributing to developmental delays.

It is generally believed that the universe emerged from the Big Bang, before which space and time did not exist. However, Penrose proposed his theory of conformal cyclic cosmology, in which an aeon existed preceding this universe. Based on the cosmological principle, the universe is homogeneous and isotropic, expanding without center, but recently more and more deviations have been observed. By studying the fundamental particles and reactions of nature, we initiated a model that the Big Bang is the result of the collapse of a neutrino star within a black hole. We therefore re-analyze the cosmic microwave background (CMB) and find that the Center of the universe where the Big Bang occurred was at 0.66 ^+0.03 _-0.01 times the radius of the surface of last scattering away from the Local Supercluster (LS) and at Galactic coordinates (l, b) = (286^o +/- 10^o, -43^{o +7} _-6). If we look from the LS to the Center, the universe is spinning clockwise. Our findings are supported by Penrose’s conformal cyclic cosmology, low-variance circle sets in the CMB, and many other independent observational evidence of cosmic inhomogeneities, spatial anisotropies, and time variations.

We present a Quantum Space Model (QSM) of the evolution of the universe based on the theory that space consists of energy quanta from which it began. We used the Friedmann equations to trace its history and show that Dark Energy is the energy of space which caused its accelerating expansion.The universe started from a quanta of space which was triggered by quantum fluctuations that caused the Big Bang. It then expanded and cooled undergoing phase transitions to radiation, fundamental particles, and matter. Matter grew into galaxies, and was consolidated by gravity into Black Holes, ending in a Big Crunch and Deep Freeze inside a Black hole at 1.380 trillion years. Fluctuations caused a new Bang to start another cycle in its life. If the Law of Conservation of Energy is universal, then the cosmos is eternal. Our results support the theoretical predictions of a cyclic universe by Steinhardt and associates, as well as Penrose. Space and energy are equivalent as embodied in the Planck energy equation. They are the two most fundamental quantities that govern cosmic evolution. The two principal long range forces are the gravitational force and the space force,which maybe the fifth force in the universe. They provide the clockwork mechanism operating our cyclic universe.

Experimental and epidemiological evidence has shown that modifications of the intrauterine environment can have deleterious consequences for individuals, expressed as an increased risk of suffering non-communicable pathologies in adult life, which is known as the hypothesis of the early origin of diseases or programming fetal. On the other hand, changes in gene expression patterns through epigenetic modifications can be the basis for long-term maintenance of the effects of fetal programming. In this sense, epigenetics comprises the study of intrauterine disturbances, which develop diseases in the adult, including Celiac Disease (CD). In addition, early feeding practices could influence the risk of CD development, such as breastfeeding timing and duration and age at gluten introduction in the diet. Gluten acts as a trigger for CD in genetically predisposed subjects, although approximately 30% of the world population has HLA DQ2 or DQ8, the prevalence of the disease is only 1-3%. It is not known what factors act to modify the risk of disease in genetically at risk subjects. Taking into account all these considerations, the aim of the current review is to elucidate the role of early programming and the effect of early nutrition on the development and progression of CD.

In a recent paper we had discussed possibility of DM at high redshifts forming primordial planets composed entirely of DM to be one of the reasons for not detecting DM (as the flux of ambient DM particles would be consequently reduced). In this paper we discuss the evolution of these DM objects as the universe expands. As universe expands there will be accretion of DM, Helium and Hydrogen layers (discussed in detail) on these objects. As they accumulate more and more mass, the layers get heated up leading to nuclear reactions which burn H and He when a critical thickness is reached. In the case of heavier masses of these DM objects, matter can be ejected explosively. It is found that the time scale of ejection is smaller than those from other compact objects like neutron stars (that lead to x-ray bursts). These flashes of energy could be a possible observational signature for these dense DM objects.

Severe early childhood caries remains the most common chronic disease affecting children. Its multifactorial etiology has established a controversy about which risk factors were more significant to its development. Therefore our study aimed through meticulous statistical analysis to arrange the “well agreed upon” common risk factors in order of significance, to aid the clinician in tailoring an adequate preventive program for this affected age group. The study reshuffled the risk factors contributing to severe early childhood caries and placed them in the order of their significance as follows: snacking of sugary food several times a day, increased number of siblings to 3 or more, night feeding, child self-employed brushing, mother caries experience, 2 siblings, on demand feeding, once/day sugary food, sharing utensils, 1 Sibling, male gender, father’s education, late first child dental visit, brushing time, mother’s education, no dental visit, decreased brushing frequency & no night brushing.

The objective of this study was to assess the effects of parity and lactation stage on the content and conversion rate of DHA in milk from dairy cows fed ruminally protected algae powder. A total of 800 cows were blocked by parity and divided into eight groups (n = 100, three groups of primiparous cows and five groups of multiparous cows) in a six-month experimental period. The lactation period was divided into three stages: 16 – 100 d, 101 – 200 d, and 201–305 d. All cows were fed 100 g of DHA-rich algae powder twice a day, with the DHA content > 13%. Milk samples were collected monthly, and daily milk yield and dry matter intake were recorded. Using infrared spectroscopy, we determined the content of protein, fat, lactose, and total solids in milk and calculated the DHA conversion rate. The results showed that parity and lactation stage had no significant effects on milk composition. However, milk yield and dry matter intake were higher in multiparous cows than in primiparous cows. The DHA content and conversion rate in milk were not significantly different between parity groups but were positively correlated with lactation stage and negatively correlated with milk fat content.

There is a pressing need for more precise biomarkers of chronic kidney disease (CKD). Plasma samples from 820 subjects [231 with CKD, 325 with end-stage kidney disease (ESKD) and 264 controls] were analyzed by LC-MS/MS to determine a metabolic profile of 28 aminoacids (AA) and biogenic amines to test their value as markers of CKD risk and progression. The Kynurenine/Tryptophan ratio showed the strongest correlation with estimated glomerular filtration rate values (coefficient=-0.731, P&lt;0.0001). Models created with Orthogonal Partial Least Squares-Discriminant Analysis (OPLS-DA) containing the metabolic signature showed high goodness of fit and predictability for controls/CKD (R2X:0.73;R2Y:0.92;Q2:0.92) and lower for CDK/ESKD (R2X:0.56;R2Y:0.59;Q2:0.55). Based on generated VIP scores, the most relevant markers for segregating samples into control/CKD or CKD/ESKD groups were citrulline (1.67) and tryptophan (1.59), respectively. ROC analysis showed that the addition of the metabolic profile to a model including CKD classic risk factors improved AUC from 86.7% (83.6-89.9) to 100% (100-100) for CKD risk (P&lt;0.0001), and from 63.0% (58.2-67.8) to 96.5% (95.3-97.8) for the risk of progression from CKD to ESKD (P&lt;0.0001). Plasma concentrations of AA and related amines may be useful as diagnostic biomarkers of kidney disease, both for CKD risk and for progression of CKD patients to ESKD.

Most of the literature on the optimization problem of transportation in supply chain networks (SCN) considered fixed costs (FC). However, in the practical applications of this problem it is important to study the effect of FC. This paper examines the impact of fixed cost increase as well as the variable cost on the optimization of a Two-Stage SCN. To do so, two mathematical models for mixed-integer nonlinear programming are developed. The first model optimizes fixed and variable costs in addition to the opening cost, whereas the second model only optimizes variable and opening costs. To evaluate the effect of considering FC on the optimization supply chain problem, four groups of instances are randomly generated, and solved using Lingo. The results of the two models are compared utilizing the average percentage deviation. In addition, sensitivity analysis is performed to determine the impact of changes in opening and variable costs on the considered optimization problem. The computational results and the sensitivity analysis show that the first model with minimized FC outperforms the second model, which does not consider the FC in minimization and FC affect the optimization.

Because of the large number of parameters that interact in their function, determining dynamic regime parameters as well as the mode of function of amplifying stages is an extremely complex problem. This paper describes a LabVIEW application for studying the functioning of an ampli-fier in various connections. The user selects the generator's parameters, the type of connection and its parameters, as well as the electric charge characteristics. The application can determine both the stage characteristics and the Bode characteristics. The amplifier's stability zone, as well as its gain and phase, are determined based on these characteristics. An important advantage of this application is that the design of the amplifier stage can be made starting from some param-eters that the amplifier can establish, from which the values of components can be determined. In order to validate the simulation results using the LabVIEW application, a specialized program Multisim was used, as well as experimental measurements using the Electronics Explorer Board. Both Multisim and Electronics Explorer Board can determine Bode characteristics. In both simu-lations and experimental amplifiers, the same schemes with the same transistor was used. The application can be used for educational purposes as well as to design the amplifier's stage to achieve specific parameters.

In China, the demand for rabbit meat is also increasing, and the production for rabbit meat is important. However, the underlying mechanisms of regulate skeletal muscle growth and development in rabbits remain unclear. The purpose of this study was to identify candidate genes related to skeletal muscle growth in rabbits and explore their potential regulatory mechanisms. RNA-seq technique was used to compare the differences of skeletal muscle transcriptome in Fujian white rabbits at different developmental stages (day 20 and 26 of embryos and birth 1, 30 and 60-day-olds) with a total of 25 individual selected. A total of 9737 DEGs that were acquired from the five groups were annotated into three ontologies of the GO database: biological process (BP), cell component (CC), and molecular function (MF). For KEGG analysis, there are 8249 genes were enriched in 1148 pathways, of which 67 pathways were significantly enriched, mainly in Hypertrophic cardiomyopathy (HCM), the PPAR signaling pathway, MAPK signaling pathway. Among all comparison groups, SE was the most abundant AS event. Real-time PCR verified that the expression patterns of differential genes were consistent with the transcriptome sequencing results. These results will provide a molecular regulation mechanism of muscle growth and development in Fujian white rabbits, and should serve an important theoretical basis for improving meat performance and growth rate of Chinese local meat rabbit breeds.

Introduction: The treatment of peritoneal dialysis in end-stage renal disease is increasing in clinical practice. The main purpose of this study was to evaluate the effect of far-infrared radiation therapy on inflammation and the cellular immunity of patients undergoing peritoneal dialysis. Materials and Methods: We recruited 56 patients undergoing peritoneal dialysis, and we included 32 patients from the experimental group and 24 patients from the control group in the final analysis. The experimental evaluation in our study was as follows: (1) We used abdominal computed tomography to measure the diameter and degree of hardening of the abdominal veins and large blood vessels to explore the changes in abdominal blood vessels. (2) The study compared the effects of peritoneal dialysis using albumin, blood urea nitrogen, creatinine, white blood cell, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, erythrocyte sedimentation rate, Hs-CRP clearance rate, and HBAlC. (3) We compared the cytokine concentration of blood between the two groups while controlling for GM-CSF, IL-2, IFN-γ, IL-6, IL-18, IL-4, IL-5, IL-13, IL-12p70, TNF-α, and IL-1β. Results and Discussion: (1) There was no significant difference in the abdominal blood vessels of the experimental group relative to the control group according to abdominal CT measured over 6 months. (2) Our study demonstrates the statistically significant effect of FIR therapy on the following parameters: albumin (p = 0.048*), creatinine (p = 0.039*), and Hs-CRP (p < 0.001**) decreased significantly, and glomerular filtration rate (eGFR, p = 0.043*) and glucose (p < 0.001**) increased significantly. Our study found that, in the experimental group, albumin and creatinine decreased significantly due to FIR therapy for 6 months. However, our study also found that, in the experimental group, glucose (p < 0.001**) increased significantly due to FIR therapy for 6 months. Peritoneal dialysis combined with FIR can reduce the side effects of glucose in dialysis buffer, which interferes with peritoneal inflammation and peritoneal mesothelial cell fibrosis. In addition, we also found that, in the experimental group, Hs-CRP (p < 0.001**) decreased significantly due to FIR therapy for 6 months. (3) No statistical significance in the inflammatory cytokines related to FIR therapy differences was observed in our study. IFN-γ (p = 0.124), IL-12p70 (p = 0.093), IL-18 (p = 0.213), and TNF-α (p = 0.254) did not exhibit significant improvements in peritoneal dialysis with FIR treatment over 6 months. IFN-γ and IL-18 in the plasma of patients in the experimental group and the control group were higher in the third month than in the first month. Conclusion: We found that the effect of peritoneal dialysis improved significantly with FIR therapy, and significant improvements in the peritoneal permeability and inflammatory response were observed. end-stage renal disease; peritoneal dialysis; far-infrared therapy (FIR)

Short stature has been associated with increased various disease and all-cause death, but no reliable data exist the association between height and end-stage renal disease (ESRD) in diabetic patients. We investigated the relationship between short stature, development of ESRD, and mortality in type 2 diabetes. This study analyzed clinical data using the National Health Insurance Database in Korea. Height was stratified by five groups according to age and sex. Risk of ESRD and all-cause mortality was analyzed with Cox proportional hazards models. During a 6.9-year follow-up period, 220,457 subjects (8.4%) died and 28,704 subjects (1.1%) started dialysis. Short stature significantly increased the incidence of ESRD and all-cause mortality in the overall cohort analysis. In multivariable analysis, hazard ratios (HR) for development of ESRD comparing the highest versus lowest quartiles of adult height were 0.86 (95% confidence interval (CI), 0.83–0.89). All-cause mortality also decreased with highest height compared to patients with lowest height after fully adjusting for confounding variables (HR 0.79, 95% CI, 0.78–0.81). Adult height had an inverse relationship with newly diagnosed ESRD and all-cause in both males and females. Short stature is strongly associated with an increased risk of ESRD and all-cause mortality in type 2 diabetes.

Intermediate-luminosity-optical-transients (ILOTs) are stellar outbursts with luminosity between those of classical novae and supernovae. They are divided into a number of sub-groups depending on the erupting progenitor and the properties of the eruption. Many of the ILOTs sit on the slanted Optical Transient Stripe (OTS) in the Energy-Time Diagram (ETD) that shows their total energy vs. duration of their eruption. We describe the different kinds of ILOTs that populate the OTS and other parts of the ETD. We also stand on similarities between Planetary Nebulae (PN) to ILOTs, and suggest that some PNe were formed in an ILOT event. The high energy part of the OTS is reserved to the supernova impostors -- giant eruption of very massive stars. We show results of 3D hydrodynamical simulations of supernova impostors that expose the mechanism behind these giant eruptions, and present new models for recent ILOTs. We stand on the connection between different kinds of ILOTs, and suggest that they are powered by a similar source of energy -- gravitational energy released by mass transfer.

This study aims to quantify carotenoids and tocopherols in human milk from healthy Chinese women, and to explore their associations with region, lactation stage, and maternal socio-economic and obstetric factors. Human milk was obtained from 509 healthy mothers and the compounds of carotenoids and tocopherols were analyzed by high-performance liquid chromatography after mild saponification and solvent extraction. Socio-economic and obstetric characteristics of the mothers and their dietary intakes through a single 24-hour dietary recall were evaluated. The median content of each component [μg/100mL, median (interquartile range)] in colostrum and mature milk was, respectively, β-carotene 8.0 (4.7-15.2) and 1.8 (1.4-2.7), β-cryptoxanthin 6.2 (2.4-12.9) and 1.8 (1.1-3.4), lutein 5.7 (2.9-10.2) and 3.4 (1.5-6.0), lycopene 6.3 (4.0-9.9) and 1.4 (1.1-2.0), zeaxanthin 1.0 (0.6-1.5) and 1.0 (0.6-1.4), α-tocopherol 645 (388-1176) and 211 (131-321), γ-tocopherol 68 (48-121) and 77 (45-120). The levels of all those vitamins presented regional differences, and decreased as lactation stage increased except for zeaxanthin and γ-tocopherol. Associations of carotenoid contents with maternal education, delivery mode, and present body mass index were found in multivariate analyses. These results suggest that some region, lactation stage, obstetric and socio-economic factors are associated with human milk concentrations of carotenoids and tocopherols in healthy Chinese mothers.

An accurate assessment of the stage-discharge relationship in open channel flows is necessary and important to the design and management of hydraulic structures and engineering in practical hydrosystems such as rivers and streams. While the flow structures and patterns at open channel junctions are interesting and have been widely studied in the literature, this paper focuses further on the effect of flow junctions on stage-discharge relationship at mountain river confluences. In this study, both the flume and physical model experiments are designed and performed carefully to test and analyze the complex flow structures and characteristics at river confluences with different configurations and hydraulic conditions. The impacts of the flow junctions on the traditional stage-discharge relationship are analyzed in this study. The results of this study are discussed in the paper for the understanding of flow structures at flow junctions and the design and management of hydraulic structures in river engineering.

Breeding early-maturing cultivars is one of the most important objectives for pear breeding. Very early-maturing pear provides an excellent parental material for crossing, while the immature embryo and low seed germination of its hybrid progenies often limit the selection and breeding of new early-maturing pear cultivars. In this study, we choose a very early maturing pear cultivar ‘Pearl Pear’ as study object, and investigate the effects of cold stratification, culture medium and seed coat on the germination and growth of early maturing pear seeds. Our results show that cold stratification (4℃) treatment could significantly improve the germination rates of early maturing pear seeds. A 100 days of low temperature pre-treatment and germination on White medium could increase the germination rate up to 84.54%. We also observe that seed coat removal could improve the germination activity of early maturing pear seeds, and middle seed coat removal (MSR) represents an optimal method with its high germination rate and low contamination. The results of our study established an improved protocol for seed germination of early-maturing pear seeds, which will greatly facilitate the breeding of new very early-maturing pear cultivars.

Link prediction is an unbalanced early retrieval problem, whose goal is to prioritize a small cohort of positive links on top of a list largely populated by unlabelled links. Differently from binary classification, here the evaluation focuses on how the predictor prioritizes the positive class because, in practice, a negative class does not exist. Previous studies explained that AUC-ROC is not apt for unbalanced class problems and is misleading for early retrieval problems, therefore standard AUC-ROC is not appropriate for evaluation of link prediction. However, some scholars argue that an AUC-ROC like evaluation accounting for the relative positioning of the few positive links among the vastness of unlabelled links remains a valid concept to pursue. Here we propose the area under the magnified ROC (AUC-mROC), a new measure that adjusts the standard AUC-ROC to work also for unbalanced early retrieval problems such as link prediction.

External stressors strongly increase cardiovascular activity and induce metabolic changes that ensure the availability of glucose and oxygen as part of a co-ordinated stress response. Exposure to stress during early life appears to have an exaggerated long-term effect on this response, leading to an increased risk or cardiometabolic disorders. Here we demonstrate that acute stress induced glucose release is impacted by the early life environment in rodent maternal deprivation and early-life infection models and this was validated in our EpiPath human early-life adversity cohort. In all three models differences in baseline blood glucose levels after ELA exposure were sex dependent. The human ELA model showed higher levels of basal glucose in females, similar to the mouse infection and rat maternal deprivation models. We anticipated that the stress induced glucose rise would be a GC dependent process. However, the kinetics of stress-induced glucose release, peaking 15-28 minutes before cortisol suggest that it is a GC-independent process. We confirmed this by administering an escalating dose of cortisol to a health human cohort, and the inability of an intravenous GC bolus induce a glucose rise in man confirms that it is a rapid, GC independent, process.In conclusion, we provide a novel perspective on the mechanisms behind stress related metabolic changes and highlights the importance of collecting early life data as a measure to understand an individual’s metabolic status in a better light.

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

Early detection improves prognosis in pancreatic ductal adenocarcinoma (PDAC) but is challenging as lesions are often small and poorly defined on contrast-enhanced computed tomography scans (CE-CT). Deep learning can facilitate PDAC diagnosis, however current models still fail to identify small (&lt;2cm) lesions. In this study, state-of-the-art deep learning models were used to develop an automatic framework for PDAC detection, focusing on small lesions. Additionally, the impact of integrating surrounding anatomy was investigated. CE-CT scans from a cohort of 119 pathology-proven PDAC patients and a cohort of 123 patients without PDAC were used to train a nnUnet for automatic lesion detection and segmentation (nnUnet_T). Two additional nnUnets were trained to investigate the impact of anatomy integration: (1) segmenting the pancreas and tumor (nnUnet_TP), (2) segmenting the pancreas, tumor, and multiple surrounding anatomical structures (nnUnet_MS). An external, publicly available test set was used to compare the performance of the three networks. The nnUnet_MS achieved the best performance, with an area under the receiver operating characteristic curve of 0.91 for the whole test set and 0.88 for tumors &lt;2cm, showing that state-of-the-art deep learning can detect small PDAC and benefits from anatomy information.

Background: The incidence of fracture and surgery of the hip and lower extremities is still high. Long postoperative bed rest has the potential to increase the incidence of various complications that may increase the morbidity and mortality rate of patients after hip and lower extremities surgery. Aim: This literature review aimed to identify the effects of early mobilization in hip and lower extremity postoperative. Method: Search for articles on several databases such as ProQuest, ScienceDirect, CINAHL, Medline, Wiley Online and Scopus, using the Boolean operator by combining several keywords according to the literature review topic, with inclusion criteria are published in the last 3 years (2019-2021), used a quantitative design, written in English and full text articles. A total of 435 articles were obtained, then screened and reviewed, so that there were 16 (sixteen) eligible articles.Result: There were 11 (eleven) effects of early mobilization, i.e. reducing length of stay, reducing the risk of deep vein thrombosis (DVT), reducing pulmonary infections (pneumonia), reducing urinary tract infections, reducing the risk of wound infection, improving extremity function and ability to walk, reducing postoperative pain, reducing the risk of pressure sores, reducing postoperative delirium, reducing readmission and lowering hospitalization costs. Conclusion: This literature review showed that early mobilization is safe and effective in postoperative patients to reduce the risk of complications and adverse events. Nurses and health workers who care for patients could implement early mobilization and motivate patients to be cooperative in undergoing early mobilization.

Traditional applications of Interferometric Synthetic Aperture Radar (InSAR) data involved inverting an interferogram stack to determine the average displacement velocity. While this approach has useful applications in continuously deforming regions, much information is lost by simply fitting a line through the time series. Thanks to regular acquisitions across most of the the world by the ESA Sentinel-1 satellite constellation, we are now in a position to explore opportunities for near-real time deformation monitoring. In this paper we present a simple statistical approach for detecting offsets and gradient changes in InSAR time series. Our key assumption is that 5 years of Sentinel-1 data is sufficient to calculate the population standard deviation of the detection variables. Our offset detector identifies statistically significant peaks in the first, second and third difference series. The gradient change detector identifies statistically significant movements in the second derivative series. We exploit the high spatial resolution of Sentinel-1 data and the spatial continuity of geophysical deformation signals to filter out false positive detections that arise due to signal noise. When combined with near-real time processing of InSAR data these detectors, particularly the gradient change, could be used to detect incipient ground deformation associated with geophysical phenomena, for example from landslides or volcanic eruptions.

Background and Aims: Screening and assessment of cognitive changes in adults with Intellectual Disabilities, mainly Down Syndrome (DS), is crucial to offer appropriate services to their needs. We present a systematic review of the existing instruments assessing dementia, aiming to support researchers and clinicians’ best practice. Methods: Searches were carried out in the databases Web of Science; PubMed; PsycINFO in March 2019 and updated in May 2020. Studies were selected and examined if they: (1) focused on assessing age-related cognitive changes in person with ID; (2) included adults and/or older adults; (3) included scales and batteries for cognitive assessment. Results: Forty-eight cross-sectional studies and twenty-six longitudinal studies were selected representing a total sample of 5,851 participants (4,089 DS and 1,801 with other ID). In those studies, we found 38 scales, questionnaires, and inventories, and 14 batteries for assessing cognitive and behavioural changes in adults with DS and other ID. Conclusion: The most used instrument completed by an informant or carer was the Dementia Questionnaire for Learning Disabilities (DLD), and its previous versions. We discuss the strengths and limitations of the instruments and outline recommendations for future use.

Chronic hemodialysis (HD) patients have very high cardiovascular risk. Acute vascular changes during dialysis mediated by factors of the endothelium may have a crucial role in this. Aim: To study acute vascular changes during HD. In 29 consecutive chronic HD patients (age: 65.6±10.4 years) pre-, mid-, and post-HD plasma syndecan-1 (SDC-1) and endothelin-1 (ET-1) levels were measured. Applanation tonometry was performed before HD. SDC-1 levels increased during HD (p=0.004). Males had higher ET-1 levels. Patients were divided into 2 groups based on pulse wave velocity (PWV): PWV≥12 m/s and PWV<12 m/s. Pre-HD and mid-HD SDC-1 levels were higher in the group with PWV≥12 m/s (10.174±2.568 vs. 7.928±1.794 ng/ml, p=0.013, and 10.319±3.482 vs. 8.248±1.793 ng/ml, p=0.044, respectively). Post-HD ET-1 levels were higher in the patient group having PWV≥12 m/s (10.88±3.00 vs. 8.05±3.48 pg/l, p=0.027). Patients having PWV≥12 m/s had higher pre-HD peripheral and aortic systolic blood pressure (p<0.05). Total cholesterol correlated with the SDC-1 decrease during HD (r=0.539; p=0.008). Pre-, mid-, and post-HD SDC-1 correlated with the ultrafiltration (r=0.432, p=0.019; r=0.377, p=0.044; and r=0.401, p=0.012, respectively). SDC-1 and ET-1 contribute to vascular changes observed during HD, and they have correlations with some cardiovascular risk factors.

Background: Recommended CKD first-line diagnostics is based on GFR-determination by Creatinine. Cystatin C-use may provide better assessment. Methods: We compared creatinine- and cystatin C-derived eGFR determination in first-line di-agnostic of 112 hospital patients aged >60 years (median=76 years). Patients were judged kid-ney-sane according to first-line diagnostic recommendations (N=61, eGFR (CKD-EPI) ≥60ml/min/m2, total urine protein <150mg/g creatinine, urinary red and white blood cells not increased) or classified at-risk for kidney insufficiency due to aortic valve dysfunction (N=51). Plausibility of eGFR-values was evaluated retrospectively by final case diagnoses. Results: eGFR (CAPA) was found linearly correlated to eGFR (CKD-EPI) (R2=0.5, slope=0.69, p<0.0001). In 93/112 (>80%) cases, eGFR (CAPA) yielded lower values (on average ≈20%). In 55/112 (49%) cases CKD-stage decreased. CKD-reclassification from kidney-sane to kid-ney-insufficient state (i.e. CKD1/2 to CKD3a/b or 4) or reclassification to more severe kidney in-sufficiency (i.e. CKD3a3b/4 or 3b4) was found in 41/112 (37%) cases. Worsening of CKD-classification (kidney-sanekidney-insufficient) based on eGFR (CAPA) was in 30% of cases plausible in the light of final case-diagnoses. Conclusion: In elderly patients (>60 years), renal function appears systematically overestimated by creatinine-based eGFR (CKD-EPI) heralding for this group employment of cystatin C-based eGFR (CAPA) as first-line diagnostic.

Plasmodium vivax causes the second highest number of malaria morbidity and mortality cases in humans. Several biological traits of this parasite species, including the formation of dormant stages (hypnozoites) that persist inside the liver for prolonged periods of time, present an obstacle for intervention measures and create a barrier for the elimination of malaria. Research into the biology of hypnozoites requires efficient systems for parasite transmission, liver stage cultivation and genetic modification. However, P. vivax research is hampered by the lack of an in vitro blood stage culture system, rendering it reliant on in vivo derived, mainly patient material, for transmission and liver stage culture. This has also resulted in a limited capability for genetic modification, creating a bottleneck in investigations into the mechanisms underlying the persistence of the parasite inside the liver. This bottleneck can be overcome through optimal use of the closely related and experimentally more amenable nonhuman primate (NHP) parasite Plasmodium cynomolgi as model system. In this review we discuss the genetic modification tools and liver stage cultivation platforms available for studying P. vivax persistent stages and highlight how their combined use may advance our understanding of hypnozoite biology.

The need for cohesive detection and defence methods against cyberattacks is significant now more than ever before to enforce security and privacy of user data and information. The inevitable increase in demand for home and flexible working from employees quite recently has meant there is a lack of awareness and training for cyberattacks. Hence, they have become prominent as attackers are aware of this and are benefitting from individuals’ lack of knowledge in how to better protect themselves and their confidential information. Employees are becoming more susceptible to such attacks and falling victim to these, resulting in economic losses for companies, data losses and decreased faith.

Diabetic nephropathy (DN), one of the primary consequences of diabetes mellitus, affecting many people worldwide. Diabetes affects yearly 463 million adults globally between the ages of 20 and 79, and is the main cause of death under the age of 60. ROS production rises during hyperglycemia and is crucial to the development of diabetic complications. Advanced glycation end products (AGEs) are produced excessively in a diabetic state and accumulate in the kidney, where they change renal architecture and impair renal function. Another important targeted pathway for the formation of DN includes NF-B, Nrf2, NLRP3, Akt/mTOR, and autophagy. About 40% of individuals with diabetes eventually acquire diabetic kidney disease and end stage renal disease that needs hemodialysis, peritoneal dialysis, or kidney transplantation, to survive. The current state of acceptable therapy for this kidney ailment is limited. The studies revealed that some naturally occurring bioactive substances might shield the kidney by controlling oxidative stress, renal fibrosis, inflammation, and autophagy. In order to provide new potential therapeutic lead bioactive compounds for contemporary drug discovery and clinical management of DN, this review was designed to examine the various mechanistic pathways by which current conventional plants derive phytocompounds that are effective for the control and treatment of DN.

In order to improve the operation performance of the multi-stage double-suction centrifugal pump and reduce the internal energy loss of the pump, this paper proposes a single-objective optimization design method based on non-hierarchical response surface model (RSM) and the multi-island genetic algorithm (MIGA). Nine parameters, such as the blade outlet width and blade wrap angle, were used as design variables, and the optimization objective was the efficiency under design conditions. In total, 149 sets of valid data were obtained under the latin hypercube sampling method (LHS), the corresponding thresholds were set for efficiency and head, and 99 sets of valid data were obtained. A cross-validation analysis of the sieved data was carried out based on non-hierarchical RSM, global optimization of the efficiency was carried out using MIGA, and numerical verification was carried out via CFD. The research results show that compared with hierarchical RSM, non-hierarchical RSM can approximate the nonlinear relationship between the objective function and the design variables with higher accuracy, and the model fitting R2 value was 0.919. The efficiency was improved by 3.717% after optimization. The overall prewhirl of the impeller inlet after optimization decreased, the internal speed of the volute significantly improved, the large-area vortex at the volute and the outlet pipe was eliminated, the impact loss at the volute separating tongue disappeared, and the overall hydraulic performance of the pump was improved. The total entropy output value of the optimized pump was reduced by 4.79 (W/K), mainly concentrated in the reduction in the entropy output value of the double volute, and the overall energy dissipation of the pump was reduced.

Regular exercise can reduce depression. However, the uptake of exercise is limited in patients with end-stage renal disease undergoing hemodialysis. To address the gap, we designed a gamified non-weight-bearing exercise program (Exergame), which can be executed during hemodialysis treatment. The Exergame is virtually supervised based on its interactive feedback via wearable sensors attached on lower extremities. We examined the effectiveness of this program to reduce depression symptom compared to supervised exercise in 73 hemodialysis patients (age=64.5±8.7years, BMI=31.6±7.6kg/m2). Participants were randomized into an Exergame group (EG) or a Supervised-exercise group (SG). Both groups received similar exercise tasks for 4-week, 3-session per week, 30-min per session, during hemodialysis treatment. Depression symptom was assessed at baseline and 4-week using Center for Epidemiologic Studies Depression (CES-D). Both groups showed significant reduction in depression score (37%, p<0.001, Cohen’s effect size d=0.69 in EG vs. 41%, p<0.001, d=0.65 in SG) with no between-group difference for the observed effect (p>0.050). The EG expressed a positive exercise experience including fun, safety, and helpfulness of sensor-feedback. Together, results suggested that the virtually-supervised low-intensity Exergame is feasible during routine hemodialysis treatment. It is as effective as supervised-exercise to reduce depression symptom, while reducing burden of administrating exercise in dialysis clinics.

Objective: To analyze the clinical efficacy and safety of monotherapy and dual therapy in patients with early ischemic stroke. Methods: The study was conducted from August 2020 to August 2021, and 80 patients with early ischemic stroke who received treatment at our hospital during this period were selected as the study population. They were randomly divided into a control group and an observation group, with 40 patients in each group. The control group received conventional monotherapy, while the observation group received conventional dual therapy. The efficacy and safety indicators of the two groups were compared.Results: The treatment efficacy, functional recovery, blood indicators, and inflammation markers in the observation group were all superior to those in the control group (all, P<0.05); there was no significant difference in the drug safety profile between the two groups (P>0.05).Conclusion: The dual antiplatelet therapy is more ideal than monotherapy for treating patients with early ischemic stroke. It can further promote the recovery of neurological and cognitive function, improve hematological and inflammatory response indicators in patients, and the safety of this regimen is comparable to monotherapy.

The Süttő 21 site is a fissure fill of the freshwater limestone of the Gazda quarry in Süttő. The material was collected between 2017 and 2019, the results are summarised in this article, with a special focus on the small vertebrate fauna of the site and its stratigraphic and paleoecological significance. The fissure fill can be placed around the early/middle Pleistocene boundary (ca. 1.1 and 0.77 Ma). The paleoecological analysis of the herpeto- and mammal fauna of the sequence indicates the proximity of a permanent water body. The lower part of the sequence is dominated by open habitat indicator taxa indicating a cool, dry climate. Towards the upper part of the sequence, the climate remained cool but became wetter, and the vegetation gradually changed to forest-steppe/open forest. The fauna of the Süttő 21 site can be compared with the material of sites, which are of similar age, thus revealing taxonomic and paleoecological differences between different areas of the country. While a warm, dry climate and open vegetation can be reconstructed in the Villány Hills around the early/middle Pleistocene boundary, the northern Hungarian areas had a cooler, wetter climate, and slightly more closed (grove, forest-steppe) vegetation during this period.

Estimation of the potential consequences from events occurring downstream of a dam are part of the risk assessment needed during the installation phase of a new dam. In case of specific Natural or Man Made ongoing or prospected events, it may be also important to carry out fast computations that can provide information on the areas at risk either because the original design analyses are not available or because the parameters needed are different. This study is aimed to develop a procedure that strongly facilitates the preparation of the input deck and the derivation of the output quantities to allow a fast analysis of a dam break event using a shallow water model, NAMI DANCE, as the analysis tool.

Background: In healthy children, the frequency of anomalous persistence of primitive reflexes (PRs) and craniosacral blocks (CBs) are unknown, as well as their impact on neurodevelopment, behaviour disorders and related consequences. We aim to know the prevalence of anomalous PRs and CBs in apparently healthy children and its relationships with behavior and neurodevelopment anomalies. Methods: Participants (n=120) were evaluated through physical examination to detect PRs and CBs, an ad hoc parent survey to collect perinatal events, and children behavior assessment by teachers using Battelle score. Results: PRs were present in 89.5%. Moro (70.8%), cervical asymmetric (78.3%) and cervical symmetric PRs (67.5%) were the most frequent observed PRs. CBs were found in 83.2%, and the most frequent CBs were dura mater (77.5%) and sphenoid bone (70%) blocks. Moro, cervical asymmetric and cervical symmetric active primitive reflexes are significantly associated to cranial blocks of dura mater, parietal zones, and sphenoid bone sway. Gestational disorders or perinatal complications were associated to a higher frequency of PRs and CBs. The presence of PRs and CBs were associated with abnormal Battelle scores and neurobehavioral problems. Conclusion: Presence of PRs and CBs in children without diagnosed diseases are frequent and related with disturbances in childhood neurodevelopment.

This study aimed to investigate how transplanting date affects the agronomic and grain quality traits of two early maturing rice varieties. The experiment was conducted in the rice research field of Chungnam Agricultural Research and Extension Services, South Korea and rice materials were transplanted at intervals of approximately 15 days from April 16 to July 16 in 2019 and 2020. Results showed that agronomic and grain quality traits varied according to the transplanting date, and earlier transplanting resulted in the longer period of days from transplanting to heading (DTH). The spikelet number m-2 was highly correlated with the milled rice yield (r = 0.963** for Jinbuol, r = 0.909** for Yeoreumi) and it significantly decreased as the transplanting date was delayed, which was leading to lower yield. Environmental factors, the mean temperature during the grain filling stage, had a negative correlation with head rice rate (r2 = 0.825** for Jinbuol, r2 = 0.803** for Yeoreumi), and the number of days from transplanting to heading showed negative correlation with protein content (r2 = 0.777** for Jinbuol, r2 = 0.833** for Yeoreumi). Therefore, increasing the number of days from transplanting to heading date can lead to higher milled rice yield and lower protein content, and avoiding heading dates on July 17 can improve the appearance traits. As a results, it is suggested that early transplanting is advantageous to increase the milled rice yield and grain quality of early maturing rice.

In this paper, we have investigated the impact of an early learning assessment on students' motivation for improving their performance throughout the semester. An observation analysis was conducted on an entry level mechanical engineering course in which students are enrolled in during their first semester of engineering work. This study analyzes the effect that a first exam, with an average below a passing grade, has on student's outcome in the course. It was hypothesized that students were motivated to achieve their desired grade outcomes following inadequate performance on the first exam. This was investigated by diving into the results of the course and referencing initial performance to the remaining exam and assessment outcomes. Students were placed into grade bands ranging from 0 to 100 in 20% increments. Their results were tracked and it was shown that for the second mechanics exam, averages jumped 43.333%, 35.35%, and 30.055% for grade bands of 0 to 20, 20 to 40, and 40 to 60 respectively. Assessment grades increased as well with the remaining assessments being averaged to a score of 91.095%. Variables contributing to student performance came from both with-in and outside the classroom. Learning communities, material differentiation, and student and professor adaptation all contributed to the rise in performance. It was concluded that the internal and external variables acted in combination with one another to increase student dedication to achieve success.

Rangelands are a key resource present all over the world as it covers half of emerged lands. They are even more important in drylands, where they cover 48% of the total area. Intensification and the additional pressure added by climate change push these systems towards desertification. Over the last two decades, we have developed and applied System Dynamics (SD) models for the study of Mediterranean grasslands. In addition, we have developed procedures and analysis tools, such as global sensitivity analysis, stability analysis condition, or risk analysis, in order to detect the main drivers of these socio-ecological systems and provide indicators about their long-term sustainability. This paper reviews these works, their scientific background, and the most relevant conclusions, including purely technical and rangeland-related ones as well as our experience as systemic modelers in a world driven by field specialists.

The aim of the current study was to determine the relation between subclinical mastitis and rumination behavior registered with an online sensor system. According to the results of the general clinical examination of 650 milking cows, 10 cows with subclinical mastitis (SCM) and 10 clinical healthy cows (HG) were selected (without clinical signs of any diseases). Rumination behavior biomarkers were registered with RumiWatch noseband sensor (RWS; ITIN + HOCH GmbH, Fütterungstechnik, Liestal, Switzerland). Sensors were implanted on the first day after calving. Data from the RWS from 13th days before the diagnosis and 13 days after diagnosis of SCM were used to compare with HG data during the same period. The healthy cows were monitored during the same days as the SCM cows.

Although the presence of dark energy is well established from various observations, its true nature is still not well understood. The cosmological constant term seems to be the preferred candidate. In earlier work we had a constant cosmological constant term to limit the sizes of large-scale structures at lower redshifts. In this work, we extend this to large scale structures at higher redshifts. Here we invoke a time varying cosmological constant to set constraints on sizes of galaxies at high redshifts and see that they are consistent with their observed sizes. The time-varying cosmological constant also provides a possible solution to the puzzle of structure formation of large disk galaxies (like the Wolfe disk) observed at very early stages of the Universe. Future observations of galaxies at even higher redshifts could support our approach.

Significant challenges exist globally regarding literacy teaching and learning, particularly in poor socio-economic settings in countries of the Global South. In this paper we argue that to address these challenges, major features of how the brain works that are currently ignored in the educational literature should be taken into account. First, perception is an active process based in detection of errors in hierarchical predictions of sensory data and action outcomes. Reading is a particular case. Second, emotions play a key role in underlying cognitive functioning. Innate affective systems underlie and shape all brain functioning, including oral and written forms of language and sign. Third, there is not the fundamental difference between listening/speaking and reading/writing often alleged on the basis of evolutionary arguments. Both are socio-cultural practices driven and learnt by the communication imperative of the social brain. Fourth, like listening, reading is not a linear, bottom-up process. Both are non-linear contextually shaped psycho-social processes of understanding, shaped by current knowledge and cultural contexts and practices. Reductionist neuroscience studies which focus on decontextualized parts of reading cannot access all the relevant processes. An integrated view of brain function reflecting this non-linear nature implies that an ongoing focus on personal meaning and understanding provides positive conditions for all aspects of literacy learning. Assessment of literacy teaching at all its stages should include indicators that take into account these foundational features relating reading and writing to neuroscience.

Osteosarcoma is the most common subtype of primary bone cancers, affecting mostly adolescents. In recent years, several studies have focused on elucidating the molecular mechanisms of this sarcoma; however, its molecular etiology has still not been determined with precision. Therefore, we applied a consensus strategy with the use of several bioinformatics tools to prioritize genes involved in its pathogenesis. Subsequently, we assessed the physical interactions of the previously selected genes and applied a communality analysis to this protein-protein interaction network. The consensus strategy prioritized a total list of 553 genes. Our enrichment analysis validates several studies that describe the signaling pathways PI3K/AKT and MAPK/ERK as pathogenic. The gene ontology described TP53 as a principal signal transducer that chiefly mediates processes associated with cell cycle and DNA damage response It is interesting to note that the communality analysis clusters several members involved in metastasis events such as MMP2 and MMP9 and genes associated with DNA repair complexes, like ATM, ATR, CHEK1, and RAD51. In this study, we could identify well-known pathogenic genes for osteosarcoma and prioritized genes that need to be further explored.

Background: Malignant pleural mesothelioma (MPM) is an atypical, belligerent tumor that matures into cancer in the pleura, a stratum of tissue bordering the lungs. Pleural mesothelioma is a common type of mesothelioma that accounts for about 75 percent of all mesothelioma diagnosed yearly in the United States. Diagnosis of mesothelioma takes several months and is expensive. Given the difficulty of diagnosing MPM, early identification is crucial for patient survival. Our study implements artificial intelligence and recommends the best fit model for early diagnosis and prognosis of MPM. Method: We retrospectively retrieved patient’s medical reports generated by Dicle University, Turkey and implemented multi-layered perceptron (MLP), voted perceptron (VP), Clojure classifier (CC), kernel logistic regression (KLR), stochastic gradient decent SGD), adaptive boosting (AdaBoost), Hoeffding tree (VFDT), and primal estimated sub-gradient solver for support vector machine (s-Pegasos). We evaluated the models, compared and tested using paired T-test (corrected) at 0.05 significance based on their respective classification accuracy, f-measure, precision, recall, root mean squared error, receivers characteristic curve (ROC), and precision-recall curve (PRC). Results: In phase-1 SGD, AdaBoost.M1, KLR, MLP, VFDT generates optimal results with the highest possible performance measures. In phase-2, AdaBoost with a classification accuracy of 71.29% outperformed all other algorithms. C-reactive protein, platelet count, duration of symptoms, gender, and pleural protein were found to be the most relevant predictors that can prognosticate mesothelioma. Conclusion: This study confirms that data obtained from biopsy and imagining tests are strong predictors of mesothelioma but are associated with high cost, however, can identify mesothelioma with optimal accuracy. Predictive analytics without using biopsy results can diagnose mesothelioma with acceptable accuracy. Implementation of phase-2 followed by phase-1 can address diagnosis expenses and maximize disease prognosis. Additionally, results indicate improved MPM diagnosis using AI methods dependent upon the specific application.

Background: This study aims to compare the impact of early and late post-discharge cardiopulmonary rehabilitation on the outcomes of intensive care unit (ICU) survivors. Methods: The retrospective, cohort study used a sub-database of the Taiwan National Health Insurance Research Database (NHIRD) that contains information of all patients had ICU admission between 2000 and 2012. Early group was defined if patients had received cardiopulmonary rehabilitation within 30 days after ICU discharge, and late group was define as if patients had received cardiopulmonary rehabilitation between 30 days and one year after ICU discharge. The end points were mortality and re-admission during the 3-year follow-up. Results: Among 2136 patients received cardiopulmonary rehabilitation after ICU discharge, 994 was classified early group and other 1142 patients were classified as late group. Overall, early group had a lower mortality rate (6.64% vs 10.86%, p = 0.0006), and a lower ICU readmission rate (47.8% vs 57.97%, p < 0.0001) than late group after 3-year follow-up. Kaplan-Meier analysis showed that early group had significantly lower mortality (p=0.0009) and readmission rate (p<0.0001) than late group. In multivariate analysis, the risk of ICU readmission was found to be independently associated with late group (HR, 1.28; 95% CI, 1.13-1.47). Conclusions: Early post-discharge cardiopulmonary rehabilitation among ICU survivors has the long-term survival benefit and significantly decreases the readmission rate.

While it is generally accepted that food habits established during infancy will track into later childhood, longitudinal analysis of children’s food preferences is rare. This paper examines whether maternal-reported child food preferences at five years of age are the same as that reported at two years; and identifies any patterns of change from two- to five- years. Mothers in the Australian NOURISH trial reported child food preferences at two and five years of age. A four point scale was utilised - ‘like’, ‘neither like or dislike’, ‘dislike’, ‘never tried’. The proportion of children having the same preference at the two time points was calculated (95%CI) for 48 foods (cereals, 4; vegetables, 20; fruit, 14; meat/alternatives, 6; dairy, 4). For foods where ≤50% children had consistent preferences, the pattern of food preference change was determined. For 40/48 foods, more than half of the children were reported to have the same preference at two years of age, and three years later, at age five. Foods for which ≤50% children had the same preference at both ages were high-sugar breakfast cereals, zucchini, mushrooms, eggplant, spinach, lettuce, cabbage and celery. Findings reinforce the importance of promoting a consistent message regarding early and frequent exposure to a variety of healthy foods, particularly during the first 2 years of life, as the preferences established in these early years are likely to be maintained over time.

Recent analyses of cosmic microwave background surveys have revealed hints that there may be a non-trivial running of the running of the spectral index. If future experiments were to confirm these hints, it would prove a powerful discriminator of inflationary models, ruling out simple single field models. We discuss how isocurvature perturbations in multi-field models can be invoked to generate large runnings in a non-standard hierarchy, and find that a minimal model capable of practically realising this would be a two-field model with a non-canonical kinetic structure. We also consider alternative scenarios such as variable speed of light models and canonical quantum gravity effects and their implications for runnings of the spectral index.

In this paper, a model of the hub covering the location-routing problem with simultaneous delivery and pickup should be designed in order to minimize the total costs, minimize the maximum vehicles travel time and minimize the amount of CO_2 gas emissions. Two-stage stochastic programming is used in this paper to control the uncertainty parameters of the problem. The mathematical model aims to decide the appropriate location of hubs and vehicle routing for simultaneous delivery and pickup of products. In this regard, the results obtained from the LP-Metric method show that there is a conflict between the objective functions, and with the reduction of the amount of CO_2 gas emissions and the reduction of the maximum vehicles travel time, the total costs have increased. On the other hand, by examining the economical factor, it was observed that by reducing this factor, the robustness factors are changed and the total costs of the network are reduced. MOIWO and MOALO were used to solve the problem in large scale, the result of which was the existence of a significant difference between the calculation time averages. Also, the efficiency of these methods was very high compared to the LP-Metric method and the maximum relative difference was less than 2.83%. The results of numerical examples show a higher efficiency of the MOALO than the MOIWO.

Oriented object detection is a challenging task in scene text detection and remote sensing image analysis, which has attracted extensive attention in recent years with the development of deep learning. Currently, mainstream oriented object detectors are based on preset anchor boxes. This method increases the computational load of the network and cause a large amount of anchor box redundancy. To solve this problem, we propose anchor-free oriented object detection based on the Gaussian centerness(AOGC), a single-stage anchor-free detection method. Our method uses contextual attention FPN(CAFPN) to obtain the contextual information of the target. Then we design a label assignment method for oriented objects. Finally, we develop a Gaussian kernel-based centerness branch, which can effectively determine the significance of different anchors. AOGC achieves mAP of 74.30% on the DOTA-1.0 datasets and 89.80% on the HRSC2016 datasets, respectively. AOGC exhibits superior performance to other methods in oriented anchor-free object detection methods.

Background. There is limited evidence on the relationship between chronic kidney disease (CKD) and frailty in older people in Vietnam. This study aimed to examine the prevalence of frailty and its impact on mortality in older patients with end-stage renal disease. Method. This is a prospective, observational study at two large Dialysis Centres in Vietnam from November 2020 to June 2021. Consecutive older patients diagnosed with end-stage renal disease and on dialysis were recruited. Participants’ frailty status was defined by the Clinical Frailty Scale (CFS). The study outcome was all-cause mortality at 6th month. Results. A total of 175 participants were recruited (mean age 72.4 years, 58.9% female). Using the cut-point of CFS ≥4, 87.4% of the participants were frail. Mortality at 6th month was 14.9%, 31.9% in participants with CFS ≥7, 12.8% in participants with CFS=6, 7.5% in participants with CFS from 4 to 5, and 4.5% in participants with CFS ≤3 (p=0.001). Cox regression analysis showed that compared to the non-frail participants, the probability of death over 6 months was nearly 2-fold higher in the mildly frail, 3-fold higher in the moderately frail, and 9-fold higher in the severely frail participants. Conclusion. This study demonstrated a very high prevalence of frailty in older patients with end-stage renal disease and dialysis and the significant impact of frailty severity on mortality. Healthcare providers should consider incorporating frailty screening into routine care for older patients with end-stage renal disease and dialysis.

Colorectal cancer remains one of the most commonly diagnosed cancers. Advanced rectal cancer patients receive neoadjuvant radiochemotherapy as well as surgery and suffer under reduced health-related quality of life due to various side effects. We were interested in the role of the COVID-19 pandemic and how it affected those patients’ quality of life. A total of 489 advanced rectal cancer patients from the University Hospital Erlangen in Germany were surveyed between May 2010 and March 2022 and asked to fill out the EORTC QLQ-C30 and QLQ-CR38 questionnaire over eight different time points: in the beginning, during and after radiochemotherapy, right before surgery and in yearly intervals after surgery for up to four years. Answers were converted to scores to compare the COVID-19 period to the time before March 2020 focusing on the follow-ups, the developments over time – including by sex and age - and the influence of the TNM cT-stage. Overall, a trend of impaired functional and symptom scores was found across all surveys with few significances (body image -10.6 percentage points (pp) after one year; defecation problems +13.5 pp, insomnia +10.2 pp and weight loss +9.8 pp after three years; defecation problems +11.3 pp after four years). cT4-stage patients lost significantly more weight than their cT1-3-stage counterparts (+10.7 to 13.7 pp). Further studies should be conducted to find possible causes and develop countermeasures for future major infectious diseases.

Groundwater (GW) flooding mechanisms differ from river flooding both spatially and temporally, and preventative methods against groundwater flooding must take this into account. Although groundwater flooding caused by river water rise occurs seldom, it can occasionally become severe and last for a long time if the river is significantly flooded. In the southwest portion of the research domain, Friedrichshafen with a few urban communities, the level of the groundwater table was discovered to be roughly 1 m below the surface. It was discovered that the urban settlement area only has one-story buildings. In the study region, it is typical for the single-story building's foundation bottom level to extend up to a depth of about 1.5 meters. Therefore, flood mitigation methods are taken into account for the southwest portion of the study region. The installation of a pumping well, drainage, and a barrier in the affected area are three different flood control strategies that are taken into consideration for the study area. From a technical and cost-benefit perspective, installing a pumping well that withdraws water and lowers the groundwater table was found to be the most effective flood control measure locally in a small region (e.g., 1km x 1km). By contrast, removing groundwater by building drainage and barriers was also shown to be ineffective to lower the groundwater table over an extended region and was significantly more expensive than the installation of wells. Additionally, when river flooding is taken into account compared to the default scenario where no intake of water from the river is included along the western border of the study area, it is discovered that the spread of pollution is significantly greater.

Background: Membranous glomerulonephritis (MGN) is one of the most common causes of nephrotic syndrome in non-diabetic adults, accounting for up to one-third of biopsy diagnostics in some regions. A watchful waiting strategy has been adopted to accurately assess the success of MGN. In this study, we predict prognostic risk factors for primary MGN patients for effective intervention and prognosis. Materials and Methods: This is a retrospective study design involving 125 biopsy-proven MGN subjects on follow-up from January 2012 to October 2019 in Hospital Serdang and Hospital Kuala Lumpur, Malaysia. Result and Conclusion: After the median follow-up of 36 (15.0-57.0) months, 26 (20.8%) consisting of 17 (13.6%) primary MGN and 9 (7.2%) secondary MGN subjects achieved complete remission while 17 (13.6%) and 10 (8.0%) of primary and secondary MGN subjects respectively achieved spontaneous remission. Subjects with nephrotic range proteinuria have 2.917 odds more at risk of primary MGN while subjects with hypertension have 2.417 odds risk of primary MGN compared to those with no hypertension at presentation. Multiple logistic regression models retained only factors directly associated with MGN with only nephrotic range proteinuria associated with primary MGN. Those with nephrotic range proteinuria were 3.04 times the odds of primary MGN when compared with those without nephrotic syndrome (95% C. I = 1.089, 8.472). The nephrotic syndrome could be used to determine the prognosis in patients with primary MGN especially those at risk of end-stage kidney disease.

Initially, retinol-binding protein (RBP), was thought to be a biomarker for proximal convoluted tubule dysfunction could be important in chronic kidney diseases (CKD). Membranous glomerulonephritis (MGN) is an important cause of CKD and end-stage renal disease (ESRD). Therefore, monitoring MGN patients using urinary RBP is important in effective treatment decision making and prognostication of MGN patients. Enzyme-linked immunosorbent assay (ELISA) technique was used to detect the RBP in the urine samples of 69 MGN patients comprising 47 primary and 22 secondary MGN, at the end of the follow-up period. The test for the urinary biomarker gave the following results: urinary RBP was detected in 27 (39.1%) and 6 (8.7%) of the primary and secondary MGN patients, respectively. The correlation analysis demonstrated a significant relationship between urinary RBP and renal function test parameters, in addition to a logistic regression analysis that proved urinary RBP as a prognostic non-invasive biomarker for primary MGN. Therefore, urinary RBP could be employed to monitor and provide effective prognosis and early treatment decisions in primary MGN.

Bacterial communities in rhizosphere and root nodules have significant contributions to the growth and productivity of the soybean (Glycine max L.). In this report, we analyzed the physiological properties and dynamics of bacterial community structure in rhizosphere and root nodules at different growth stages using BioLog EcoPlate and high-throughput sequencing technology, respectively. The BioLog assay found that the metabolic capability of rhizosphere is in increasing trend in the growth of soybeans as compared to the bulk soil. As a result of the Illumina sequencing analysis, the microbial community structure of rhizosphere and root nodules was found to be influenced by the variety and growth stage of the soybean. At the phylum level, Actinobacteria were the most abundant in rhizosphere at all growth stages, followed by Alphaproteobacteria and Acidobacteria and the phylum Bacteroidetes showed the greatest change. But, in the root nodules Alphaproteobacteria were dominant. The results of the OTU analysis exhibited the dominance of Bradyrhizobium during the entire stage of growth, but the ratio of non-rhizobial bacteria showed an increasing trend as the soybean growth progressed. These findings revealed that bacterial community in the rhizosphere and root nodules changed according to both the variety and growth stages of soybean in the field.

The rearing temperature of the immature stages can have a significant impact on the life-history traits and the ability of adult mosquitoes to transmit diseases. This review assessed published evidence of the effects of temperature on the immature stages, life-history traits, insecticide susceptibility, and expression of enzymes in the adult Anopheles mosquito. Original articles published through 31 March 2021 were systematically retrieved from Scopus, Google Scholar, Science Direct, PubMed, ProQuest and Web of Science databases. After applying eligibility criteria, 29 studies were included. The review revealed that immature stages of Anopheles arabiensis were more tolerant (in terms of survival) to a higher temperature than An. funestus and An. quadriannulatus. Higher temperatures resulted in smaller larval size and decreased hatching and pupation time. The development rate and survival of Anopheles stephensi were significantly reduced at a higher temperature than a lower temperature. Increasing temperatures decreased the longevity, body size, length of the gonotrophic cycle and fecundity of Anopheles mosquitoes. Anopheles mosquitoes exposed at 18° or 30 °C had a higher risk of dying compared to those exposed at 25 °C. Increasing temperature also significantly increased NOS expression and decreased insecticide toxicity. Both extreme low and high temperatures affect Anopheles mosquito development and survival. Climate change could have diverse effects on Anopheles mosquitoes. There seems to be inconclusive evidence of the effects of temperature on the development and survival of Anopheles species, and more studies are needed to clarify this relationship.

The production of butanol, acetone and ethanol by Clostridium acetobutylicum is a biphasic fer-mentation process. In the first phase the carbohydrate substrate is metabolized to acetic and bu-tyric acid, in the following second phase the product spectrum is shifted towards the economi-cally interesting solvents. Here we present a cascade of six continuous stirred tank reactors (CCSTR), which allows performing the time dependent metabolic phases of an ace-tone-butanol-ethanol (ABE) batch fermentation in a spatial domain. Experimental data of steady states under four operating conditions - with variations of the pH in the first bioreactor between 4.3 and 5.6 as well as the total dilution rate between 0.042 1/h and 0.092 1/h - were used to optimize and validate a corresponding mathematical model. Beyond a residence time distribution representation and substrate, biomass and product kinetics this model also includes the differen-tiation of cells between the metabolic states. Model simulations predict a final butanol product concentration of 8.2 g/L and a butanol productivity of 0.75 g/(L h) in the CCSTR operated at a pH in bioreactor 1 of 4.3 and D = 0.092 1/h, while 31 % of the cells are differentiated to the solventogenic state. Aiming at an enrichment of solvent-producing cells, a feedback loop was introduced into the cascade - sending cells from a later state of the process (bioreactor 4) back to an early stage of the process (bioreactor 2). In agreement with the experimental observations, the model accurately predicted an increase of butanol formation rate in bioreactor stages 2 and 3, resulting in an overall butanol productivity of 0.76 g/(L h) for the feedback loop cascade. The here presented CCSTR and the validated model will serve to investigate further ABE fermentation strategies for a controlled metabolic switch.

Abstract: Thermal desalination is yet a reliable technology in the treatment of brackish water and seawater; however, its demanding high energy requirements have lagged it compared to other non-thermal technologies such as reverse osmosis. This review provides an outline of the development and trends of the three most commercially used thermal or phase change technologies worldwide: Multi Effect Distillation (MED), Multi Stage Flash (MSF), and Vapor Compression Distillation (VCD). First, state of water stress suffered by regions with little fresh water availability and existing desalination technologies that could become an alternative solution are shown. The most recent studies published for each commercial thermal technology are presented, focusing on optimizing the desalination process, improving efficiencies, and reducing energy demands. Then, an overview of the use of renewable energy and its potential for integration into both commercial and non-commercial desalination systems is shown. Finally, research trends and their orientation towards hybridization of technologies and use of renewable energies as a relevant alternative to the current problems of brackish water desalination are discussed. This reflective and updated review will help researchers to have a detailed state of the art of the subject and to have a starting point for their research, since current advances and trends on thermal desalination are shown.

Land engineering is a specific new academic discipline in China. Although the undergraduate major of land engineering was officially approved and established lately since 2017, the birth of land engineering as an academic discipline dates back 40 years ago. It has passed through four development stages: the incubation stage in 1978-1985, the initial stage in 1986-1997, the growth stage in 1998-2011, and the expanding stage from 2012 to present. However, land engineering as an academic discipline remains immature and seriously lags behind practice. There are still no unified academic community and broad academic consensus. After a historical overview of the four development stages, this study gave a strategic consideration to five key questions. We argue that the study object of the discipline is land engineering activity, which is defined as the artificial transformation of a land complex combined by various natural and human elements. The uniqueness of the discipline is rooted in its ability to study the comprehensive and integrated reorganization or rebuilding of various elements of land as a complex, with the theory of land complex reconstruction being the core theory. The discipline of land engineering is based on land pure science and land technology, and is one basis of land management. It consists of two modules (rural land engineering and urban land engineering), five secondary disciplines of each module (land development, land rearrangement, land improvement, land protection, and land remediation), and more than 30 research directions. Various technologies are only instrumental but not essential components of land engineering as an academic discipline.

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

In this paper, a two-stage stochastic programming modelling is proposed to design a multi-period, multistage, and single-commodity integrated forward/reverse logistics network design problem under uncertainty. The problem involves both strategic and tactical decision levels. The first stage deals with strategic decisions, which are the number, capacity, and location of forward and reverse facilities. At the second stage tactical decisions such as base stock level as an inventory policy is determined. The generic introduced model consists of suppliers, manufactures, and distribution centers in forward logistic and collection centers, remanufactures, redistribution, and disposal centers in reverse logistic. The strength of proposed model is its applicability to various industries. The problem is formulated as a mixed-integer linear programming model and is solved by using Benders’ Decomposition (BD) approach. In order to accelerate the Benders’ decomposition, a number of valid inequalities are added to the master problem. The proposed accelerated BD is evaluated through small-, medium-, and large-sized test problems. Numerical results reveal that proposed solution algorithm increases convergence of lower bound and upper bound of BD and is able to reach an acceptable optimality gap in a convenient CPU time.

This paper proposes a novel single-stage buck-boost three-Level neutral-point-clamped (NPC) inverter with two independent dc sources coupled for the grid-tied photovoltaic (PV) application, which can effectively solve the unbalanced operational conditions generally appeared between two coupled independent PV sources induced by the unequal irradiation and temperature distribution. The proposed control scheme can simultaneously guarantee the maximum power point (MPP) operation of both PV sources and maintain the output waveform quality. Compared to the traditional two-stage PV inverter, the proposed NPC inverter could reduce the PV array voltage requirement and dc-link capacitors’ voltage rating, meanwhile show the advantage in operational efficiency. MATLAB simulations and the captured experimental results are presented to show the performance of the proposed three-level inverter.

Aedes aegypti is the main vector of various arboviruses including dengue, yellow fever, Zika and chikungunya virus. This mosquito species originated in Africa but has a wide range of distribution, colonising various ecological zones. The transmission dynamics of arboviruses depends on environmental factors, but also on mosquito life history traits including development time, fecundity, and longevity. The objective of the current study was to assess the Aedes aegypti immature development time, adult longevity, fecundity and body variation from different sampling localities. Aedes aegypti mosquitoes were collected as eggs from different geographical zones and cohorts of mosquitoes were reared in standardized laboratory conditions to assess the life history traits parameters. Emerged adults were discriminated into morphotypes according to the density of white scales on the first abdominal tergite. The means of fecundity, longevity, development time and body size were assessed, and linear models were fitted to the traits parameters to assess the effects of other covariables. Average Aedes aegypti development time was estimated to 7.35 days; 7.40 days; 6.98 days and 7.40 days respectively for Dori, 1200 logements, Bobo-Dioulasso and Toudweogo. The fecundity did not vary across study sites and was not associated with the body size. The longevity varied according to the study sites with the mosquitoes from Bobo-Dioulasso having the longest longevity while the shortest longevity was found at Dori. Fed mosquitoes had longer longevity compared to unfed ones. Morphological identification showed that Aedes aegypti aegypti-like mosquitoes were more predominant than Aedes aegypti formosus-like mosquitoes in all the study sites, suggesting the predominance of Aedes aegypti in the urban environment. Our data suggest that the geographical origin of Aedes aegypti mosquitoes in Burkina Faso has a little effect on its life history traits.

Based on the similarity theory, a large-size salt rock horizontal well cavity-leaching test platform was built, and horizontal-well cavity leaching tests with nitrogen cushion were carried out, and based on the cavity-leaching parameters, the extension characteristics of cavity morphology and the influence law of the cavity-leaching parameters were analysed; and through the establishment of numerical models reflecting the actual horizontal-well cavities morphology and characteristics, a long-term stability analysis of the horizontal well cavities was carried out, and in combination with the cavity morphology and characteristics, the distribution characteristics of the horizontal well cavity displacements and the plastic zones in the long-term operation were analysed.

Background: This study aimed to investigate the molecular profiles of stage III CRC patients from the international IDEA study. It also sought to correlate these profiles with Toll-like and vitamin D receptor polymorphisms, clinicopathological and epidemiological characteristics, and patient outcomes. Methods: Whole Exome Sequencing and PCR-RFLP on surgical specimens and blood samples, respectively, were performed to identify molecular profiling and the presence of Toll-like and vitamin D polymorphisms. Bioinformatic analysis revealed mutational status. Results: Among the enrolled patients, 63.7% were male, 66.7% had left-sided tumors, and 55.7% received CAPOX as adjuvant chemotherapy. Whole exome sequencing identified 59 mutated genes in 11 different signaling pathways from the Kyoto Encyclopedia of Genes and Genomes (KEGG) CRC panel. On average, patients had 8 mutated genes (range, 2-21 genes). Mutations in ARAF and MAPK10 emerged as independent prognostic factors for reduced DFS (p=0.027 and p<0.001, respectively), while RAC3 and RHOA genes emerged as independent prognostic factors for reduced OS (p=0.029 and p=0.006, respectively). Right-sided tumors were also identified as independent prognostic factors for reduced DFS (p=0.019) and OS (p=0.043). Additionally, patients with tumors in the transverse colon had mutations in genes related to apoptosis, PIK3-Akt, Wnt, and MAPK signaling pathways. Conclusions: Molecular characterization of tumor cells can enhance our understanding of the disease course. Mutations may serve as promising prognostic biomarkers, offering improved treatment options. Confirming these findings with require larger patient cohorts and international collaborations to establish correlations between molecular profiling, clinicopathological and epidemiological characteristics and clinical outcomes.

ccurate recording of growth indicators for aquaculture species at different stages is essential for evaluating aquaculture production effectiveness and the rationality of feed formulations. Due to their convenience and non-invasiveness, weight, length, and condition factor are commonly used to assess the growth of aquaculture species . However, fish growth indicators, can vary significantly with age structure and feed components(nutrition), and relying on a single indicator may lead to misjudgments . In this study we investigated the growth indicators of gibel carp (Carassius auratus gibelio var. CAS V) at different growth stages (juvenile and adult) and different feed formulations. Meanwhile, fish weight-length relationship () was used to assess the growth indicators. The results showed that the weight-length relationship of gibel carp varied significantly with age and feed formulations. Additionally, the condition factor calculated depended on the weight-length relationship was more consistent with weight/length changes than measured. Weight analysis indicated that both weight, length, height, back thickness, and carcass ration had higher weights in analyzing fish growth. Therefore, during aquaculture production, fish growth evaluating requires considering diverse indicators such as weight, length,body height, back thickness, carcass ration,as well as condition factor to avoid misjudging the actual growth situation. Meanwhile, the use of the condition factor should consider the sufficient amount of data and whether the assumptions (such as being in a isometric growth period) are met.

The extensive utilization of rebar during the construction of the project generates immense rebar waste, leading to increased construction costs and significant greenhouse gas emissions. Various approaches have been explored focusing on the minimization of rebar-cutting waste, such as optimizing cutting patterns, lap splice position, and special-length rebar utilization. Nonetheless, reducing rebar usage by minimizing the number of splices remains uninvestigated. In response to these issues, a two-stage optimization algorithm was developed, prioritizing special-length rebar to achieve near-zero rebar-cutting waste of less than 1% and concurrently reduce rebar usage, thereby promoting sustainable construction practices. The two-stage algorithm presented in this study involves the optimization of the lap splice position for the continuous rebar with a reduction of splices number. Furthermore, it integrates a special-length minimization algorithm for the additional rebars. Applying the algorithm to beam structures in a small-sized factory building project led to a notable reduction of 29.624 tons of rebar, equivalent to 12.31% of the total purchased quantity. Greenhouse gas emissions were reduced by 102.68 tons, and associated costs decreased by USD 30,256. A rebar-cutting waste of 0.99% which is near zero was achieved. These findings highlight the significant potential of the proposed algorithm in reducing rebar waste and facilitating sustainable construction practices. In addition, the application of the proposed algorithm in reinforced concrete construction projects will amplify the associated advantages accordingly.

This paper proposes a single-stage asymmetrical half-bridge fly-back (AHBF) converter with resonant mode using dual-mode control. The presented converter has an integrated boost converter and asymmetrical half-bridge fly-back converter and operates in resonant mode. The boost-cell always operates in discontinuous conduction mode (DCM) to achieve high power factor. The presented converter operates simultaneously using a variable-frequency-controller (VFC) and pulse-width-modulation (PWM) controller. Unlike the conventional single-stage design, the intermediate bus voltage of this controller can be regulated depending on the main power switch duty ratio. The asymmetrical half-bridge fly-back converter utilizes a variable switching frequency controller to achieve the output voltage regulation. The asymmetrical half-bridge fly-back converter can achieve zero-voltage-switching (ZVS) operation and significantly reduce the switching losses. Detailed analysis and design of this single-stage asymmetrical half-bridge fly-back converter with resonant mode is described. A wide AC input voltage ranging from 90 to 264 Vrms and output 19 V/ 120 W prototype converter was built to verify the theoretical analysis and performance of the presented converter.