A proportion of osteoarthritis (OA) patients are unsatisfied with post-operative outcomes following total joint replacement surgery (TJR), with insufficient pain relief or poor functional improvement. Predicting those will have poor outcomes would be beneficial for patients and clinicians. The aim of this study was to determine the relationship between baseline anthropometric data and the concentration of pre-operative serum and peri-operative synovial fluid (SF) cytokines with 7-month post-operative outcomes in a cohort of knee and hip OA patients. 160 OA patients were recruited who were scheduled for TJR. The concentration of 24 cytokines were measured in blood and SF by multiplex assay. EQ5Dindex health status was assessed pre-operatively and at 7-months post-operatively. 13% of patients were identified as non-responders based on EQ5Dindex. Compared to responders, non-responders were of higher BMI, had greater waist and hip circumference and had higher levels of SF leptin but lower levels of SF Resistin (p<0.05). Linear regression analysis found a significant relationship between pre-operative body weight and post-operative response (ΔEQ5Dindex; r=0.222, p=0.049). The combination of body weight with SF amphiregulin and SF IL-6 provided an improved predictive model of post-operative response (r=0.470, p=0.035).

This study aimed to investigate the effect of adding Mirror Visual Feedback Therapy (MFT) after Dry Needling (DDN) on sensitivity and motor performance in patients diagnosed with Post-Needling pain from Myofascial Trigger Points (MTrPs) in lateral elbow pain patients. A randomized, controlled, two-arm pilot trial following Consolidated Standards of Reporting Trials (CONSORT) was conducted at the European University of Madrid between February 1, 2023, and June 2, 2023. A total of 49 patients (F=23, M=26) were randomly assigned to the Experimental Group Deep Dry Needling, Ischemic Compression, Cold Spray, Stretching, and Mirror Therapy (n=25), and the others receiving the same interventions without Mirror Therapy (n=24). Pre- and post-treatment assessments encompassed Post-needling pain (VAS), pressure pain threshold (PPT), two-point discrimination threshold (TPDT), and maximum hand grip strength (MHGS). Post-needling pain intensity in the EG showed statistically significant reductions (MD = 0.400, SEM = 0.271, W = 137.00, p = 0.047) following the addition of MT to the DDN protocol. Similarly, PPT exhibited significant improvements (MD = 0.148 Kg/cm2, SEM = 0.271, W = 262.00, p < 0.001). However, TPDT and MHGS did not show significant differences between initial and post-treatment measurements. The addition of MFT to DDN for MTrPS in lateral elbow pain reduced Post-needling pain and influenced on sensory perception in lateral elbow pain patients with Myofascial Trigger Points. Despite observed clinical effects not reaching statistical significance, these findings offer valuable insights for future research considerations.

Background: Quality of life (QoL) in IC/BPS patients is an evidence gap in guidelines, because studies are limited and outdated. Therefore, guidelines might not reflect the current situation accurately, and no possible improvements in QoL of these patients. Secondly, guidelines suggest multimodal approach in therapy, however unknown is how the efficacy of these therapies are perceived by the patient themselves. The aim of this study is to investigate the perception of IC/BPS patients on their QoL and to determine which treatments they received and how they evaluate the efficacy of these various (alternative) therapies.Methods: Quantitative retrospective database study in IC/BPS patients, compiled of existing patient survey data (n=217) from July 2021. Results: The QoL of patients is affected significantly by IC/BPS. This is evident from the substantial self-reported impact by patients, the various affected domains on EQ-5D 5L. The QoL was not negatively affected by delayed diagnosis, but there were differences between female and males. Secondly, there was the wide array of (alternative) treatments utilized, although some have doubtful results and high dropout rates. Conclusion: QoL is considerably impaired in IC/BPS patients. Coagulation therapy and intravesical GAG therapy were most appreciated treatments. The diverse responses and adherence to various treatments warrant a personalized approach (phenotype-oriented therapy). To achieve improvement in the QoL, it is important to incorporate the patient’s perspective in treatment guidelines.

Background: The COVID-19 pandemic has presented numerous challenges to global healthcare system and emerging evidence suggests a potential link between COVID-19 treatment, specifically steroid therapy, and the development of avascular necrosis (AVN) of the hip. This review aims to provide a comprehensive overview of recent studies and case reports investigating the relationship between COVID-19, corticosteroid therapy, and the development of AVN. Understanding the nuances of AVN in the context of COVID-19 is crucial for healthcare professionals to navigate treatment decisions and mitigate potential complications. Materials and Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used in the systematic review until September 1st, 2023. The full-texts of the remaining twenty-three (n=23) articles were independently reviewed by the authors of this review.  Conclusions: The association between steroid therapy for COVID-19 and the development of hip AVN is a noteworthy concern even though, no relationship is evident between the duration of treatment, cumulative dosage of medication, maximum daily dosage received, and the presence of AVN. Further research with larger cohorts and long-term follow-up is needed to better understand the causative relationship and optimal management strategies for hip AVN in the context of COVID-19 and steroid therapy

Background and Objectives: Botulinum toxin injections are commonly used for the treatment of spasticity. However, injection procedures are associated with pain and procedural anxiety. While pharmacological approaches are commonly used to reduce these, inno-vative technology might be considered as a potential non-pharmacological alternative. Given this context, immersive virtual reality (VR) has shown effectiveness in the man-agement of procedural pain[1]. Our retrospective pilot study aimed to assess the potential added value of virtual reality in the management of pain and anxiety during intra-muscular injections of botulinum toxin. Materials and Methods: Twenty-one adult patients receiving botulinum toxin injections were included. A numerical rating scale was used to assess pain and anxiety during the injection procedure. The patient reported the pain experienced during previous injections without VR before injection and the pain expe-rienced in the current procedure with VR after the end of the procedure. Level of satis-faction of VR experience, if they agreed to reuse VR for the subsequent toxin botulinum injection, and if they would recommend VR to other patients were assessed. Results: The use of virtual reality showed a decrease of 1.8 pain-related points compared to without technology. No significant improvement in the level of anxiety was reported. Patients were very satisfied by their VR experience (7.9 out of 10) and would agree to reuse VR in their next injection procedure (88%) and to recommend the use of VR in other patients (100%). Conclusion: VR was useful for managing procedural pain related to botulinum toxin injection in adults, with a high level of satisfaction reported by the patient. VR should be considered as a valuable alternative to pharmacological approach to manage procedural pain during Botulinum toxin injection in adults.

This study aimed to investigate the characteristics and outcomes of patients who underwent per-cutaneous coronary intervention (PCI) and visited an emergency department (ED) with chest pain in Saudi Arabia. A retrospective analysis of patient data was conducted, focusing on demographics, risk factors, pain assessment, triage, diagnostic testing, and management. The results revealed a young adult population (40-59 years old) at risk for coronary heart disease (CHD), highlighting the need for increased awareness and education. Gender differences in cardiovascular disease (CVD) presentation and underdiagnoses in women also require attention for effective prevention and treatment. Accurate pain assessment during triage was found to be essential to prevent mistriage and negative patient outcomes. Chest pain and shortness of breath were common symptoms, emphasizing the importance of recognizing acute myocardial infarction (AMI) symptoms for proper triage, diagnostic testing, and prompt treatment. The study identified modifiable CVD risk factors, including diabetes (51.1%), hypertension (43.8%), and smoking (25.9%), stressing the importance of lifestyle modifications to reduce CVD risk. Saudi Arabia faces significant challenges in addressing cardiovascular disorders, but efforts to improve healthcare access and establish specialized centers are promising. In conclusion, this study underscores the need for increased awareness of CHD among young adults, accurate pain assessment during triage, and lifestyle modifications to address modifiable CVD risk factors. Furthermore, healthcare teams must stay updated on new chest pain guidelines in the ED and prioritize early detection of implicated arteries and prompt reperfusion. Further research investigating chest pain patient triage and assessments across Saudi Arabia is recommended to identify areas of improvement and implement necessary changes in clinical practice.

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

The aim of this study was to measure the effects on 3D active cervical Range of Motion (ACROM) and perceived pain of a n elastic taping (ET) application in the cervical area. Thirty participants (n: 22M and 8F, age 35.4±4.4 years; body height 173.1±8.4 cm; body mass 73.5±12.8 kg) for the study group (SG) and twenty subjects (n: 11M and 9F, age 32.6±3.9 years; body height 174.9±10.9 cm; body mass 71.2±12.9 kg) for the control group (CG) were recruited. All subjects were symptomatic for neck and cervical pain in baseline condition. Each group performed on ACROM test and the perceived pain on neck basing as Numerical Rating Scale (NRS 0-10, a.u.): at the baseline (T0); after 20' from ET application (T1); after three days of wearing the ET application (T2). Between T0 and T1 an ET was applied on the cervical area of the SG participants. Statistical analysis did not show any significant change in CG in any measurement session for ACROM and neck pain parameters. Conversely, the SG showed significant improvements for ACROM rotation left (T0 64.8 ± 7.7° - T2 76.0 ± 11.1° p &lt; 0.000) and right (T0 66.0 ± 11.9° - T2 74.2 ± 9.6° p &lt; 0.000); lateral inclination left (T0 37.5 ± 6.9° - T2 40.6 ± 10.8° p &lt; 0.000) and right (T0 36.5 ± 7.9° - T2 40.9 ± 5.2° p &lt; 0.000); flexion posterior (T0 47.0 ± 12.9° - T2 55.1 ± 12.3° p &lt; 0.001) and anterior (T0 55.0 ± 3.6° - T2 62.9 ± 12.0° p &lt; 0.006). A significant decrease was measure also in SG for pain NRS between T0 and T2 (T0 7.5 ± 1.0° - T1 5.5 ± 1.4 - T2 1.4 ± 1.5° p &lt; 0.000). In conclusion, the results of this study underline the usefulness of a bilateral and symmetrical ET cervical application in terms to enhance multiplanar ACROM and to reduce subjective self-perceived cervical pain when it is needed. These findings can be applied for managing musculoskeletal health of different kind of individuals.

Background: Online teaching has resulted in university students adopting a sedentary lifestyle. Prolonged sitting and reduced physical activity due to pandemic restrictions have led to musculoskeletal pain in various body areas, significantly impacting the students’ quality of life. This study aims to investigate the effects of remote learning on Sicilian physiotherapy students during the COVID-19 pandemic, specifically focusing on the occurrence of musculoskeletal pain. Methods: An observational study was conducted using an online survey administered through Google Forms. The survey consisted of 26 multiple-choice questions and was distributed to students enrolled in Physiotherapy programs at the Universities of Catania, Messina, and Palermo. Participants were contacted via social channels or email, and data collection spanned 5 weeks. The collected data were analyzed using R software. Results: A total of 128 questionnaires were collected. More than half of the students (51.6%) reported dedicating 15–22 h per week to distance learning for a duration of 6–12 months (50%). Regarding study location, most students preferred studying at a desk (82.8%), with slightly over half (57.8%) adopting a backrest while studying remotely. Analysis of the students’ posture during study hours revealed common positions, including tilting the head forward by more than 20 degrees (47.8%), leaning the trunk forward by more than 20 degrees (71.9%), both shoulders being hunched forward (57.0%), wrists positioned above the level of the elbows (46.1%), thighs pointing upwards (41.4%), and one or both feet in a downward or dorsiflexed position (69.5%). Conclusion: The questionnaire responses indicate that the lifestyle of university students, influenced by online teaching, has deteriorated, leading to musculoskeletal pain, including myofascial pain. These results are primarily influenced by the adopted posture and the duration of time spent in these positions.

Polymyalgia rheumatica (PMR) is the most common inflammatory rheumatic disease among people over the age of 50 and occurs with symptoms such as musculoskeletal pain and stiffness in the neck, shoulders and hips. To date, corticosteroids represent the cornerstone of PMR treatment, although it is well known that their prolonged use is associated with several adverse effects, making it crucial to find therapeutic alternatives to their use. The purpose of this case report was to describe the effectiveness of 10 whole-body cryostimulation (WBC) sessions on a 74-year-old woman suffering from PMR. An improvement in disease impact, fatigue, pain, quality of sleep and total physical activity was observed after WBC. Moreover, the patient reduced her daily drug intake by 67% following WBC treatments. Given the increasing prevalence of PMR and considering the side effects that drug treatments can lead to, WBC could represent a valuable adjuvant and well-tolerated alternative for the treatment of PMR.

Introduction: The relation between physical well-being and chronic pain is complex and involves several subjective and objective covariates. We aimed to assess the role of media-tor, confounder, or interactor played by covariates, including sleep quality, physical activity, perceived stress, smoking, and alcohol drinking in the relation between physical well-being and chronic pain. Method: We used Poisson regression to obtain incidence rate ratios (IRR) of the associa-tion between physical well-being and chronic pain in a cohort study carried out among uni-versity students. We applied General Structural Equation Modeling (GSEM) to assess me-diation, and stratum-specific analysis to distinguish confounding from interaction. We computed Relative Excess Risks due to Interaction (RERI), Attributable Proportion (AP), and Synergy index (S) to measure additive interaction. Results: High physical well-being is related to a large decrease in the risk of chronic pain (IRRTotal Effect= 0.58; 95%CI 0.50-0.81). Perceived stress mediates 12.5% of the total effect of physical well-being on chronic pain. The stratum-specific IRRs of current smokers and non-current smokers were different from each other and were larger than the crude IRR (IRR=1.49; 95% CI: 1.24-1.80), which indicates that smoking could be both confounder and interactor. Interaction analyses showed that physical activity could act as a potential interactor (RERI=0.25; 95% CI: 0.13, 0.60). Conclusion: Perceived stress is an important mediator of the relation between physical well-being and chronic pain, while smoking is both a confounder and an interactor. Our findings may prove useful in distinguishing high-risk from low-risk groups, in the interven-tions aimed at reducing chronic pain.

Oral mucositis (OM) is inflammation of the mouth caused by damage to the mucous membranes that line the mouth and throat. It is a side effect of cancer treatment, particularly in patients with head and neck squamous cell carcinoma (HNSCC) who undergo radiotherapy, chemotherapy, and/or immunotherapy with immune checkpoint inhibitors. The etiology and pathogenic mechanisms of OM is complex and multifaceted, involving cytotoxicity (cell death), inflammation, infection, change in microbiome, and immune-mediated cytotoxicity. We summarize the literature about attempts to use various omics methodologies (genomics, transcriptomics, microbiomics and metabolomics) to elucidate the biological pathways associated with the development or the severity of OM. Integrating different omics into multi-omics approaches carries the potential to discover links among host factors (genomics), host responses (transcriptomics, metabolomics), and local environment (microbiomics).

Chemotherapy-induced peripheral neuropathy (CIPN) develops as a challenging nerve-damaging adverse effect of anticancer drugs used in chemotherapy. The disorder may require a dose reduction of chemo-therapy and its most common sensory symptoms are severe pain, tingling, and numbness in the hands and feet. CIPN affects dramatically the patient's quality of life (QoL). Pain and sensory abnormalities may occur for months, or even years after the termination of chemotherapy. This disease has complicated pathophysiology featured by underlying mechanisms not completely known. Although many pharmaco-logical and non-pharmacological therapeutic approaches have been tested to overcome these symptoms, there is currently no standardized cure to prevent or treat CIPN. According to current guidelines, Duloxe-tine is the only recommended agent for painful neuropathic symptoms. Therefore, finding effective thera-pies for CIPN is mandatory. The purpose of this review is to dissect CIPN, the target and immunothera-py-based approaches to this disorder, as well as to offer new insights for novel therapeutic perspectives.

Modulation of nociception allows animals to prioritise their survival by adapting their behaviour in different contexts. In mammals, this is executed by neurons from the brain, and is referred to as the descending control of nociception. Whether insects have this control, or have the neural circuits underpinning it, has not been clarified. Here, we review evidence supporting descending control of nociception control in insects, and consider which neuronal sub-types and brain areas may be involved.

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

As neck and/or shoulder pain (NSP) frequently occur together with tension-type headache (TTH) and migraine, we explored how concomitant NSP affects perceived treatment responses to an analgesic. An anonymous survey was performed among 895 TTH and migraine sufferers who used the analgesic 400 mg ibuprofen/100 mg caffeine. NSP was relatively abundant among patients (42.4% for TTH; 39.2% for migraine), and associated with &gt;1 additional day with headache per month. Reported pain reduction was independent from NSP for TTH and migraine. More patients became pain-free at 2 h in migraine with NSP (42.9%) compared to migraine without NSP (32.2%), which is different from TTH with NSP (60.6%) and TTH without NSP (71.4%). For both, migraine and TTH, a recurrence of headache on the same day was more prevalent in those with concomitant NSP leading to a greater likelihood of taking a second dose of the analgesic. NSP frequently occurs together with TTH and migraine patients. In migraine, NSP seems to be associated with a better treatment response at 2 h. The more frequent recurrence of pain in those with concomitant NSP indicates that NSP makes both headache types worse. Further studies are needed to substantiate these effects.

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

Lower back musculoskeletal disorders (MSD) are an important public health problem and the leading cause of disability worldwide, but with prevalence yet unknown among shellfish gatherers. To investigate the prevalence and work-related factors associated with lower back MSD in a population of female shellfish gatherers, an epidemiological cross-sectional study was carried out in Saubara, Bahia – Brazil, in 2013. The Brazilian version of the Job Content Questionnaire (JCQ) and the Nordic Musculoskeletal Questionnaire (NMQ), in addition to a questionnaire containing the physical demands adapted to the artisanal work, were applied to a random sample of 209 female shellfish gatherers. The prevalence of lower back MSD was 72.7%. Using multivariate logistic regression, the shellfish gatherers who had worked for more than 26 years in the activity showed a prevalence of 1.22 (95% CI: 1.04-1.44) times higher compared to those unexposed. Lower back MSD was 1.24 (95%CI: 1.08-1.42) times higher among those more exposed to work sitting with trunk flexion. Those performed manual handling and muscle force with the arms had a prevalence ratio of 1.18 (95%CI: 1.01-1.39). These results show the need for greater awareness of health and social welfare factors impacting workers in small-scale fisheries and will promote the elaboration of health care policies for this occupational class.

Low Back Pain (LBP) is one of the most common problems among adults. The usual physiotherapy treatment is to perform physical exercises. However, some LBP patients have false beliefs regarding their pain and they tend to avoid physical movements which might increase their pain and disability. Virtual Reality (VR) has shown to be an effective intervention in improving motor functions and reducing pain perception. Existing VR interventions for LBP rehabilitation were based on a non-immersive VR, whereas to effectively reduce the pain intensity, we need an immersive VR. In this paper, we introduce the development and evaluation of a serious game called RabbitRun with an immersive experience to engage the patients in a virtual environment and distract them from the pain while performing LBP exercises. The initial usability evaluation results suggest that RabbitRun game is enjoyable and acceptable. The game is easy to play and learn and most of the participants are willing to play the game at home. This solution will enhance the rehabilitation outcome since the patients who are suffering from LBP can use the system at their home and train more for long period of time using a smartphone and low-cost virtual reality device such as Google Cardboard.

This paper is an interdisciplinary study of novel applications of techniques and tools of an area of brain science, known as Synesthesia (involving associations and/or confusion between distinct senses), to area of Computer Science known as Immersive Virtual Reality (VR), that makes the subject’s awareness of physical self be diminished by being surrounded in an engrossing artificial environment. Natural Synesthesia has for the last decade been an important emerging area in brain science but is present in only a small proportion of the population. For example a person with Natural Synesthesia, when viewing a grapheme, may perceive a color additionally to be associated to the grapheme. In contrast, Artificial synesthesia (also known as virtual synesthesia or synthetic synesthesia) has been defined as the sensory joining due a cross-modal mapping device, where information of one sense is accompanied by an induced perception in another sense. In particular, we propose use of a multimodal manner of displaying information in VR to increase and concentrate attention. Artificial Synesthesia to synthetically create induced associations between senses, allowing Artificial Synesthesia to be experienced by anyone using a VR system. The paper describes the enhancement of immersive VR by use of Artificial Synesthesia to improve the system’s performance at steering and directing the attention of the user. We describe techniques for an enhanced immersive VR that displays associations between a variety of senses: between colors and characters, also between colors and sounds, and between sounds and the position of tactile sensations. The sense association provided by Artificial Synesthesia allows the system to better capture the user’s attention and better direct that attention. A major application of our work in VR-induced Artificial Synesthesia is to provide an enhanced methodology for controlling the attention of the subject, and to improve the direction of attention of subjects undergoing guided imagery therapies for pain relief. Other potential high-impact applications include improved immersive VR, more programmable human/computer interfaces and other medical therapies.

Major depressive disorder (MDD) is a common mental disorder, which results in seriously impaired condition in the patients and great global disability burden. In light of its quite diverse etiologies, comorbidity with many other diseases, and complex underlying pathology, it has been a great challenge to understand the physiological basis of MDD, which may be a complex of related diseases, rather than a single one. In addition to the partial understanding of MDD, the individual heterogeneities among patients may render the development of a universal treatment an elusive goal. But studying how each of currently available treatments affects the disease can generate useful information to stratify patients into different subtypes for individualized treatments. In this case report, we present the first report of repeated success of using meditation as the only treatment of MDD, compared to initial success but no remission with other conventional antidepressants on the same patient. We hypothesized that the short but continuous natural pain during one-hour meditation sittings has the therapeutic effect to treat depression in the case of this patient and potentially others with MDD. This special opportunity of eliminating tremendous heterogeneity among different individuals has enabled us to probe deeply into the potential mechanism of depression treatments and the complex physiology of depression itself, both of which have likely profound implications in the treatment of other MDD patients as well. More importantly, this case report helps us dissect one specific component of meditation for its long-known and well-established benefit against depression.

Malnutrition and dental caries in early childhood remain persistent and intertwined global health challenges, particularly for indigenous and geographically-remote populations. To examine the prevalence and associations between early childhood dental caries, parent-reported mouth pain and malnutrition in the Amazonian region of Ecuador, we conducted a cross-sectional study of the oral health and nutrition status of 1,407 children from birth through age 6 in the “Alli Kiru” program (2011-2013). We used multivariate regression analysis to examine relationships between severe caries, parent-reported mouth pain measures, and nutritional status. The prevalence of dental caries was 65.4%, with 44.7% of children having deep or severe caries, and 33.8% reporting mouth pain. The number of decayed, missing and filled teeth dmft) increased dramatically with age. Malnutrition was prevalent, with 35.9% of children stunted, 1.1% wasted, 7.4% underweight, and 6.8% overweight. As mouth pain increased in frequency, odds for severe caries increased. For each unit increase in mouth pain frequency interfering with sleeping, children had increased odds for underweight (AOR: 1.27; 95% CI: 1.02 – 1.54) and decreased odds for overweight (AOR: 0.76; 95% CI: 0.58 – 0.97). This relationship was most pronounced among 3-6 year-olds. Early childhood caries, mouth pain and malnutrition were prevalent in this sample of young children. Parent-reported mouth pain was associated with severe caries, and mouth pain interfering with sleeping was predictive of poor nutritional status. We demonstrate the utility of a parsimonious parent-reported measure of mouth pain to predict young children’s risk for severe early childhood caries and malnutrition, which has implications for community health interventions.

The objective of this work is to analyze the improvement of heat transfer in trapezoidal fin heat exchangers using numerical simulation. Heat exchangers are essential components frequently used in contemporary electronic gadgets to effectively disperse heat produced by high-power components. Nevertheless, as electronic devices continue to advance and become more powerful, the heat transfer capacity of heat exchangers is facing more requirements, therefore requiring enhanced heat dissipation efficiency. Afterwards, various fin angles were adjusted, and the heat transmission efficiency was compared. Modifying the angles can significantly improve the effi-ciency of convective heat dissipation. Moreover, it has been found that employing an optimized trapezoidal fin structure can further enhance the efficiency of heat transfer. The results indicate that trapezoidal fin heat exchangers provide superior heat dissipation efficiency compared to conventional heat exchangers. This is important for enhancing the thermal dissipation capabili-ties of electrical gadgets, hence guaranteeing steady functionality and extending their longevity. Subsequent study might explore supplementary methods to boost heat transmission in different heat exchanger configurations in order to meet the growing requirements for heat dissipation.

The design complexity of the new generation of civil aero-engines results in higher demands on engines’ components, higher component temperature, higher heat generation, and, finally, critical thermal management issues. This paper will propose a methodological approach to create physics-based models for heat loads developed by sources as well as a systematic sensitivity analysis to identify the effects of design parameters on the thermal behaviour of civil aero-engines. The ranges and levels of heat loads generated by heat sources (e.g., accessory gearbox, bearing, pumps, etc.) and heat absorption capacity of heat sinks (e.g., engine fuel, oil, and air) are discussed systematically. The practical research challenges for thermal management system design and development for the new and next generation of turbofan engines will then be addressed through a sensitivity analysis of the heat load values as well as the heat sinks flow rates. The potential solutions for thermal performance enhancements of propulsion systems will be proposed and discussed accordingly.

Regeneratively cooled scramjet has already been successfully verified as propulsion device for hypersonic vehicle. As a result, dynamic process of flow and heat transfer in cooling channel is commonly occurred which may bring hazard and control difficulties for scramjet. To study transient flow and heat transfer process in cooling channel, a dynamic numerical model is established. Dynamic characteristics of flow and heat transfer under different conditions are calculated and discussed, which includes change of inlet fuel mass flow, heat flux and pressure working conditions. Results show that stable time of cooling channel outlet fuel temperature is related to the change rate of inlet mass flow and heat flux. The stable time of outlet fuel temperature under heat flux decreasing working conditions are about 12.5 s. The initial response of working pressure fluctuation will lead to fuel temperature fluctuation, which has little effect on wall temperature.

This paper proposes a simulation technique for investigating the battery thermal management system based direct refrigerant cooling (BTMS-DRC). It employs finite element method for a combined-conduction-convection heat transfer to predict the module temperature and to prove the temperature uniformity. The refrigerant side cooling is based on the two-phase flow evaporation which is represented by the convection heat transfer (flow evaporation) under a certain refrigerant saturation temperature. The battery heat generation is modeled as the constant heat flux. The main module is modeled as the conduction heat transfer. The real BTMS-DRC is constructed for experimentation with the test bench which is based on the dual-evaporators vapour compression refrigeration system. The simulated result is validated with the experimental results to ensure the correction of the modelling. The simulation also investigates the impact of the heat generation, convection heat transfer coefficient, refrigerant saturation temperature, and thermal conductivity on the module temperature and temperature uniformity. It is found that the simulated results agree well with the experimental results. The errors are around 2.9 - 7.2% throughout the specified working conditions. Overall, the proposed technique can be used as a design tool for further developing the BTMS-DRC.

Geothermal energy is likely to be a significant contributor in achieving sustainable energy goals and net-zero emissions targets. Within geothermal power plants, heat exchangers play a critical role in harnessing this renewable energy source. However, these heat exchangers encounter significant challenges when exposed to geothermal fluids, including erosion, corrosion, and scaling, which adversely affects their performance and longevity. The current review focuses on surface engineering techniques, particularly coatings, as a highly effective and economically viable solution to address these challenges in geothermal heat exchangers. The review begins by providing an overview of geothermal energy, its significance in the context of sustainability and the important role played by heat exchangers in geothermal power generation, followed by the challenges and their impact on heat exchangers. The subsequent section focuses on surface engineering by coatings and its types employed to enhance the performance of heat exchangers. In the final part, the reader is presented with an overview of the challenges associated with the application of coatings in geothermal heat exchangers and potential future directions in this field. This review offers a detailed understanding of the critical role coatings play in improving the efficiency and service life of heat exchangers in geothermal power plants.

Is HSP-27 an emerging marker of good prognosis in septic shock patients – a pilot study Objective To estimate the value of serum changes of C-reactive protein, procalcitonin, presepsin, heat shock protein 27 (HSP27) and neutrophil to lymphocyte ratio in assessing the prognosis in patients with septic shock (SS) treated in intensive care unit. Methods The SS was diagnosed and treated in accordance with the guidelines of the Surviving Sepsis Campaign. 37 selected adult patients with SS were included. Serum concentrations of biomarkers were measured at admission and daily for 4 consecutive days (time points T0,T1, T2, T3 and T4 respectively). The mortality rate was determined 28 days after admission. Patients were divided into survivor and non-survivor groups according to their mortality. The differences between the levels of biomarkers at the T0 and T4 time points were analyzed. Results The mean value of the SOFA score on admission was 11.7 ± 2.7, and the APACHE II scale 29.9 ± 6.85. Nine patients died. Univariate logistic analysis revealed that changes between T0 and T4 time points of presepsin, procalcytonin, and HSP27 were associated with prognosis. A multivariate Cox analysis showed that an increase in HSP27 on T4 was the only independent predictor of good prognosis in SS patients. The area under the receiver operating characteristics curve for HSP27 was 0.785. Kaplan–Meier analysis showed that the mortality was lower (p=0.014) in patients who had an increase in HSP27 on T4 compared to those whose serum HSP27 did not increase on T4. Conclusions The increase of HSP27 level on the 4th day predicts favorable outcome in SS patients.

The heritage of ancient buildings is an important part of the world's history and culture, which has an extremely rich historical-cultural value and artistic research value. Beijing has a large number of palace ancient buildings, and because of the age of their construction, many of them have problems of varying degrees of peeling and mold on the inner surfaces of the envelope. To solve the problems of the damp and moldy interior of palace buildings, a mathematical model of indoor heat and moisture transfer was established based on a wooden palace ancient building in Beijing. Through the indoor mold distribution validation model, the effects of outdoor humidity, soil moisture, wall humidity, and other factors on the indoor heat and moisture transfer of ancient buildings were simulated and analyzed by using the control variables method. The results showed that the molds were distributed at the indoor corners and floors, and the simulation of indoor humidity match the measured humidity. Thus, the simulation results were consistent with the actual situation. The variable trend of the relative humidity of the indoor environment with the outdoor humidity is inconsistent from plane to plane, i.e. it increases or remains constant with the increase of the outdoor humidity. The indoor ambient relative humidity increased with increasing the wall humidity. And the indoor average temperature is 23.3 ℃ and indoor relative humidity ranged between 90.9 % to 92.44 %. Soil moisture and wall humidity were the main factors affecting the indoor environmental relative humidity.

Demand for development of the convergence industry, research studies on electrical conductivity, thermal characteristics, semiconductors, motors, and batteries using special materials have come to the fore. Meanwhile, molybdenum (Mo) exhibits relatively small inorganic qualities, and the thermal conductivity rate is applied to various fields. In this study, in-depth characteristics were considered regarding the concentration of thermal characteristics, IR car terminal characteristics, and IR ve-hicles. This study calculated each phase temperature of the molybdenum sputtered specimens in the steady state according to the heat transfer theory. When the molybdenum-sputtered fabric’s metal layer pointed to the outside air, the heat transfer rate (Q) was high at 5748.3W, In contrast, if the molybdenum sputtered film’s metal layer of the pointed toward the heat source, the heat transfer rate (Q) was low at 187.1W. As a result of measuring the IR transmittance, the infrared transmit-tance of the molybdenum sputtering-treated sample was significantly reduced compared to the untreated sample. In the case of untreated samples, the transmittance ranged from 92.7 to 42.0%. When only the cross part was treated with molybdenum sputtering and the molybdenum surface was directed toward the IR irradiator, the IR transmittance was 66.8~0.7%. It is believed that the molybdenum sputtering polyamide samples produced in this study can be applied to multifunc-tional military wear, biosignal detection sensors, semiconductor products, batteries, etc., by utilizing excellent electrical properties, stealth functions, IR blocking properties, and lightness for infrared thermal imaging detectors.

Neonicotinoids (NEOs) have become the most widely used insecticides in the world since the mid-1990s. According to Chinese dietary habits, rice and water are usually heated before being consumed, but the information about the alteration through the heat treatment process is very limited. In this study, the parents of NEOs (p-NEOs) accounted for >99% of the total NEOs mass (∑NEOs) in both uncooked (median: 66.8 ng/g) and cooked (median: 41.4 ng/g) rice samples from Guangdong Province, China, while the metabolites of NEOs (m-NEOs) involved in this study accounted for less than 1%. We aimed to reveal the concentration changes of NEOs through heat treatment process, thus, several groups of rice and water samples from Guangdong were cooked and boiled, respectively. Significant (p < 0.05) reductions in acetamiprid, imidacloprid (IMI), thiacloprid, and thiamethoxam (THM) have been observed after the heat treatment of the rice samples. In water samples, the concentrations of THM and dinotefuran decreased significantly (p < 0.05) after the heat treatment. These results indicate the degradation of p-NEOs and m-NEOs during the heat treatment process. However, the concentrations of IMI increased significantly in tap water samples (p < 0.05) after heat treatment process, which might be caused by the potential IMI precursors in those industrial pesticide products. The concentrations of NEOs in rice and water can be shifted by the heat treatment process, so this process should be considered in relevant human exposure studies.

Thin-wall heat pipe is an efficient heat transfer component, which has been widely used in the field of heat dissipation of high-power electronic equipment in recent years. In this study, the orange peel morphology defect of thin-wall heat pipes after bending deformation was analyzed both for the macro 3D profile and for the micro-formation mechanism. The results show that after high temperature sintering treatment, the matrix grains of heat pipe are coarsened seriously and formed a strong Goss texture, while a certain annealing twins with the unique Copper orientation are retained. The distribution of Schmid factor value subjected to the uniaxial stress indicate the inhomogeneity of intergranular deformation exist among the annealing twins and matrix grains. The annealing twin exhibit a “hard-oriented” component during the deformation; thus, it plays a role as barrier and hinder the slipping of dislocation. As the strain accumulates, part of the annealing twins may protrude from the surface of heat pipe, forming a large-scale fluctuation of the surface as the so called the “orange peel” morphology. The 3D profile shows the bulged twins mostly perpendicular to the drawing direction, with about 200-300μm in width and 10-20μm in height.

A quantum Otto engine with a single ion harmonic oscillator as its working substance is studied for an adiabatic operation at high and low temperature limits. Using the universal optimization method, the heat engine is effectively optimized and found to yield better working conditions in some ranges of temperature ratios. Accordingly, the figure of merit, ψ, is found to be greater than unity in the range: 0&lt;β2β1≤0.12; showing that the heat engine performs better in the optimized condition than in the maximum power working condition. ψ is determined to be less than one in the range 0.12≤β2β1≤0.35 under the same temperature limit ; depicting that the maximum power working condition is preferred to the optimized working condition. On the other hand, in the low temperature limit, the figure of merit, ψ, is found to be greater than unity in the range 3.7&lt;ω1ω2≤18; revealing that optimized working condition is better than the maximum power working condition for the heat engine. In the same temperature limit, ψ is found to be less than one in the range 0≤ω1ω2≤3.7; showing that maximum power working condition is preferred to the optimized one. For the model of heat engine studied, in some ranges of temperature ratio, it is found to work better in the optimized condition, whereas in the other ranges it performs better under the maximum power working condition. So, it is possible to switch the engine between the two conditions depending on one’s need.

The study of the influence of the nanoparticle volume fraction and aspect ratio of microchannels on the fluid flow and heat transfer characteristics of nanofluids in microchannels is important in the optimal design of heat dissipation systems with high heat flux. In this work, the computational fluid dynamics method was adopted to simulate the flow and heat transfer characteristics of two types of water–Al2O3 nanofluids with two different volume fractions and five types of microchannel heat sinks with different aspect ratios. Results showed that increasing the nanoparticle volume fraction reduced the average temperature of the liquid–solid heat transfer surface and thereby improved the heat transfer capacity of the nanofluids. Meanwhile, the increase of the nanoparticle volume fraction led to a considerable increase in the pumping power of the system. Changing the aspect ratio of the microchannel effectively improved the heat transfer capacity of the heat sink. Moreover, increasing the aspect ratio effectively reduced the average temperature of the heating surface of the heat sink without significantly increasing the flow resistance loss. When the aspect ratio exceeded 30, the heat transfer coefficient did not increase with the increase of the aspect ratio. The results of this work may offer guiding significance for the optimal design of high heat flux microchannel heat sinks.

The mechanical engineering requires heat treatment after rough machining to reach the mechanical strength, but the heat treatment can induce workpiece deformation, so that the workpiece cannot be reworked. In this study, the plasma was integrated with a lathe, and the on line heat treatment was performed to achieve the mechanical strength and hardness, so as to reduce the machining process and handling. However, for on line heat treatment, it is important to study the machine and plasma parameters of the lathe and plasma, and the research method is used eventually to optimize the process, reduce the machining cost and machining error. The variable factors in surface on line real-time heat treatment are revolution, feed rate and current, the objective function is the hardness of mechanical properties. In the screening experiment, the interaction of factors was discussed using full factorial experiment. The Central Composite Design was combined with the Lack-of-Fit test for optimization experiment, the R2 coefficient was used to determine whether the regression model is appropriate. The optimum parameters were derived from the contour diagram and response surface diagram. The experimental results show that the significant factors include revolution, feed rate and current, the optimum parameters include revolution 168rpm, feed rate 0.068mm/rev and current 86A. The experimental results of optimum parameters show that the surface hardness is increased from 306HLD to 806HLD, the surface hardening effect is enhanced by 163%, so the on line real-time heat treatment equipment has a best hardening effect.

Photosynthesis is a pivotal process that determines the synthesis of carbohydrates required for sustaining growth under normal or stress situation. Stress exposure reduces the photosynthetic potential owing to the excess synthesis of reactive oxygen species that disturb the proper functioning of photosynthetic apparatus. This decreased photosynthesis is associated with disturbances in carbohydrate metabolism resulting in reduced growth under stress. We evaluated the importance of melatonin in reducing heat stress-induced severity in wheat plants (Triticum aestivum L.). The plants were subjected to 25 ˚C (optimum temperature) or 40 ˚C (heat stress) for 15 days at 6 hours time duration and then developed the plants for 30 days. Heat stress led to oxidative stress with increased production of TBARS and H2O2 content and reduced accrual of total soluble sugars, starch and carbohydrate metabolism enzymes which are reflected in reduced photosynthesis. Application of melatonin not only reduced oxidative stress through lowering TBARS and H2O2 content, through augmenting the activity of antioxidative enzymes but also increased the photosynthesis in plant and carbohydrate metabolism that is needed to provide energy and carbon skeleton to the developing plant under stress. However, the increase in these parameters with melatonin was mediated via hydrogen sulfide (H2S), as the inhibition of H2S by hypotaurine (HT; H2S inhibitor) reversed the ameliorative effect of melatonin. This suggests a crosstalk of melatonin and H2S in protecting heat stress-induced photosynthetic inhibition via regulation of carbohydrate metabolism.

Demolished concrete and plastic waste are two increasingly aggravating problems. In this study, a novel method was proposed to simultaneously recycle concrete and plastic wastes by compacting concrete and plastic powders together under pressure and temperature. The influence of compression pressure and temperature as well as the mixture proportion on the bending strength of specimens was investigated. The results showed that pressure and temperature had a positive effect on the specimen strength; however, the molding temperature should not exceed the melting temperature of plastic. The proportion of plastic had a minimal effect on the bending strength of the specimen when plastic accounted for 25%–75% of the overall mass of the test piece.

The calculation of the isobaric heat capacities of the liquid and solid phase of molecules at 298.15 K is presented, applying a universal computer algorithm based on the atom-groups additivity method, using refined atom groups. The atom groups are defined as the molecules' constituting atoms and their immediate neighbourhood. In addition, the hydroxy group of alcohols are further subdivided to take account of the different intermolecular interactions of primary, secondary and tertiary alcohols. The evaluation of the groups' contributions has been carried out by means of a fast Gauss-Seidel fitting calculus using experimental data from literature. Plausibility has been tested immediately after each fitting calculation using a 10-fold cross-validation procedure. For the heat capacity of liquids, the respective goodness of fit of the direct (R2) and the cross-validation calculations (Q2) of 0.998 and 0.9975, and the respective standard deviations of 8.2 and 9.16 J/mol/K, together with a medium absolute percentage deviation (MAPD) of 2.69%, based on the experimental data of 1133 compounds, proves the excellent predictive applicability of the present method. The statistical values for the heat capacity of solids are only slightly inferior: for R2 and Q2, the respective values are 0.9915 and 0.9875, the respective standard deviations are 12.19 and 14.13 J/mol/K and the MAPD is 4.65%, based on 732 solids. The predicted heat capacities for a series of liquid and solid compounds has been directly compared to those received by a complementary method based on the "true" molecular volume [1] and their deviations elucidated.

Drying food involves complex physical atmospheric mechanisms with non-linear relations from the air-food interactions and those relations are strongly dependent on the moisture contents and the type of food. Such dependence makes it complex to design suitable dryers dedicated to a single drying process. To streamline the design of a novel compact food-drying machine, a heat pump dryer component design optimization algorithm was developed as a subprogram of a Computer Aided Engineering tool. The algorithm requires inputting food and air properties, the volume of the drying container and the technical specifications of the heat-pump off-the shelf components. The heat required to dehumidify the food supplied by the heat exchange process from condenser to evaporator, and the compressor’s requirements (refrigerant mass flow rate and operating pressures) are then calculated. Compressors can then be selected based in the volume and type of food to be dried. The algorithm is shown via a flow chart to guide the user through 3 different stages: Changes in drying air properties, Heat flow within dryer and Product moisture content. Example results of how different compressors are selected for different type of produces and quantities (Agaricus Blazei mushroom with 3 different moisture contents or fish from Thunnini tribe) conclude this article.

In this investigation steel P355NH has been successfully cladded with Inconel 625 through the method of explosive welding. Explosively welded bimetal clad-plate was subjected to the two separated post weld heat treatment processes: stress relief annealing (at 620oC for 90 minutes) and normalizing (at 910oC for 30 minutes). In order to analyze the microstructure of the joint in the as-welded state and to investigate the influence of the post weld heat treatment on it, the light and scanning electron microscope observations and microhardness analysis have been performed. The examination of the diffusion zone microstructure has been performed by using the scanning transmission electron microscope. It was stated that obtained joint has characteristic wavy-shape geometry with the presence of the melted zones and severe deformed grains of both joined materials. Strain hardening of the materials in joint zone was established with microhardness analysis. In both of the heat treatments the changes in the grain structure have been observed. The normalizing heat treatment has the most significant impact on the microstructure of the joint as well as the concentration of the chemical elements in the joint zone. It was reported that due to normalizing the diffusion zone has been formed together with precipitates in the joint zone. The analysis of the diffusion zone images leads to the conclusion that the diffusion of alloying elements from Inconel 625 to steel P355NH takes place along the grain boundaries with additional formation of the voids in this area. The precipitates in Inconel 625 in the joint zone are two type of carbides – chromium-rich and molybdenum-rich. Scanning transmission electron microscope observation of the grain microstructure in the diffusion zone shows that this area consists of equiaxed grains (from the side of Inconel 625 alloy) and columnar grains (from the side of steel P355NH).

The fatigue strength of the hot work steel depends on various factors, including the mechanical, properties and behavior and bulk and the surface under layer, the microstructural features as well as heat treatments. The influence of a series of heat treatments on the fatigue strength of H13 hot work steel was investigated. Different preheating, quenching and tempering treatments were applied to four sets of specimens and fatigue tests were conducted at room temperature using a rotating bending test machine. All heat treatments resulted in a certain improvement of the fatigue strength. Highest fatigue strength obtained by applying a double tempering heat treatment (first tempering at 550 °C for two hours and second tempering at 610 °C for two hours) after initial preheating and quenching. One tempering treatment (550 °C for two hours after preheating and quenching) did not significantly improve the fatigue strength.

Heating systems such as heat pump and combined heat and power cycle systems (CHP) are representing a key component in the future smart grid. Their capability to couple the electricity and heat sector promises a massive potential to the energy transition. Hence, these systems are continuously studied numerical and experimental to quantify their potential and develop optimal control methods. Although numerical simulations provide time and cost-effective solution for system development and optimization, they are exposed to several uncertainties. Hardware in the loop (HiL) system enables system validation and evaluation under different real-life dynamic constraints and boundary conditions. In this paper, a HiL system of heat pump testbed is presented. This system is used to present two case studies. In the first case, the conventional heat pump testbed operation method is compared to the HiL operation method. Energetic and dynamic analyses are performed to quantify the added value of the HiL and its necessity for dynamics analysis. The second case, the HiL testbed is used to validate the heat pump operation in a single family house participating in a local energy market. It enables not only the dynamics of the heat pump and the space heating circuit to be validated but also the building room temperature. The energetic analysis indicated a deviation of 2% and 5% for heat generation and electricity consumption of the heat pump, respectively. The model dynamics emphasized the model capability to present the dynamics of a real system with a temporal distortion of 3%.

In this work, we experimentally investigate mass and heat transport phenomena in a modular device while converting a solution salinity difference into a temperature difference. Operations occur under fixed total ambient pressure and without mechanical moving parts, thus realizing a fully static conversion. Provided that a constant salinity gradient can be imposed, the proposed device is able to generate a steady cooling capacity. Here, we purposely operate with environmentally benign and easily accessible sodium chloride water solutions only. A numerical model is finally elaborated, validated and used to explore a wider range of possible device configurations and operating conditions.

The urban heat island (UHI) and its intensity is one of the phenomena that are of determining importance for the comfort of living in cities and their sustainable development in the face of deepening climate change. The study is objectively difficult due to the large dynamics like land cover and the considerable diversity of land use patterns in urban areas. Various approaches and methods are used in research practice, based both on ground measurements and in the use of remote methods and satellite information. However, most of these approaches provide information with problematic spatial and temporal resolution, making them difficult to apply for sustainable urban planning purposes, which require adequate information provision. This paper presents the results of the application of thermal photogrammetry based on the use of unmanned aerial systems (UAS), combined with geographic information systems (GIS), in the study of surface urban heat island intensity (SUHI), at the local level for the largest housing complex in Bulgaria - Lyulin district of the capital of Sofia city. The studies were carried out during a heat wave in July 2023. A difference of 16.5oC was found between locations with SUHI occurrence and suburban areas. The information benefits of locally addressed data and their direct applicability are discussed to support decision-making processes in the planning and management of urban areas, including their climate adaptation and sustainable development.

After peripheral nerve injury, axon and myelin regeneration are key events for optimal clinical improvements. We have previously shown that early bone marrow mononuclear cell (BMMC) transplantation exerts beneficial effects on myelin regeneration. In the present study we analyze whether there is a temporal window in which BMMC migrate more efficiently to damaged nerves while still retaining their positive effects. Adult Wistar rats of both sexes, with sciatic nerve crush were systemically transplanted with BMMC at different days post injury. Vehicle-treated, naïve, and sham rats were also included. Morphological, functional, and behavioral analyses were performed in nerves from each experimental group at different survival times. BMMC transplantation between 0 and 7 days after injury resulted in the largest number of nested cells within the injured sciatic nerve, which supports the therapeutic value of BMMC administration within the first week after injury. Most importantly, later BMMC administration 7 days after sciatic nerve crush was associated with neuropathic pain reversion, improved morphological appearance of the damaged nerves, and a tendency toward faster recovery in the sciatic functional index and electrophysiological parameters. Our results thus support the notion that even delayed BMMC treatment may represent a promising therapeutic strategy for peripheral nerve injuries.

Purpose To investigate the effects of intra-articular glenohumeral joint triamcinolone injection in treating secondary adhesive capsulitis after breast cancer surgery.Methods This study prospectively enrolled 37 participants, 22 of the breast cancer surgery group and 15 of the idiopathic group. All participants received intra-articular glenohumeral joint injection in the affected shoulder joint and received physiotherapy for 12 week. The clinical assessment evaluated before, and 1, 3, and 6 months after the intervention. The primary outcome was the change in the Shoulder Pain and Disability Index (SPADI).Results The total SPADI(%) in both groups showed significant decrease from baseline to 1, 3, and 6 months after the intervention. There was no significant difference in the differences of the total SPADI from baseline to 1, 3, and 6 months between two groups. However, the improvement in the SPADI pain subscale and the PROM of abduction at 3 and 6 months post-injection in the breast cancer group were inferior to the idiopathic group.Conclusion Intra-articular triamcinolone injection for adhesive capsulitis after breast cancer surgery significantly improved in significant improvements of pain, shoulder function and the PROM. The effects were similar to idiopathic adhesive capsulitis, but in the breast cancer surgery group, appropriate pain and ROM management and monitoring are required even 3 months after injection. With a standardized injection protocol, intra-articular triamcinolone injection could be an effective and safe treatment option for secondary adhesive capsulitis after breast cancer surgery.

This review article discusses the involvement of the Brain-Derived Neurotrophic Factor (BDNF) in the control of pain. BDNF, a neurotrophin known for its essential role in neuronal survival and plasticity, has garnered significant attention for its potential implications as a modulator of nociception and pain. This comprehensive review aims to provide insights into the multifaceted interactions between BDNF and pain pathways, encompassing both physiological and pathological pain conditions. I delve into the molecular mechanisms underlying BDNF's involvement in pain processing and discuss potential therapeutic applications of BDNF and its mimetics in managing pain. Furthermore, I highlight recent advancements and challenges in translating BDNF-related research into clinical practice.

The correlation between pain and emotional status in subjects with temporomandibular disorders (TMD) is known. Regardless of that up to date these findings were seldomly confronted with the objective assessment of pain using a digital algometer on the mastication muscles. The aim of the study was to investigate the relationship between the emotional status, chronic pain pain pressure threshold (PPT). 38 subjects were screened for the existence of temporomandibular disorders with the 3Q/TMD questionnaire, for chronic pain (GCPS) and emotional status (PHQ-9 and GAD-7). The results were confronted with the PPT measured with the digital algometer on the masseter muscles. Each subject was examined three times (after 1 month and after 7 months from the initial exami-nation session. Chronic pain scores (GCPS) were found to be higher in the TMD group in all three examination sessions (p<0,05). The pain, depression and anxiety levels were higher in females de-spite the existence of TMD, but only some were significant.A correlation between chronic orofacial pain scores and PPT was found in 2 out of 3 examination sessions. The PPT scores on the masseter muscles did not correlate with the emotional state in the study population.

Functional neurological disorders (FND) are relatively frequent disabling conditions. Given their complexity, multidisciplinary rehabilitation is envisaged. Whole-body cryostimulation (WBC) represents a promising adjuvant treatment, mainly because of its anti-inflammatory and exercise-mimicking effects. Here, we propose a novel use of WBC in a wheelchair-ridden 61-year-old woman diagnosed with FND and other comorbidities, who, after several therapeutic and rehabilitation failures, underwent a multidisciplinary rehabilitation program including WBC. The 4-week program included physiotherapy, nutritional intervention, psychological support, and WBC. Questionnaires to assess disease impact, pain level, perceived fatigue and sleep quality were administered. At discharge, improvements in body composition, haematological biomarkers, physical performance, and questionnaire scores were observed. The patient was able to walk with a walker for medium distances, even outdoors. We observed unprecedented improvements, particularly in functional parameters and questionnaire scores. Although we cannot ascertain to which extent WBC per se contributed to the improvements measured, subjective reporting and our clinical observation were that WBC, the only intervention not previously experienced by the patient, acted as a booster for the rehabilitation interventions. Further research will be necessary to rule out any possible placebo effect and to assess the effects of WBC on FND.

Autologous micrografting technology (AMT®) involves the use of autologous micrografts to stimulate/enhance the repair of damaged tissue. This study assessed the efficacy and safety of the AMT® procedure in patients with early stages of knee osteoarthritis. Briefly, the AMT® procedure involved extraction of auricular cartilage, disaggregation using the Rigeneracons® SRT in 4.0 mL of saline solution and injection of the disaggregated micrografts into the external femorotibial compartment area of the affected knee. Ten patients (4 men, 6 women; age range: 37─84 years) were included in the study. In all patients, there was a steady improvement in knee instability, pain, swelling, mechanical locking, stair climbing and squatting at 1- and 6-months post-procedure. Improvement in mobility was observed as early as 3 weeks post-procedure in 2 patients. Significant improvements were seen in mean scores of all five subscales of Knee Injury and Osteoarthritis Outcome Score (KOOS [KOOS symptoms, KOOS pain, KOOS ADL, KOOS sport and recreation, and KOOS quality-of-life]) between pre-procedure and 1- and 6-months post-procedure (all p≤0.05). Autologous auricular cartilage micrografts obtained by AMT® procedure (using Rigenera® technology) is an effective and safe protocol in the treatment of early-stage knee osteoarthritis. These encouraging findings need to be validated in a larger patient population.

The combination of non-steroidal anti-inflammatory drugs (NSAIDs) with non-opioid analgesics is common in clinical practice for the treatment of acute pain conditions like post-operative and post-traumatic pain. Besides that, and despite the very satisfactory results achieved by oral analgesics, parenteral analgesia is a key tool in the treatment of painful conditions when the enteral routes are not convenient. The parenteral ready-to-use fixed-dose combinations of NSAIDs with non-opioid analgesics like paracetamol or metamizole could play a central role in the treatment of painful conditions since they are able to gather into only one formulation the advantages of multimodal and parenteral analgesia. Surprisingly, only very recently a parenteral ready-to-use fixed-dose combination of Ibuprofen/Paracetamol was launched to the market. This review aims to review the current availability of NSAID-based Parenteral Fixed-dose combinations with paracetamol and metamizole in the European and American markets, and how the combination of such drugs could play a central role in a multimodal analgesia strategy. Also, it is explored how the parenteral formulations of NSAIDs, paracetamol, and metamizole could serve as starting elements for the development of new parenteral ready-to-use fixed-dose combinations. With this review, we concluded that, despite the well-recognized utility of combining NSAIDs with non-opioid analgesics, there are in the literature several randomized clinical trial studies unable to demonstrate clear advantages concerning their efficacy and safety. In the future, it is deemed necessary to perform clinical trials specifically designed to assess the efficacy and safety of these fixed-dose formulations to generate solid evidence of their clinical advantages.

Shoulder pain is a serious clinical disease frequently related to absence from work. It’s characterized by pain and stiffness probably connected to the presence of an inflammatory substrate involving gleno-humeral capsule and collagen tissues. A physioterapy programme has shown to be effective for the conservative treatment of this disorder. Our aim is to assess if a manual treatment directed to fascial tissues could get better improvement regarding pain, strength, mobility and function. 94 healthcare workers with recurrent shoulder pain were recruited and then randomized in two groups: the control group (CG) underwent a physiotherapy programme; the study group (SG) underwent to 3 sessions of physiotherapy and to 2 session of Fascial Manipulation (FM) technique. At the end of the treatment phase, both groups improved every outcome. Despite few statistical differences between groups, at the follow up visit a greater percentage of subjects in SG overcame the minimal clinical important difference (MCID) in every outcome. We conclude that FM is effective for treatment of shoulder pain and further studies should better assess how to manage this treatment to get better results.

Background: Low-level (LLLT) and high-intensity laser therapy (HILT) can be beneficial additions to knee osteoarthritis (KOA) rehabilitation exercises; however, it is still being determined which modality is more effective. Aim: To compare the effects of LLLT and HILT as adjuncts to rehabilitation exercise (LL+EX and HL+EX) on clinical outcomes in KOA. Methods: Thirty-four adults with mild to moderate KOA were randomly allocated to either LL+EX (n = 17) or HL+EX (n = 17) groups. All participants underwent their designated laser treatment combined with rehabilitation exercises weekly for twelve consecutive weeks. The Knee Injury and Osteoarthritis Outcome Score (KOOS), Numerical Pain Rating Scale (NPRS), active knee flexion, and Timed Up-and-Go test (TUG) were assessed at baseline and immediately post-intervention. Results: Post-intervention, both groups significantly improved their KOOS, NPRS, active knee flexion, and TUG scores compared to baseline (p &lt; 0.01). The mean difference of change in KOOS, NPRS, and active knee flexion scores for the HL+EX group surpassed the minimal clinically important difference threshold. In contrast, the LL+EX group only demonstrated clinical significance in NPRS scores. Conclusions: Incorporating HILT as an adjunct to usual KOA rehabilitation led to significantly higher improvements in pain, physical function, and knee-related disability compared to LLLT.

Objective: Physical inactivity is linked to chronic illnesses and disabilities among workers, especially those in high demanding jobs like teachers. Despite the global prominence of sedentary behaviour research, studies drawing the relationships between physical inactivity and multimorbidity among working teacher populations in low-and middle-countries remain untapped. This study assessed the sedentariness and health status of primary school teachers in Cape Coast Metropolis in Ghana. Method: This cross-sectional survey employed 1109 primary school teachers from the Cape Coast Metropolis in the Central Region of Ghana, using convenient sampling method. Results: Generally, the teachers were highly sedentary and reported poor health status. Other results showed no difference in sedentariness across gender, t (1107) = -0.32, p > .05. However, female teachers suffer more pain and discomfort, [t (1103.51) = - 3.07, p < .05, anxiety and depression, [t (1099.56) = - 2.85, p < .000,)], and poor health status [t (1107) = 2.14, p < .05, than their male counterparts. Also, pain and discomfort, anxiety and depression, health status and years of work significantly predicted sedentariness among the teachers, F (4, 1104) = 5.966, p=.00, R = .145, R2 = .029, adjusted R2 = .018. Conclusion: The findings suggest that individualized or personalized interventions are urgently needed to promote regular physical activity to improve the health status and reduce associated complications on the health and well-being, especially among the female primary school teachers. Given the health risks of sedentary lifestyle, behavioral interventions at the person-level (i.e., individualized- routine weekly physical activity programmes) and built environmental restructuring (e.g., creation of walkways to encourage regular walking) could be done to physical activity behavior among teachers within the Cape Coast Metropolis, and perhaps beyond.

Chronic pain is a source of major alterations in quality of life. It represents significant costs for health systems, and reduces the competitiveness of the working population. Vulnerability can drive the incidence of chronic pain, through its influence on modifiable risk factors, and reduced utilization of health care systems. But vulnerability can also be the consequence of a chronic pain: illness can push people into precariousness. We analysed the factors associated with pain intensity among vulnerable persons with a chronic condition, in five European countries (N=1,364). Pain was, among the whole set of variables, the main predictor of sleep problems, fatigue, depression, self-perceived health, physical and mental quality of life. This is in line with other studies showing the major impact of pain on an individual’s health and life. Multivariable analyses, adjusting for the whole set of variables, showed that women had more intense pain, as well as participants with a lower education level. These results confirm the social component in the complex etiology of pain and clearly plaid in favor of integrated care, taking into account individual characteristics and environment.

Cannabis has been used as an herbal remedy for thousands of years and recent research indicates promising new uses in medicine. Researchers have been particularly interested in the potential uses of cannabinoids in treating cancer due their ability to regulate cancer-related cell cycle pathways, leading to many beneficial effects such as tumor growth prevention, cell cycle obstruction, and cell death. The aim of this review is to summarize current knowledge on mechanisms of cannabinoids and their role in treating chemotherapy-induced nausea and vomiting, relieving cancer-associated pain, and obstructing tumor cell growth.

Understanding neck pain is an important societal issue. Kinematic data from sensors may help to gain insight on the pathophysiological mechanisms associated with neck pain through a quantitative sensorimotor assessment of one patient. The objective of this study was to evaluate the potential usefulness of artificial intelligence with several Machine Learning (ML) algorithms in assessing neck sensorimotor performance. Angular velocity and acceleration measured by an inertial sensor placed on the forehead during the DidRen laser test in thirty-eight acute and subacute non-specific neck pain (ANSP) patients were compared to forty-two healthy control participants (HCP). Seven supervised ML algorithms were chosen for the predictions. The most informative kinematic features were computed using Sequential Feature Selection methods. The best performing algorithm is the Linear Support Vector Machine with an accuracy of 82% and Area Under Curve of 84%. The best discriminative kinematic feature between ANSP patients and HCP is the first quartile of head pitch angular velocity. This study has shown that supervised ML algorithms could be used to classify ANSP patients and identify discriminatory kinematic features potentially useful for the clinicians in the assessment and monitoring of the neck sensorimotor performance in ANSP patients.

Exercises for lower trapezius (LT) often use overhead positions, causing compressive forces to the subacromial space. Scapular retraction would be an alternative to activate LT muscle. Electromyography of infraspinatus (IS), upper (UT) and LT was recorded during scapular retraction under progressive adduction loads of 42 participants, divided in 2 groups: with (SP, n=26) and without shoulder pain (nSP, n=16). The adduction loads of 20, 30, 40 and 50% of the maximal voluntary contraction were applied using a load cell. Normalized electromyography and the ratio between UT and LT (UT:LT) were used for statistical analysis. No differences were observed between groups, but a condition effect occurred for all muscles: UT showed higher values at 50% vs. 20% (p=0.004); LT showed higher values on 40% and 50% (p=0.001; 0.006). Higher values for IS were noted at 40% (vs 20%; p=0.04), and at 50% (vs. 20%; p=0.001, vs. 30%, p=0.001; vs. 40%; p=0.001). UT:LT showed lower values at 50% (vs. 20%; p=0.001, and vs. 30%; p=0.016). Scapular retraction with adduction loads at 40-50% is an alternative to overhead exercises aiming to activate the LT and the IS muscles. The exercise ensures higher levels of LT and IS excitation, without increasing UT excitation.

Rationale:First discovered in 1990, the endocannabinoid system (ECS) was initially shown to have an intimate relationship with central areas of the nervous system associated with pain, reward, and motivation. Recently, however, the ECS has been extensively implicated in the cardiovascular system with contractility, heart rate, blood pressure, and vasodilation. Emerging data demonstrates modulation of the ECS plays an essential role in cardio metabolic risk, atherosclerosis, and can even limit damage to cardiomyocytes during ischemic events.Patient Concerns:This case describes a 63-year-old male who presented to a primary care physician for a medical cannabis (MC) consult due to unstable angina (UA) not relieved by morphine or cardiac medications; having failed all first- and second-line poly-pharmaceutical therapies. The patient reported frequent, unprovoked, angina and exertional dyspnea.Diagnosis:Having a complex cardiac history, the patient first presented 22 years ago after a suspected myocardial infarction (MI). He re-presented in 2010 and underwent stent placement at that time for inoperable triple-vessel coronary artery disease (CAD) which was identified via percutaneous transluminal coronary angioplasty. UA developed on follow up and, despite medical management over the past 6 years, his UA became progressively debilitating.Interventions and Outcomes:In conjunction with his standard cardiac care, patient had a gradual lessening of UA related pain, including frequency and character, after using an edible form of medical cannabis (MC) (1:1 CBD:THC). Following continued treatment, he ceased long term morphine treatment and describes the pain as no longer crippling. As demonstrated by his exercise tolerance tests, the patient experienced an improved functional capacity and reported an increase in his daily functioning, and overall activity.Lessons:This case uniquely highlights MC in possibly reducing the character, quality, and frequency of UA; while concordantly improving functional cardiac capacity in a patient with CAD. Additional case reports are necessary to verify this.

Analgesic products for piglet castration are critically needed. This requires extensive animal experimentation such as to meet regulatory-required proof of efficacy. At present, there are no validated methods of assessing pain in neonatal piglets. This poses challenges for investigators to optimize trial design and to meet ethical obligations to minimize the number of animals needed. Pain in neonatal piglets may be subtle, transient and / or variably expressed and, in the absence of validated methods, investigators must rely on using a range of biochemical, physiological and behavioural variables, many of which appear to have very low (or unknown) sensitivity or specificity for documenting pain, or pain-relieving effects. A previous systematic review of this subject was hampered by the high degree of variability in the literature base both in terms of methods used to assess pain and pain mitigation, as well as in outcomes reported. In this setting we provide a narrative review, to assist in determining the optimal methods currently available to detect piglet pain during castration and methods to mitigate castration-induced pain. In overview, the optimal outcome variables identified are nociceptive motor and vocal response scores during castration, and quantitative sensory-threshold response testing and pain-associated behaviour scores following castration.

Transient receptor potential (TRP) channel family proteins are sensors for pain, which sense variety of thermal and noxious chemicals. Sensory neurons innervating the gut abundantly express TRPA1 and TRPV1 channels and are in close proximity of gut microbes. Emerging evidence indicates a bi-directional gut-brain cross-talk in several entero-neuronal pathologies; however, the direct evidence of TRP channels interacting with gut microbial populations is lacking. Herein, we examine whether and how the knockout (KO) of TRPA1 and TRPV1 channels individually or combined TRPA1/V1 double-knockout (dKO) impacts the gut microbiome in mice. We detect distinct microbiome clusters among the three KO mouse models versus wild-type (WT) mice. All three TRP-KO models have reduced microbial diversity, harbor higher abundance of Bacteroidetes, and reduced proportion of Firmicutes. Specifically distinct arrays in the KO models are determined mainly by S24-7, Bacteroidaceae, Clostridiales, Prevotellaceae, Helicobacteriaceae, Rikenellaceae, and Ruminococcaceae. A1KO mice have lower Prevotella, Desulfovibrio, Bacteroides, Helicobacter and higher Rikenellaceae and Tenericutes; V1KO mice demonstrate higher Ruminococcaceae, Lachnospiraceae, Ruminococcus, Desulfovibrio and Mucispirillum; while A1V1dKO mice exhibit higher Bacteroidetes, Bacteroides and S24-7 and lower Firmicutes, Ruminococcaceae, Oscillospira, Lactobacillus and Sutterella abundance. Also, the abundance of taxa involved in biosynthesis of lipids and primary and secondary bile acids is higher while that of fatty acid biosynthesis-associated taxa is lower in all KO groups. To our knowledge, this is the first study demonstrating distinct gut microbiome signatures in TRPA1, V1 and dKO models and should facilitate prospective studies exploring novel diagnostic/ therapeutic modalities regarding the pathophysiology of TRP channel proteins.

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

Isolated fallopian tube torsions presenting to the emergency department are a very rare cause of childhood acute abdominal pain. Since the diagnosis to be made in the early period is of importance in terms of affecting tubal damage and fertility, it was aimed to evaluate the cases in the light of literature. Materials and Methods: This study included 10 patients under 18 years of age presented to the emergency department with abdominal pain between January 2003 and December 2018. The mean age was 14.5±1.43 years (range: 12-17years). The demographic characteristics, surgical findings, and methods, concomitant pathology results of these patients were retrospectively evaluated. Results: The reason for admitting to the emergency department of 10 patients included in the study was abdominal pain. The mean duration of hospital admission with pain was 4.97 days. The onset of pain was less than 24 hours in 7 patients (70%) and was more than 24 hours in three patients (30%). Of the patients, 9 (90%) had tenderness in the lower abdominal quadrant, 5 (5%) had the defense, and 3 (30%) had a rebound. Nausea, vomiting, and leucocytosis were present in 50% of the cases. Right and left tubal involvement of the cases was equal. Seven (70%) of the isolated tubal torsions were accompanied by paraovarian cysts. Of the patients, 8 (80%) underwent open surgery and 2 (20%) underwent laparoscopic intervention. Detorsion was performed in 5 (50%) and salpingectomy was performed in 5 (50%) cases. Conclusion: Isolated tubal torsion should be considered in children presenting with acute abdominal pain in early adolescence. Early diagnosis is important for the maintenance of fertility.

The correlation and comorbidity between depression and chronic pain have been observed for a long time. Generally, it is considered that the two conditions reinforce each other, whereas the causal relationship between them is not clear. However, some evidence suggested that chronic pain may reverse the progression of depression in some cases. This article presents a selective review of clinical and pharmacological relationship between depression and pain, and their interactions at neurochemical and neurobiological levels. In addition, we open a discussion on a recent case report of repeated success of using short but continuous pain (SCP) during meditation as the only treatment for depression, compared to initial success but no remission with other conventional antidepressants on the same patient. Together this review proposes an updated model for depression and its various treatments that is based on synaptic and system homeostasis. More importantly, it suggests that SCP may benefit depression recovery through its properties that are different from either acute or chronic pain and represents a novel research area that has been largely neglected to date.

The use of pain relief during castration and dehorning of calves on commercial beef operations can be limited by constraints associated with the delivery of analgesic agents. As topical anaesthetic (TA) and buccal meloxicam (MEL) are now available in Australia, offering practical analgesic treatments for concurrent castration and dehorning of beef calves, a study was conducted to determine their efficacy in providing pain relief when applied alone or in combination. Weaner calves were randomly allocated to; (1) no castration and dehorning / positive control (CONP); (2) castration and dehorning / negative control (CONN); (3) castration and dehorning with buccal meloxicam (BM); (4) castration and dehorning with topical anaesthetic (TA); and (5) castration and dehorning with buccal meloxicam and topical anaesthetic (BMTA). Weight gain, paddock utilisation, lying activity and behaviour following treatment were measured. CONP and BMTA calves had significantly greater weight gain than CONN calves (P < 0.001). CONN calves spent less time lying compared to BMTA calves on all days (P < 0.001). All dehorned and castrated calves spent more time walking (P = 0.024) and less time eating (P < 0.001) compared to CONP calves. There was a trend for CONP calves to spend the most time standing and CONN calves to spend the least time standing (P = 0.059). There were also trends for the frequency of head turns to be lowest in CONP and BMTA calves (P = 0.098) and tail flicks to be highest in CONN and BM calves (P = 0.061). The findings of this study suggest that TA and MEL can improve welfare and production of calves following surgical castration and amputation dehorning.

In areas with a deep floor plan, the distribution of natural light is not uniform. Consequently, relying solely on daylight may not suffice to meet the space's lighting requirements, necessitating the use of artificial lighting in darker areas. Therefore, a lighting system is needed that not only controls the glare near the windows but also increases the light at the end of the room and provides uniform daylight. One of the widely used systems is the “light shelf“which has three main functions: shading, increasing the depth of light penetration and reducing glare. Review articles about light shelves have been done in 2015 and 2017, while more than 80% of the studies have been carried out since 2016 and light shelves with more diverse forms and dynamic elements and many consolidations were proposed. Therefore, there is a need for a more comprehensive review. The main question of this research is how different parameters (including climate, material, ceiling and integrated systems) can help to increase the efficiency of light shelves. By using a systematic review, studies in the past three decades were classified in order to determine the effect of these parameters on improving lighting performance and controlling solar heat gain.

Heat waves are a significant consequence of climate change threatening public health by increased morbidity and mortality. The aim of this study was to estimate individuals’ knowledge, attitudes and practice related to heat waves. We conducted an exploratory cross-sectional study in Greece during September 2023. We employed a convenience sample of 1055 participants. We used the heat wave knowledge, awareness, practice and behavior scale (HWKAPBS) to measure our outcome. We measured several socio-demographic variables, such as gender, age, educational level, etc. as potential determinants. Mean scores for the knowledge, awareness, practice and behavior factors were 12.5, 22.7, 22.2 and 12.1 respectively. Females had higher scores on the four factors compared with males. We found a positive relationship between self-perceived health status and awareness, practice and behavior about heat waves. Similarly, we identified a positive relationship between self-perceived financial status and awareness and behavior about heat waves. Increased age was associated with increased practice score, while increased educational level was associated with increased knowledge score. Additionally, behavior score was higher among participants in urban areas than those in rural areas. We found statistically significant positive correlations between the four factors. Levels of knowledge, awareness, practice and behavior about heat waves were high in our sample. Several socio-demographic variables affect participants’ knowledge, awareness, practice and behavior concerning heat waves.

“Anti-stripping Agents" or "adhesion promoters” can enhance the chemical affinity between as-phalt and aggregate by increasing their mutual attraction. Various forms of anti-stripping agents have been proposed to mitigate pavement stripping, and siloxane-based Zychotherm is one of them. Choosing the appropriate type and dose of anti-stripping additives is no doubt vital to the intended performance. Therefore, it is critically important to determine the dose of the additives used in the modification of asphalt binders. This research developed a feasible detection method that can closely measure the dose (0.05% and 0.1%) of siloxane-based anti-stripping liquid agents. Related test methods including heat combustion test, residue visualization, burning, and ignition were implemented. Heat combustion results showed that with the addition of Zychotherm anti-stripping additive, average heat combustion value decreased by 1.34% and 1.72% for 0.05% and 0.1% Zychotherm modified binder respectively. In the burning and ignition process, the modified binder leaves yellowish substances in the residue, which is an indication of the presence of Zy-chotherm. The weight of the yellowish residue relates more to the quantity of Zychotherm in as-phalt binder.

The solar heat pump system based on photovoltaic photothermal (PV/T) modules is a new technology that integrates photovoltaics and heat reutilization. It can improve the efficiency of photovoltaic conversion and recovery the remaining heat generated during the photoelectric conversion process, thereby improving the comprehensive efficiency of the whole system. Simulink software is a visual simulation tool, which has the advantages of strong applicability, clear simulation structure and calculation process. The design of its graphical programming greatly simplifies the user modeling process and allows for direct viewing of results, therefore improving the simulation efficiency. At present, there is little research on simulation of solar heat pump systems with PV/T modules based on Simulink software. In this paper, the mathematical models of each component contained in the PV/T solar heat pump system were established based on the system working principle, energy conservation equations and some empirical formulas, and then the operation of the system was simulated by the Simulink software. Due to the operation characteristic of PV/T modules is the key influencing factor for the whole system performance, the model and simulation process for PV/T modules were introduced in detail. The results showed that the surface temperature of PV/T modules under different operating conditions was significantly lower than that of ordinary photovoltaic panels, and the temperature change amplitude was lower. As results, the power generation and photovoltaic conversion efficiency were significantly improved.

In the dairy cattle sector, the evaluation of the effects induced by heat stress is still one of the most impactful and investigated aspects as it is strongly connected to both sustainability of the production and animal welfare. On the other hand, more recently, the possibility of collecting large dataset made available by the increasing technology diffusion is paving the way for the application of advanced numerical techniques based on machine learning or big data approaches. In this scenario driven by rapid change there could be the risk of dispersing the relevant information represented by the physiological animal component, which should maintain the central role in the development of numerical models and tools. In the light of this, the present literature review aims to consolidate and synthesize existing research on the physiological consequences of heat stress in dairy cattle. The present review provides, in a single document, an overview as complete as possible of the heat stress-induced responses in dairy cattle with the intent of filling the existing research gap for extracting the veterinary knowledge present in the literature and make it available to those who are developing numerical models and tools.

Laser heat treatment is applied after coating. Evaluation of the results was performed by studying the microstructures by metallographic, SEM/EDX microscopy and the mechanical properties were obtained by microscopic hardness and abrasion resistance. The objective of this study was to investigate the effect of laser heat treatment on the wear resistance of metal coatings. The results show the influence of the microstructure and chemical composition of the electrodes used on the micro-hardness and wear resistance of the metal coatings.

Converting chemical energy from green hydrogen to electricity using Membrane Exchange Protons Fuel cell (PEMFC) is a promising solution in various applications such e-mobility and building facilities. The electrical efficiency of PEMFCs can reach 60%. However, they are immensely sensitive to the working temperature, requiring good thermal management. Active thermal management systems are expensive and energy-consuming. Passive thermal management systems enable PEMFC thermal management without additional energy consumption. Here various passive thermal management technologies are reviewed. Different techniques are thorougly described and critically compared in terms of complexity, efficiency, cooling rate, scope of applicability, and the sizes of PEMFCs to which they apply. The conclusions provide a solid background for further investigations, and recommendations for future work are suggested.

The shortage of precooling equipment in litchi producing regions could lead to a high loss rate, poor quality of litchis. It is urgent to develop a portable precooling device for litchi producing regions. In this study, a novel spray hydrocooler with thermal energy storage (TES) were designed, fabricated, and tested. A simple mathematical model of TES capacity, ice coil thermal resistance and refrigeration system was employed to determine hydrocooler parameters. Then designed the structure of the spray hydrocooler. Maximum charging test was implemented with full TES capacity and litchi spray hydrocooling experiments were carried out at different charging times, spray flow rate, and litchi load with one-third TES capacity. Results showed that: (1) the spray hydrocooler allows for the rapid and effective precooling of litchis; (2) the hydrocooler can precool 299 kg litchis with one-third TES storage, meet the precooling requirements; (3) the effective TES capacity achieved 1.25×108 J at the maximum TES capacity of the hydrocooler, while the energy efficiency ratio (EER) is 2; (4) the precooling capacity was maximum and the average power consumption was minimum when the litchi load was 23 kg and the spray flow rate was 30 L min-1. Longer charging time is the most important factor in increasing precooling capacity and reducing average power consumption.

In this investigation, Cu-Ni alloys for possible fixed dental prostheses (FDPs), with different aluminum additions were produced using vacuum atmosphere. Annealed alloys (He atmosphere) with low aluminum concentration showed a coarse dendritic structure, while samples with high aluminum concentration showed a refined dendritic structure. Structural defects analyses have shown a relative low vacancy concentrations. Hardness value increases approximately five times for the alloyed samples compared with the as-cast and unalloyed samples. Compression test results have shown a noticeable strengthening improvement, mainly in samples heat treated with 10 at % Al, while samples with 5 at % Al presented also acceptable resistance. Results are discussed in terms of dislocation mobility and hardening precipitation mechanism.

The spiral tube heat exchange is widely used in large-scale liquefaction process. However, the research on the friction pressure drop of the two-phase flow in the spiral tube is limited, especially for the offshore sloshing condition. In this paper, an experimental system is designed and built, and the effects of sloshing form (roll, pitch, heave), sloshing period (5-15s), mass flux (200-800 kg/(m2·s)), vapor quality (0.3-0.9) and operating pressure (2-4 MPa) on friction pressure drop of methane/ethane (C1/C2) mixture in spiral tube are studied. The result shows that the growth rate of time-averaged friction pressure drop during condensation under sloshing condition is less than 0, which indicates that sloshing will lead to drag reduction. And under the three sloshing parameters, the growth rate of time-averaged friction pressure drop of C1/C2 is reduced by-5.99%%, 5.97% and -6.70% respectively.

Following the rapid spread of COVID-19 across the globe, the intense response that was demanded of diagnostic centers and research laboratories prompted the use of numerous products and protocols for the management of SARS-CoV-2 specimens. In these settings, proper handling of such infectious specimen is necessary to ensure the safety of personnel and to reduce the risk of active transmission. Our aim was to evaluate the inactivation efficacy of different inactivating methods, notably from commercial lysis buffers available in diagnostic kits. Heat and sodium dodecyl sulfate detergent were also included in our investigations. A cell culture-based assay was used, and supported by molecular qRT-PCR detection, to show in vitro infectivity reduction after inactivation treatment. Overall, all the investigated methods were successful in inactivating SARS-CoV-2. Ten minutes of contact with the commercial buffers completely stopped in vitro SARS-CoV-2 infectivity. Fifteen minutes at 68°C and 30 minutes at 56°C as well as one hour with sodium dodecyl sulfate detergent at 2, 1, 0.5, and 0.1% yielded the same results. These findings demonstrate the reliability of these protocols with regards to biosafety. Inactivation by heat and sodium dodecyl sulfate detergent are rather simple and can be readily available methods for rendering an infectious SARS-CoV-2 specimen inactive, especially in settings where commercial buffers are not available.

Thermal simulations are an important part in the design of electronic systems, especially as systems with high power density become common. In simulation-based design approaches, a considerable amount of time is spent by repeated simulations. In this work, we present a proof-of-concept study of the application of convolutional neural networks to accelerate those thermal simulations. The goal is not to replace standard simulation tools but to provide a method to quickly select promising samples for more detailed investigations. Based on a training set of randomly generated circuits with corresponding Finite Element solutions, the full 3D steady-state temperature field is estimated using a fully convolutional neural network. A custom network architecture is proposed which captures the long-range correlations present in heat conduction problems. We test the network on a separate dataset and find that the mean relative error is around 2 % and the typical evaluation time is 35 ms per sample ( 2 ms for evaluation, 33 ms for data transfer). The benefit of this neural-network-based approach is that, once training is completed, the network can be applied to any system within the design space spanned by the randomised training dataset (which includes different components, material properties, different positioning of components on a PCB, etc.).

We aimed to evaluate the protective effects of acetyl-xylogalactan on the activity of RAW264.7 macrophages against heat stress. To this end, we assessed cell survival, phagocytic activity, in-tracellular Ca2+ level, mitochondria potential exchange, apoptotic assay findings, galactosidase activity and the RNA-seq by NGS and real-time polymerase chain reaction (PCR) expression. In our evaluation of macrophage morphology at 37°C and 41°C, the macrophages showed an oval shape at 41°C , unlike the spindle shape at 37°C. Therefore, 41°C was chosen as the heat stress condition. Subsequently, we designed an experiment to evaluate changes in the RAW264.7 macrophages after acetyl-xylogalactan treatment under heat stress. The survival of RAW264.7 macrophages treated with acetyl-xylogalactan was higher than that of controls that were not treated with acetyl-xylogalactan. Moreover, on the basis of the results of the annexin-V detection assay, the apoptotic activity of macrophages appeared to have reduced after treatment with ac-etyl-xylogalactan. Moreover, treatment with acetyl-xylogalactan resulted in a stronger recovery trend in the intracellular Ca2+ and mitochondrial membrane potential after heat stress. RNA sequencing and real-time polymerase chain reaction (PCR) illustrated that Sarcodia suieae acetyl-xylogalactan could upregulate the expression of the anti-apoptosis Cflar gene and down-regulate the expression of the apoptosis factors Ddit3, and Hyou1 to protect macrophages under heat stress.

Objective On the eve of the summer Olympic Games in Tokyo research focus has shifted on the core temperature responses of elite athletes competing in the heat. In the absence of the field data of core temperature during Olympic sailing competition aim of the present study was to identify core temperature response during the Tokyo 2020 Olympic Test Event. Methods Four elite athletes from Olympic sailing (177.5±5.2 cm, 71.1±7.4 kg, body mass index 22.5±1.4 kg/m2, 24.8±3.7 yrs, VO2max 50.6±7.2 mL/min/kg)): 2 males and 2 females participated in the study. Core temperature was recorded using e-Celsius ingestible capsules, heart rate using a heart rate monitor. Ambient conditions in direct sunlight were measured using portable meteo station. Results Core temperature was recorded at water environment via an ingestible capsule in 4 sailors during the training (T), and competition (C), respectively. Ambient conditions in direct sunlight were hot and humid: during training temperature were 30.9°C±1.7°C and relative humidity 81.4%±2.8%, corresponding to a wet-bulb globe temperature of 41°C±4°C and during competition temperature was 31.2°C±2.3°C and relative humidity 87.2%±4.4%, corresponding to a wet-bulb globe temperature of 45.2°C±8.9°C. Core temperature increased during training reaching higher peak values (38.6°C±0.4°C) and during competition (38.9°C±0.4°C). The highest temperature recorded was 39.4°C (C). Conclusion The current study provides unique information into the core temperature parameters under heat stress in elite Olympic sailors during training and race event.

The objective of this study was to evaluate biomarkers of heat stress (HS) from automatic milking system (AMS), the relationships between measurements of temperature-humidity index (THI) and reticulorumen ph and temperature and some automatic milking systems parameters in dairy cows (rumination time (RT), milk traits, body weight (BW) and consumption of concentrate (CC)) during summer period. The experiment was carried out on a dairy farm at 54.9587408, 23.784146. Lithuanian Black and White dairy cows (n=365) were selected. The cows were milked with Lely Astronaut® A3 milking robots with free traffic. The rations were calculated to meet physiological requirements of the animals. Daily milk yield, rumination time, body weight, milk fat and protein ratio were collected from the Lely T4C management program for analysis. The pH and temperature of the contents of cow reticulorumen were measured using specific smaX-tec boluses manufactured for animal care. The daily humidity and air temperature in the farm zone were obtained from the adjacent weather station (2 km away). According this study during HS, the higher THI had positive correlation with ML, which show tendencies to increase risk of mastitis, and decrease CC, RT, BW, MY, reticulorumen ph and F/P. Some biomarkers of HS can be milk yield, milk lactose, somatic cell count, concentrate conception, rumination time, body weight, reticulorumen ph and milk fat – protein ratio. We can recommend to monitoring these parameters in the herd management program to identify possibility of heat stress.

Alzheimer’s disease is a prominent neurological disorder, which leads to progressive dementia. The microtubule-associated protein Tau is been considered as one of the major causes of Alzheimer’s disease. Physiologically Tau assists in the stabilization of microtubules, contrary to this the pathological state of Tau results in the formation of neurotoxic tangles of Tau. The posttranslational modifications, such as GSK-3β-mediated Tau phosphorylation results in the generation of Tau pathology. Neuroinflammation generated in Alzheimer’s disease, contributes to elevated body temperature. The aim of present work is to study the effect of high temperature on Tau phosphorylation. The neuroblastoma cells were exposed to heat stress for 40 minutes. The immunofluorescence and western blot studies suggested that high temperature increases the levels of GSK-3β in cells. Heat stressed cells was also observed to have elevated levels of phosphorylated Tau. Additionally, heat stressed cells found to have modulated nuclear transport as the level of Ran was reduced. The results of present work suggested that increased temperature could be considered as a risk factor in Alzheimer’s disease as it elevated the GSK-3β levels in cells thus, resulting in increased Tau phosphorylation.

Energy system optimization models (ESOM) are widely used to inform about energy transition strategies. The heterogeneity of consumers, especially in the heat sector, is rarely considered in these model types. Integrating consumer heterogeneity and behavioral factors into ESOMs may generate new insights for energy policy. In this study a literature review was conducted, identifying empirical data on consumer behavior for adopting residential heating systems. This data was integrated into an ESOM for the German heat sector, combining established methods for integrating consumer heterogeneity and a novel approach for calculating indirect costs, representing behavioral factors. The incorporation of consumer choice leads to a higher diversity in technology market shares in a business as usual and an ambitious measures scenario. Especially, the future role of log wood technologies in the private household sector may have been underestimated in previous studies and should be discussed, when designing policies. Still, these findings need to be handled with care, since the empirical data basis and the methodological basis is limited.

Chronic heat stress (HS), aggravated by global warming, reduces the production efficiency of the buffalo dairy industry. Here, we conducted a proteomic analysis to investigate the adaptation strategies used by buffalo in response to heat stress. Seventeen differentially abundant proteins with known functions were detected using label-free quantification (LFQ), and five of these differentially expressed proteins were validated with parallel reaction monitoring (PRM). These five proteins were associated with various aspects of heat stress, including decreased heat production, increased blood oxygen delivery, and enhanced natural disease resistance. Lipase (LPL), glutathione peroxidase 3 (GPX3), cathelicidin-2 (CATHL2, LL-37), ceruloplasmin (CP), and hemoglobin subunit alpha 1 (HBA1) were shown to play cooperative roles in the tolerance of chronic HS in dairy buffalo. We found that high levels of HBA1 increased blood oxygen transport capacity. Our results increase our understanding of the adaptation of dairy buffalo to chronic heat stress.

We apply the stochastic thermodynamics formalism to describe the dynamics of systems of complex Langevin and Fokker-Planck equations. We provide in particular a simple and general recipe to calculate thermodynamical currents, dissipated and propagating heat for networks of nonlinear oscillators. By using the Hodge decomposition of thermodynamical forces and fluxes, we derive a formula for entropy production that generalises the notion of non-potential forces and makes transparent the breaking of detailed balance and of time reversal symmetry for states arbitrarily far from equilibrium. Our formalism is then applied to describe the off-equilibrium thermodynamics of a few examples, notably a continuum ferromagnet, a network of classical spin-oscillators and the Frenkel-Kontorova model of nano friction.

The future power equipment tends to take hydrogen or middle/low heat-value syngas as fuel for low emission. The heat transfer of film cooled turbine blade shall be influenced more by radiation. Its characteristic of conjugate heat transfer is studied experimentally and numerically in the paper by considering radiation heat transfer, multi-composition gas and TBC. The Weighted Sum of Gray Gases spectral model and Discrete Transfer Model are utilized to solve the radiative heat transfer in the multi-composition field, while validated against the experimental data for the studied cases. It is shown that the plate temperature increases significantly when considering the radiation and the temperature gradient of the film cooled plate becomes larger. It is also shown that increasing percentage of steam in gas composition results in increased temperature on the film-cooled plate. The normalized temperature of the film-cooled plate decreases about 0.02, as the total percentage of steam in hot gas increases per 7%. As for the TBC effect, it can smooth out the the temperature distribution and insulate the heat to a greater extent when the radiative heat transfer becomes significant.

ASTM A743 CA6NM alloy is a martensitic stainless steel typically used in energy industry -runners and hydraulic turbine components- due to its superior toughness, yield and fatigue properties. In both the manufacturing, shielded metal arc welding is applied to join for this grade steels. However, weldability of the steels is limited due to formation of hard and brittle phases such as untempered martensite during welding and post weld heat treatment processes. The formation causes a reduction in toughness. In this study, influence of post-weld heat treatment procedure (single tempering and double tempering) and parameters on microstructure and hardness of AWS410NiMo all weld metal. Hardness tests were conducted from weld metal. Microstructures of the all weld metals subjected to different heat treatment process were characterized.

The color changes corresponding to chromophore structures in lignin caused by exposure of Eucalyptus（Eucalyptus grandis and E. urophylla）to heat were investigated. Eucalyptus wood samples were heated in saturated steam atmospheres for 10 h at 110℃, 130℃, and 150℃. The lignin was isolated before and after heat treatment. The physicochemical properties of the lignin and changes in chromophore structures during heat treatment was evaluated through wet chemical analysis, FTIR, UV-Vis, GPC, XPSand 13C-NMR. The color of the wood became darker and redder with the increase in pressure and temperature. Depolymerization and dehydration reactions occurred via demethoxylation with heat treatment in saturated steam at 110℃ or 130℃. Lignin condensed to form insoluble compounds after heat treatment in saturated steam at 150℃. G units increased and S units decreased through demethylation during heat treatment, as revealed by FTIR and 13C-NMR analysis.

This study examines the optimization of ground source heat pump (GSHP) systems and energy piles for sustainable urban development, with a focus on Southeast Asia. GSHPs, which utilize geothermal energy for indoor HVAC needs, offer a sustainable alternative to traditional systems by utilizing consistent subsurface temperatures for heating and cooling. The study highlights the importance of understanding thermal movement within the soil, especially in soft marine clays prevalent in Southeast Asia, to improve GSHP system efficiency. Using a one-dimensional finite-difference model, the study examines the effects of soil thermal conductivity and density on system performance. The results show that GSHP systems, especially when integrated with energy piles, significantly reduce electricity consumption and greenhouse gas emissions, underscoring their potential to mitigate the urban heat island effect in densely populated areas. Despite challenges posed by the region's hot and humid climate, which could affect long-term effectiveness, the study highlights the need for further study, including field experiments and advanced modeling techniques, to optimize GSHP configurations and fully exploit geothermal energy in urban environments. The study's insights into soil thermal dynamics and system design optimization contribute to the advancement of sustainable urban infrastructure development.

Remote sensing technologies are critical for analyzing the escalating impacts of global climate change and increasing urbanization, providing vital insights into land surface temperature (LST), land use and cover (LULC) changes, and the identification of urban heat island (UHI) and surface urban heat island (SUHI) phenomena. This research focuses on the nexus between LULC alterations and variations in LST and air temperature (Tair), with a specific emphasis on the intensified SUHI effect in Kharkiv, Ukraine. Employing an integrated approach, the study analyzes time-series data from Landsat and MODIS satellites, alongside Tair climate records, utilizing machine learning techniques and linear regression analysis. Key findings indicate a statistically significant upward trend in Tair and LST during summer months from 1984 to 2023, with a notable positive correlation between Tair and LST across both datasets. MODIS data exhibit a stronger correlation R² = 0.879, compared to Landsat R² = 0.663. The application of supervised classification through Random Forest algorithms and vegetation indices on LULC data reveals significant alterations, manifested as a 70.3% increase in urban land, concurrently with a decrement in vegetative cover, especially 15.5% reduction in dense vegetation and a 62.9% decrease in sparse vegetation. Change detection analysis elucidates a 24.6% conversion of sparse vegetation into urban land, underscoring a pronounced trajectory towards urbanization. Temporal and seasonal LST variations across different LULC classes were analyzed using kernel density estimation (KDE) and boxplot analysis. Urban areas and sparse vegetation had the smallest average LST fluctuations, at 2.09°C and 2.16°C, respectively, but recorded the most extreme LST values. Water and dense vegetation classes exhibited slightly larger fluctuations of 2.30°C and 2.24°C, with the bare land class showing the highest fluctuation 2.46°C, but fewer extremes. Quantitative analysis with the application of Kolmogorov-Smirnov tests across various LULC classes substantiated the normality of LST distributions p &gt; 0.05 for both monthly and annual data sets. Conversely, the Shapiro-Wilk test validated the normal distribution hypothesis exclusively for monthly data, indicating deviations from normality in the annual data. Thresholded LST classifies urban and bare lands as warmest classes with 39.51°C, 38.20°C and water by 35.96°C and dense vegetation 35.52°C, sparse vegetation 37.71°C as coldest, a trend consistent annually and monthly. The analysis of SUHI effects demonstrates an increasing trend in UHI intensity, with statistical trends indicating a growth in average SUHI values over time. This comprehensive study underscores the critical role of remote sensing in understanding and addressing the impacts of climate change and urbanization on local and global climates, emphasizing the need for sustainable urban planning and green infrastructure to mitigate UHI effects.

Despite the remarkable success of Carnot’s heat engine cycle in founding the discipline of thermodynamics two centuries ago, false viewpoints of his use of the caloric theory in the cycle still linger, limiting his legacy. An action revision of the Carnot cycle can correct this, showing that the heat flow powering external mechanical work is compensated internally with configurational changes in the thermodynamic or Gibbs potential of the working fluid, differing in each stage of the cycle quantified by Carnot as caloric. Action (@) is a property of state having the same physical dimensions as angular momentum (mrv=mr2ω). However, this property is scalar rather than vectorial, including a dimensionless phase angle (@=mr2ωδφ). We have recently confirmed with atmospheric gases that their entropy is a logarithmic function of the relative vibrational, rotational and translational action ratios with Planck’s quantum of action ħ. The Carnot principle shows that the maximum rate of work (puissance motrice) possible from the reversible cycle is controlled by the difference in temperature of the hot source and the cold sink, the colder the better. This temperature difference between the source and the sink also controls the isothermal variations of the Gibbs potential of the working fluid, that Carnot identified as reversible temperature-dependent but unequal exchanges in caloric. Importantly, the engine’s inertia ensures that heat from work performed adiabatically in the expansion phase is all restored to the working fluid during the adiabatic recompression, less the net work performed. This allows both the energy and the thermodynamic potential to return to the same values at the beginning of each cycle, a point strongly emphasized by Carnot. Our action revision equates Carnot’s calorique, or the non-sensible heat later described by Clausius as ‘work-heat’ exclusively to negative Gibbs energy (-G) or quantum field energy. This action field complements the sensible energy or vis-viva heat as molecular kinetic motion and its recognition should have significance for designing more efficient heat engines or better understanding of the heat engine powering the Earth’s climates.

The inhibition of heat shock protein 90 (Hsp90) a molecular chaperone for multiple oncogenic client proteins is considered as a promising approach to overcome radioresistance. Since most Hsp90 inhibitors activate HSF-1 that induces the transcription of cytoprotective and tumor-promoting stress proteins such as Hsp70 and Hsp27, a combined approach consisting of HSF-1 knockdown (k.d.) and Hsp90 inhibition was investigated. A specific HSF-1 k.d. was achieved in H1339 lung cancer cells using RNAi-Ready pSIRENRetroQ vectors with puromycin resistance. The Hsp90 inhibitor NVP-AUY922 was evaluated at low concentrations - ranging from 1-10nM - in control and HSF-1 k.d. cells. Protein expression (i.e., Hsp27/Hsp70, HSF-1, pHSF-1) and transcriptional activity was assessed by Western blot analysis and luciferase assays and radiosensitivity was measured by proliferation, apoptosis (Annexin V, active caspase 3), clonogenic cell survival, alkaline comet, γH2AX, 53BP1 and Rad51 foci assays. The k.d. of HSF-1 resulted in a significant reduction of basal and NVP-AUY922-induced Hsp70/Hsp27 expression levels. A combined approach consisting of HSF-1 k.d. and low concentrations of the Hsp90 inhibitor NVP-AUY922 potentiates radiosensitization which involves an impaired homologous recombination mediated by Rad51. Our findings are key for clinical applications of Hsp90 inhibitors with respect to adverse hepatotoxic effects.

Temperature differences between the atmosphere and river water allow rivers to be used as a hydrothermal energy source. The river-water heat pump system is a relatively non-invasive renewable energy source; however, effluent discharged from the heat pump can cause downstream temperature changes which may impact sensitive fluvial ecosystems. In this study, the water temperature recovery distance of the effluent was estimated for a river section in the Han River Basin, Korea, using the heat transfer equation and the Environmental Fluid Dynamic Code (EFDC) model. Results showed that, compared to the EFDC model, the heat transfer equation tended to overestimate the water temperature recovery distance due to its simplified assumptions. The water temperature recovery distance could also be used as an objective indicator to decide the reuse of downstream river water. Furthermore, as the river system was found to support an endangered fish species that is sensitive to water environment changes, care should be taken to exclude the habitats of protected species affected by water temperatures within water temperature recovery distance.

Background Popular movement-based injury risk screens have been shown to lack predictive precision, leading to interest in multifactorial models. Furthermore, there is a lack of research regarding injury risk assessment for those currently or planning to be recreationally active. This study aims to provide injury risk insights by analyzing multifactorial injury risk models and as-sociated clinical measures in the U.S. population. Methods Data related to injury, inflammatory markers, physical functioning, body composition, physical activity, and other variables from 21,033 respondents were extracted from NHANES. Odds ratios for self-reported injury were calculated for single predictors and risk models. Case-control and principal component analyses (PCA) were conducted to elucidate confounders and identify risk factor clusters, respectively. Receiver operating characteristic analysis was used to test the precision of a risk factor cluster to identify pain points and functional difficulties. Results Sociodemographic, individual, and lifestyle factors were strongly associated with higher odds of injury. Increases in fibrinogen and C-reactive protein were significantly associated with all risk groups. Membership to the high-risk group (age over 40, obesity, no muscle-strengthening activities, sedentary lifestyle, and low back pain) predicted at least one functional difficulty with 67.4% sensitivity and 87.2% specificity. In the injury group, bone turnover markers were higher, yet confounded by age and there was a significantly higher prevalence of self-reported osteoporosis compared to the control. In males, low testosterone was associated with injury, and higher estradiol was associated with pain and functional difficulties. In females, higher levels of follicle-stimulating hormone were associated with functional difficulties. PCA revealed four high-risk profiles, with markers and activities showing distinct loadings. Conclusion A comprehensive approach to injury risk assessment should consider the nexus of aging, lifestyle, and chronic disease to enhance tailored injury prevention strategies, fostering safe and effective physical activity participation and reducing the burden of musculoskeletal disorders.

Research indicates that painful experiences can significantly affect the fear of cancer recurrence among cancer survivors, which is a distressing concern that influences both physiological and psychological recovery. Yet, the role of potential factors and mechanisms in these relationships is not fully known. This cross-sectional study aimed to advance our comprehension of the associa-tions between total pain and the fear of recurrence in post-treatment cancer patients by examining two potential mediators: psychological flexibility and mentalization. Three hundred and thirty-five participants (aged 22 to 88, 49.1% female) who had finished their cancer treatment completed self-report assessments of total pain, fear of recurrence, psychological flexibility, and mentalization. The serial mediation analysis showed that all dimensions of total pain were positively related to the fear of recurrence indirectly through psychological flexibility and mentalization, in serial. Additionally, gender moderated these serial mediational effects. In line with the psychological flexibility model, personal capacities to face difficult internal/external problems and interpret one’s behaviour in motivational terms can counterbalance patients’ negative emotions and feelings related to the illness.

Shoulder tendinopathies produce pain and reduce functionality. The aim of this randomized clinical trial was to analyze the effects of Percutaneous electrolysis (PE), Percutaneous peripheral Nerve Stimulation (PNS) and eccentric exercise (EE), on pain (NPRS), strength, electromyographic activity, ultrasound characteristics of the tendon (echogenicity, thickness and hypervascularization) and functionality (DASH and SPADI) on individuals with supraspinatus tendinopathy. Participants (n=50) were divided into two groups, they received 4 treatment sessions, one per week, of PE and PNS (n=25) or 10 treatment sessions of TENS and US (n=25). Both groups performed EE program consisted of 3 sets of 10 repetitions of each of the 3 exercises, twice a day, during the 4 weeks. Follow-up was carried out at 4, 12 and 24 weeks after the start of the intervention. There are statistically significant differences in the analysis between groups (p&lt;0.001) in the post-treatment and follow-up measurements favorable to the PE+PNS+EE treatment on pain (NPRS), strength, supraspinatus electromyographic amplitude, ultrasound characteristics of the tendon (echogenicity, thickness and hypervascularization) and DASH and SPADI questionnaires. The combined treatment PE, PNS and EE is an effective option in the clinical management of tendinopathies, with positive results in the short and long term on the variables studied.

Vascular anomalies are a diverse group of abnormal blood vessel developments that can occur at birth or shortly afterward. Embolization and sclerotherapy have been utilized as a treatment option for these malformations but may cause moderate to severe pain. This study aims to evaluate the utilization of peripheral nerve blocks in opioid consumption, pain scores, and length of stay. A retrospective chart review was conducted at the UPMC Children's Hospital of Pittsburgh for all patients who underwent embolization and sclerotherapy between 2011 and 2020. Patient data was collected to compare opioid consumption, pain scores, and length of stay. Eight hundred fifty-four procedures were performed on 347 patients. The morphine milligram equivalent per kilogram mean ratio between groups was 0.9 (0.86, 0.95) with a p-value of &lt;0.001. The pain score mean ratio was –1.17 (–2.2, -0.1) and a p-value of 0.027. Length of stay had a mean ratio of 0.94 (0.4, 2) and a p-value of 0.875. By decreasing opioid consumption and postoperative pain scores, peripheral nerve blocks may have utility in patients undergoing embolization and sclerotherapy while not clinically increasing the length of stay for patients. Their use should be individualized and carefully discussed with the interventional radiologist.

Background: Previous investigations have found a correlation between abnormal curvatures and a variety of patient complaints such as cervical pain and disability. However, no study has shown that loss of the cervical curve is a direct result of exposure to a motor vehicle collision (MVC). This investigation presents a retrospective consecutive case series of patients with both a pre-injury cervical lateral radiograph (CLR) and a post-injury CLR after exposure to a MVC. Computer analysis of digitized vertebral body corners on CLRs was performed to investigate the possible alterations in the geometric alignment of the sagittal cervical curve. Methods: Three spine clinic records were reviewed, over a 2-year period, looking for patients where both an initial lateral cervical x-ray and an examination were performed prior to the patient being exposed to a MVC; afterwards an additional exam and radiographic analysis were required. A total of 41 patients met the inclusion criteria. Examination records of pain intensity on numerical pain rating scores (NPRS) and neck disability index (NDI), if available, were analyzed. The CLRs were digitized and modeled in the sagittal plane using curve fitting and the least squares error approach. Radiographic variables included total cervical curve (ARA C2-C7), Chamberlain’s line to horizontal (skull flexion), horizontal translation of C2 relative to C7, segmental translations (retrolisthesis and anterolisthesis), and circular modelling radii. Results: There were 15 males and 26 females with an age range of 8-65 years. Most participants were drivers (28) involved in rear end impacts (30). The pre-injury NPRS was 2.7 while the post injury was 5.0; p &lt; 0.001. The NDI was available on 24 /41 (58.5%) patients and was found to increase following exposure to the MVC: 15.7% to 32.8%, p &lt; 0.001. An altered cervical curvature was identified following exposure to MVC, characterized by an increase in radius of curvature and an approximate 8° reduction of lordosis from C2-C7; p &lt; 0.001. The mid cervical spine (C3-C5) showed the greatest curve reduction with localized mild kyphosis at these levels on average. Several participants developed segmental translations that approached the instability value of translation &gt; 3.5mm. Conclusions: Abnormalities of cervical lordosis occurred following exposure to a MVC. The average loss of cervical curvature was 8° from C2-C7, with mild flexion of the mid cervical segments. Snap through type or dynamic buckling during the MVC may explain our findings. The primary contribution of this study to the motor vehicle collision literature is that altered cervical lordosis may result from MVC exposures and the consequences of an altered cervical alignment, in turn, may lead to future pain, disability and decreased health-related quality of life.

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

Background: One of the most common occupational health hazard and serious health concern, now a days, recognized is Musculoskeletal disorders (MSDs). The high prevalence among students and teachers is a major cause of decline in their health related quality of life and work performance. This study aimed to identify the prevalence of musculoskeletal disorders among teachers and students during online education. Methods: A cross-sectional survey was conducted among university faculty members and students who were involved in online education during COVID-19. Data collection was carried out electronically through a validated Arabic version of the Nordic Musculoskeletal Questionnaire (NMQ) which is self reported. A total of 175 respondents responded to the questionnaire (response 60%). Results: The prevalence of any part of the body was 90.3%. The commonest site of MSDs for past 12 months was the low back (65.7%), the neck (58.3%), and shoulders (57.7%). Females (80%) suffered more than males (20%). The students reported slightly higher MSDs as compared to teachers (93.1% vs 90.3). Binominal regression analysis showed association of females with low back pain “OR: 2.24 (95% CI): 1.04-4.83; p = 0.03” and neck pain “OR: 2.7 (95% CI): 1.24–5.84; p = 0.012)” while bad posture was associated with pain in upper back “OR: 3.46 (95% CI): 1.73-6.93; p = 0.001”. Conclusion: The faculty members and students are prone to high MSDs during online classes and significant measures should be taken to reduce the prevalence by addressing associated risk factors.

Abstract: Introduction: A retrospective case-controlled study was performed to evaluate the out-comes of shoulder arthroplasty performed as a day case in carefully selected patients, compared to the traditional inpatient approach. Materials & Methods: Patients who had total or hemiarthro-plasty of the shoulder performed as a day case or inpatient procedure were recruited. The primary outcome compared rates of uneventful recovery, defined by the absence of any complications or readmission to hospital within six months of surgery, between Inpatient and Outpatient groups. Secondary outcomes included examiner-determined functional scores and patient-determined pain scores at one, six, twelve, and twenty-four weeks post-surgery. A further assessment of pa-tient determined pain scores was carried out at a minimum of two years post-surgery (5.8 ± 3.2). Results: 73 patients (36 Inpatients and 37 Outpatients) were included in the study. Within this time frame 25/36 inpatients (69%) had uneventful recoveries compared to 24/37 outpatients (65%) (p = 0.17). Outpatients showed significant improvement over pre-operative baseline levels in more of the secondary outcomes (strength and passive range-of-motion) by six months post-operation. Outpatients also performed significantly better than Inpatients in external rotation (p<0.05) and internal rotation (p=0.05) at six-weeks post-surgery. Both groups showed significant improvement compared to pre-operative baselines in all patient-determined secondary outcomes except level of activity at work and sport. Inpatients, however, less severe pain at rest at six weeks (p=0.03), sig-nificantly less frequent pain at night (p=0.03) and extreme pain (p=0.04) at 24 weeks; and less se-vere pain at night at 24 weeks (p<0.01). By minimum two years postoperation, inpatients were more comfortable repeating their treatment setting for future arthroplasty (16/18) compared to outpatients (7/22) (p = 0.0002). Conclusions: At a minimum of two years follow up, there were no significant differences in rates of complications, hospitalisations, or revision surgeries between pa-tients that underwent shoulder arthroplasty as an inpatient versus as an outpatient. Outpatients demonstrated superior functional outcomes but reported more pain at six months post-surgery. Patients in both groups expressed a preference for inpatient shoulder arthroplasty in future. What is Known About This Subject: Shoulder arthroplasty is a complex procedure, and has tradition-ally been performed on an inpatient basis, with patients admitted for six to seven days post-surgery. One of the primary reasons for this is the high level of postoperative pain, usually treated with hospital-based opioid therapy. Two studies demonstrated outpatient TSA to have a similar rate of complications as inpatient TSA, however these studies only examined patients within a shorter term 90 day postoperative period, and did not evaluate functional outcomes between the two groups or in the longer term. What This Study Adds to Existing Knowledge: This study provides evidence supporting the longer-term results of shoulder arthroplasty done as a day case in carefully selected patients, which are comparable to outcomes in patients that are admitted to hospital post-surgery.