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.

To achieve n-type doping in diamond, extensive investigations employing first principles have been conducted on various models of phosphorus doping and boron-phosphorus co-doping. The primary focus of this study is to comprehensively analyze the formation energy, band structure, density of states, and ionization energy of these structures. It is observed that within a diamond structure solely composed of phosphorus atoms, the formation energy of an individual carbon atom is excessively high. However, the substitution of two carbon atoms leads to the conversion of diamond into a p-type semiconductor. Upon examining the P-B co-doping structure, it is revealed that the doped impurities exhibit a tendency to form more stable cluster configurations. As the separation between the freely doped atoms and the cluster impurity structure increases, the overall stability of the structure diminishes, consequently resulting in an elevation of the ionization energy. Analysis of the electronic density of states demonstrates that the electron orbit of the B atom makes negligible contributions to the impurity levels during P-B doping.

The NOSTR is a communication protocol for the social web, based on the w3c websockets standard. Although it is still in its infancy, it is well known as a social media protocol, thousands of trusted users and multiple user interfaces, offering a unique experience and enormous capabilities. To name a few, the NOSTR applications include but are not limited to direct messaging, file sharing, audio/video streaming, collaborative writing, blogging and data processing through distributed AI directories. In this work, we propose an approach that builds upon the existing protocol structure with end goal a decentralized marketplace for federated learning and LLM training. In this proposed design there are two parties: on one side there are customers who provide a dataset that they want to use for training an AI model. On the other side, there are service providers, who receive (parts of) the dataset, train the AI model, and for a payment as an exchange, they return the optimized AI model. The decentralized and censorship resistant features of the NOSTR enable the possibility of designing a fair and open marketplace for training AI models and LLMs.

This study introduces a compact Raman spectrometer with a 1064 nm excitation laser coupled with a fiber probe and an inexpensive motorized stage, offering a promising alternative to widely used Raman imaging instruments with 785 nm excitation lasers. The benefits of 1064 nm excitation for biomedical applications include further suppression of fluorescence background and deeper tissue penetration. The performance of the 1064 nm instrument in detecting cancer in human bladder resectates is demonstrated. Raman images with 1064 nm excitation were collected ex vivo from 10 human tumor and non-tumor bladder specimens and the results are compared to previously published Raman images with 785 nm excitation. K-Means cluster (KMC) analysis is used after pre-processing to identify Raman signatures of control, tumor, necrosis, and lipid-rich tissues. Hierarchical cluster analysis (HCA) groups the KMC centroids of all specimens as input. The tools for data processing and hyperspectral analysis were compiled in an open source Python library called SpectraMap (SpMap). In conclusion, the 1064 nm Raman system can differentiate between tumor and non-tumor bladder tissues in a similar way to 785 nm Raman spectroscopy. These findings hold promise for future clinical hyperspectral imaging.

Background: In most cases, intra-labyrinthine schwannoma (ILS) occurs in patients with unilateral hearing deterioration or neurofibromatosis type II (NF II). The pattern of localization of these tumors is various but affects mostly the cochlea. Extirpation of the ILS, if hidden by the cochlea modiolus, is difficult under the aspect of complete removal. Therefore, a tissue removal device (TRD) was designed and tested in temporal bones. The principle of handling the new device is a pushing and pipe cleaner handling inside the cochlea. This present study aimed to describe the first in vivo experience with the newly developed TRD for removing cochlear intra-labyrinthine schwannoma. Methods: In three patients, the TRD was used for the tumor removal of ILS. In two patients with a cochlear schwannoma in combination with a cochlea implantation and one patient suffering from NF II, a cochlear schwannoma was removed with the TRD. The access was performed with a posterior tympanotomy, an enlarged round window approach, and an additional second-turn access. The device was inserted and extracted gradually from the second turn access until the rings were visible in the second turn access. By pushing and pipe cleaner handling, the tumors were removed. An MRI control was performed on the day postoperatively with a T1 GAD sequence. Results: Tumor removal with the TRD was performed in a 15-minute procedure. MRI control confirmed a complete removal on the postoperative day in both cases. Conclusion: In vivo handling of the device confirmed a straightforward handling for tumor removal. MRI scanning showed a complete removal of the tumor by the TRD.

China's economic development has shifted from high speed to high quality. This study constructs an evaluation index for China’s high-quality development utilizing a new development concept. The entropy method and cluster analysis were used to assess the level of high-quality development in China between 2015 and 2021. Kernel density estimation method was employed to explore spatiotemporal dynamics. The results reveal significant differences in the level of economic development among provinces in China; the eastern region is significantly better than the central, northeastern, and western regions. From the perspective of the sub-item evaluation, challenges with uneven, uncoordinated, and insufficient economic development exist in various Chinese provinces.

Cartilage degeneration is a characteristic of osteoarthritis (OA) which is often observed in aging populations. This degeneration is due to the breakdown of articular cartilage (AC) mechanical and tribological properties, primarily attributed to lubrication failure. Understanding the reasons behind these failures and identifying potential solutions could have significant economic and societal implications, ultimately enhancing the quality of life. This review provides an overview of developments in the field of AC, focusing on its mechanical and tribological properties. The emphasis is on the role of lubrication in degraded AC, offering insights into its structure and function relationship. Further it explores the fundamental connection between AC mechano-tribological properties and the advancement of its degradation and puts forth recommendations for strategies to boost its lubrication efficiency.

Two strongly curved areas of the Carpathians in Romania are earthquake-prone: Vrancea - in the South-Eastern Carpathians, and Danubian – in the western edge of the Southern Carpathians. By far the highest seismicity episode in 2023 was recorded in the Southern Carpathians, near Targu Jiu city, of more than 4000 earthquakes. A first ML 5.2 mainshock was recorded on 13 February, followed by a second one, ML 5.7, on 14 February. Our purpose is to provide a first analysis of this sequence in order to explain its extent and unusual development, in time. The possible role of fluids in the middle crust, is discussed in connection with the rather unusual character of the space-time distribution of aftershocks. A large and high-quality dataset is provided by the dense array of seismic stations which has been gradually improved by adding new stations in the epicentral area. The thorough revision of the phase picking and location reveals a few interesting and intriguing features of seismicity that still remain worthy to be further investigated. The database built within this paper provides excellent information not only for Targu Jiu area, but for any other investigation in intra-continental regions characterized by diffuse and sporadic seismic activity.

The Dph1•Dph2 heterodimer from yeast is a radical SAM (RS) enzyme that generates the 3-amino-3-carboxy-propyl (ACP) precursor for diphthamide, a clinically relevant modification on eukaryotic elongation factor 2 (eEF2). ACP formation requires SAM cleavage and atypical Cys-bound Fe-S clusters in each Dph1 and Dph2 subunit. Intriguingly, the first Cys residue in each motif locates next to another, ill-defined cysteine that we show in-here is conserved across eukaryotes. As judged from structural modeling, the orientation of these tandem cysteine motifs (TCM) suggests a candidate Fe-S cluster ligand role. Hence, we generated by site-directed DPH1 and DPH2 mutagenesis, Dph1•Dph2 variants with cysteines from each TCM replaced individually or in combination by serines. Assays diagnostic for diphthamide formation in vivo reveal that while single substitutions in the TCM of Dph2 cause mild defects, double mutations almost entirely inactivate the RS enzyme. Based on enhanced Dph1 and Dph2 subunit instability in response to cycloheximide chases, the variants with Cys substitutions in their cofactor motifs are particularly prone to protein degradation. In sum, we identify a fourth functionally cooperative Cys residue within the Fe-S motif of Dph2 and show that the Cys-based cofactor binding motifs in Dph1 and Dph2 are critical for the structural integrity of the dimeric RS enzyme in vivo.

Introduction. Intra-abdominal cystic formations represent heterogeneous pathologies with varied localization and clinical manifestation. The first challenge of a giant intra-abdominal cystic lesion is identifying the organ of origin. The clinical presentation of intra-abdominal cystic lesions varies from acute manifestations to non-specific symptoms or accidental discovery. Case presentation: A 2-year-old girl presents to the emergency unit with a fever of 38.5 Celsius, loss of appetite, and apathy. The investigations showed a gigantic intra-abdominal mass whose organ belonging could not be specified. Postoperatively, a giant mesenteric lymphangioma was evident, which was completely excised. Discussions Giant cystic formations modify the anatomical reports and become space-replacing formations, and the starting point is even more challenging to assess preoperatively. Nevertheless, the careful evaluation of the characteristics of the formation, the effect on the adjacent organs, the age of the patient, and the clinical picture can provide elements of differential diagnosis.

The ultrasound guided viscosupplementation of the hip joint with hyaluronic acid(HA)is considered a standard procedure among the conservative treatments for hip arthritis.The aim of the study was to evaluate the clinical benefit and the incidence of adverse events of the technique in a obseravtional study at one year follow up. We evaluated a consecutive series of 85 patients with a diagnosis of symptomatic arthritis that performed intra-articular ultrasound-guided hyaluronic acid injections. The scales used for evaluation were modified Harris Hip Score(mHHS),WOMAC (Western Ontario and McMaster University),Hip Outcome Score (HOOS) with subscale Sport (HOOSs), for pain the Visual Analogic Scale (VAS).The patients were classified according to Tonnis’ radiological classification of arthrosis (range 0-3):20 patients(grade 0),32(grade 1),18(grade 2),15(grade 3).At last follow up all the scales increased:mHHS from 59.35 to 82.1,HOOS from 69.45 to 78.53,HOS Sport from 47.4 to 58.11,VAS from 6.09 to 3.97,WOMAC from 33.2 to 31.5 (p<0.05 for all the parameters);13/85 requested arthroplasty. Based on our findings, indication for use of hyaluronic acid is limited to patients with mild to moderate arthritis.Patients in advanced arthritis refusing replacement surgery and asking for this treatment should be informed about the poor results of the technique even in the short term follow up.

This study presents the interaction with human host metabolism of SARS-CoV-2 ORF7b protein (43 aa), using a Protein-Protein-Interaction Networks analysis. After pruning, we selected from BioGRID the 51 most significant proteins among 2,753 proven interactions and 1,708 interactors, specific to ORF7b. We used these proteins as functional seeds and we got a significant network of 551 nodes via STRING. We performed topological analysis and calculated topological distributions by Cytoscape. Seven high ranked proteins as hub and seven as bottleneck following a hub-and-spoke network-architectural-model were found. Through this interaction model, we identified significant GO-processes (5,057 terms in 15 categories) induced in human metabolism by ORF7b. High statistical significance processes of dysregulated molecular cell mechanisms by the action of ORF7b were discovered. We detected disease-related human proteins and their involvement in metabolic roles, how they relate in a distorted way to signaling and/or functional systems, in particular intra- and inter-cellular signaling systems and the molecular mechanisms that supervise to programmed cell death, with mechanisms similar to that of cancer metastasis diffusion. A cluster analysis showed 10 compact and significant functional clusters, where two of them overlap in a Giant-Connected-Components core of 206 total nodes. These two clusters contain most of the high-rank nodes. ORF7b mainly acts through these two clusters, inducing most of the metabolic dysregulation. We conducted a co-regulation, transcriptional analysis by hub and bottleneck proteins. This analysis allowed us to define the transcription factors and miRNAs that control the high-ranking proteins and the dysregulated processes, within the limits of the poor knowledge that these sectors still impose.

This article examines the evolution of the most extensively researched subjects in E-mobility during the previous two decades. The objective of this analysis is to identify the lessons that the State of Kuwait, which is falling behind other nations in E-mobility, can absorb in its efforts to embrace adoptions of electric vehicles (EVs). To strengthen the body of knowledge and deter-mine the most effective and efficient route to an "EV-ready" nation, the authors compiled data on the latest developments in the EV industry. A bibliometric analysis was performed on 3,962 articles utilizing the VOSviewer software, which identified six noteworthy clusters that warranted further attention. Additionally, we examine the sequential progression of these clusters as follows: 1. The environmental ramifications of electric mobility; 2. Advancements in electric vehicle technology, including range extension and soundless engines; and capital (CAPEX) and operational (OPEX) expenditures of purchasing and operating EVs. 3. Concerns regarding effectiveness and durability of EV batteries, 4. Availability of EV charging stations and grid integration, 5. Charging time, and finally 6. Origin and source of the energy utilized in the development of e-mobility. We are of the opinion that by delineating the critical aspects of e-mobility development, policymakers and decision-makers in Kuwait will be better equipped to formulate timely and economical choices pertaining to sustainable transportation.

Phagocytosis (and endocytosis) is an unusual cellular process which results in the formation of a novel subcellular organelle, the phagosome. This phagosome contains not only the internalised target of phagocytosis, but also the external medium, creating a new border between extracellular and intracellular environments. The boundary at the plasma membrane is, of course, tightly controlled and exploited in ionic cell signalling events. Although there has been much work on the control of phagocytosis by ions, notable Ca2+ ions influxing across the plasma membrane, increasing our understanding of the mechanism enormously, very little work has been done exploring the phagosome/cytosol boundary. In this paper, we have explored the changes in the intra-phagosomal Ca2+ ion content which occur during phagocytosis and phagosome formation in human neutrophils. Measuring Ca2+ ion concentration in the phagosome is potentially prone to artefacts as the intra-phagosomal environment experiences changes in pH and oxidation. However, by excluding such artefacts, we conclude that there are open Ca2+ channels on the phagosome, which allow Ca2+ ions to ‘drain’ into the surrounding cytosol. This conclusion was confirmed by monitoring the translocation of intracellularly expressed YFP-tagged C2 domain of PKC-γ. This approach marked regions of membrane at which Ca2+ influx occurred, the earliest being the phagocytic cup, and then the whole cell. This paper therefore presents data which has novel implications for understanding phagocytic Ca2+ signalling events, such as peri-phagosomal Ca2+ hotspots, and other phenomena.

Measurements of temperature and salinity in the Amazon River plume in the open ocean of the western tropical North Atlantic are considered. The measurements were carried out using the AML CTD probe in the upper layer and a flow-through system that measures salinity and turbidity of seawater while the vessel is on the way. Additionally, archive oceanographic data from the WOD18 database, data of satellite altimetry measurements (AVISO), and satellite salinity data from Aquarius and SMOS were used. It is shown that the width of the Amazon plume is about 300–400 km, the depth of desalination is from 50 to 100 m. Surface salinity decreases compared to the background (36 PSU) by 0.5 PSU in February and more than by 3 PSU in September during the period of maximum development of the plume, which is determined from satellite measurements of surface salinity. Lagrangian modeling of the back-in-time advection of passive markers simulating freshwater particles was carried out. It was shown that the source of fresh water in the measurement area is the discharge of the Amazon.

Aiming at the problem of UAV cluster configuration reconstruction, in order to obtain the cluster reconstruction method, the theory and simulation of cluster reconstruction control strategy is studied by simplifying the model，deducing the theoretical formula and analyzing the example. Taking 10 UAVs cluster as an example, the distribution of UAVs in different configurations was analyzed. According to the change of cluster configuration, the principle of formation reconstruction and the execution ability of configuration, the cluster capability was analyzed. The group behavior is modeled by group behavior rules, reconfiguration topology analysis and reconfiguration cost measurement. Based on the cluster parameters and configuration characteristics, simulation experiments were carried out to obtain the change curve of the reconstruction cost and time and the trajectory movement diagram of the UAV in different configurations.

Physical exercise favorably affects visceral adipose tissue (VAT) which is a risk factor for cardiometabolic diseases. However, many people are unable or unwilling to conduct frequent and intensive exercise programs that have favorable effects on VAT. The present study aimed to determine the effect of the time-efficient and joint-friendly whole-body electromyostimulation (WB-EMS) technology on VAT volume in overweight to obese adults with osteoarthritis of the knee. In total 72 women and men 40-70 years old with femuro-tibial knee osteoarthritis were randomly allocated to WB-EMS (n=36) with 1.5 sessions of 20 min/week for 29 weeks or a usual care control group (CG: n=36) with 6 sessions of physiotherapy. Magnetic Resonance Imaging (MRI) using a non-contrast enhanced 2-point Dixon Gradient Echo Volumetric Interpolated Breath-hold Examination determined VAT. Twelve slices covered a total length of approximately 5 cm from mid L2 to mid L3. In summary, VAT volume increased non-significantly in the CG (p=.261) and decreased non-significantly in the WB-EMS group (p=.160). We failed to determine significant WB-EMS-induced effects i.e. group differences for absolute changes on VAT volume (p=.097). Due to the low application volume, present WB-EMS protocols might not be the perfect tool for decreasing VAT in overweight to obese adults.

Hepatitis D virus (HDV) infection represents the most severe form of chronic viral hepatitis. We have shown that the delivery of HDV replication-competent genomes to the hepatocytes using adenoassociated virus (AAV-HDV) as gene delivery vehicles offers a unique platform to investi-gate the molecular aspects of HDV and associated liver damage. Here, we generated HDV ge-nomes modified by site directed mutagenesis aimed to: i) prevent some post-translational modi-fications of HDV antigens (HDAgs) such as Large-HDAg (L-HDAg) isoprenylation or Short-HDAg (S-HDAg) phosphorylation ii) alter the localization of HDAgs within the subcellular compartments and iii) inhibit the right conformation of the delta ribozyme. First, the different HDV mutants were tested in vitro using plasmid-transfected Huh-7 cells and then in vivo in C57BL/6 mice using AAV vectors. We found that Ser 177 phosphorylation and the ribozymal ac-tivity are essential for HDV replication and HDAg expression. Mutation of the isoprenylation domain prevent the formation of infectious particles and increase cellular toxicity and liver dam-age. Finally, altering the intracellular localization od HDAg have a profound on viral replication in vivo but liver toxicity is maintained. Mutation in the nuclear export signal impair the for-mation of infectious viral particles. These findings contribute valuable insights into the intricate mechanisms of HDV biology and have implications for therapeutic considerations

Streptomyces sp. HNS054, which was previously isolated from a marine sponge, demonstrates vigorous growth and facile genetic modification. This study explores its potential as a marine ac-tinomycete chassis through complete genome sequencing and genetic engineering. With a 7.5 Mb genome containing 6678 predicted genes, 21 secondary metabolic biosynthetic gene clusters (BGCs), and 8 common site-specific recombination (SSR) system attB loci, HNS054 shows a close phylogenetic relation to S. griseoincarnatus strain RB7AG. Utilizing multiplexed site-specific ge-nome engineering (MSGE) and the CRISPR/Cas9 method, engineered strains derived from HNS054 (with three copies of the target BGCs) produce higher amounts of aborycin and ac-tinorhodin than S. coelicolor M1346 (containing three copies of the same BGCs). HNS054 stands out for its remarkable characteristics, including salt tolerance, rapid growth, and compatibility with synthetic biology tools, and positions it as a promising candidate for developing marine ac-tinomycete hosts to enhance secondary metabolite production.

This research paper examines the effects, advantages, challenges, and economic aspects of a research town. The study concludes that inclusion and diversity not only constitute fundamental values but also serve as crucial drivers of business success and sustained competitiveness. Universities play a central role in shaping the prosperity of the research town by functioning as knowledge hubs, fostering collaboration, nurturing talent, and contributing to the broader innovation ecosystem. The symbiotic relationship between universities and industries within the cluster establishes a dynamic and resilient environment for research and development. The presence of startups within the research cluster introduces novel ideas, enhancing the overall vibrancy and competitiveness of the local economy. In an era where social media algorithms increasingly influence people's choices, the potential for foreign interference emerges as a significant threat.

The ability of S. aureus to infect humans and cause a wide range of infections so efficiently is a consequence of the many variant virulence factors that it can produce. Superantigens (SAgs) make up a group of them and include staphylococcal enterotoxins (SE). The main objective of this study was to detect enterotoxin gene cluster (EGC) in S. aureus isolates that caused infections in Paraguayan children in the year 2017, through an observational and cross-sectional study. The detection of the EGC including the seg, sei, sem, sen, seo, and seu genes, was carried out by end-point PCR. 181 S. aureus isolates were collected, most of them caused skin and soft tissue infections (SSTI, n=140, 77%) and came from children under 6 years 50% (n=90). At least one SE gene was detected in 96% (174/181) of isolates and 24% (44/181) carried the entire EGC. An association between methicillin resistance and seg, sei, seo, and seu gene carriage (p ≤0.05) was observed. A high prevalence of EGC was detected in S. aureus isolates collected from infected children attending the main health care centers in Paraguay, its importance is due to the potential of these toxins to aggravate staphylococcal infections.

As urbanization has accelerated, China has started to build smart cities, which have formed smart city clusters. It is critical to coordinate development within smart city clusters to enhance the efficiency of city cluster construction. From the perspective of demographic economics, this study innovatively constructed an evaluation system for the coordinated development of smart city clusters and utilized the coupled coordination degree model to conduct an in-depth study of smart city clusters in Jiangsu Province. The results show that there are clear differences in the development between the three regions of Jiangsu Province: Southern Jiangsu, Central Jiangsu, and Northern Jiangsu. The development within Jiangsu Province is imbalanced, where the overall development trend is high in the southern region and low in the northern region. The main driving factors include geography, the Matthew effect, game thinking, and industrial structure. Accordingly, the results suggest the following recommendations for the coordinated development of smart city clusters: strengthening cross-regional cooperation, promoting data sharing and interoperability, deepening synergistic industrial development, and expanding innovation capacity.

Heptanuclear {GdIII7} (complex 1) and tetradecanuclear {GdIII14} (complex 2) have been synthesized using a Rhodamine 6G ligand HL (Rhodamine 6G salicylaldehyde hydrazone) and characterized. Complex 1 has a rare disc-shaped structure, where the central Gd ion was connected to the peripheral six GdIII ions via CH3O-/μ3-OH- bridges. Complex 2 has an unexpected three-layer double sandwich structure with a rare μ6-O2- ion in the center of the cluster. Magnetic studies revealed that complex 1 exhibits a magnetic entropy change of 17.4 J kg−1 K−1 at 3 K and 5 T. On the other hand, complex 2 shows a higher magnetic entropy change of 22.3 J kg−1 K−1 at 2 K and 5 T.

Climate research shows that extreme weather events and their effects are increasing in frequency, severity, and impact. Extreme wind events can cause massive societal and economic damage. High wind occurrences and their causes must be identified because they are hard to define and understand. Extreme wind modeling affects wind power plant planning, installation, and building modeling. This applies to city, vegetation, and vegetational area modeling. The scientific literature utilizes statistical, dynamic (Weather Research and Forecasting-WRF), and machine learning methods to identify extreme wind speeds. This study explores the relationship between lower-level extreme wind speeds and upper-level parameters like Z500, and T850 based on cluster analysis. The aim is to explore the correlation between upper-level atmospheric dynamics and lower-level wind behavior. K-Means cluster analysis method was employed to classify Turkish regions with similar severe wind episodes. WRF model simulation findings from NEWA (New European Wind Atlas) project (2019) were used for that purpose. The NEWA project's wind speed data at 100m a.g.l. was used for cluster analysis. We simplify the process by grid point reduction and applying the top 2% percentile as threshold value. Self-Organized Maps (SOM) clustering was also applied using the upper-level variables.

Iberian ham, a traditional Spanish meat product, is renowned for its unique nutritional and sensory attributes, garnering widespread appreciation both domestically and internationally [1]. It is one of the most outstanding Spanish gastronomic treasures, with very special nutritional and sensory properties that make it highly appreciated throughout the world [2]. Recent trends indicate a notable surge in its consumption, a pattern projected to persist [3]. For an enhanced online shopping experience, understanding the specific characteristics and requirements of various consumer segments is crucial. This study aims to scrutinize national Iberian ham consumption patterns and, through survey methodologies, discern the preferences and needs of online consumers purchasing whole Iberian hams. The subsequent cluster analysis will empower suppliers with insights to pinpoint business prospects and craft segment-specific online marketing strategies.

Abstract Background: Cluster randomized controlled trials are increasingly becoming popular in public health research interventions and health services research in primary health care design and use in low and middle-income countries. However, the majority of researchers in these trials did not account correctly for the effect of confounders and clustering in the design and analysis stages. Objectives: This article aimed to review the main implications of implementing a cluster randomized controlled trials design in public health research and emphasize the practical application of proper analytical methods and the performance of different statistical models. Methods: The practical application of various analytical methods is validated via the utilization of experimental data from a public health research case study. This article also demonstrated the performance of hierarchical models and made comparisons in terms of empirically precise effect size estimates. Results: Three hierarchical statistical models were provided with highly varied effect sizes during the analysis of the intervention effect on outcome, such as model 1 (AOR: 14.32; 95% CI: 3.75–54.68), model 2 (ARR: 3.52; 95% CI: 2.16–5.77), and model 3 (ARR: 4.79; 95% CI: 2.69–5.52).Conclusion: Inaccurate results and potentially misleading conclusions can arise from improper cluster randomized controlled trial designs and analyses. This article has shown that real-world data can be adjusted for the effects of confounders and clustering, and we advocate for the routine use of suitable design and analytical methods. This article concludes that researchers should be careful when selecting hierarchical models to analyze cluster randomized controlled trials.

Abstract: Intra-abdominal abscesses (IAA) may commonly arise following complicated gastrointestinal tract infections and, on occasion, from infections within the urinary system. Many of these IAA are initiated as a consequence of post-surgical complications. These abscesses have a substantial risk of morbidity and mortality. As a result, it is crucial to diagnose and treat them promptly to minimise these adverse outcomes. Therefore, radiological modalities play a vital role in diagnosing, localising, and detecting associated complications of IAA, as sometimes other investigations could be less reliable and non-specific. Radiological modalities are pivotal in achieving an accurate diagnosis, localising the abscesses, and identifying associated complications. This is especially important since alternative investigative methods may be misleading in certain situations. Radiological techniques such as ultrasound scans (USS), contrast-enhanced computed tomography (CECT), and even magnetic resonance imaging (MRI) are immensely helpful in diagnosing these conditions. These imaging tools guide clinicians in determining the most appropriate patient management strategies. In this article, we compile a case series involving tubo-ovarian abscess, appendicular abscess, diverticular abscess and infected walled-off pancreatic necrosis, paying particular attention to radiological features in the diagnosis. Furthermore, we reviewed the existing literature to delineate characteristic radiological features related to the cases we discussed.

AbstractIntroduction: Increasing knowledge of obstetric danger signs (ODS) and encouraging birth preparedness and complication readiness (BPCR) practices are strategies to increase skilled maternal health service utilization in low-income countries. One of the methods to increase mothers' knowledge about ODS and promote BPCR practice is through health education intervention (HEI). However, the effect of context-specific community-based health education led by women's groups on these outcomes has not been comprehensively studied, and the existing evidence is inconclusive. Thus, we aimed to evaluate the effect of a context-specific community-based HEI led by women's groups on mothers' knowledge regarding ODS and BPCR practices in southern Ethiopia.Methods: An open-label, two-arm parallel group cluster-randomized controlled trial was conducted from January to August 2023 on pregnant women from 24 clusters (kebeles) (12 interventions and 12 controls) in the northern zone of the Sidama region. The Open Data Kit smartphone application was utilized to collect data. The intention-to-treat analysis was used to compare outcomes between groups. We fitted multi-level mixed-effects modified Poisson regression with robust standard error to account for between and within cluster effects. Results: One thousand and seventy pregnant women (540 in the intervention and 530 in the control clusters) responded to this study, making the overall response rate 95.02%. Excessive vaginal bleeding (94.3% in the interventional group vs. 88.7% in the control group) was the commonest ODS mentioned during childbirth. Overall, 68.7% of women in the intervention group and 36.2% of mothers in the control group had good knowledge of ODS (P-value < 0.001). Saving money and materials (97.1% in the interventional group vs. 92.7% in the control group) was the most frequently practiced BPCR plan. Overall, 64.3% of women in the intervention group and 38.9% of mothers in the control group practiced BPCR (P-value < 0.001). HEI significantly increased overall knowledge of ODS (adjusted risk ratio [ARR]: 1.71; 99% CI: 1.14-2.57) and improved overall BPCR practice (ARR: 1.55; 99% CI: 1.02-2.39). Conclusions: A community-based HEI led by women's groups improved mothers' knowledge regarding ODS and BPCR practices in a rural setting in southern Ethiopia. Interventions designed to increase women's knowledge of ODS and improve BPCR practice must implement context-specific, community-based HEI that aligns with World Health Organization recommendations. Trial registration: NCT05865873

Digital twins are gaining in popularity for simulating complex natural and urban environments. In this context, accurate segmentation of objects within 3D urban environments is of crucial importance. The aim of this project is to develop a methodology for extracting buildings from textured 3D meshes. To this end, PicassoNet-II, a semantic segmentation architecture is employed. The methodology also incorporates Markov field-based contextual analysis to assess post-segmentation features. In addition, building instantiation is performed using cluster analysis algorithms. Training this model to fit various datasets requires a large amount of annotated data, both from Quebec City, Canada, and from simulated data. Experimental results show that the use of simulated data improves segmentation accuracy, and the DBScan algorithm proves effective in extracting isolated buildings. This project paves the way for improved applications in 3D urban modeling, offering opportunities in fields ranging from urban planning to resource management. The positive results with simulated data reinforce the impact of this research on improving digital models of our ever-changing urban environments.

During the COVID-19 pandemic, immunosuppressed patients showed prolonged SARS-CoV-2 infections, with several studies reporting the accumulation of mutations in the viral genome. The weakened immune system present in these individuals, along with the effect of antiviral thera-pies, are thought to create a favourable environment for intra-host viral evolution and have been linked to the emergence of new viral variants, which strongly challenged the containment measures and some therapeutic treatments. To assess whether an impaired immunity could lead to an increased instability of viral genomes, longitudinal nasopharyngeal swabs were collected from eight immunocompromised patients and fourteen non-immunocompromised subjects, all undergoing SARS-CoV-2 infection. Intra-host viral evolution was compared between the two groups through deep sequencing, exploiting a probe-based enrichment method to minimize the possibility of artefactual mutations commonly generated in amplicon-based methods, which heavily rely on PCR amplification. Although, as expected, immunocompromised patients expe-rienced significantly longer infections, the acquisition of novel intra-host viral mutations was similar between the two groups. Moreover, a thorough analysis of viral quasispecies showed that the variability of viral populations in the two groups is comparable not only at the consensus level, but also when considering low frequency mutations. This study suggests that a compro-mised immune system alone does not affect SARS-CoV-2 within-host genomic variability.

This narrative review aims to summarize evidence regarding the current utilization and future applications of neuromodulation in patients with headaches, with special attention paid to migraine and chronic cluster headache. We performed a narrative review of the literature to identify studies that detail the effectiveness of neuromodulation therapies in the treatment of headache syndromes. The literature was refined to predominantly focus on systematic reviews published in the last year that have the most robust reporting of research done on this topic. Patients with headache face several challenges, including medication overuse, cost burden, non-compliance to medications due to inability to tolerate side effects, or treatments that are ineffective. Neuromodulation is an emerging field that encompasses implantable and non-implantable technologies that intervene on the signaling and perception of pain. In recent years, this technology has been used as an analgesic, and has been shown to be effective for treatment-resistant headache, particularly when used in patients with migraine and chronic cluster headache.

Since China’s economic reform launched in the late 1970s, rural industrial parks (RIPs) have played a crucial role in the rise of the manufacturing industry in the Pearl River Delta (PRD), transforming the former agricultural land into a location of world-famous factories. However, as China has put forward higher requirements for economic development and stricter control measures for environmental pollution, RIPs with low-end industries and low efficiency present an urgent need for renovation and upgrade. By analyzing the spatial and socioeconomic cross-sectional dataset of rural industrial parks in Nanhai District of Foshan City, this paper attempts to classify the existing industrial parks into groups and propose corresponding redevelopment strategies. The results of the spatial analysis show that the spatial distribution of rural industrial parks is closely related to their location and transportation conditions. Failure of the market has resulted in large tracts of advantageous land being taken up by inefficient industrial parks. Cluster analysis and overlay analysis are used evaluate the difficulty of redevelopment and divide the industrial parks into three clusters: retained RIPs, medium-term-removed RIPs, and near-term-removed RIPs. It is shown that some of the industrial parks are still in good form while the majority need substantial reconstruction. Taking economic and institutional factors into consideration, the authors put forward that different strategies should be adopted for the future renovation of medium-term-removed and near-term-removed RIPs.

Leucobryum is a moss genus that exhibits various bioactivities. However, the identification of Leucobryum species with morphology alone remains difficult. Nowadays, chemical profile analysis provides additional tools for plant classification, especially in medicinal plants. This method uses chemical similarities to identify the differences among some plants, especially for the different varieties of the same species. The objective of this study was to obtain the chemical profiles and use chemometrics to identify selected Leucobryum species found in Thailand. Lipophilic extracts from 18 samples of five taxa were analyzed with TLC and HPLC. Cluster analysis and PCA were used to investigate the similarities of the chemical profiles. PERMANOVA was performed to determine the difference among taxa. The results showed that the TLC profile could separate only the genus of the sample, while HPLC chromatograms showed separation among the Leucobryum taxa and consistent patterns within the same species. In addition, the chemical profiles of Leucobryum species were separated at the species level in PCA. The PERMANOVA showed significantly different profiles among the species (P = 0.002). Therefore, this work illustrated the potential of chemometrics as supporting evidence for species delimitation in the moss genus Leucobryum.

The field of human microbiome and gut microbial diversity research has witnessed a profound transformation, driven by advances in omics technologies. These advancements have unveiled essential connections between microbiome alterations and severe conditions, spurring the development of new frameworks through epidemiological studies. Traditionally, each individual was thought to harbor unique microbial communities acquired early in life, but recent research challenges this belief. The neonatal microbiome's onset, influenced by factors like delivery mode and maternal health, remains a subject of intense debate, hinting at potential intrauterine microbial processes. In-depth research reveals associations between microbiome profiles and specific health outcomes, ranging from obesity to neurodevelopmental disorders. Understanding these diverse microbiome profiles is essential for unraveling the intricate relationships between the microbiome and health outcomes.

In this perspective article, we ponder topographical enhancements of artificial neural networks. In our recent paper in JMLR, we proved a quasi-equivalence between the network width and depth and also discussed the power of intra-links, which can be viewed as network height. In 1982, Hopfield published a network to model human associative memory, which contains many loops for dynamic evolution toward fixed points. Based on noising-denoising loops, diffusion models are recently developed to enable Bayesian modeling and inference with big data. Furthermore, we envision development of multi-AI-agent systems through “netware” engineering as a quantum leap of software engineering for emergent behaviors and autonomous AI at individual and population levels. We believe that the novel use of links and loops in space and time via multi-scale coupling would catalyze the next-generation neural networks.

One of the most important sources of energy is the sun. Taiwan is located at north 22-25° latitude. Due to its proximity to the equator, it experiences only a small angle of sunlight incidence. Its unique geographical location which can obtain sustainable and stable solar resources. This study takes research on the forecast of solar radiation to maximize the benefits of solar power generation, and develops methods that can predict the future solar radiation pattern to help reduce the costs of solar power generation. This study builds supervised machine learning models, known as deep neural network (DNN) and long short-term memory neural network (LSTM). The hybrid supervised and unsupervised model, namely cluster-based artificial neural network (k-means clustering and fuzzy C-means clustering-based models), was developed. After establishing these models, the study evaluated their prediction results. For different prediction periods, the study selected the best-performing model based on the results and proposed combining them to establish a real-time updated solar radiation forecast system capable of predicting the next 12 hours. The study area covered Kaohsiung, Hualien, and Penghu in Taiwan. Data from ground stations of the Central Weather Administration, collected between 1993 and 2021, as well as the solar angle parameters of each station, were used as input data for the model. The results of this study show that different models have their advantages and disadvantages in predicting different future times. Therefore, the hybrid prediction system can predict future solar radiation more accurately than a single model.

Facial expression recognition is crucial for understanding human emotions and nonverbal communication. With the growing prevalence of facial recognition technology and its various applications, accurate and efficient facial expression recognition has become a significant research area. However, most previous methods have focused on designing unique deep-learning architectures while overlooking the loss function. This study presents a new loss function that allows simultaneous consideration of inter- and intra-class variations to be applied to CNN architecture for facial expression recognition. More concretely, this loss function reduces the intra-class variations by minimizing the distances between the deep features and their corresponding class centers. It also increases the inter-class variations by maximizing the distances between deep features and their non-corresponding class centers, and the distances between different class centers. Numerical results from several benchmark facial expression databases, such as Cohn-Kanade Plus, Oulu-Casia, MMI, and FER2013, are provided to prove the capability of the proposed loss function compared with existing ones.

The persistence of geographic inequities in vaccination coverage often evidences the presence of zero-dose and missed communities and vulnerabilities to vaccine-preventable diseases. These inequities were exacerbated in many places during the COVID-19 pandemic, due to severe disruptions to vaccination services. Understanding changes in zero-dose prevalence and associated risk factors in the context of the COVID-19 pandemic is, therefore, critical to designing effective strategies to reach vulnerable populations. Using data from nationally representative household surveys conducted before the COVID-19 pandemic in 2018 and during the pandemic in 2021 in Nigeria, we fitted Bayesian geostatistical models to map the distribution of three vaccination coverage indicators: receipt of DTP1, MCV1 and any of the four basic vaccines (BCG, OPV0, DTP1 and MCV1), and corresponding zero-dose estimates independently at 1x1 km resolution and the district level during both time periods. We also explored changes in the factors associated with non-vaccination at the national and regional levels using multilevel logistic regression models. Our results revealed no increases in zero-dose prevalence due to the pandemic at the national level, although considerable increases were observed in a few districts. We found substantial subnational heterogeneities in vaccination coverage and zero-dose prevalence both before and during the pandemic, showing broadly similar patterns in both time periods. Areas with relatively higher zero-dose prevalence occurred mostly in the north and a few places in the south in both time periods. We also found consistent areas of low coverage and high zero-dose prevalence using all three zero-dose indicators, revealing areas in greatest need. At the national level, risk factors related to socioeconomic/ demographic status (e.g., maternal education), maternal access to and utilization of health services and remoteness were strongly associated with the odds of zero dose in both time periods, while those related to communication were mostly relevant before the pandemic. These associations were also supported at the regional level, but we additionally identified risk factors specific to zero dose in each region; for example, communication and cross-border migration in the northwest. Our findings can help guide tailored strategies to reduce zero-dose prevalence and boost coverage levels in Nigeria.

There is no well-defined threshold for intra-operative blood transfusion (BT) in advanced epithelial ovarian cancer (EOC) surgery. We developed a Machine Learning (ML)-driven prediction algorithm to trigger and explain a communication alert for BT based on anticipated peri-operative events irrespective of BT policies. We analysed prospectively collected data from 403 EOC patients who underwent cytoreductive surgery between 2014 and 2019. We calculated the estimated blood volume (EBV) using the formula EBV = weight x 80 and set off 10%EBV as threshold for individual intervention. Based on the known estimated blood loss (EBL) we identified two groups. We employed Receiver operating characteristic (ROC) curves for performance metrics. The model performance for the above threshold prediction was satisfactory (AUC 0.823, 95% CI 0.76-0.88). The top feature commonly shared between interrogators was operative time (OT). Intra-operative blood loss of at least 10%EBV was associated with OT&gt;250 minutes, primary surgery, serous histology, performance status 0, R2 resection and surgical complexity score &gt;4. Large bowel resection, stoma formation, ileocecal resection/right hemicolectomy, mesenteric resection, bladder and upper abdominal peritonectomy were amongst sub-procedures clearly associated with increased intervention risk. Precise prediction of blood requirements is not possible unless a rough estimate of OT is known in advance.

Transportation tasks in nursing are common and shorten the time for direct patient care in times of nursing shortage and an aging society. There is a lack of research on transportation needs, with most studies focusing on overall nursing task analysis without a deeper analysis of transportation tasks. In July and September 2023, we conducted weekly observations of nurses to assess clinical transportation needs. We aim to understand the economic impact and the methods nurses use for transportation tasks. We conducted a participant observation using a standardized app-based form over a seven-day observation period in two rural clinics. N=1,830 transports were made by nurses and examined by descriptive analysis. Non-medical supplies account for 27.05 % (n=495) of all transports, followed by medical supplies at 17.32 % (n=317), pharmacotherapy at 14.10 % (n=258) and other other categories like meals or drinks contributing 12.68 % (n=232). Most transports had a factual transport time of under a minute, with patient transport and lab samples displaying more variability. In total, 77.15 % of all transports were made by hand. Requirements to collect items or connect transports with patient care were included in 5 % of all transports. Our economic evaluation spotlighted meals as the most costly transport, with 9,596.16€ p.a. in the observed clinics. Budget-friendly robots would amortize over one year by transporting meals. We support understanding nurses’ transportation needs via further research on assistive robots to validate our findings and determine the feasibility of transport robots.

Seventeen bacterial strains able to suppress plant pathogens have been isolated from healthy Vietnamese crop plants, and taxonomically assigned as members of the Bacillus cereus group. In order to prove their potential as biocontrol agents, we performed a comprehensive analysis which included whole genome sequencing of selected strains, and mining for genes and gene clusters involved in the synthesis of endo- and exotoxins, and secondary metabolites, such as antimicrobial peptides (AMPs). Kurstakin, thumolycin, and other AMPs were detected and characterized by different mass spectrometric methods, such as MALDI-TOF-MS, and LIFT-MALDI-TOF/TOF fragment analysis. Based on their whole genome sequences, the plant-associated isolates were assigned to the following species and subspecies: B. cereus subsp. cereus (6), B. cereus subsp. bombysepticus (5), Bacillus tropicus (2), and Bacillus pacificus. Three isolates represented novel genomospecies. Genes encoding entomopathogenic crystal and vegetative proteins were detected in B. cereus subsp. bombysepticus TK1. In vitro assays revealed that many plant-associated isolates enhanced plant growth and suppressed plant pathogens. Our findings indicated that plant-associated representatives of the B. cereus group are a rich source of putative antimicrobial compounds with potential in sustainable agriculture. However, the presence of virulence genes might restrict their application as biologicals in agriculture.

Given the recent advances in information technology, speed has become an important requirement in data transmission. Given that an LED (light emitting diode) can turn on and off several thousand or even millions of times per second, then LiFi (light fidelity) technology has strong advantages over WiFi (wireless fidelity) in terms of speed. In this research project, a consortium involving an academic institution decided to evaluate the maturity of LiFi technology and design a demonstrator that could be integrated in a vehicle via an intra-vehicle data transmission system. The demonstrator is to implement a two-way LiFi communication between the reading light of a vehicle and a portable device such as a tablet or smartphone. The nomadic device must display, via an interface, data in real time. The data is RNT (Digital Terrestrial Radio) and TNT (Digital Terrestrial Television) provided by an in-house antenna. LiFi depends on optical technology. The optical characteristics have significant influences on the system. The paper shows ways to improve the system’s throughput, communication range, and reception area. By replacing the reading light with a more powerful one with better optical characteristics, the communication range and reception area improve. By using symmetrical power supply, the throughput improves. Likewise, by using optical filters that eliminate noise, the throughput also improves. We have demonstrated that LiFi data transmission in the vehicle is feasible; low-definition videos were successfully transmitted. The paper acknowledges that there are still various avenues for this work’s improvement.

A mixture of nonlabeled (14N2H4) and 15N labeled hydrazine (15N2H4) in an aqueous solution is oxidized to 15N2, 14N2, and 14N15N molecules, indicating the intermediate existence of the 14NH2-14NH-15NH-15NH2 with subsequent hydrogen transfers and splitting of side N-N bonds. Structures, thermodynamics, and electron characteristics of various N4H6 molecules in aqueous solutions are investigated using theoretical treatment at the CCSD/cc-pVTZ level of theory to explain the crucial part of the hydrazine oxidation reaction. Most N4H6 structures in aqueous solutions are decomposed during geometry optimization. Splitting the bond between central nitrogen atoms is the most frequent, but the breakaway of the side nitrogen is energetically the most preferred. The N-N fissions are enabled by suitable hydrogen rearrangements. Gibbs free energy data indicate the dominant abundance of NH3... N2... NH3 species. The side N atoms have very high negative charges, which should support hydrogen transfers in aqueous solutions. The only stable cyclo-(NH)4…H2 structure has a too high Gibbs energy and breaks the H2 molecule. The remaining initial cyclic structures are split into hydrazine and HN≡NH or H2N≡N species, and their relative abundance in aqueous solutions is vanishing.

CD74 is a type II cell surface receptor found to be highly expressed in several hematological and solid cancers, due to its ability to activate pathways associated with tumor cell survival and proliferation. Over the past 16 years, CD74 is emerging as a commonly detected fusion partner in multiple oncogenic fusion proteins. Studies have found CD74 fusion proteins in a range of cancers including lung adenocarcinoma, inflammatory breast cancer, and pediatric acute lymphoblastic leukemia. To date, there are five known CD74 fusion proteins, CD74-ROS1, CD74-NTRK1, CD74-NRG1, CD74-NRG2a, and CD74-PDGFRB, with a total of 16 different variants, each with unique genetic signatures. Importantly, the occurrence of CD74 in the formation of fusion proteins has not been well explored despite the fact that ROS1 and NRG1 families utilize CD74 as the primary partner for the formation of oncogenic fusions. Fusion proteins known to be oncogenic drivers, including those of CD74, are typically detected, and targeted after standard chemotherapeutic plans fail and the disease relapses. The analysis reported herein provides insights into early intervention of CD74 fusions and highlight the need for improved routine assessment methods so that targeted therapies can be applied while they are most effective.

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.

This paper proposes an active-reactive power collaborative scheduling model with cluster division for the flexible distributed energy resources (DERs) of smart building system to resolve the high complexity of centralized optimal scheduling of massive dispersed DERs in the distribution network. Specifically, the optimization objective of each cluster is to minimize the operational cost, the power loss cost, and penalty cost for the flexibility deficiency, and the second-order cone-based branch flow method is utilized to convert the power flow equations into the linearized cone constraints, reducing the nonlinearity and heavy computation burden of the scheduling model. Customized virtual battery models for the building-integrated flexible DERs are developed to aggregate the power characteristics of flexible resources while quantifying their regulation capacities with time-shifting power and energy boundaries. Moreover, a cluster division algorithm considering the module degree index based on the electrical distance and flexible balance contribution index is formulated for cluster division to achieve the information exchange and energy interaction in the distribution network with high proportion of building-integrated flexible DERs. Comparative studies have demonstrated the superior performance of the proposed methodology on the economic merits and voltage regulation.

Adverse events associated with opioid use in palliative care have been extensively studied. However, predicting the occurrence of adverse events based on the specific opioid used remains unclear. This study aimed to comprehensively analyze the adverse events caused by µ receptor stimulation of opioids approved in Japan and investigate the tendencies of adverse event occur-rence among different opioids.We utilized the FDA Adverse Event Reporting System (FAERS) database to extract reported adverse events of opioids approved in Japan. Cluster analysis was performed on reporting odds ratios (RORs) of adverse event names among opioids to visualize relationships between opioids and adverse events, facilitating a comparative study of their clas-sifications.We calculated the RORs of adverse events for the target opioids. Based on these RORs, we performed a cluster analysis, which resulted in the classification of 11 target opioids into five distinct groups. we were able to comprehensively compare and examine the relationships between opioids and adverse events. This analysis helps in understanding and managing the risks and benefits of each drug in palliative care settings. By analyzing relationships between opioids and adverse events, clinicians can make informed decisions about opioid selection, dosage, and monitoring to maximize patient safety and comfort.

Contrast-enhanced ultrasonography (CEUS) is useful for evaluation of the hemodynamics of hepatic tumors and surrounding he-patic parenchyma in real time. CEUS with intravenous contrast administration is well established for evaluation of hepatocellular carcinoma (HCC). On the other hand, intra-arterial (transcatheter) CEUS (IAUS) is an emerging technique that allows more selective evaluation of the arterial supply to the tumor. IAUS was performed by administration of Sonazoid® through the microcatheter and imaging of the area of the target lesion with a dedicated, contrast-specific technique. Sonazoid® (0.5 ml diluted with 49.5 ml of distilled water) was used as the contrast medium in IAUS. The diluted Sonazoid® was introduced into the feeding artery by in-termittent injection of 0.3-1.0 ml through a microcatheter placed in the artery and flushing with saline at the same flow rate. We report the three cases in which IAUS was useful in transarterial chemoembolization (TACE) for HCC. Two cases were performed TACE for hepatic metastasis. In any cases, plain computed tomography (CT) after TACE showed accumulation of Lipiodol® only in the metastases. One case was suspected having HCC rupture and urgent abdominal angiography was performed. IAUS was performed frequently to reduce the amount of iodinated contrast agent as much as possible because of renal failure. Concomitant use of IAUS enabled reduction of the amount of contrast agent.

Intra-abdominal pressure (IAP) elevation during capnoperitoneum can cause adverse cardiovascular and respiratory effects. This study aimed to determine if a sequentially increased IAP affects cardiovascular and respiratory variables in anesthetized dogs and evaluate the effects of constant rate infusion of dexmedetomidine (Dex) on cardiovascular and respiratory variables with increased IAP. Five dogs were anesthetized, instrumented, and the Veress needle was equipped to adjust the IAP using a carbonic anhydrase insufflator. Stabilization was conducted for 1 h, and physiological variables were measured in IAPs of 0, 5, 10, 15, and 20 mmHg and after desufflation. After the washout period, the dogs underwent similar procedures along with constant rate infusion of dexmedetomidine. Cardiovascular effects of increased IAP up to 20 mmHg were not significant in healthy beagle dogs and those administered with dexmedetomidine. In the control group, the arterial pressure slightly increased, but not statistically significant, at an IAP of 20 mmHg compared with that at baseline (mean arterial blood pressure, p = 0.399; systolic arterial blood pressure, p = 0.293; diastolic arterial blood pressure, p = 0.141). When comparing the control and dexmedetomidine groups, overall significant effects of dexmedetomidine were noted on heart rate, cardiac output, and systemic vascular resistance during the experiment. Respiratory effects were not affected by abdominal insufflation when compared between different IAPs and between the two groups. Overall, an increased IAP of until 20 mmHg did not significantly affect cardiovascular and respiratory variables in both control and dexmedetomidine groups. This study suggests that dexmedetomidine infusion administration is applicable in laparoscopic procedures in healthy dogs.

This paper considers the problem of predicting earthquakes. It uses a small amount of information to create a descriptive key that can be used as a footprint to describe an event. A frequency grid clusters events that occurred at the same time and then the algorithm averages the history of these events over preceding days, in particular the gaps when the events did not occur. The gaps are measured for the clustered events only and can be used to create a description that is quite unique. Results suggest that seismic events can in fact be traced using this key and subsequently recognised again, if the same conditions reoccur. They also suggest that force direction may be more important than magnitude, after the initial cluster selections are made. Greek and USA datasets have been looked at and the prediction accuracy can be 70% or better. The author therefore suggests that this is an interesting method that deserves attention.

Neuromonitoring of the efferent nerve impulses transmission in the spinal cord tracts during surgical scoliosis treatment makes it possible to assess whether the functional status is deteriorating, affecting the procedure's safety. Is there any relationship between pre- and intraoperative motor evoked potentials recordings and does idiopathic scoliosis (IS) surgical correction improve directly the spinal efferent transmission? This study aimed to compare the results of surface recorded electromyography (EMG), electroneurography (ENG, M and F-waves), and especially motor evoked potentials (MEP) from tibialis anterior (TA) muscle bilaterally in 353 girls with the right idiopathic scoliosis (types 1A-4C according to Lenke classification). It has not yet been documented whether the results of MEPs recordings induced by transcranial single magnetic stimulus (TMS, pre – and postoperatively) and trains of electrical stimuli (TES; intraoperatively in T0-before surgery, T1 – after pedicle screws implantation, T2 – after scoliosis curvature distraction and derotation following two rods implantation) can be compared for diagnostic verification of improvement of the spinal neural transmission. The study also attempted to determine whether the constant level of optimal anesthesia during the certain surgical steps of scoliosis treatment affects the parameters of MEPs recorded during neuromonitoring procedures. No neurological deficits have been observed postoperatively. Values of amplitudes but not latencies in MEPs recordings evoked with TMS in IS patients compared before and after surgery indicated a slight improvement in the efferent transmission of neural impulses within the fibers of the spinal tracts postoperatively. Results of all neurophysiological studies in IS patients were significantly asymmetrical and recorded worse on the concave side, suggesting greater neurological motor deficits at p=0.04. This asymmetry had been significantly reduced following IS surgery. The surgeries in IS patients brought significant improvement (p=0.04) in parameters of amplitudes of sEMG recordings, however reflecting still the consequences of the neurogenic injury of TA muscle motor units. ENG studies results indicated the symptoms of the axonal type injury in peroneal motor fibers improved only on the concave side at p=0.04 in parallel with the significant improvement of F-waves parameters, which suggests that surgeries might result in the lumbar ventral roots decompression. There were not detected significant differences in amplitudes or latencies of MEPs induced with TMS or TES comparing the parameters recorded preoperatively (one day before surgery) and intraoperatively in T0. The amplitudes of TES evoked MEPs increased gradually at p=0.04 in the subsequent periods (T1 and T2) of observation. The significant reduction of MEPs latency at p=0.05 was observed only at the end of the IS surgery. Studies on the possible connections between the level of anesthesia fluctuations and the required TMS stimulus strength, as well as the MEPs amplitude changes measured in T0-T2 revealed lack of relationships. It is not likely that they could be the factors influencing the efferent transmission in spinal pathways beside the surgical procedures. Considering that MEPs amplitude parameter reflects the number of axons excited from the motor cortex and transmitting the efferent impulses via spinal descending tracts in the white matter, pre- (TMS evoked) and intraoperative (TES evoked) recordings are reliable for evaluating the patient’s neurological status before and during surgical scoliosis correction procedures. The results of this study indicate an agreement between preoperative and early-intraoperative evaluations with these both diagnostic methods. An increase of MEPs amplitude parameters recorded on both sides after scoliosis surgery proves immediate improvement of the total efferent spinal cord transmission. Considering comparative pre- and postoperative sEMG and ENG recordings it can be concluded that surgeries might directly result in the additional lumbar ventral roots decompression. Our results of the tests on the possible variability of the anesthesia level on the parameters of intraoperative recorded MEPs show no clear relationships. We can conclude that MEPs parameters changes are determined by the surgery procedures during neuromonitoring, not the anesthesia conditions if they are kept stable, which influences a decrease in the number of false-positive neuromonitoring warnings. Further studies on a larger population of patients with long-lasting observation postoperatively are required to confirm the presented conclusions on the direct influences of scoliosis surgery on improvement of the motor function in patients with IS.

In recent years discrete element method (DEM) has gradually been applied to the traditional fluidization simulation of fine particles in micro fluidized bed (MFB). The application of DEM in simulating fast fluidization of fine particles in MFB has not yet received attention. This article presents a drag model that relies on the surrounding environment of particles, namely particle circumstance-dependent drag modle or PCDD model. Fast fluidization in MFB of fine particles is simulated using DEM based on the PCDD model. It is found that the gas-solid two-phase flow in MFB meets the common law of fast fluidization in circulating fluidized bed (CFB) to a certain extent, and also presents a special law that is significantly different from that in CFB. Simulations indicate that the local structure in MFB exhibits particle aggregation which is a natural property of fast fluidized, forming a structure where continuous dilute phase and dispersed concentrated phase coexist. The formation and fragmentation of particle clusters in different local regions of the bed have time synchronization. There exists strong effect of solid back-mixing in MFB, leading to relatively low outlet solid flux. The gas back-mixing effect is, however, not so distinct. The axial porosity shows a monotonically increasing distribution with the bed height, but does not strictly follow the single exponential distribution. The solid volume fraction at the bottom of the bed is significantly lower than the correlated value in CFB. The axial heterogeneous distribution of the cross-sectional average porosity in the lower half of the bed is also weakened. The radial porosity shows a distribution pattern of higher in the central region and lower in the sidewall region. Compared with the correlation results in CFB, the porosity near the central region in MFB is relatively low, while the porosity near the sidewall region is relatively high. The geometric size of the container, especially the radial size, is much smaller than that of a CFB. The relative area of contact between the MFB wall and particles is larger, and the wall friction factor becomes more significant. This may be the main reason for the time synchronization of particle agglomeration, severe particle back-mixing, low outlet solid flux, monotonically increasing axial porosity and weak core-annular structure of radial porosity.

A unified electro-gravity (UEG) theory, which has been successfully used for modeling an elementary particle, is applied in this paper to model gravitation in spiral galaxies. The new UEG model would explain the "flat rotation curves'' commonly observed in the spiral galaxies, without need for any hypothetical dark matter. The UEG theory is implemented in a somewhat different manner for a spiral galaxy, as compared to the simple application of the UEG theory to an elementary particle. This is because the spiral galaxy, unlike the elementary particle, is not spherically symmetric. The UEG constant $\gamma$, required in the new model to support the galaxies' flat rotation speeds, is estimated using measured data from a galaxy survey, as well as for a selected galaxy for illustration. The estimates are compared with the $\gamma$ derived from the UEG model of an elementary particle. The UEG model for the galaxy is shown to explain the empirical Tully-Fisher Relationship (TFR), is consistent with the Modified Newtonian Dynamics (MOND), and is also independently supported by measured trends of galaxy thickness with surface brightness and rotation speed. The UEG theory may similarly be extended to emulate the hypothetical dark matter in galaxy clusters as well as in cosmology.

Alzheimer’s disease (AD) is an age-related neuropsychiatric disorder and a common cause of progressive dementia. Diltiazem (DTZ), the non-dihydropyridine benzothiazepine class of calcium channel blocker (CCB), used clinically in angina and other cardiovascular disorders have proven neurological benefits. In the present study, the neuroprotective anti-dementia effects of DTZ against intra-cerebroventricular-streptozotocin (ICV-STZ)-induced sporadic AD (SAD)-type rat model was investigated. ICV-STZ-induced cognitive impairments were measured by passive avoidance and Morris water maze tasks. Anti-oxidative enzyme status, pro-inflammatory markers, and amyloid-beta (Aβ) protein expression in rat brain tissues were measured by ELISA kits, Western blotting, and immunostaining techniques. Data revealed that ICV-STZ injection in rats significantly induced cognitive deficits and altered the levels of oxidative and pro-inflammatory markers (p &lt; 0.05 ~ p &lt; 0.001). Treatment with DTZ (10 mg/kg, 20 mg/kg, and 40 mg/kg. p.o.) daily for twenty-one days, 1 h before a single ICV-STZ (3 mg/kg) injection, significantly improved cognitive impairments, ameliorated the ICV-STZ-induced altered nitrite, pro-inflammatory cytokines (TNF-α, and IL-1β) and anti-oxidative enzyme levels (superoxide dismutase, lipid peroxidation, and glutathione). Further, DTZ restored the increased Aβ protein expression in ICV-STZ-induced brain tissue Considering the data obtained, DTZ exhibited a potential neuroprotective anti-dementia role in ICV-STZ-induced SAD-type conditions in rats and might be repurposed as a potential therapeutic agent in the treatment and management of AD and related dementia pathologies.

In order to explore the genetic diversity of the extremely small population wild plant Habenaria dentata and protect and optimize its wild resources. The genetic diversity of 133 samples from 6 wild populations of H.dentata was analyzed by ISSR molecular marker technique to provide a scientific basis for the screening of improved germplasm resources. The results show that the average number of alleles (Na) was 1.765, the average number of effective alleles (Ne) was 1.424, the average Nei 's gene diversity index (He) was 0.252, the average Shannon information diversity index (I) was 0.381, and the average percentage of polymorphic loci (PPL) was 76.499%. The variation within populations was 77.34%, and the variation between populations was 22.66%. Gene flow (Nm) was 1.705 8, greater than 1. The results of cluster analysis showed that the six populations were mainly divided into four branches and not classified according to geographical location. There was no significant correlation between geographical location and genetic distance between populations (r=0.557, P>0.05). The genetic diversity of H.dentata is high. Among the six wild populations, the genetic diversity of Mulun population is the highest and this population can be used as a key protection unit.

Abstract: Interrupted-sampling repeater jamming (ISRJ) is a kind of intra-pulse coherent decep-tion jamming that can generate false target peaks in the range profile and interfere with the de-tection and tracking of real targets. In this paper, an anti-ISRJ method based on the intra-pulse orthogonal waveform is proposed, which can recognize common interference signals by com-paring sub-signal matched filtering results. For some special scenes where real targets cannot be directly differentiated from false targets, a new recognition method based on the energy discon-tinuity of the interference signal in the time domain is proposed in this paper. The method pro-posed in this paper can recognize real and false targets in all ISRJ modes without any prior in-formation, such as jammer parameters, with a small amount of calculation, which is suitable for actual radar systems. Simulation experiments using different interference parameters show that although this method has a 3dB loss of pulse compression gain, it can completely suppress dif-ferent kinds of ISRJ interference when the SNR before pulse compression is higher than -20dB, with 100 % target detection probability.

The paper proposes a rock classification method using the vibration signal of the rotary drilling process. This proposed method classifies four rocks with a reliability of 100 %, from the vibration signal record of a lasting 1/4 second. For the design of a suitable classification method, several attributes of the vibration signal were calculated for two different signal recording lengths. Cluster dendrogram, ANOVA test, and boxplot were used to determine useful attributes and proper signal length. The classification rule was found using a decision tree, machine learning tool. The publication gradually describes the process of creating the classification method and the results of the reliability verification of the proposed classification method. Rock disintegration by rotary drilling was carried out under standardized experimental conditions. The disintegration rocks were andesite, granite, limestone, and concrete.

The polymerase chain reaction (PCR) is a widely used technique in the biosciences and has become increasingly popular in recent years. One of the key elements of this technique is the use of a DNA polymerase that is heat-stable and retains fidelity during the process. To this end, archaeal Fam-ily-B DNA polymerases are preferred due to their high thermostability and fidelity. In particular, the DNA polymerase from Thermus aquaticus (Taq DNApol) is widely utilized in PCR procedures. In this work, a novel in-silico structure-based methodology was employed to examine the most heat-tolerant DNA polymerase available. In spite of this, Thermococcus kodakarensis and Geobacillus stearothermophilus DNApol are more stable and heat-tolerant DNApols due to their high number of intra-protein interactions. Variations in the content of polar amino acids also played a significant role in the increase in heat stability. A further factor contributing to the stability of proteins is the stabilization of helix in secondary structure through the use of charged amino acids. DNApol from these organisms has been shown to be suitable for use in PCR, as well as in other biological processes able to withstand high temperatures. In this study, it has been demonstrated that im-provements in PCR performance can be easily obtained by blending elements from closely related archaeal polymerases, a strategy that may, in the future, be extended to other archaeal polymer-ases. This approach allowed for a comprehensive analysis of the enzyme's thermal stability and fidelity, leading to an improved understanding of the polymerase's properties and potential ap-plications

Results from an explorative study revealing spatio-temporal patterns of the SARS-CoV-2/COVID-19 epidemic in Germany are presented. We dispense with contestable model assumptions and show the intrinsic spatio-temporal patterns of the epidemic dynamics. The analysis is based on COVID-19 incidence data, which are age-stratified and spatially resolved at the county level, provided by the Federal Government’s Public Health Institute of Germany (RKI) for public use. Although the 400 county-related incidence time series show enormous heterogeneity both with respect to temporal features as well as spatial distributions, the counties’ incidence curves organise into well distinguished clusters that coincide with East and West Germany. The analysis is based on dimensionality reduction, multidimensional scaling, network analysis, and diversity measures. Dynamical changes are captured by means of difference-in-difference methods which are related to fold changes of the effective reproduction numbers. The age-related dynamical patterns suggest a considerably stronger impact of children, adolescents and seniors on the epidemic activity than previously expected. Besides these concrete interpretations, the work mainly aims at providing an atlas for spatio-temporal patterns of the epidemic which serves as a basis to be further explored with the expertise from different disciplines, particularly sociology and policy makers. The study should also be understood as a methodological contribution to getting a handle on the unusual complexity of the COVID-19 pandemic.

This paper presents an in-depth contextualized tutorial on Agricultural IoT (Agri-IoT), covering the fundamental concepts, assessment of routing architectures and protocols, and performance optimization techniques via systematic survey and synthesis of related literature. The negative impacts of climate change and the increasing global population on food security and unemployment threats have motivated the adoption of the wireless sensor network (WSN)-based Agri-IoT as an indispensable underlying technology in precision agriculture and greenhouses to improve food production capacities and quality. However, most related Agri-IoT testbed solutions have failed to achieve their performance expectations due to the lack of an in-depth and contextualized reference tutorial that provides a holistic overview of communication technologies, routing architectures, and performance optimization modalities based on users’ expectations. Thus, although IoT applications are founded on a common idea, each use case (e.g., Agri-IoT) varies based on specific performance and users expectations as well as its technological, architectural, and deployment requirements. Likewise, the agricultural setting is a unique and hostile area where conventional IoT technologies do not apply, hence the need for this tutorial. Consequently, this tutorial addresses these via the following contributions: (1) a systematic overview of the fundamental concepts, technologies, and architectural standards of WSN-based Agri-IoT, (2) an evaluation of the technical design requirements of a robust, location-independent, and affordable Agri-IoT, (3) a comprehensive survey of the benchmarking fault tolerance techniques, communication standards, routing and medium access control (MAC) protocols, and WSN-based Agri-IoT testbed solutions, and (4) an in-depth case study on how to design a self-healing, energy-efficient, affordable, adaptive, stable, autonomous, and cluster-based WSN-specific Agri-IoT from a proposed taxonomy of multi-objective optimization (MOO) metrics that can guarantee an optimized network performance. Furthermore, this tutorial established new taxonomies of faults, architectural layers, and MOO metrics for cluster-based Agri-IoT (CA-IoT) networks and a 3-tier objective framework with remedial measures for designing an efficient associated supervisory protocol for cluster-based Agri-IoT networks.

The free energy principle (FEP) is a mathematical and scientific principle that describes the relationship between the physical behavior of a dynamical system and the interpretation of such behavior as carrying out inference. It blurs the boundary between the ontological mode of the system of interest and the epistemological significance it acquires through its dynamic interaction with the environment. New materialism (or neo-materialism), despite lacking a single definition, refers to a range of emerging perspectives that attempt to dismantle the long-held divisions between ontology, epistemology, and even ethics, with the aim of achieving a comprehensive transformation of naturalized thinking. In this context, new materialism provides powerful tools to reframe some of the conceptual foundations of the FEP. This paper is the first in a series that aims to systematically construct a neo-materialistic perspective for the FEP, exploring its wide-ranging implications. It serves as an introduction to the series, arguing for the justification of deploying new materialism to reframe the FEP and introducing some essential concepts to be utilized in developing a neo-materialistic account of the FEP.

The proliferation of the Internet of Things (IoT) has revolutionized traditional services, giving rise to emerging smart infrastructures by connecting the physical and digital worlds. Sensory data is essential in IoT-based systems for providing context-aware and location-based services. Hence, the accurate localization of IoT devices is paramount. Anchor misplacement can significantly affect location information and coverage services in IoT. We study the effect of anchor misplacement in typical IoT settings where sensors are randomly deployed, can be mobile and may belong to multiple providers. We identify sensing coverage holes formed by anchor misplacement and analyze their presence and impact. To mitigate the impact of anchor misplacement on network reliability, we propose a framework to identify the affected sensor nodes and then identify and remove misplaced anchor nodes. The validity of our approach is verified, and its effectiveness is demonstrated by several experiments with different network topologies and parameters. Our results are promising and can be utilized in multiple coverage applications, such as smart agriculture systems and habitat monitoring, regardless of the sensors or deployment types. It also sheds light on best practices and methods for a reliable design of IoT-based systems.

The general theory of relativity (GR) is symmetric under smooth coordinate transformations also known as diffeomorphisms. The general coordinate transformation group has a linear subgroup denoted the Lorentz group of symmetry which is maintained also in the weak field approximation to GR. The dominant operator in the weak field equation of GR is thus the d'Alembert (wave) operator which has a retarded potential solution. Galaxy Clusters are huge physical systems having dimensions of many hundreds of millions of light years. Thus any change at the cluster center will be noticed at the rim only hundreds of millions of years later. Those retardation effects are neglected in present day cluster modelling and in particular are neglected in virial calculations used to relate mass and velocities on the cluster. The significant differences between the predictions of Newtonian instantaneous action at a distance and observed velocities are usually explained by either assuming dark matter or by modifying the laws of gravity (MOND). In this paper we will show that taking general relativity seriously without neglecting retardation effects one can explain the velocities in a galactic cluster without postulating dark matter. It should be stressed that the current approach does not require that velocities, $v$ are high, in fact the vast majority of cluster bodies are substantially subluminal. In other words, the ratio of $\frac{v}{c} \ll 1$. Typical velocities in galaxies are less than ~1000 km/s, which makes this ratio $0.01$ or smaller. However, one should consider the fact that every gravitational system even if it is made of subluminal bodies has a retardation distance, beyond which the retardation effect cannot be neglected. Every natural system such as stars and galaxies and even galactic clusters exchange mass with its environment. For example, the sun losses mass through the solar wind and galaxies accrete gas from the intergalactic medium. This means that all natural gravitational systems have a finite retardation distance. The question is thus quantitative, how large is the retardation distance? The change of mass of the sun is quite small and thus the retardation distance of the solar system is quite large allowing us to neglect retardation effects within the solar system. However, for galaxies and galaxy clusters the retardation distance is within the system itself and cannot be neglected.

This study investigates how Electronic Livestock Health Recording Systems (ELHRs) facilitates the detection of disease burden and make cluster analysis by applying data analytics tools and techniques. A sample size of 18333 livestock disease cases reported from 2007-2015 by the Ministry of Agriculture of the Federal Democratic of Ethiopia was used for data collection. The results showed that ELHRs are important as livestock disease data preservers, saving costs, and facilitating the extraction of up-to-date and complete information. Euclidean and Manhattan distance performed well at 98%, while cosine distance measurement metrics performed poorly. Finally, with the application of the selected clustering techniques, metrics, tools, and dataset, it has been attempted to successfully detect an optimal number of disease clusters and meet the objectives of the study.

This study explores several global and country cluster sustainable development (herein SD) models. It jointly examines constructs from the “Neoliberal-turn” ((e.g., Institutional Enhancers (e.g., business freedom, property rights, government integrity, and judicial effectiveness), Financial Enhancers (e.g., government spending and monetary, trade, investment, and financial freedoms), Foreign Direct Investment, Global Competitiveness-institutions, and Global Competitiveness-innovation-sophistication)), and the “Social-turn” (five SD pillars (e.g., Planet, People, Peace, Prosperity, and Resources), which synthesize the 17 United Nations SD goals); and Happiness and Life Satisfaction (herein H&amp;LS). The study examines a large and diverse set of relationships encompassing 11 years of data of 108 social, economic, and environmental indicators from 129 countries at the global, country cluster, and country levels. We analyze data using structural equation modeling. Remarkably, Planet, an SD pillar constituted by biophysical variables, is the least of the five SD pillars positively related to the "neoliberal-turn" constructs and H&amp;LS. Results show model configurations and scale effects. Furthermore, findings reveal both synergies between neoliberal and the five SD pillars as well as both negative and non-significant relationships among them. The diversity of results calls for further model integration and specificity. Diverse findings entail caution and difficulties in generalizing knowledge. Similarly, results suggest that it is not advisable, since there may be many different and partly legitimate alternatives, to rely on just one perspective (e.g., giving primacy to economic-based analyses) and or in analyses at only one scale. The perspective effects and the stakes involved in SD urgently call for more collaborative efforts at all levels.

Bermudagrass (Cynodon spp.) is one of the drought-resistant warm-season turfgrasses adapted to the southern and transitional zones in the United States. Multiple hybrid varieties have been developed and released for use as a turfgrass and others are in pipeline. Increasing genetic di-versity of commercial varieties is vital to tackle stress tolerance. A DNA profiling study of 21 experimental selections from the Oklahoma State University (OSU) turfgrass breeding program and 11 cultivars was conducted using 51 simple sequence repeat (SSR) primer pairs that spread across the bermudagrass genome. Pairwise genetic relationship analysis among the genotypes using 352 polymorphic bands showed genetic similarity coefficients ranging from 0.59 to 0.89. Cluster analysis using the un-weighted paired group method with arithmetic average (UPGMA) method grouped the entries into six clusters. Correlation analysis identified different levels of pairwise genetic relationship among the entries that largely reflected parental relationship. Di-rectional breeding and selection for cold hardiness or drought resistance created progeny that had distinct genetic diversity in the tested bermudagrasses. It is evident that an increase in genetic diversity of the existing cultivar pool with the release of one or more of the experimental selec-tions for commercial use will strengthen and improve bermudagrass systems.

Background: Globally, women’s responsibility for unpaid care work (UCW) remains a barrier to gender equality and women’s empowerment. Rwanda, a low-income country, has a legal and policy framework for promoting gender equality but remains a patriarchal society with women responsible for UCW. Reseaux des Femmes, a local NGO, has been delivering a programme targeted at reducing and redistributing the UCW of women with the objective of gender transformational change. However, there has been no impact evaluation of their intervention to date. Methods/Design: The impact evaluation will be a proof-of-concept critical realist cluster control trial (CRcCT) to evaluate for which women, how and under what circumstances the intervention reduces and redistributes women’s UCW, promote gender equality and women’s empowerment, and improves women’s quality of life. Four clusters of villages in each of five districts in Rwanda will be randomly allocated to the intervention or control arms, and all eligible households, those headed by a couple with at least one child under 12 years, will be recruited. This will yield a sample of around 550 intervention households and 550 control. Discussion: This protocol describes the design of mixed-methods research to evaluate an intervention in Rwanda aimed at reducing and redistributing the time women spend on UCW, thereby promoting gender equality and women’s empowerment. This paper will contribute to our understanding of interventions for transforming gender relations from a scholarly perspective. From a policy perspective, it will act as a proof of concept of Reseaux des Femmes’ Programme.

Climate change is an issue that is the order of the day, and among the many consequences it has on the environment one is its influence on the amount and frequency of rainfall on our planet, since our water supply depends on them. Therefore, in order to quantify these effects, a rainfall analysis has been carried out using data collected in Bilbao over the last 150 years. Thanks to this, it has been possible to observe that, although the total annual amount seems to suffer a slight decrease, hardly quantifiable with certainty, it is true that the intra-annual patterns are more concentrated at certain times of the year, with greater imbalances between one month and another than in previous years. However, taking into account the capacity of the reservoirs that supply the Greater Bilbao area, it can be concluded that this does not pose any problem for Bilbao's supply, at least at present.

Abstract: Hox gene clusters are crucial in Embryogenesis. It was observed that some Hox genes were located in order along the telomeric to centromeric direction of the DNA sequence: Hox1, Hox2, Hox3…. These genes were expressed in the same order in the ontogenetic units of the Drosophila embryo along the Anterior-Posterior axis. The two entities (genome and embryo) differ significantly in linear size and in-between distance. This strange phenomenon was named Spatial Collinearity (SP). Later, it was observed that, particularly in the Vertebrates, a Temporal Collinearity (TC) coexists: first is Hox1 expressed, later Hox2 and even later Hox3,…,. Hox clusters are irreversibly elongated along the force direction. According to a Biophysical Model (BM), pulling forces act at the anterior end of the cluster while a cluster fastening applies at the posterior end. During Evolution, the elongated Hox clusters are broken at variable lengths thus split clusters may be created. An Empirical Rule was formulated distinguishing development due to a complete Hox cluster from development due to split Hox clusters. BM can explain this Empirical Rule. In an accidental mutation where the cluster fastening is dismantled, a minimal pulling force can automatically shift the cluster inside the Hox activation domain. This cluster translocation can probably explain the absence of temporal collinearity in Drosophila.

City zones have become increasingly overcrowded as a result of the extensive population widening ratio and the swift relocation of people from villages. The traffic monitoring process is a major issue in these areas due to the massive traffic flow on the roads. This research proposed a cluster-based improved authentication and communication scheme for an Intelligent Transportation System in Vehicular AdHoc Networks (VANETs). Our primary objective is to optimize resource sharing in vehicular communication. We enhanced the reliability, scalability, and stability of fast-moving VANETs by introducing cluster-based routing schemes for Vehicle-to-Vehicle (V2V) and Vehicle-to-Infrastructure (V2I) communications. We used a third-party certification authority for vehicle authentication to address security and privacy concerns. Our proposed schemes support minimizing the end-to-end (E2E) delay and route request, in addition to reducing link failure. Our schemes’ leading yield includes throughput enhancement, TCP Socket Initialization time minimization, TCP handshake response speedup, and DNS lookup improvement. The schemes are centred on short-range peer-to-peer (P2P) wireless communication in a 400-meter radius cluster. This includes innovative P2P wireless communications on VANET using minimized resources. The proposed schemes deliver a secure authentication mechanism with a securely generated vehicle authentication key provided by a certification authority. Furthermore, we have developed RESTful APIs in vehicular communication for implementation purposes, and also offered and implemented algorithms for resource sharing regarding V2V and V2I communication. Ultimately, we evaluated the performance of our experiments.

Physics of high-Tc superconducting cuprates is obscured by the effect of strong electronic correlations. One way to overcome the problem is to seek for an exact solution at least within the small cluster and expand it to the whole crystal. Such an approach is in the heart of the cluster perturbation theory (CPT). Here we develop CPT for the dynamic charge and spin susceptibilities (spin-CPT), within which the correlation effects are explicitly taken into account by the exact diagonalization. We apply spin-CPT to the effective two-band Hubbard model for the cuprates obtained from the three-band Emery model and calculate one- and two-particle correlation functions, namely, spectral function and spin and charge susceptibilities. Doping dependence of the spin susceptibility was studied within spin-CPT and CPT-RPA that is the CPT generalization of the random phase approximation (RPA). Both methods produce the low energy response at four incommensurate wave vectors in qualitative agreement to the results of the inelastic neutron scattering on overdoped cuprates.

Abstract: (1) Background: Minimally-invasive sacroiliac joint (SIJ) fusion is the preferred surgical intervention to treat chronically severe pain associated with SIJ degeneration and dysfunction. (2) Methods: This paper details the ten-step surgical procedure associated with the postero-inferior approach using the PsiF™DNA Sacroiliac Joint Fusion System. (3) Results: The posterior surgical approach with an inferior operative trajectory (postero-inferior) utilizes easily identifiable landmarks to provide the safest, most direct access to the articular joint space for transfixing device placement. Implanting the device through the subchondral bone, provides maximum fixation and stabilization of the joint by utilizing an optimal amount of cortical bone-implant interface. Approaching the joint from the inferior trajectory also places the implant perpendicular to the S1 endplate at a “pivot point” near the sacral axis of rotation, which addresses the most significant motion of the joint. (4) Conclusions: Further observational data from real-world clinical use are encouraged to further validate this procedure as the surgical preference for minimally-invasive SIJ fusion.

The integration of deep learning methods, especially Convolutional Neural Networks (CNN), and Synthetic Aperture Radar Automatic Target Recognition (SAR ATR) has been widely deployed in the field of radar signal processing. Nevertheless, these methods are frequently regarded as black-box models due to the limited visual interpretation of their internal feature representation and parameter organization. In this paper, we propose an innovative approach named C-RISE, which builds upon the RISE algorithm to provide a post-hoc interpretation technique for black-box models used in SAR Images Target Recognition. C-RISE generates saliency maps that effectively visualize the significance of each pixel. Our algorithm outperforms RISE by clustering masks that capture similar fusion features into distinct groups, enabling more appropriate weight distribution and increased focus on the target area. Furthermore, we employ Gaussian blur to process the masked area, preserving the original image structure with optimal consistency and integrity. C-RISE has been extensively evaluated through experiments, and the results demonstrate superior performance over other interpretation methods based on perturbation when applied to neural networks for SAR image target recognition. Furthermore, our approach is highly robust and transferable compared to other interpretable algorithms, including white-box methods.

Chorioamnionitis (CA) at term of pregnancy can have infectious and/or inflammatory origin and is associated with adverse outcomes. Triple I (Intrauterine Inflammation, Infection or both, TI) has been proposed to reduce the overdiagnosis of infection and the neonatal overtreatment. The aim of the study is to identify clinical and histological variables predicting adverse outcomes when TI has been suspected and/or confirmed. This retrospective cohort study included 404 pregnancies ≥37 g.a. that were divided into 5 all-inclusive and mutually exclusive groups. TI was defined according to NICHD definition of 2015 and it could be confirmed (TI+) or not (TI-) by histological examination. Signs of infection/inflammation not respecting the definition of TI were classified as “Clinical suspicion”, supported (CS+) or not (CS-) by histology. Histological chorioamnionitis (HCA) without clinical manifestation represented fifth group. Whole Placental Involvement (WPLI), was defined as a histological inflammation involving maternal and fetal side. There were 113 TI+, 30 TI-, 186 CS+, 35 CS- and 40 isolated HCA. WPLI was diagnosed in 133 cases (39.2%). Composite neonatal outcome (CNO) occurred in 114 cases (28.2%) while composite maternal outcome (CMO) occurred in 192 cases (47.5%). TI+ compared to CS+ was more predictive of CNO (p=0.001), CMO (p<0.001) and WPLI (p=0.005). WPLI was related both to CNO (p<0.001) and CMO (p=0.046). TI+ and WPLI showed similar sensitivity but different specificity in predicting CNO. At logistic regression, CNO was independently predicted by TI+ (OR 2.21; p=0.001) and by WPLI (OR 2.23; p=0.001). TI, compared to CS, is a better predictor of CNO and can be useful for the identification of newborns at risk.

The article presents a new scalable iterative method for linear programming called the “apex method”. The key feature of this method is constructing a path close to optimal on the surface of the feasible region from a certain starting point to the exact solution of linear programming problem. The optimal path refers to a path of minimum length according to the Euclidean metric. The apex method is based on the predictor-corrector framework and proceeds in two stages: quest (predictor) and target (corrector). The quest stage calculates a rough initial approximation of linear programming problem. The target stage refines the initial approximation with a given precision. The main operation used in the apex method is an operation that calculates the pseudoprojection, which is a generalization of the metric projection to a convex closed set. This operation is used both in the quest stage and in the target stage. A parallel algorithm using a Fejér mapping to compute the pseudoprojection is presented. An analytical estimation of the parallelism degree of this algorithm is obtained. Also, an algorithm implementing the target stage is given. The convergence of this algorithm is proven. An experimental study of the scalability of the apex method on a cluster computing system is described. The results of applying the apex method to solve problems from the Netlib-LP repository are presented.

Peptides are promising drug development frameworks thanks to their high target selectivity, tolerability and relatively low production cost. However, despite the fact that several thousand potentially therapeutic peptides reported, only sixty have arrived at the market. This concerning low proportion is partially explained by undesired properties such as peptide-induced hemolytic activity. Hence, we aim to get a better insight into the chemical space of hemolytic peptides using a novel approach based on network science and interactive data mining as an alternative to design more effective peptide drugs with low hemolytic activity. Metadata networks (METNs) were used to characterize and find general patterns associated to hemolytic peptides, whereas Half-Space Proximal Networks (HSPNs), created using five different two-way dissimilarity measures, represented the hemolytic peptide space. Then, using the best candidate HSPNs, we extracted various scaffolds that capture information of almost all the chemical space but avoiding peptide overrepresentation. Such scaffolds can have many applications, such as training accurate ML-based prediction models, constructing one-class multi-query similarity searching models and characterizing the diversity of hemolytic peptides using a manageable set of peptides. Finally, by means of an alignment-free approach, we reported 47 putative hemolytic motifs, which might provide hints about the mechanisms of hemolysis and can also be used as toxic signatures when developing novel peptide-based drugs.

Working memory (WM) is a brain system for short-term storage and manipulation of information and plays an important role in complex cognitive tasks. In the synaptic theory of WM memorized elements are stored in the form of short-term potentiated connections in a sample population of neurons. In this paper, we show that such populations can be formed due to the mechanisms of spike-timing-dependent plasticity (STDP) – the phase dependence associated with the ratio of the pulse times of the interacting neurons. We propose a WM model considering two types of plasticity: short-term plasticity and STDP. We have shown formation of neuronal clusters encoding items in the WM model, that can be formed by external stimulation of a group of neurons due to the mechanisms of STDP and hold and reactivated by short-term plasticity mechanisms. The dynamic formation of neuronal clusters instead of pre-formed clusters gives additional flexibility to the model.

A new treatment option for cluster headache (CH) prevention is needed. Monoclonal antibodies (mABs) against calcitonin gene-related peptide (CGRP) ligands are used as a preventative treatment for migraine. Considering the CGRP’s role in the CH attack’s ignition and upkeep, fremanezumab and galcanezumab have been evaluated for CH preventative treatment. However, only high-dose (300 mg) galcanezumab was proven for episodic CH prevention. We herein report 3 cases of migraine and comorbid CH with previous failures of preventive treatments. The 2 cases were treated with fremanezumab and the one with non-high-dose galcanezumab. All 3 cases showed good results not only on migraine but also on CH attacks. Our report suggested the efficacy of CGRP-mABs for CH prevention. Our cases differed from the cases in the phase 3 trials of CGRP-mABs for CH prevention in the following 2 points. First, the patients had both migraine and comorbid CH. Second, the combined use of CGRP-mABs with preventative drugs for CH, such as verapamil and/or prednisolone, was performed. Future accumulation of real-world data may prove the efficacy of CGRP-mABs for CH prevention.

Nowadays, frameworks and models are critical to enabling organizations to identify their current sustainability integration into business and to follow up on these initiatives over time. In this context, the maturity models offer a structured way of analyzing how a supply chain meets specific sustainability requirements and which areas demand attention to reach maturity levels. This study proposes a five-level maturity model to help supply chains identify their level of engagement with sustainability practices combining three perspectives: intra and inter-organizational sustainability practices, triple-bottom-line approach and critical areas for sustainability. All the steps followed in constructing the maturity model were based on a literature review, and case studies supported its improvement, application, and testing. The proposed model presents many advantages, such as being used as a self-assessment tool, a roadmap for sustainability behaviour improvement, and a benchmarking tool to evaluate and compare standards and best practices among organizations and supply chains.

Generalized relativistic pseudopotentials (GRPP) of atomic cores implying the use of different potentials for atomic electronic shells with different principal quantum numbers give rise to accurate and reliable relativistic electronic structure models of atoms, molecules, clusters, and solids. These models readily incorporate the effects of Breit electron-electron interactions and one-loop quantum electrodynamics effects. Here we report the computational procedure for evaluating one-electron integrals of GRPP over contracted Gaussian functions. This procedure was implemented in a library of routines named LIBGRPP, which can be integrated into existing quantum chemistry software, thus enabling the application of various methods to solve the many-electron problem with GRPPs. Pilot applications to electronic transitions in the ThO and UO2 molecules using the new library and intermediate-Hamiltonian Fock space relativistic coupled cluster method are presented. The results clearly demonstrate that rather economical tiny-core GRPP models can exceed in accuracy relativistic all-electron models defined by Dirac-Coulomb and Dirac-Coulomb-Gaunt Hamiltonians.

The coronavirus 2019 (COVID-19) pandemic was caused by a positive sense single-stranded RNA (ssRNA) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, other human coronaviruses (hCoVs) exist, of which Middle East Respiratory Syndrome (MERS) and SARS-CoV (SARS) showed higher mortality rates without causing a pandemic. As of December 2022, SARS-CoV-2 has resulted in over 6.6 million deaths worldwide through an array of acute to chronic pathologies. Historical pandemics include smallpox and influenza with efficacious therapeutics utilized to reduce overall disease burden. Therefore, immune system process analysis is required to compare innate and adaptive immune system interactions. Lymphatic system organs include bone marrow and thymus using a network of nodes throughout which white blood cells traverse glycolipid membranes utilizing cytokines and chemokine gradients that affect cell development, differentiation, proliferation, and migration processes as well as genetic factors affecting cell receptor expression. Innate processes involve antigen-presenting cells and B lymphocyte cellular responses to pathogens relevant to other viral and bacterial infections but also in oncogenic diseases. Such processes utilize cluster of differentiation (CD) marker expression, major histocompatibility complexes (MHC), pleiotropic interleukins (IL) and chemokines. The adaptive immune system consists of Natural Killer (NK) and T cells. Other viruses are also contributory to cancer including human papillomavirus (cervical carcinoma ), Epstein-Barr virus (EBV) ( lymphoma), hepatitis B and C (hepatocellular carcinoma) and human T cell leukemia virus-1 (adult T-cell leukemia). Bacterial infections also increase the risk of developing cancer( e.g. H. pylori). Therefore, as the above factors can cause both morbidity and mortality along-side being transmitted within clinical and community settings, it is appropriate to now examine advances in single cell sequencing, FACS analysis and many other laboratory techniques that allow insights into discoveries of newer cell types. These developments offer improved clarity and understanding that over-lap with known autoimmune conditions that could be affected by innate B cell or T cell responses to SARS-CoV-2 infection. Thus, this review quantifies and outlines the nature of specific receptors and proteins relevant to clinical laboratories and medical research by documenting both innate and adaptive immune system cells within current coronavirus immunology case study data and other pathologies to date.

Kubernetes (K8s) defines standardized APIs for container-based cluster orchestration so it becomes possible for application managers to deploy their applications in a unified manner across different cloud providers. A practical problem is however feature incompatibility between different K8s vendors, who offer commercial K8s products based on the open-source K8s distribution. A large number of documented features in this open-source distribution are optional features that are turned off by default, but can be activated by setting specific combinations of parameters and plug-in components in configuration manifests for the K8s control plane and worker node agents. However, none of these configuration manifests are standardized, giving K8s vendors the freedom to hide the manifests behind a single, more restricted, and proprietary customization interface. Therefore some optional K8s features cannot be activated consistently across K8s vendors and applications that require these features cannot be run on those vendors. In this paper we present a unified, vendor-agnostic feature management approach that bypasses the proprietary customization interface of K8s vendors in order to consistently activate optional K8s features across a federation of clusters hosted by different Kubernetes vendors. We describe vendor-agnostic reconfiguration tactics that are already applied in industry and cover a wide range of optional K8s features. Based on these tactics, we design and implement an autonomic controller for declarative feature compatibility management across a cluster federation. We found that the features configured through our vendor-agnostic approach have no impact on application performance when compared with a cluster where the features are configured using the configuration manifests of the open-source K8s distribution. Moreover, the maximum time to complete reconfiguration of a single feature is within 100 seconds, which is 6 times faster than using proprietary customization interfaces of mainstream K8s vendors such as Google Kubernetes Engine. However, there is a non-negligible disruption to running applications when performing the reconfiguration; this disruption impact does not appear using the proprietary customization methods of the K8s vendors. Therefore, our approach is best applied in the following three use cases: (i) when starting up new K8s clusters, (ii) when optional K8s features of existing clusters must be activated as quickly as possibly and temporary disruption to running applications can be tolerated or (iii) when proprietary customization interfaces do not allow to activate the desired optional feature.

: This study was aimed at assessing adaptation and bonding of discontinuous (short) glass fiber-reinforced composite to intraradicular dentin EverX Flow (GC Corporation, Tokyo, Japan), when used as intracanal composite filling and anchorage instead of traditional fiber posts. (2) Methods: Seventy intact extracted human teeth were endodontically treated and randomly divided into 6 groups (n=10), depending on the materials used in the post space. In Group 1, a 2-bottle universal adhesive G2 Bond Universal + EverX Flow were tested. In group 2, a single-component universal adhesive G-Premio Bond + EverX Flow were used. In groups 3 and 4 the same materials are tested, but after cleaning of the canal walls with 17% EDTA and final irrigation with 5.25% NaOCl Ultrasound Activated. In the last three Groups (5-7) traditional prefabricated GC Fiber Posts 1.6 mm silanized with G-Multi Primer for 1 minute are cemented with a dual-cured composite resin cement (GradiaCore), after ultrasonic irrigation in the groups 6 and 7. In each group, 1 mm-thick slices from each sample (n=10) were cut for light microscope and SEM inspection for study materials adaption to the dentin and for measuring push-out strength of post / cemement material to the dentin / prefabricated post. These results were statistically analyzed: as the data distribution was not normal, the Kruskal-Wallis Analysis of Variance by Ranks had to be applied. The level of significance was set at p<0.05. Results: Push-out forces varied between 6.66-8.37 MPa. No statistically significant differences were recorded among the groups. Microscopic examination showed that ultrasonic irri-gation increased adaptation of the materials to the dentin surface. There was a trend of higher bond strength among the tested groups when EverX Flow was used. Also, the type of failure was more often cohesive when ultrasonic irrigation and two-step adhesive system were used. Conclusions: Within the limitations of this in vitro study, it may be concluded that when EverX Flow was used for intracanal anchorage in the post-endodontic recon-struction, similar push-out retentive forces and strength to those of traditional fiber posts cemented with particulate filler resin composite cements were achieved. Although further studies are necessary, EverX Flow represents an effective alternative to traditional fiber post adhesion in particular when used in combination with the two-step adhesive system and ultrasonic activation.

Tuberculosis (TB), an infectious airborne disease caused by Mycobacterium tuberculosis (Mtb), is a serious public health threat reported as the leading cause of morbidity and mortality worldwide. South Africa is a high TB burden country with TB being the highest infectious disease killer. The study investigated the distribution and clustering of Mtb mutations and spoligotypes in rural Eastern Cape Province. The Mtb isolates included were 1,157 from DR-TB patients and analysed by LPA followed by spoligotyping of 441 isolates, of these, 36 were whole genome sequenced. Distribution of mutations and spoligotypes was done by spatial analysis and clustering analysis was done by Bayesian model-based clustering of allele frequencies at heterozygous sites, using Mclust package in R. The rpoB gene had highest number of mutations. The distribution of rpoB and katG mutations was more prevalent in four health care facilities, inhA mutations were more prevalent in three healthcare facilities and heteroresistant isolates were more prevalent in five healthcare facilities. The Mtb was genetically diverse with Beijing more prevalent and largely distributed. Spatial analysis and mapping of gene mutations and spoligotypes revealed better picture of distribution. Clustering of isolates indicates that there is transmission of mixed infection in this area.

The most common long-term complication of silicone breast implants (SMI) remains capsular fibrosis. The etiology of this exaggerated implant encapsulation is multifactorial but primarily induced by the host response towards the foreign material silicone. Identified risk factors included specific implant topographies. Of note, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), has only been observed in response to textured surface implants. We hypothesize that reduction of SMI surface roughness causes less host response hence better cosmetic outcome with fewer complications for the patient. A total of 7 patients received the routinely used CPX®4 breast expander (~60 µM Ra) and the novel SmoothSilk® (~ 4 µM Ra), fixed prepectoral with a titanised mesh pocket and randomized to the left or right breast after bilateral prophylactic NSME (nipple-sparing mastectomy). We aimed to compare the postoperative outcome regarding capsule thickness, seroma formation, rippling, implant dislocation as well as comfortability and practicability. Our analysis shows that surface roughness is an influential parameter in controlling fibrotic implant encapsulation. First time intra-individually compared in patients, our data confirm an improved biocompatibility with minor capsule formation around SmoothSilk® implants with an average shell roughness of 4 µM and in addition an amplification of host response by titanised implant pockets.

OBJECTIVE A quality improvement study to assess catheter-associated urinary tract infection (CAUTI) rate post-implementation of a bladder catheter with integrated active drain line urine clearance and automated intra-abdominal pressure monitoring in a burn intensive care unit (ICU). DESIGN Eight-year retrospective before and after study (2015–2022). SETTING A single American Burn Association verified Burn Center with fourteen inpatient beds. PATIENTS Patients meeting criteria for admission to a Burn Center METHODS Retrospective cohort study following the implementation of a novel urine output monitoring system with integrated drain line and urine clearance. Data from a 48-month (from January 2015-December 2018) historical control (period 1) were compared to data from a 28-month (from January 2020 to April 2022) post-implementation period (period 2). Pre- and post-implementation CAUTI event incidences were compared. Charts were reviewed to characterize the patients. RESULTS A total of 42 CAUTIs in 2243 patients were identified using the National Health and Safety Network (NHSN) definition during the analyzed period. There were 40 CAUTI events in period 1 and two CAUTIs in period 2. The incidence of CAUTI events pre-implementation was 0.030 (mean of 10 CAUTI events per year) compared to 0.002 (mean of 1 CAUTI event per year) post-implementation of an automatic drain line clearing UO monitoring system showing a significant reduction in CAUTI events (P<0.01, risk ratio novel vs. gravity bladder catheter 0.071, 95% confidence interval: 0.017-0.294). CONCLUSIONS CAUTIs were reduced in the period following the implementation of a novel urinary catheter system with an integrated active drain line and urine clearance in burn patients.

INTRODUCTION: The purpose of the study was to determine (a) the overall preclinical character; (b) the cumulative cutoff values and the risk ratio, and (c) the factors associated with severity by a unidimensional and multidimensional analysis on 2173 Sars-Cov2 patients. METHODS: The machine learning study population consisted of 2173 patients (1587 mild and non symptoms patients, 377 moderate patients, 209 severe patients). The status of the patients was recorded from September 2021 to March 2022. RESULTS: The Covid19 Severity directly links with a significant correlation to Age, Score index of the chest X-ray, percentage and quantity of neutrophils, Albumin, C reactive protein, and ratio of Lymphocytes. Their important cut off values (from regression analysis) respectively are: 77.56 years old (the mild-moderate group), 5.53 (the mild-moderate group) and 10.51 (the moderate-severe group), 84.80% (the mild-moderate group) and 87.74%(the moderate-severe group), 11.77G/L (the moderate-severe group), 29.73g/L (the moderate-severe group), 7.46mg/dL (the mild-moderate group), 6.32% (the moderate-severe group). Their significant (p<0.0001) R score correlation with the severity of Covid19, are: 0.44, 0.52 and 0.52, 0.33 and 0.44, 0.42, -0.43, 0.40, -0.41. Their significant risk ratio (p<0.00001) from the meta-analysis, respectively are: 4.19 [3.58-4.95], 3.29 [2.76-3.92] and 3.03 [2.4023;3.8314], 3.18 [2.73-3.70] and 3.32 [2.6480;4.1529], 3.15 [2.6153;3.8025], 3.4[2.91-3.97], 0.46 [0.3650;0.5752] (p<0.00001), 0.34 [0.2743;0.4210]. The pair ALT – Leucocytes and Transferrin – Anion Chloride get the most important correlation shift. ALT – Leucocytes show the important negative link (R=-1, p<0.00001) in the mild group to the significant positive correlation in the moderate group (R=1, p<0.00001). Transferrin–anion Chloride has an important positive association (R=1, p<0.00001) in the mild group with a significant negative correlation in the moderate group (R=-0.59, p<0.00001). The network map and HCA show that in the mild-moderate group, the closest neighbors with the Covid19 severity are ferritins, Age. Then there is C-reactive protein, SI of X-ray, Albumin, and Lactate dehydrogenase, which are the next close neighbors of these three factors. In the moderate-severe group, the closest neighbors with the Covid19 severity are Ferritin, Fibrinogen, Albumin, the quantity of Lymphocytes, SI of X-ray, white blood cells count, Lactate dehydrogenase, and quantity of neutrophils. CONCLUSIONS: Complete multidimensional study in 2173 Covid19 patients in Vietnam shows the whole picture of all the preclinical factors, which may become the clinical reference marker for surveillance and diagnostic management

Smartphone-based mobility apps enable users to make informed transportation decisions, offering instant access to transport-related information. This development has created a smartphone-enabled ecosystem of mobility services in developed countries while it is slowly picking up pace in the global south, which can contribute towards the decarbonization of urban transport. Work on this has already started in India, and there is considerable evidence indicating the profound impact of these apps on the perceived utility and usage of transport modes, with far-reaching implications for sustainable development goals (SDGs). However, for most users, the use of smartphone apps is a novel trend, and the knowledge of the impacts of usage of existing apps on the usage pattern of transport modes by various user groups is essential for positioning new consolidated app-based services soon. Against this backdrop, the present study uses latent class cluster analysis to empirically investigate the impacts of mobility apps on transport mode usage patterns in Delhi by classifying users into latent classes based on socioeconomic characteristics, attitudes/preferences, smartphone app usage, and mode usage pattern. The characteristics of the latent class and factors affecting the individual’s probability of being classified to these cluster have been discussed, along with some measures to encourage app-based mobility for each cluster.

Background: The role played by the non-dominant parietal lobe in motor cognition, attention and spatial awareness networks has potentiated the use of awake surgery. When this is not feasible, asleep monitoring and mapping techniques should be used to achieve an onco-functional balance. Objective: This study aims to assess the feasibility of a dual-strip method to obtain direct cortical stimulation for continuous real-time cortical monitoring and subcortical mapping of motor and visual pathways simultaneously in parietal lobe tumour surgery. Methods: Single-centre prospective study between May’19-November’20 of patients with intrinsic non-dominant parietal-lobe tumours. Two subdural strips were used to simultaneously map and monitor motor and visual pathways. Results: Fifteen patients were included. With regards to motor function, a large proportion of patients had abnormal interhemispheric resting motor threshold ratio (iRMTr) (71.4%), abnormal Cortical Excitability Score (CES) (85.7%), close distance to the corticospinal tract – Lesion-To-Tract Distance (LTD) – 4.2mm, Cavity-To-Tract Distance (CTD) – 7mm and intraoperative subcortical distance - 6.4mm. Concerning visual function, the LTD and CTD for optic radiations (OR) were 0.5mm and 3.4mm, respectively; the mean intensity for positive subcortical stimulation of OR was 12mA±2.3mA and 5/6 patients with deterioration of VEPs>50% had persistent hemianopia and transgression of ORs. 12 patients remained stable, one patient had a de-novo transitory hemiparesis, and two showed improvements in motor symptoms. A higher iRMTr for lower limbs was related with a worse motor outcome (p=0.013) and a longer CTD to OR was directly related with a better visual outcome (p=0.041). At 2 weeks after hospital discharge, all patients were ambulatory at home and all proceeded to have oncological treatment. Conclusion: We propose motor and visual function boundaries for asleep surgery of intrinsic non-dominant parietal tumours. Pre-operative abnormal cortical excitability of the motor cortex, deterioration of the VEP recordings and CTD<2mm from the OR were related to poorer outcomes.

Viral variant analysis is a bedrock of the disease surveillance. When combined with temporospatial analysis variant analysis can further the knowledge of disease spread in a study area. This paper suggests a method to perform the analysis in an operational setting which will allow for real-time surveillance of viral variants and allow local public health professionals to rapidly respond to changes in the evolution of the disease. This method includes three main subprocesses: preprocessing, analysis, and rendering. This method can be performed across multiple software platforms. A use case is given in which it was found that this method helped a hospital system understand the spread of SARS-CoV-2 in Northeast, Ohio.

The reaction of [Co2(CO)8] with an equimolar amount of P(OPh)3] in toluene solution yields in situ generated [Co2(CO)7{P(OPh)3}] 1. Subsequent heating of 1 provides in a condensation reaction an alternative synthetic access to the tetranuclear cluster [{Co4(μ2-CO)3(CO)8{P(OPh)3}] 2. Compound 2 has been characterized by IR and 31P NMR spectroscopy, the tetranuclear cluster framework has be ascertained by a single-crystal X-ray diffraction study performed at 100 K.

Spinal Cord Stimulation (SCS) is an effective and validated treatment to address chronic refractory neuropathic pain in Persistent Spinal Pain Syndrome-Type 2 (PSPS-T2) patients. Surgical SCS lead placement is traditionally performed under general anesthesia due to its invasiveness. In parallel, recent works have suggested that Awake Anesthesia (AA), consisting in Target Controlled Intra-Veinous Anesthesia (TCIVA), could be an interesting tool to optimize lead anatomical placement using patient intra-operative feedback. We hypothesized that combining AA with Minimal Invasive Surgery (MIS) could improve SCS outcomes. The goal of this study was to evaluate SCS lead performance (defined by the area of pain adequately covered by paraesthesia generated via SCS), using an intraoperative objective quantitative mapping tool, and secondarily to assess pain relief, functional improvement and change in quality of life with a composite score. We analyzed data from a prospective multicenter study (ESTIMET) to compare the outcomes of 115 patients implanted with MIS under AA (MISAA group) or General Anesthesia (MISGA group), or by Laminectomy under General Anesthesia (LGA group). All in all, MISAA appears to show significantly better performance in terms of patient pain coverage, as well as improved secondary outcomes. One step further, our results suggest that MISAA combined with intra-operative hypnosis could potentialize patient intraoperative cooperation and could be proposed as a personalized package offered to PSPS-T2 patients eligible for SCS implantation in highly dedicated neuromodulation centers.

The successive waves of the Covid-19 pandemic are driven by SARS-CoV-2 variants that reached critical detection levels in different parts of the world. But how evolved the Wuhan virus since its detection in December 2019 into the Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), Delta (B.1.617.2) and Omicron (B.1.1.529) variants of concern? This is a story of mice and men, of up to 1,000,000 infected cells in one person, where each cell produces between 10⁵ and 10⁶ viral RNAs, of immune-compromised patients, the digestive tract and viral recombination.

(1) Background: In order to study the effects of different electric cookers on the nutritional components of millet porridge, five different electric cookers were selected to cook millet porridge, and sensory and nutritional components in millet porridge, millet soup, and millet grains were analyzed. (2) Methods: Using principal component and cluster analysis, a variety of nutritional components were comprehensively compared. (3) Results: The results showed that among the different cooked samples, the content of amylose and reducing sugar was the highest in the samples cooked by electric cooker no. 3. The electric cooker no. 4 samples had the highest sensory evaluation score, crude fat, and protein content. The contents of ash, fatty acids, bound amino acids, and minerals were the highest in the electric cooker no. 5 samples. The sensory evaluation score and content of crude fat, ash, reducing sugar, direct starch, and Cu were higher in millet grains than in millet soup or porridge. The content of fatty acid, protein, amino acid, Zn, Fe, Mg, Mn, and Ca was highest in millet soup. Different electric cookers produced millet porridge with varying nutritional levels. (4) Conclusions: This study provides a reference for the further development of new electric cookers.

China’s rural e-commerce has been developing rapidly. Taobao Villages are combination of e-commerce and rural industries. When rural e-commerce coverage evolves from Taobao village to Taobao town, the scale of industrial clusters has been expanding synchronously. This paper investigates flower and seedling industrial cluster in Xinhe Town, Yanji Town and Miaotou Town of Shuyang County, China, and conducts the econometric analysis of the expansive determinants of flower and seedling industrial cluster of Taobao Villages. An effective sample of 263 was obtained through a face-to-face survey of e-merchants of flower and seedling in the Shuyang County of Jiangsu Province. Bases on the structural equation modeling, series of test results show that the data can be used to calculate the path regression. The outcomes shows that creation of e-merchants of flower and seedling, integration of e-commerce platform, supply chain friendliness, involvement of e-commerce service providers, and governmental policy guidance are driving expansion of flower and seedling industrial cluster together, moreover, the five forces interact with each other. This implies that expansion of flower and seedling industrial cluster is a systematic process, each stakeholder needs to pay attention to the role of other forces, and five forces achieve a balanced situation in the cluster.

Feline panleukopenia (FPL), a highly contagious and frequently fatal disease of cats, is caused by Feline parvovirus (FPV) and Canine parvovirus (CPV). We characterized the diversity of these Carnivore protoparvovirus 1 variants in 18 faecal samples collected from domestic cats with FPL during an outbreak, using targeted parvoviral DNA metagenomics to a mean depth of >10,000 X coverage per site. All samples comprised FPV alone. Compared to the reference FPV genome, isolated in 1967, 44 mutations were detected. Ten of these were non-synonymous, including 9 in non-structural genes and one in VP1/VP2 (Val232Ile), which was the only one to exhibit inter-host diversity, being present in five sequences. There were five other polymorphic nucleotide positions, all with synonymous mutations. Intra-host diversity at all polymorphic positions was low with sub-consensus variant frequencies (SVF) of >1% except for two positions (2108 and 3208) in two samples with SVF of 1.1 – 1.3%. Intra-host nucleotide diversity was measured across the whole genome (0.7 - 1.5%) and for each gene, and was highest in the NS2 gene of four samples (1.2 – 1.9%). Overall, intra-host viral genetic diversity was limited and most mutations observed were synonymous, indicative of a low background mutation rate and strong selective constraints.

Background: Elevated fasting plasma glucose and visceral fat area (VFA) is highly prevalent in obese adults. This study investigated the associations between systemic arterial hypertension (SAH) and laboratory, anthropometric, heart rate variability (HRV), and obstructive sleep apnea markers. Methods: Cross-sectional study with 95 obese patients treated at Obesity Treatment and Surgery Center, located in Salvador, BA, Brazil. SAH data were obtained from electronic medical records of patients. To evaluate the association of SAH with the predictor variables, the sample was stratified in Normotense Group (NG) and Hypertensive Group (HG), and laboratory markers, body composition, polysomnography data, and HRV were measured. Results: The average age of the NG was 36.3 ± 10.1 and HG 40.4 ± 10.6 years, 73.7% were women in the NG and 57.9% in HG; 82.4% in HG had insulin resistance. In the multivarious logistics regression model with adjustments age, sex, height, and oxyhemoglobin saturation, SAH was inversely associated with fasting plasma glucose mg/dL (odds ratio [OR] = 0.96; 95% interval confidence [CI] = 0.92 - 0.99) and VFA cm² (OR = 0.98; 95% CI = 0.97 - 0.99). The area under curve the VFA was 0.728; CI 95% (0.620 - 0.836) and fasting plasma glucose 0.693; CI 95% (0.582 - 0.804). Conclusions: Lower VFA and fasting plasma glucose concentrations were inversely associated with SAH. These results indicate opportunities to improve the outcome in obese patients through counseling and clinical interventions.

We previously described a model of deep intrinsic resistance of breast cancer wherein we used a function-based approach to selection of cancer cells that can survive a variety of challenges in prolonged but reversible quiescence. Our experimental results suggested that resistant cancer cells possess a variety of mechanisms, including modifications of the epigenome and transcriptome, for generating a high degree of cellular heterogeneity. In the present study, we evaluated JIB-04, a small-molecule epigenetic inhibitor initially discovered to inhibit cancer growth, to determine its ability to affect deep intrinsic resistance in our breast cancer model. We found that long pretreatment with JIB-04 sensitized resistant triple-negative inflammatory breast cancer cells and their parental cell line SUM149 to the chemotherapeutic drugs doxorubicin and paclitaxel. Resistant cancer cells derived from another inflammatory breast cancer cell line, FC-IBC02, were considerably more sensitive to JIB-04 than was the parental cell line. Investigating a mechanism of sensitization, we found that JIB-04 exposure increased the expression of PD-L1 in resistant cells, suggesting that JIB-04 may also sensitize resistant breast cancer cells to anti-PD-L1 immune therapy. Finally, these results support the usefulness of our experimental strategy for evaluating anticancer agents such as JIB-04 that may halt cancer evolution and prevent development of cancer resistance to currently used therapies.

Acute kidney injury (AKI), especially if recurring represents a risk factor for future chronic kidney disease. In intensive care units, increased intraabdominal pressure is well-recognized as a significant contributor of AKI. However, the importance of transiently increased intra-abdominal pressures procedures is less commonly appreciated during laparoscopic surgery, the use of which has rapidly increased over the last few decades. Unlike the well-known autoregulation of the renal cortical circulation, medulla perfusion is modulated via partially independent regulatory mechanisms and strongly impacted by changes in venous and lymphatic pressures. In our review paper, we will provide a comprehensive overview of this evolving topic, covering a broad range from basic pathophysiology up to and including current clinical relevance. Key regulators of oxidative stress such as ischemia-reperfusion injury, the activation of inflammatory response and humoral changes interacting with procedural pneumoperitoneum formation and AKI risk will be recounted. Moreover, we present an in-depth review of the interaction of pneumoperitoneum formation with general anesthetic agents and animal models of congestive heart failure. A better understanding of the relationship between pneumoperitoneum formation and renal perfusion will support basic and clinical research, leading to improved clinical care and collaboration among specialists.

Background: The course of obesity and type 2 diabetes (T2D) development is highly dependent on adipose tissue (AT) angiogenesis. Moreover, angiogenic microRNAs (miRNAs) play pivotal role in AT functionality. The aim of this study was to analyze the relationship of the human AT miR-221-3p/222-3p cluster and their regulatory network with obesity and T2D. Methods: miR-221-3p/222-3p and their target genes (TG) expression levels were measured in visceral and subcutaneous ATs from patients classified according to their BMI and to their glycemic status with a high degree of insulin resistance (IR) and T2D. In silico analyses of miR-221-3p/222-3p and their TGs were performed to identify relevant signaling pathways. Results: A multivariate analysis, including the simultaneous expression of miR-221-3p and miR-222-3p as dependent variables, showed significant differences considering the variables; tissue depot, obesity, IR and T2D altogether as independent variables. In addition, miRNAs and their TGs were differentially expressed according to obesity degree, glycemic status, and AT depot type. Our in silico analysis showed that miR-221-3p/222-3p cluster TGs are mostly involved in angiogenesis, WNT signaling pathway and apoptosis. Conclusion: These findings suggest that the miR-221-3p/222-3p cluster and their related regulatory networks could represent tangible targets for the management of obesity and associated metabolic disorders