As Li-ion batteries use is spreading, incidents in large energy storage systems (stationary storage containers, …) or in large-scale cell and battery storages (warehouse, recyclers, …), often leading to fire, are occurring on regular basis. Water remains one of the most efficient fire extinguishing agents for tackling those battery incidents and large quantities are usually necessary. Since bat-teries contains various potentially harmful components (metals and their oxides or salts, sol-vents…) and that thermal runway induced battery incidents are accompanied with complex and potentially multistage fume emissions (containing both gas and particles) the potential impact of fire run-off water on the environment should be considered and assessed carefully. The tests presented in this paper focus on the analysis of the composition of run-off waters used to spray NMC Li-ion modules under thermal runaway. It highlights that waters used for fire-fighting are susceptible to contain many metals, including Ni, Mn, Co, Li and Al mixed with other carbonaceous species (soot, tarballs) and sometimes undecomposed solvents used in the elec-trolyte. Extra-polation of pollutant concentrations compared with PNEC values showed that, for large scale incidents, run-off water could be potentially hazardous to the environment.

A two-way coupled model between polydisperse particle phases with compressible gases and a density-based coupling implicit solution method combining the third-order MUSCL with QUICK spatial discretization scheme and the second-order temporal discretization scheme are constructed based on the discrete-phase model (DPM) and the stochastic wander model (DRWM) in the Eu-lerian-Lagrangian framework in conjunction with a unitary particulate source (PSIC) approach and the SST k-ω turbulence model. The accuracy of the numerical prediction method is verified using previous supersonic nozzle gas-solid two-phase flow experiments. Numerical simulation of two-phase jet of dry powder extinguishing agent gas with pilot-type supersonic nozzle was carried out to analyze the influence of geometrical parameters such as length ratio rL and area ratio rA of main nozzle on the two-phase flow field as well as on the jet performance indexes such as particle mean velocity vp,a, velocity inhomogeneity Φvp, particle dispersion Ψp, particle mean acceleration ap,a and so on. By analyzing the parameters, we indicate the requirements for the combination of jet performance metrics for different flame types such as penetrating, spreading, and dispersing.

This project involves the development of Fire Suppression System (FSS) leveraging of Home automation system using Graphical System design (LabVIEW) software and Arduino microcontroller for real-time monitoring and control. The system integrates an Infrared (IR) flame sensor, an MQ2 gas sensor to detect and suppress fire hazards efficiently. The LabVIEW interface facilitates real-time monitoring of sensor data, allowing users to visualize and analyze the environmental conditions. Through this system, fires are automatically subdued, enhancing safety without requiring human intervention. This advances fire safety by swiftly containing threats and minimizing potential damage.

This study focuses on the increased risk of high heat release and asphyxiation (toxic gas poisoning) in the event of a fire of polyurethane (PU) and MDF-based building materials, which are commonly used in building fires. Among them, polyurethane (PU) building materials are essential for buildings except in Europe and some other countries due to their excellent thermal insulation performance, but problems of short-term heat release and spread of toxic gases in the event of a fire continue to occur. To overcome these problems, researchers are actively working on introducing various flame retardants into building materials. Therefore, in this study, we produced a laboratory-sized (500mm*500mm) plate flame retardant board that can be utilized as a building material with a lower heat release rate and a lower toxicity index by mixing expanded graphite and ceramic binder as flame retardants in a main material based on the cellulose of waste paper by replacing the existing building materials with a hot-press method. According to the ISO-5660-1 test on the heat release rate of the plate flame retardant board, the THR value was 2.9 (MJ/m2) for 10 minutes, showing an effect of reducing the THR value by 36.3 (MJ/m2) compared to the THR value of 39.2 (MJ/m2) of the specimen made using only paper. In addition, the toxicity index of the flame retardant board was checked through the NES 713 test. As a result, the test specimen showed a toxicity index of 0.7, which is 2.4 lower than the toxicity index of 3.1 of MDF, which is utilized as a conventional building material. Based on the results of this study, the cellulose fire retardant board showed the effect of reducing the heat release rate and toxicity index of building materials in a building fire, which reduces the risk of rapid heat spread and smoke toxicity. This has the potential to improve the evacuation time (A-SET) of evacuees in fires. It is also important to show that recycling waste paper and utilizing it as the main material for building materials can be an alternative in terms of sustainable development.

The spontaneous combustion of coal in goaf is the main cause of mine fire at present. Lignite has become a major hidden danger in mine production safety because of its easy oxidation. In this paper, an innovative strategy was proposed to inhibit the spontaneous combustion of lignite by using the principle of microbial-induced calcium deposition. Based on the optimized culture method, a novel composite inhibitor of Bacillus pasteurelli was prepared. SEM, pore size analysis and FT-IR experiments were carried out simultaneously, and the oxidation properties of lignite before and after inhibition were quantitatively characterized from the perspective of microstructure, and the flame retardant properties of microbial and chemical retardants on coal samples were compared. The results show that a large number of deposited calcium carbonate particles are obviously attached to the surface of lignite after microbial inhibition treatment, which plays a physical oxygen insulation role. At the same time, the total pore volume and specific surface area of the coal sample decreased by 68.49% and 74.01%, respectively, indicating that microbial inhibitors can effectively plug the primary pores of lignite. Based on the peak measurement of 400-4000cm-1 infrared spectrum of coal samples, it is found that the contents of active groups including hydroxyl, carboxyl and methyl/methylene in lignite molecules after microbial inhibition are lower than those in raw coal, especially the methyl/methylene content involved in the initial oxidation reaction decreased by 96.5% compared with the baseline content in raw coal. The results show that the oxidation and self-heating capacity of lignite after microbial inhibition is effectively restrained in the initial spontaneous combustion. The research results of this paper can provide effective solutions for the prevention and control of coal spontaneous combustion risk in mined-out area.

As major natural disasters in grassland areas, fires and dust events seriously threaten human safety, property, and animal husbandry. Furthermore, these phenomena may be mutually reinforcing, which can lead to more severe cascading disasters. However, few studies have been on the mechanisms of grassland fire and dust events disaster chain. Therefore, we selected Dornod aimag (province), a typical temperate grassland, as the study area and analyzed the spatiotemporal variation patterns of grassland fires and dust weather, as well as the effect of grassland fires on dust weather based on MCD64A1 Burnt Area data and SYNOP dust data. The mechanism of grassland fires on dust weather was further investigated using the MOD13A3 vegetation index product and ERA5 wind speed, wind direction, and precipitation data. The results revealed that grassland fires and dust weather varied spatially across the study area. Furthermore, grassland fires occurred mainly in spring (April to May), summer (June), and autumn (October), while dust weather mainly occurred in spring (March to May). Moreover, autumn, winter, and spring cumulative grassland fires (both days and area) substantially affected the spring total dust weather days and dust storm days, particularly the spring cumulative dust storm days. Additionally, higher precipitation in the summer of 2014 resulted in higher vegetation coverage and more fuel in the autumn and winter of 2014, and even in the spring of 2015. As a result, the cumulative grassland fire days was higher, and the area was larger from September 2014 to April 2015, leading to a considerable increase in the cumulative dust storm days in May 2015. This study has important implications for disaster prevention and mitigation, ecological and environmental protection, and sustainable development in grasslands.

As a follow-up to previously published research, this paper examines the responses of a group (n=185) of professional and volunteer firefighters directly involved in fighting extreme wildfire events of the 2017 summer season in Portugal. The data used in this research stem from two open-ended questions in response to a web-based survey: i) lessons learned and ii) proposals for improving the Civil Protection service. The replies were qualitatively examined. Participants exhibit incomplete awareness of extreme wildfires, and their only answers are i) the improvement of both the current organization and the technical and human resources of the suppression model (question 1), and ii) the increase in human and material resources, the single command, the in-dependence from Civil Protection and the valorization of experience, as the main aspects for the improvement of Civil Protection (question 2). Little attention is given to prevention and to the concept of control capacity, respectively. The answers to both questions showcase scarce knowledge of the paradigm shift in reference to the prevention model. The ratios of missing re-plies to both questions were 32.43% and 47.57%, respectively. The work stands out for its novelty and originality, as to our knowledge there is a total lack of similar works in all European Union literature.

The change in the value of the breaking energy is discussed here for selected steel grades used in building structures after subjecting the samples made of them to episodes of heating in the steady-state heating regime and then cooling in a simulated fire conditions. These changes were recorded based on the instrumented Charpy impact tests, in relation to the material initial state. The S355J2+N, 1H18N9T steels and also X2CrNiMoN22-5-3 duplex steel were selected for detailed analysis. The fire conditions were modelled experimentally by heating the samples and then keeping them for a specified time at a constant temperature of: 600°C (first series) and 800°C (second series), respectively. Two alternative cooling variants were investigated in the experiment: slow cooling of the samples in the furnace, simulating the natural fire progress, without any external extinguishing action, and cooling them in water mist simulating an extinguishing action by a fire brigade. The temperature of the tested samples was set at the level -20oC and alternatively at the level + 20oC. The conducted analysis is aimed at assessing the risk of sudden, catastrophic fracture of load-bearing structure made of steel degraded as a result of a fire previously occurred with different development scenarios.

This paper explores decision analysis on product integration of family security services and residential fire insurance in the London and Taiwan markets by using the proposed mathematical models for counting sustainable value. This paper shows the five main different results between London and Taiwan markets with ten different parameters of the family security market, to find out the optimal number of family security integrated services for each security company in London. The improvement of the risk aversion effect based on risk and financial management will enhance the market share of the private security industries in the London and Taiwan markets. The results of this research can serve as a reference for the decision-making of private security industries on product integration under sustainable value consideration. The research findings highlight the potential benefits for both the private security industry and the insurance industry in their design and negotiation for product integration to improve both of business operation and achieve corporate social responsibility goals to match the sustainability in the future.

A novel coronavirus, named 2019-nCoV, is responsible for current epidemic outbreaks in China and also other countries that cause acute pneumonia that was primarily linked to a seafood wholesale market in Wuhan, China. To control and prevent the existing epidemic outbreaks of coronavirus in China, a precise and easy disinfection/sterilization technique is important to disinfect/sterilize the mass-level peoples and their ambient environments (e.g. atmospheric air/aerosols). Among the disinfection techniques, control fire/flame (CF) could be applied. Large-size CF (LSCF) can be generated by using gas burner, gas cylinder that used in restaurant, coals, kerosene (petroleum), dried straws, dried woods) at entry and exit points of big gathering locations (e.g. hospital, airport, rail stations, seaports, apartments, streets/roads, etc. Additionally, small-size CF (SSCF) can be produced by using gas burner of kitchen, electric heater, kindle or waste papers at individual home and ward/room at hospital. Individual person can be soaked/immersed their hands and their belongings nearby CF for a moment, likely followed sterilization during quantification of the number of bacteria in experimental observation, that can rapidly sterilize the person perfectly. Correspondingly, the ambient air/aerosols moved towards CF due to water evaporation by fire that subsequently refresh all ambient air/aerosols by killing all viruses. Such CF could certainly reach the temperature higher than 56 degree C that could effectively disinfect/sterilize/kill the coronavirus. Therefore, CF could be effectively applied to control and prevent the epidemic outbreaks of coronavirus across China and worldwide.

Nanoparticles of graphene and carbon nanotubes are attractive materials for improvement of mechanical and barrier properties and functionality of biodegradable polymers for food packaging applications. However, the increase of the manufacture and consumption increases the probability of exposure of human and environment to such nanomaterials, this rising questions about the risks of nanomaterials since they can be toxic. For a risk assessment, it is crucial to know whether airborne nanoparticles of graphene and carbon nanotubes can be released from nanocomposites into the environment at their end-life, or they remain embedded in the matrix. In this work the release of graphene and carbon nanotubes from the poly(lactic) acid nanocomposite films were studied for the scenarios of: (i) biodegradation of matrix polymer at the disposal of wastes; and (ii) combustion and fire of nanocomposite wastes. Thermogravimetric analysis in air atmosphere, TEM, AFM and SEM were used to verify the release of nanoparticles from nanocomposite films. The three factors model was applied for the quantitative and qualitative risk assessment to the release of graphene and carbon nanotubes from nanocomposite wastes for these scenarios. Safety concern is discussed in respect to the existing regulations for nanowastes stream.

This article presents a narrative review of neonatal and paediatric complications in post-dated pregnancy and covers scientific views on the aetiology, pathology, risk factors, symptoms and complications of post-dated pregnancy. A pregnancy extending beyond 42 weeks of gestation is termed as a post term pregnancy. There are multiple complications that can occur in the perinatal period, some of the most common ones are stillbirth, asphyxia, meconium aspiration syndrome, fetal distress syndrome, etc which are found to be greater in post-dated pregnancy and hence ultimately leads to increased mortality and morbidity of the new born. Studies have shown that post-term pregnancy also causes increased risk of developing behavioural and emotional problems in children of paediatric age group. It is surprising not much importance has been given to the maternal and neonatal consequences of post- term pregnancies. It is not well understood why some women experience post-dated pregnancies. It is found that factors such as hormones and genetic build up, are responsible for causing post-term pregnancy in an obese female. The treatment and management of a post-term pregnancy still poses a challenge to clinicians in determining the right choice and right time for a particular intervention so that both mother and fetus can be prevented from having complications.

Introduction: Outcome measures using telerehabilitation (TR) in the context of post-stroke rehabilitation is an area of emerging research. The current review assesses the literature related to TR for patients requiring post-stroke rehabilitation. The purpose of this study additionally is to survey the outcome measures used in TR studies and to define which parts of the International Organization of Functioning are measured in trials. Methods: TR studies were searched in Cochrane Central Register of Controlled Trials, PubMed, Embase, Scopus, Google Scholar, and Web of Science from 2016 to June 2023. Two reviewers individually assessed the full text. Disagreements about inclusion or exclusion were determined by consensus or by checking with a third reviewer. Results: A total of 24 studies were included in the current review. The results were synthesized and reported considering the implications of the results within clinical practice, areas of investigation, and strategic implementation. Conclusions: The current scoping review recognized a wide range of outcome measures used in TR studies and helped elucidate gaps in the current use of outcome measures in the literature. The scoping review also informs researchers and end users (i.e. clinicians and policymakers) regarding the most suitable outcome measures for TR.

The purpose of this study was to analyze the influence of Chitosan 0.2% in various final cleaning methods on the bond strength of fiberglass post (FP) to intrarradicular dentin. Ninety bovine incisors were sectioned to obtain root remnants measuring 18 mm in length. The roots were divided: G1: EDTA 17%; G2: EDTA 17% + PUI; G3: EDTA 17% + EA; G4: EDTA 17% + XPF; G5: Chitosan 2%; G6: Chitosan 2% + PUI; G7: Chitosan 2% + EA; G8: Chitosan 2% +XPF. After carrying out the cleaning methods, the posts were installed, and the root cleaved to to generate two disks from each root third. Bond strength values (MPa) obtained from the micro push-out test data were assessed by Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner tests for multiple comparisons (α = 5%). Differences were observed in the cervical third between G1 and G8 (p=0.038), G4 and G8 (p=0.003), G6 and G8 (p=0.049), and Control and G8 (p=0.019). The final cleaning method influenced the adhesion strength of cemented FP to intrarradicular dentin. Chitosan 0.2% + XPF positively influenced adhesion strength, with the highest values in the cervical third.

Actively combating post-harvest food spoilage and waste can dramatically increase the efficiency of food utilization worldwide. In climacteric fruits, chemical treatments such as 1-MCP are an effective way of reducing post-harvest spoilage and waste by inhibiting the fruit’s ability to perceive ethylene. 1-MCP treatment is increasingly being used to explore the complex nature of ripening physiology at a fundamental level, however, differences in application and quantitation methods create difficulties in comparing conclusions across studies. Here we report an effective and reproducible method for 1-MCP application and quantitation for small-medium sized research applications. By use of surrogate alkene standards 1-butene and cis-2-butene, the highly volatile and elusive 1-MCP molecule can be identified and quantified by gas chromatography and subsequent standard curves may be developed. It is hoped that the methodology outlined here can help standardize consistent 1-MCP application for post-harvest research without excessive investment in specialized equipment.

Post-evaluation of ecological redevelopment is a good method for its achievements. The eco-engineering technologies and achievements of landscape water reconstructed from aquaculture ponds in Shanghai Chenshan Botanical Garden have been introduced in this study. The sediments and water quality were also sampled and tested for basic physicochemical parameters and heavy metal concentration. The ecological redevelopment of landscape water reconstructed from aquaculture ponds was evaluated using the Nemero comprehensive pollution index method. The results shown that nutrients including organic matter, organic nitrogen and their ratio of sediment were found to be in a state of moderate pollution, while their ecological risk of heavy metals was low. Although total nitrogen and total phosphorus of water quality was really higher than that of other indexes, the decline trends of ammonia nitrogen, total nitrogen and total phosphorus was obvious presented over time. In general, this is a good example that redevelopment of water ecosystems from aquaculture ponds using eco-engineering technologies.

Residential satisfaction with post-disaster housing is crucial for the success and sustainability of a resettlement project. However, little attention has been given to this aspect in the permanent houses developed after the 2015 Gorkha earthquake. To bridge this gap, the study examined factors affecting residential satisfaction among poor displaced households resettled in the Panipokhari Integrated Settlement of Nepal. Data were collected through a questionnaire survey, interviews, and field observation. Internal consistency and reliability were assessed using Cronbach's Alpha test, while satisfaction was measured by mean satisfaction scores. The relative importance index ranked the factors, and Spearman's rank correlation coefficient analyzed their relationship with overall residential satisfaction. The study identified several crucial fac-tors influencing residential satisfaction, including the design and layout of the house, space for modification, provision of a kitchen garden and cattle shed, thermal comfort, completeness of the house, provision of a hearth, and spaces for rituals and cultural events. These findings shed light on the resettlement decisions of affected populations and provide valuable insights for policymakers, implementers, and researchers aiming for successful and sustainable resettlement outcomes.

Background: Optimal hypofractionated schedule of post-prostatectomy radiotherapy remains to be established. We evaluated treatment outcomes and toxicity of the moderately hypofractionated post-prostatectomy radiotherapy in 16 daily fractions delivered with IMRT/VMAT. The treatment schedule selection was motivated by limited technology resources. Methods: One hundred consecutive M0 patients with post-prostatectomy radiotherapy were evaluated. Radiotherapy indication was adjuvant (ART) in 19%, early salvage (eSRT) in 46% and salvage (SRT) in 35%. The dose prescription for prostate bed PTV was 52.8 Gy in 16 fractions of 3.3 Gy. The Common Terminology Criteria v.4 for Adverse Events scale was used for toxicity grading. Results: The median follow-up was 61 months. Five-year biochemical recurrence-free survival (bRFS) was 78.6%, distant metastases-free survival was 95.7% and overall survival was 98.8%. Treatment indication was the only significant factor for 5-year bRFS in multivariate analysis which was 84.6% vs. 67.6% for ART or eSRT vs. SRT respectively (HR 0.15, 95% CI 0.05–0.47, p=0.001). Acute GI toxicity grade 2 was recorded in 24%, grade 3 in 2% and acute GU toxicity grade 2 in 10% and no grade 3. Cumulative rate of late GI toxicity grade ≥2 was observed in 9% and late GU toxicity grade ≥2 in 16%. Conclusion: Observed results confirmed efficacy and acceptable toxicity of post-prostatectomy hypofractionated radiotherapy in 16 daily fractions.

Current study was to estimation the post-harvest loss of avocado at the producer level using cross-sectional data obtained from 385 proportionately sampled respondents from Wolaita and Kembata Tembaro Zones, the SNNPR of Ethiopia. Descriptive and multiple regression analysis were used to the amount and determinant of post harvest loss of avocado fruits. Estimated total post harvest- loss of avocados was 24%; of which 5.7% unacceptable harvesting methods and 4.9% of improper storage practices. The respondent's sex, education, income, training, contact with extension agents, distance from the nearest road, and off-farm income were found to be negative determinants, whereas storage accessibility and avocado harvest techniques were found to be positive determinants of post-harvest loss of avocado fruits. Post-harvest management techniques for avocados need to be better understood and used by avocado growers if they are to minimize losses. Post-harvest losses contribute considerably to food insecurity and create a problem for the source of revenue for people and the economy of the country as well. Therefore, the use of a practical and effective post-harvest loss reduction technique could be a sustainable solution to increase food availability, eliminate hunger and improve farmers' livelihoods.

The universal chirality is the commonly accepted view of nature. Biological chirality is the distinct part of the more general phenomena. Following this view, all living organisms are characterized by the non-equilibrium state of their molecular constituents. From the thermodynamic perspective, the non-equilibrium state of biomolecular ensemble holds inevitable consequences being the substrate of spontaneous reactions directed to equilibrium (not associated with life) state. At the protein level, spontaneous biological reactions represent the natural part of proteins' post-translational modifications (PTMs). The essential contribution to the origin and maintenance of the non-equilibrium state belongs to prevalent bio-molecular chirality. Correspondently, spontaneous PTMs such as racemization and glycation, working against life-supporting prevalent chirality, are known as the significant determinants of protein misfolding, dysfunctions, and aggregation. Accumulation of aberrant protein during life-span allows consideration of time-dependent spontaneous racemization and glycation as protein aging. Spontaneous PTMs of proteins is occurring in the interaction with other forms of enzymatic and non-enzymatic PTMs. In this review, we are considering the contribution of spontaneous racemization and non-enzymatic glycosylation to protein aging.

Smoking during pregnancy remains one of the most significant risk factors for poor birth outcomes. The Loma Linda University Health Comprehensive Tobacco Treatment Program (CTTP) is the largest maternal tobacco cessation program in San Bernardino County – the largest county in the contiguous US. CTTP is an eight week, incentivized, behavioral intervention for tobacco cessation for pregnant smokers. As part of program evaluation, we used a retrospective cohort design to assess smoking abstinence and to identify predictors of relapse/smoking after enrollment. Among CTTP cohort enrollees (n=233) from 2012-2013 we found: 1) a 28.4% 8 week point prevalence abstinence (PPA), and at a median of 9 months of follow-up after the PPA, 81.6% continued to indicate tobacco cessation, and 2) a high rate of relapse or loss to follow-up (56%). Our modeling of relapse/smoking after enrollment indicated that this was higher in young mothers, non-Hispanic mothers (White, Black), first/third trimester mothers, and rural mothers. The evaluation identified efficacy of the behavioral model at 8 weeks, but that relapse/smoking was occurring in disparity populations. Formative research is needed to expand the programmatic outreach and enrollment of mothers wanting to quit smoking.

Postpartum depression (PPD), a condition that affects up to the 15% of mothers in high-income countries, reduces attention toward the needs of the child and it is among the first causes of infanticide. PPD is usually identified using self-report measures and therefore the diagnosis may not always be valid. Previous studies highlighted the presence of significant differences in the acoustical properties of the vocalizations of children of depressed and healthy mothers. In this study, cry episodes of infants of depressed and non-depressed mothers are analyzed to investigate the possibility that a machine learning model can identify PPD in mothers from the acoustical properties of infants' vocalizations. Acoustic features (F0, F1-4, Intensity) are first extracted from recordings of crying infants, then novel cloud-based artificial intelligence models are employed to identify maternal depression versus non depression from estimated features. Trained model shows that commonly adopted acoustical features can be successfully used to individuate Post-Partum Depressed mothers with very high accuracy (89.5%).

Background: Paracetamol may be use as antipyretic agent for the treatment of fever, as well as an analgesic in the treatment of mild to moderate pain on post vaccination in infants. The use of Paracetamol during fever may be or may not be recommended since it may alter natural human body immune response although it may reduce pain. Objectives: This study described the relevancy of Paracetamol use post infants vaccination based on data collection systematic review analyses. This study aims to describe the effectiveness of breastfeeding in reducing pain and Paracetamol in reducing fever and pain post infants vaccination. Data Sources and Study Selection: Electronic literature search by hand searching six (6) databases which include Ovid LWW Total Access Collection and Medline, CINAHL (Cumulative Index to Nursing and Alled Health Literature) Plus with Fulltext, Science Direct, Proquest Dissertations and Theses, Proquest Education Journal and Proquest Health and Medical Complete. Additionally, manual reference checks of all articles on Paracetamol and breastfeeding post infants vaccination published in English Language between 1978 and 2017. Two level of screening were used on 9614 citations which include screening of abstracts and titles followed by full text screening. Data Synthesis: Data synthesis were tabulated into study characteristics, quality and effects. Authors of trials were not contacted for further details or provision of original data if the published report contained insufficient information. The study findings, as reported by the authors, were included in this review. The data in this research cannot be pool due to not enough data regarding odd ratio or relative risk as well as confidence interval in each study. Results: Systematic review of breastfeeding included three (3) studies from 9614 of database searching. The reviews of all these three (3) studies found significant benefit from breastfed in pain score and duration of crying as well as behavioral changes. None study stated the unbeneficial of breastfeeding before, during and after immunization. Meanwhile, systematic review of Paracetamol effectiveness included four (4) studies from 1177 of database searching. The reviews of two (2) studies found significant benefit from prophylaxis Paracetamol in fever and only one (1) study found significant benefit from prophylaxis Paracetamol in fussiness. On the other hand, there was one (1) study found not signifiant benefit from prophylaxis Paracetamol in fever. Other than that, there were two (2) studies evaluate the safety of prophylactic Paracetamol which revealed different outcomes, in which study by Prymula et. al. in 2009 found that antibody responses to several antigens were reduced significantly, and the other study by Uhari et. al. in 1988 found that antibody titres to DTP bacteria of placebo and PCM not differ significantly. Thus, Paracetamol seems to be not relevant post infants vaccination and breastfeeding was found to be beneficial post infants vaccination. Conclusions: The relevancy of giving Paracetamol post all types of vaccination may be questionable since the safety issue of this intervention may be arised. Breastfeeding before, during and after immunization are recommended for pain reduction as it was proved effectively. Finally, in deciding Paracetamol to be of rational use following infants immunization, it may need for further research which include in depth quantitative and qualitative studies to identify specific problem and causes regarding this issue.

Introduction: Despite more than one year passed since the first cases of SARS-CoV-2 were reported, there is still no consensus on the definition and clinical management of post-acute-COVID-19. The condition has heterogeneously been named as Chronic COVID syndrome, Post COVID-19 Syndrome, post-acute sequela of SARS-CoV-2 (PASC), and the more familiar long COVID. Method: In order to capture all relevant published studies, we undertook a multi-step search with no language restriction. The following four-step search strategy was utilized: First, a preliminary (limited) search was conducted on January 20, 2021, in Google Scholar and PubMed to identify the appropriate keywords. Then, on January 30, 2021, we adopted a search strategy of electronic databases from Cochrane Library, PsycINFO, PubMed, Embase, Scopus, and Web of sciences, using those keywords. Then, after duplicate removal, we screened all titles, abstracts, and full texts. This resulted in 66 eligible studies. Subsequently, after a forward and backward search of their references and citations an additional 54 publications were found, resulting in a total of 120 publications that formed the basis of the present analysis. The titles, abstracts, and full-texts of non-English articles were translated using Google Translate for further evaluation. We conducted our scoping review based on the PRISMA-ScR Checklist.Results: We found only one randomized clinical trial in our search. Of the 67 original studies, 22 were cohort and 28 were cross-sectional studies totaling 74.6% of the original studies. Of the total of 120 publications, 59 (49.1%) focused on signs and symptoms, 28 (23.3%) were focused on management, and 13 (10.8%) focused on pathophysiology. Ten (9%) publications focused on imaging studies. Ninety-one percent of the original investigations came from high and upper-middle-income countries, highlighting the scarcity of reports originating from low-income and lower-middle-income countries.Conclusion: The predominant symptoms among those with the so-called “Long COVID” were: fatigue, breathlessness, arthralgia, sleep difficulties, and chest pain. Recent reports also point to the risk of long-term sequela with cutaneous, respiratory, cardiovascular, musculoskeletal, mental health, neurologic, and renal involvement in those who survive the acute phase of the illness. The ambiguity and controversies in its definition have impaired proper recognition and management of those requiring additional support following the resolution of the acute phase of this infection. This has resulted in long-standing distress for the patients and their families. Our findings highlight the need for a multidisciplinary approach, support, and rehabilitation for these patients in terms of long-term mental and physical health.

Fires are a significant threat to people, property, and environment. One of the requirements for the buildings during fires is ensuring the safe evacuation of persons. The evacuation assessment has usually been based on a comparison of the Required Safe Egress Time (RSET) and the Available Safe Egress Time (ASET). One of the important factors influencing the safe evacuation of persons is smoke, which is an important accompanying phenomenon in the burning of polymers. The smoke layer interface is one basic barrier for effective evacuation. The current calculation technique for assessing the smoke layer interface in the Czech Republic is unsatisfactory. For this reason, a calculation technique CSN has been derived, which has been compared with the selected simple calculation techniques, the zone fire model Consolidated Model of Fire and Smoke Transport (CFAST) and the field type model Fire Dynamics Simulator (FDS). The CSN technique was also compared with a real large-scale experiment. The data were also subjected to statistical evaluation using the root mean square error method (RMSE). The deviations between the NFPA, ISO and CSN calculation techniques, the CFAST and FDS fire models and the implemented experiment ranged from 0.05 to 2.41. The established deviations indicate that the calculation technique CSN will be practically usable.

This paper uses probability method to evaluate the fire safety performance of prestressed steel-concrete beam bridges based on simulation experimental research. Firstly, fire simulation experimental sample analysis was conducted on actual small box girder bridges to obtain the structural response of prestressed steel-concrete structures under fire, which is in line with engineering practice. Next, construct a reliability analysis model for the fire resistance performance of prestressed steel-concrete beam bridges; Combining reliability theory with finite element method, establish a reliability analysis method for the fire resistance performance of prestressed steel-concrete beam bridges. Subsequently, a safety factor evaluation model for the fire resistance performance of prestressed steel-concrete beam bridges was proposed, and a safety factor evaluation method for the fire resistance performance of prestressed steel-concrete beam bridges based on reliability back analysis was established. Finally, based on the analysis of the structural response after a fire in a specific case of a simply supported to continuous prestressed steel-concrete continuous beam bridge project, a structural resistance sample of the prestressed steel-concrete beam bridge is generated through uniform design method, and statistical analysis is conducted. Subsequently, probability methods are used to evaluate the safety of the prestressed steel-concrete beam bridge after a fire. Through analysis, it can be concluded that the time of fire has a significant impact on the structural performance of prestressed steel-concrete beam bridges, and the randomness of parameters has a significant impact on the safety reserve of prestressed steel-concrete beam bridges after fire. It is necessary to pay attention to it in specific engineering practice and strengthen the monitoring and statistics of structural random characteristics.

As in many parts of the world, rural-urban, forest-urban interface areas surrounding urban regions expose the natural areas they interact with to a threat of fire risk that can reach various sizes. This risk has been assessed for various regions of the world using many different methods and numerical models so far. Among these, it is seen that machine learning models have successful applications in risk assessment and risk prediction studies. For the fire risk prediction of Istanbul's yet unurbanized regions, but where the city is anticipated to potentially shift, data was collected using the opportunities provided by Geographic Information Systems and Remote Sensing technologies based on fires that occurred between 2000-2021, and the region was examined. Machine learning methods' Random Forest (RF), Extreme Gradient Boosting (XGB), and Light Gradient Boosting (LGB) models were applied for the classification of factors effective in fire. The best result was given by the RF model with 0.93 accuracy, 0.062 F1 score, and 0.753 Area Under Curve (AUC) value. In the classification of factors in the RF model, the grouping between fire-initiating factors and factors effective in spreading is evident, while this distinction is partially noticeable in the other two models.

In the framework of the FireStorm project, four portable weather stations were installed in the Lousã/Estrela mountain range. Given that the Portuguese Institute for Sea and Atmosphere’s sur-face network has two weather stations installed in this region, the new data allows an improved monitoring of the vertical variability of near-surface variables in this mountainous region. As most of the wildfires in mainland Portugal affect areas with complex terrain with elevations below 1200 m and major fires continue to burn overnight, it is also relevant to monitor the vertical changes of meteorological variables in the nighttime period, as these may exhibit large variability. This study provides the first assessment of the available data, with focus on the summer seasons of 2021 and 2022. The results highlight the large variability that was observed in the region and suggest that the risk of extreme fire behaviour in the nighttime period may be underestimated.

Fire behavior of natural rubber latex foam under different thickness conditions(d=1,2and 5cm)were explored though a little of experiments by using the self-built small scale experimental platform. It can be shown that the flame spread law of thermally thin and thermally thickness are different. Natural rubber latex foam with thickness of 2cm show higher fire risk, which value of flame spread rate, maximum flame height, maximum mass loss rate and maximum temperature is 0.00293m/s, 851.875mm, 1.83g/s, 948K,repectively.That may because the thickness of residue formed of thermally thick materials is larger than the thin one, obstructing the contact of the natural rubber latex foam with fresh air .In addition, a special phenomenon is noticed that during the second stage, the bottom unburned zone located in the four edges(thermally thin material) and middle player(thermally thick material).

Large-span post-tensioned (PT) beams play a crucial role in maximizing the benefits of post-tensioning techniques. Bonded and unbonded systems are prevalent, with the latter being more widespread in the United States. While bonded systems are advantageous for creating long spans when multiple tendons are grouped in ducts, limited literature exists on their demolition. In a case study, this paper addresses the unique challenge of demolishing large-span bonded post-tensioned beams due to a building's functional change. Emphasizing insights for engineers, it explores the use of cutting and dismantling methods, considering the presence of prestressed cables. The demolition process is distinctive due to the presence of numerous pre-stressed cables along the beams, necessitating a specialized and cautious cutting approach. This is accomplished through the use of a drilling technique that selectively distresses the tendons, ensuring they are not all affected simultaneously. An intriguing observation discussed in this paper pertains to the occurrence of horizontal cracks accompanied by loud sounds following the drilling process, offering insights from the design perspective of PT systems. The paper details an innovative method for safely demolishing large-span bonded PT beams, using ground-penetrating radar and computer models to navigate structural complexities and ensure nearby structures' safety.

The pandemic was an enormous experience all over the world. The type of living, working and study were changed irreversibly. Facing the opportunity to establish old frames of education in universities is impossible. The adoption of new ways of teaching and assessments reveal their convenience and in the same way their weak points. In response to that stage, on 14 December 2022, the EU parliament accepted the "Digital Decade Policy Programme 2030", for the establishment of a digital transformation community (EU 2022). Trakia University had an online assessment system, quizzes for self-training, and final exams, developed in 2008 on Moodle virtual learning environment. During the pandemic, online exams and lectures were conducted using platforms like BigBlueButton in Moodle or Google Meets. The article gives the results of online exams before, during, and after the pandemic. The outcome, without doubt, displays the lowering knowledge level or performance during the social isolation due to COVID-19, and after, and the reasons are discussed. During the second year of the pandemic was mentioned also a high dropout of students. Now the situation is returning to the previous levels, before the pandemic, but the quality of education is not yet reached. The article values the grades results of session exams and has the intention to clarify the influence of the pandemic period on the excellence of high institution education.

The study aimed to evaluate the after-effects of the COVID-19 pandemic on the sleep quality and patterns of women across different cultural settings within Iraq, spanning the period of 2022. A cross-sectional survey was administered to a diverse cohort of women from multiple provinces in Iraq. The survey measured various parameters, including sleep duration, onset latency, and disturbances. The post-pandemic period has seen a notable decline in sleep quality among the female population. Contributing factors include psychological stress, lifestyle changes due to the pandemic, and ongoing socio-economic challenges. The impact on sleep quality exhibited variation across different cultural groups, indicating a significant cultural influence on the pandemic's psychological aftermath. The study concludes that the post-pandemic phase has adversely affected the sleep health of women in Iraq, with cultural factors playing a critical role in these changes. There is a pressing need for culturally sensitive public health strategies to address sleep disturbances and mitigate their long-term effects on women's health. Public health initiatives should be tailored to address the specific cultural contexts within Iraq to improve sleep health among women. Further research is warranted to explore the long-term consequences of disturbed sleep patterns and the effectiveness of different intervention strategies.

Background Posttraumatic stress disorder (PTSD) is a complex condition that represents a significant burden in terms of individual disability and societal costs. Despite decades of research investigating treatment options, PTSD remains a major cause of quality-of-life impairment. We hypothesized that patients with PTSD might benefit from peripheral somatosensory stimulation (PSS) therapy. Methods Six adult patients with clinically diagnosed PTSD were enrolled to undergo daily PSS therapy over a 4-week period. Patients completed two surveys evaluating satisfaction with treatment and overall well-being (Survey 1) and severity of PTSD symptoms (Survey 2). Survey 1 was completed weekly during the course of the study. Survey 2 was based on the 9-question National Stressful Events Survey PTSD Short Scale (NSESSS) and was completed as a baseline prior to initiation of therapy and then at the conclusion of the trial. All data were analyzed by an independent statistician. Results Six male patients were enrolled in the study; all completed the trial. All patients demonstrated a decrease in symptoms within one week of initiation of therapy. This benefit was sustained and appeared to further improve over the course of the trial. For Survey 1, the overall median scores demonstrated a significant time-dependent improvement across measurement times (p < 0.001). For Survey 2, patients had statistically significant improvements from baseline regarding feelings of being emotionally upset and being overly alert. Results from a cumulative link mixed model demonstrated that treatment yielded a 38.2-fold higher likelihood of transitioning from a higher PTSD score at baseline to a lower (improved) score at week 4. No adverse events were described by the patients. Conclusions PSS stimulation appeared to improve symptoms in all six patients with PTSD symptoms in this trial. Patients had unanimous and clinically meaningful improvement in overall PTSD symptoms with treatment. By week 4, all patients responded that they enjoyed the treatment and would like to keep their device. We suggest that further investigation into the potential usefulness of PSS therapy in patients with PTSD is warranted.

Post-traumatic stress disorder (PTSD) is a debilitating mental health disorder that causes significant dysfunction in individuals. Currently, there are many approved Pharmacotherapy and Psychotherapy treatment options for PTSD, but unfortunately, half of the patients do not respond to traditional therapies. In this article, we reviewed clinical trials and research on 3,4-methylenedioxymethamphetamine (MDMA) assisted Psychotherapy in PTSD patients, its pharmacokinetics and current treatment guidelines for PTSD. Based on the results of the efficacy of MDMA assisted Psychotherapy from six phases II Randomized controlled trials. MDMA-assisted Psychotherapy for PTSD has received the “Breakthrough Therapy” designation from the FDA. MDMA can potentially reduce PTSD symptoms even in treatment-resistant cases by increasing certain neurohormones, i.e. dopamine, serotonin, norepinephrine and oxytocin. It also modulates activities in the brain regions involved in fear and anxiety. Future research is needed to show whether the advantages outweigh the disadvantages and whether its use can be integrated into available treatment options for PTSD.

Aims: The aims of this meta-analysis were to assess: the prevalence of Post-Acute COVID-19 sequalae in HIV positive patients; average time of diagnosis; and meta-regress for possible moderators of PACS.Methods: A standard search strategy was used in PubMed, and then later modified according to each specific database to get the best relevant results. These included Medline indexed journals; PubMed Central; NCBI Bookshelf and publishers' Web sites in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. Search terms included “long COVID-19 or post-acute COVID-19 syndrome/sequalae”, “persons living with HIV or HIV. The criteria for inclusion were published clinical articles reporting HIV in association with long COVID-19, further, the average time to an event of post-acute COVID-19 sequelae among primary infected patients with COVID-19. Random-effects model was used. Rank Correlation and Egger's tests were used to ascertain publication bias. Sub-group, sensitivity and meta-regression analysis were conducted. A 95% confidence intervals were presented and a p-value < 0.05 was considered statistically significant. Review Manager 5.4 and comprehensive meta-analysis version 4 (CMA V4) were used for the analysis. The review/trial was PROSPERO registered (CRD42022328509).Results: A total of 43 studies reported post-acute COVID-19 syndrome. Of those, five reported post-acute COVID-19 sequalae in PLHIV. Prevalence of post-acute COVID-19 sequalae was 43.1% (95% CI 20.5% to 68.9%) in persons living with HIV (PLWH). The average time to PACS diagnosis was 4 months at 64% [0.64 (95% CI 0.230, 0.913) (P < 0.0000), I²= 93%] and at one year to PACS diagnosis was at 70 %, however with non-significant correlation (P > 0.05). On comorbidities, asthenia was associated with PACS at 17.6 % [0.176 (95% CI 0.067, 0.385) (P = 0.008), I²= 86%] while fatigue at 82%, however not related with PACS event incidence (P < 0.05). Americas, Asian and European regions showed PACS events rates of 82%, 43% and 19 % respectively (P<0.05) relative to HIV infection. Conclusion: PACS prevalence in PLWH was 43% occurring at an average time of 4 months at 64% and 70 % at 12 months however non-significant with PACS. Asthenia was significantly associated with PACS at 17.6 % while fatigue at 82%, however not related with PACS event incidence. Americas recorded the highest PACS event rates in PLWH.

In this review we extensively describe the main post-translational modifications that give rise to the multiple proteoforms characterized to date in the human salivary proteome and their potential role. Most of the data reported were obtained by our group in over twenty-five years of research carried out on human saliva mainly by applying a top-down strategy. At the beginning we describe the products generated by proteolytic cleavages, which can occur before and after secretion. In this section the most relevant families of salivary proteins are also described. Next, we report the current information concerning the human salivary phospho-proteome and the limited news available on sulfo-proteome. Three sections are dedicated to the description of the glycation and enzymatic glycosylation. Citrullination and N- and C- terminal PTMs and a miscellaneous of other modifications are described in the last two sections. Results highlighting the variation in the level of some proteoforms in local or systemic pathologies are also reviewed along the sections of manuscript to underline the impact and relevance of this information for the development of new diagnostic biomarkers useful in clinical practice.

Abstract Congenital rubella syndrome is a constellation of birth defects that can have devastating consequences, impacting approximately 100,000 births worldwide each year. The incidence is much lower in countries that routinely vaccinate their population. In the US, postnatal immunization of susceptible women is an important epidemiological strategy for the prevention of rubella. However, concerns that co-administration of Rubella vaccine with other immunoglobins (i.e., Rhogam) could comprise vaccine efficacy has produced warnings that can delay the administration of Rubella vaccination postpartum, leaving women susceptible in a subsequent pregnancy. We aimed to address whether co-administration of Rubella vaccine and Rhogam decreased antibody responses as compared to those receiving only Rubella vaccination. This retrospective cohort study utilized clinical data from 80 subjects who received Rubella vaccine and Rhogam after delivery and 43 subjects received Rubella vaccine alone. Maternal demographics, pregnancy complications and rubella status at the start of a subsequent pregnancy were recorded for analysis. Overall, the two cohorts had similar baseline characteristics; however, lower parity was noted in the participants having both Rubella vaccination and Rhogam. Based on maternal antibody IgG index for rubella during the next pregnancy, we observed that 88% of the Rhogam + Rubella vaccine group had positive titers, which was not significantly different than the 81% in the Rubella vaccine only cohort (p=0.36). In conclusion, no differences in the rubella immunity status in a subsequent pregnancy were observed in those mothers administered both Rubella vaccine and Rhogam concurrently. Given these findings, warnings against co-administration of Rubella vaccine in combination with other immunoglobulins should be discontinued.

(1) Background: High-grade cervical dysplasia is primarily caused by human papillomavirus (HPV) infection. Conservative surgery is the preferred treatment approach for this condition. The most commonly employed technique is the loop electrosurgical excision procedure (LEEP), which involves removing the affected portion of the cervix. Excisional treatments are often curative, and complications are typically rare and minor; (2) Methods: The loop electrosurgical excision procedure (LEEP) is the standard method used for conservative surgery in high-grade cervical dysplasia. It entails the excision of the specific area of the cervix where the abnormal cells are present. The procedure employs a wire loop carrying an electrical current to remove the affected tissue; (3) Results: Excisional treatments, such as LEEP, have shown to be effective in treating high-grade cervical dysplasia. They have a high success rate in eliminating abnormal cells and reducing the risk of cervical cancer. Complications associated with LEEP are infrequent and usually minor. Short-term complications may include bleeding, which can be managed easily. Long-term complications may involve cervical canal stenosis, which can impact fertility; (4) Conclusions: Conservative surgery, particularly the loop electrosurgical excision procedure (LEEP), is the preferred and effective treatment for high-grade cervical dysplasia caused by HPV infection. It offers a high cure rate with rare and minor complications. While short-term bleeding is a common occurrence, it is manageable. Long-term complications such as cervical canal stenosis may impact fertility. However, an extremely rare and possibly unique complication described in this case is the development of a vaginorectal fistula. This complication is likely due to indirect thermal injury resulting from compromised tissue. Further research is needed to better understand and prevent such complications.

Abstract: Gastroesophageal reflux disease (GERD), the inflammatory bowel disease (IBD), and mental health issues are significant public health concerns in globally. Although rising peaks observed post-COVID-19, there is a sever paucity in high quality data. Using descriptive analysis, we identified the frequency and associations of age- and gender, sport, genetic, and psychiatric consequences in the coexistence of GERD and IBD in 2067 participants 18 to &gt;60 years with mean age of 26.8 ± 12.9 years. Most were 18 -29 years old (66%, n=1364) of which majority were young Saudi females (72.4%, n=1496). Estimated 1099 (53.2%) were students, 428 (20.7%) were unemployed, and 540 (26.1%) were. The majority were Saudis (94.7%, n= 1957). Psychological syndromes anxiety (60.7%), stress (60.7%), and depression (60.6%) were most frequent; whereas, IBD (48.7%) and GERD (36.3%), respectively were the second and third. In 51 % respondents depression, anxiety, and stress occurred first while in 33.9%, and 24.3% IBD and GERD, respectively, were the first signs. In most respondents (59.2%, n=1178), these signs first appeared recently and 33.6% (n=669) reported occurrence during adult life, and only in 7.2% (n=144) the signs noticed during childhood (7.2%, n=144)). Aggravating factors were 32.9% (n=681) genetic and other factors of which 476 (69.9%) inherited IBD while 215(31.6%) and 175 ((25.7), respectively, inherited psychological (depression, anxiety, and stress) and GERD. However, only 18.3% sought treatment (n=378) and only 66 (3.2%) had colectomy or a colostomy bag. Little over half of the studied population (58.1%, n=1201) were active in outdoor. GERD or IBS and psychological factors (anxiety, depression, and stress), were significantly associated with age (P value =.001).; GERD with old age, IBD with mid-age 40-49 years, and psychological disorders among younger ages. Thus, while mental health issues predispose young millennial women to neurogastroenterological disorders, the IBD and GERD initiate psychological problems in old and mid-ages, respectively. Intriguingly, despite the significantly mosaic global genetic population structures, their lifestyles, and nutritional habits, the pattern of these disorders remains similar. Thus, this is potentially consistent with notion that the gut nerve cells are conserved and that the changes in gut dysbiosis of gut microbiome signatures are responsible. These findings have significant clinical implications in the patient treatment strategies and tailored educational and awareness programs in lifestyle medicine. Future microbiome studies would reveal more insight into the mechanisms of disorders.

The rapid development of quantum computing devices promises powerful machines with capabilities that solve a wide range of problems that traditional computers cannot. Therefore, quantum computers generate new threats at unprecedented speed and scale and specifically pose an enormous threat to encryption. Lattice-based cryptography is considered to be the rival to a quantum computer attack and the future of post-quantum cryptography. So, cryptographic protocols based on lattices have a variety of benefits, like security, efficiency, lower energy consumption, and speed. In this work, we study the most well-known lattice-based cryptosystems while a systematic evaluation and comparison is presented also, and focuses on their strengths and weaknesses.

Temperature is a critical factor that influences the proliferation of pathogens in hosts. The impact of temperature on pathogens is commonly explored in controlled and constant temperatures. Experiments under varying environmental temperature are becoming more frequent, however, testing every temperature scenario à la carte is unachievable. One example of this is the human pathogen Vibrio parahaemolyticus (Vp) in oysters. Here, a predictive model was developed for predicting the growth of Vp in oysters under varying ambient temperature. The model was fitted and evaluated against data from experiments studying growth and inactivation of Vp in oysters at eight constant temperatures. Once evaluated, Vp dynamics in oysters were estimated at different post-harvest varying temperature scenarios affected by water and air temperature, and different ice treatment timing. The model performed adequately under varying temperature, reflecting that (i) increasing temperature, particularly in hot summers, favors a rapid Vp growth in oysters, resulting in a very high risk of gastroenteritis in humans after consumption of a serving of raw oysters, (ii) pathogen inactivation due to day/night oscillations, and more evidently, due to ice treatments, (iii) ice treatment is much more effective limiting risk of illness when applied immediately onboard compared to dockside. The model results to be a promising tool for improving the understanding of the Vp-oyster system and support studies on public health impact of pathogenic Vp associated with raw oyster consumption. Although robust validation of the model predictions is needed, initial results and evaluation show the potential of the model to be easily modified to match similar systems where the temperature is a critical factor shaping the proliferation of pathogens in hosts.

Sepsis is a life-threatening condition with high hospital mortality. Elevated mortality has also been observed in patients after hospital discharge due to post-sepsis syndrome (PSS). The etiology of PSS is still not entirely known, but it involves inflammation. Plasma extracellular vesicles (EVs) are recognized as a unique mechanism of intercellular communication in inflammatory processes. It has been reported that EV microRNA (miRNA) production during the acute sepsis phase may persist until after disease resolution and is associated with PSS. We employed mass spectrometry and qPCR analysis to determine the protein and miRNA composition of plasma-derived EVs of 36 patients during sepsis-related hospitalization, immediately after ICU discharge (post-sepsis), and three, six, twelve, and up to 36 months post-sepsis. We determined that patients’ immune system cells were the primary EV source. Fifteen differentially expressed EV miRNAs (DEmiRs) were identified in samples from septic patients compared to the control group. Predictive analyses revealed that these DEmiRs could influence inflammation by modulating pathways mediated by NF-κB, STAT3, and TLR4 signaling activation. Thirteen miRNAs (-15b-5p,-16-5p,-20a-5p,-25-3p,-27a-3p,-29a-3p,-30d-5p,-93-5p,-146a-5p,-148a-3p,-191-5p,-195-5p,-223-3p) were downregulated in the death group compared to the survivor group, making them candidate prognostic markers of ICU survival. One year after ICU discharge, the expression of miR-21-5p and miR-195-5p were decreased in the survivor group. The miRNAs identified in the present study represent potential biomarkers for the survival prognosis of post-sepsis patients.

This study is a cross-sectional survey involving physicians around Indonesia aimed to explore physician hesitancy to treat COVID-19 patients after experiencing COVID-19 infection coupled with associated occupational risk factors. The questionnaire was distributed via contact information from the Indonesian Physician Association database. Out of 383 participants, 25.6% suffered from moderate symptoms of COVID-19 and 2.9% were admitted for critical care. Hesitancy to treat suspected, probable, or confirmed COVID-19 patients was found in 20.3% of physicians. A higher hesitancy rate was found in older physicians and those with less experience in treating COVID-19 patients. Specialist trainees and those who work in public hospitals were physicians with the lowest hesitancy in treating COVID-19 patients. There is a significant hesitancy in treating COVID-19 patients among physicians who have suffered from COVID-19 which calls for further action by management and policy makers.

Plastid gene expression involves many post-transcriptional maturation steps resulting in a complex transcriptome composed of multiple isoforms. Although short read RNA-seq has considerably improved our understanding of the molecular mechanisms controlling these processes, it is unable to sequence full-length transcripts. This information is however crucial when it comes to understand the interplay between the various steps of plastid gene expression. Here, the study of the Arabidopsis leaf plastid transcriptome using Nanopore sequencing showed that many splicing and editing events were not independent but co-occurring. For a given transcript, maturation events also appeared to be chronologically ordered with splicing happening after most sites are edited.

Background: Percutaneous coronary intervention (PCI) is known as a very rare possible trigger of pericarditis. Most frequently it develops after a latent period or early in case of periprocedural complications. In this report, we present an atypical early onset of pericarditis after the uncomplicated PCI. Case Summary: A 58-year-old man was admitted to the hospital for the PCI of the chronic total occlusion of left anterior descending (LAD) artery. An initial electrocardiogram (ECG) was unremarkable. PCI attempt was unsuccessful. There were no procedure related complications observed at the end of PCI attempt and patient was symptom free. Six hours after interventional procedure the patient complained of severe chest pain. The ECG demonstrated ST-segment elevation in anterior and lateral leads. Troponin I was mildly elevated but coronary angiogram did not reveal impairment of collateral blood flow to the LAD territory. Because of pericarditic chest pain, typical ECG findings and pericardial effusion with elevated C-reactive protein, the diagnosis of acute pericarditis was established, and a course of nonsteroidal anti-inflammatory drugs (NSAIDs) was initiated. Chest pain was relieved and ST-segment elevation almost completely returned to baseline after three days of treatment. The patient was discharged in stable condition without chest pain on the fourth day after symptom onset. Conclusions: Acute pericarditis is a rare complication of PCI. Despite the lack of specific clinical manifestation, post-traumatic pericarditis should be considered in patients with symptoms and signs of pericarditis and a prior history of iatrogenic injury or thoracic trauma.

The influence of post-processing conditions on the magnetic properties of amorphous and nanocrystalline microwires have been thoroughly analyzed, paying attention on the influence of magnetoelastic, induced and magnetocrystalline anisotropies on the hysteresis loops of Fe-, Ni- and Co-rich microwires. We showed that magnetic properties of glass-coated microwires can be tuned by the selection of appropriate chemical composition and geometry in as-prepared state or further considerably modified by appropriate post-processing, which consists of either annealing or glass-coated removal. Furthermore, stress-annealing or Joule heating can further effectively modify the magnetic properties of amorphous magnetic microwires owing to induced magnetic anisotropy. Devitrification of microwires can be useful for either magnetic softening or magnetic hardening of the microwires. Depending on the chemical composition of the metallic nucleus and on structural features (grain size, precipitating phases) nanocrystalline microwires can exhibit either soft magnetic properties or semi-hard magnetic properties. We demonstrated that the microwires with coercivities from 1 A/m to 40 kA/m can be prepared.

Blackberry is a fruit that has high nutritional value, a factor that has expanded its consumption worldwide. However, due to the fragility of the fruits and the high incidence of postharvest diseases, the fruits have a short shelf life. Thus, the objective of this study was to evaluate whether the application of coatings based on microfibrillated cellulose (NC) and lemongrass essential oil (EO) nanoparticles can prolong the shelf life of blackberry fruits after harvest. EO-coated blackberry fruits at nanocellulose concentrations were analyzed as follows: 0; 0.2; 0.4; 0.6 and 0.8%, in addition to the control treatment of which neither essential oil nor nanocellulose was used, for each treatment five repetitions were used. The fruits were analyzed soon after the application of the cover and at three and six days after storage. Fruit quality was assessed by soluble solids (SS), titratable acidity (TA), pH, fresh weight loss (FWL) and colorimetric parameters such as luminosity, hue angle and fruit peel chroma. Coating on EO (1000 ppm) blackberries combined with NC at concentrations of 0.2, 0.4 and 0.6% is promising in preserving blackberry fruits and reducing the process color reversal, up to six days of storage. The 0.4% NC + 1000 ppm EO conjugated coating showed no SS changes in blackberry fruits during the six days of storage.

Background and Objectives: Due to huge demand and availability of Banana, innovative cost effective method is necessary to promote and smoothen the banana production among farmers commercially mitigating the demand. Method and Materials: In this study, we feed cow dung mixture along with Urea, TSP, MoP, water to the distal part of rachis after cutting down male bud as soon as the female flowers matured into fruits (T1). The effect of this method was then compared with two control groups; one with the same strategy except fertilizer applied on root following ring method (C1, Positive control) and another was male flower untouched without applying fertilizer on rachis or root (C2, Negative control). Results and Conclusion: T1 showed more than double increase in length than controls. In the same way, in case of shape (diameter), T1 (0.46 cm) showed twice as better growth in the C1 (0.22 cm) and C2 (0.18 cm). Trend analysis showed the test group T1 curve is much steeper than the control groups suggesting faster growth rate than the other two. Finally, the cost of fertilizers for T1 per plant was estimated 0.091 USD while for positive control C1 it was 2.9 USD. This study shows an approach to be effective and economic comparing to traditional method of fertilizer application, which can be adapted as a new method of banana production.

Annually, the oak forests of the Zagros Mountain chains, in western Iran and northeastern Iraq, face recurring challenges posed by forest fires, particularly in the Kurdo-Zagrosian forests situated in western Iran and northeastern Iraq. Assessing fire susceptibility relies significantly on vegetation condition. Integrating in situ data, Remote Sensing (RS) data, alongside the integration of Geographical Information Systems (GIS), presents a cost-effective and precise approach to capturing environmental conditions before, during, and after fire events, minimizing the need for extensive fieldwork. This study refines and applies the Zagros Grass Index (ZGI), a local vegetation index tailored to discern between grass-covered surfaces from tree canopies in Zagros forests, identifying the grass masses as the most flammable fuel type. Utilizing Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Difference Vegetation Index (NDVI) product as input, from 2013 to 2022, the ZGI aims to mitigate the influence of tree canopies, isolating NDVI values solely attributable to grass cover. By incorporating phenological characteristics of forest trees and grass species, the ZGI outperforms NDVI in mapping grass-covered areas that are crucial for fire susceptibility assessment in the study region. Results demonstrate a strong overlap between ZGI-based maps and recorded fire occurrences, validating the efficacy of the index in fire susceptibility estimation.

Findings primarily drawn from literature review and interviews with professional resource persons suggest that although the RMG industry of Bangladesh has made substantial progress in correcting structural risks within factory buildings, fire still remains an unresolved issue posing unceasing threat to safety. These findings are significant for all stakeholders within the global supply chain network of Bangladesh, concerned with improving sustainability of the RMG industry and seeking to outline the responsibilities for each group of actors towards preventing building disasters. Both Tazreen Fashion fire incident and the Rana Plaza building collapse served as ‘critical junctures’ in rapid transfer of physical technology to enhance structural safety and streamline production planning within the RMG manufacturing factories within Bangladesh. However, the transfer of social technology within the supply chain network of a developing nation in areas such as development of organisational safety culture or promoting workplace ethics, requires long-term planning and prolonged practices. The paper thus concludes that in developing countries, transfer of physical technology is more readily achievable than the adoption of social technology.

Chaparral shrublands are the dominant wildland vegetation type in southern California and the most extensive ecosystem in the state. Disturbance by wildfire and climate change have created a dynamic landscape in which biomass mapping is key in tracking the ability of chaparral shrub-lands to sequester carbon. Despite this importance, most national and regional scale estimates do not account for shrubland biomass. Employing plot data from several sources, we built a random forest model to predict above ground live biomass in southern California using remote sensing data (Landsat NDVI) and a suite of geophysical variables. By substituting the NDVI and precipi-tation predictors for any given year we were able to apply the model to each year from 2000-2019. Using a total of 980 field plots, our model had a k-fold cross validation R2 of 0.51 and a RMSE of 3.9. Validation by vegetation type ranged from R2 = 0.17 (RMSE=9.7) for Sierran mixed conifer to R2 = 0.91 (RMSE = 2.3) for sagebrush. Our estimates showed an improvement in accuracy over a two other biomass estimates that included shrublands, with an R2 = 0.82 (RMSE = 4.7) compared to R2 = 0.068 (RMSE = 6.7) for a global biomass estimate and R2 = 0.29 (RMSE = 5.9) for a regional biomass estimate. Given the importance of accurate biomass estimates for resource managers we calculated the mean year 2010 shrubland biomass for the four national forests which ranged from 3.5 kg/m2 (Los Padres) to 2.3 kg/m2 (Angeles and Cleveland). Finally, we compared our estimates to field-measured biomass from the literature summarized by shrubland vegetation type and age class. Our model provides a transparent and repeatable method to generate biomass measure-ments in any year, thereby providing data to track biomass recovery after management actions or disturbances such as fire.

Wildfire is the main disturbance in forested ecosystems of southern Europe and is due to complex interactions between climate-weather, fuels and people. Warmer and drier conditions projected in this region are expected to profoundly affect wildfires, which will impact ecosystems and humans. We review the scientific literature addressing the assessment of climate change impacts on wildfires in southern Europe, with a twofold objective: (i) report the trends in wildfire danger and activity projected under warming climate in southern Europe and (ii) discuss the limitations of wildfire projections under the specific biogeographical context of southern Europe.We identified 22 projection studies that examined future wildfire danger or wildfire activity at local, regional or continental scale. Under the scenario with the highest greenhouse gas emissions, we found that projections studies estimate an increase in future fire danger and burnt areas varying, on average, from 2 to 4 % and from 15 to 25 % per decade, respectively. Fire-prone area expansion to the north and to Mediterranean mountains is a concern, while climate-induced burnt area increase might be limited by fuel availability in the most arid areas. While all studies agreed on the direction of changes, further comparisons on the magnitude of increase remained challenging because of heterogeneous methodological choices between projections studies (climate models, projection period, spatial scale and fire metrics). We then described three main sources of uncertainty that may affect the reliability of wildfire projections: climate projections, climate-fire models, and the influences of fuel load/structure and human related factors on the climate-fire relationships. We finally suggest research directions to address some of these issues for the purpose of refining fire danger and fire activity projections in southern Europe.

Tularemia is a zoonotic disease caused by {\it Francisella tularensis} bacteria, a gram-negative coccobacillus-shaped bacterium. There are multiple transmission routes of the infection to humans such as consumption of contaminated food or water, handling of infected animals or bites from {\it haematophagous} arthropods (such as ticks, deer flies, or mosquitoes). In this study we focus on transmission via the bites of ticks and developed a deterministic model of ordinary and impulsive differential equations to gain insight in the differential effect of prescribed fire on {\it Demacenta variablis} and {\it Amblyomma americanum} ticks and the prevalence of tularemina. We found that prescribed fire differentially reduce the number of the two ticks with {\it A. americanum} reduced the least compare to {\it D. variablis} subsequently leading to differential increase of tularemia new infected cases in humans and rodents. Our result further indicates that the spatial arrangement of burn against unburn areas may not matter as either arrangement led to fewer ticks and reduction in tularemia transmission when prescribed fire was implemented. The results of this study provide important new understandings of the intricate effect of prescribed fire on tick species, and the dynamics of the tick-borne disease, tularemia disease in this study.

Abstract: Wildfires in forest ecosystems exert substantial ecological, economic, and social impacts. The effectiveness of fire management hinges on precise pre‐fire risk assessments to inform mitigation efforts. This study aims to investigate the relationship between predictions from pre‐fire risk assessments and outcomes observed through post‐fire burn severity analyses. In this study, forest fire risk was assessed with the Fuzzy Analytical Hierarchy Process, in which fire behavior factors were used as input. The degree of burn was determined using the Random Forest method using 11519 training points and 400 test points on Sentinel‐2 satellite images in three different classes. According to the results obtained from 266 selected test points located within the forest boundaries, all primary factors showed an increased effect in areas with high burn severity. Climate, in particular, emerged as the most influential factor, accounting for 52% of the overall impact. However, in cases of high fire severity, climate proved to be the most effective risk factor, ac‐counting for 67%. It followed by topography with 50% accuracy at high fire intensity. In the risk assessment is based on the FAHP method, climate was assigned the highest weight value among other factors with 32.2%. Topography emerged as the second most effective risk factor with 27 %. To evaluate the results more comprehensively both visually and statistically, two regions with different stand canopy characteristics were selected within the study area. While high burn severity had the highest accuracy in Case 1 area, moderate burn severity had the highest in Case 2 area. During the days when the fire continued, the direction of spread was obtained from MODIS images. In this way, the fire severity depending on the direction of fire progression was also interpreted. Through an analysis of various case studies and existing literature, the research underscores both the strengths and limitations inherent in predicting forest fire behavior‐based pre‐fire risk assessments. Furthermore, it emphasizes the necessity of continuous improvement to increase the success of forest fire management.

Photoelectric smoke detectors are the most cost-effective devices for very early fire alarms. However, due to different light intensity response values for different fire smoke and interference from interferential aerosols, they have a high false alarm rate, which limits their popularity in Chinese homes. To address these issues, an embedded spatial-temporal convolutional neural network (EST-CNN) model is proposed for real fire smokes identification and aerosols (fire smokes and interferential aerosol) classification. EST-CNN consists of three modules including information fusion, scattering feature extraction, and aerosol classification. Moreover, a two dimensional spatial-temporal scattering (2D-TS) matrix is designed to fuse the scattered light intensities in different channels and adjacent time slices, which is the output of the information fusion module and the input of the scattering feature extraction module. EST-CNN is trained and tested with experimental data measured on the established fire test platform using the developed dual-wavelength dual-angle photoelectric smoke detector. The optimal network parameters are selected through extensive experiments resulting in an average classification accuracy of 95.6% for different aerosols with only 66 kB network parameters. The experimental results demonstrate the feasibility of the designed EST-CNN model to be directly installed in existing commercial photoelectric smoke detectors to realize aerosol classification.

Ensuring fire safety is an important condition for the successful operation of industrial enterprises. It is necessary to detect the threat of fire before ignition. An indicator of danger is the appearance of gas, which occurs as a result of unauthorized heating of equipment. Gas sensors make it possible to detect the appearance of gases characteristic of the decomposition of materials at the stage of smouldering and pyrolysis, which cause a change in the composition of the atmosphere. This paper presents a mathematical method for the rational placement of gas analyzers for premises of potentially hazardous industries. It is the rational placement of gas sensors, which ensures safety, taking into account economic feasibility that determines the effectiveness of their use. For the first time, the analysis of gas accumulation during the movement of the flow from the source to the ceil-ing, then propagation to the location of the sensors, is used for the first time to select the placement of gas sensors. Depending on the permissible values of the gas volume, the placement and number of gas sensors are selected. The calculation of the conditions for the rational placement of gas sen-sors for the most common indicators, such as carbon monoxide and hydrogen at different sizes and heights of rooms, is carried out. The method of calculating the location of gas analyzers makes it possible to diagnose and predict fire hazard at technological facilities on the basis of gas control, and compare the obtained values with the maximum permissible values. This method provides cal-culation of the coordinates of the gas source from the coordinates of the triggered sensors. Knowing the coordinates of all sensors, the coordinates of the sensors that gave the alarm, and the formula for determining the volume of the gas cloud under these sensors, it is possible to assess the localization of the source of dangerous gas in the protected room. This increases the efficiency of the fire safety system. The method makes it possible to control the layout of sensors depending on the volume of protected premises, types of production, the creation of new sensors, changes in the composition of hazardous gas in different technological conditions.

CO2 is widely used in the prevention and control of coal spontaneous combustion. In this manuscript, three low-rank coals with different metamorphic degrees were selected as the research objects. The temperature-programmed experiments, in-situ infrared cooling experiments, simulation of competitive adsorption of CO2 and O2 in coal pores, and simulation study of CO2 inhibition of coal oxygen composite reaction were used to obtain the role and effect of CO2 in preventing oxygen adsorption in coal at low-temperature oxidation stage. It is concluded that CO2 can displace the O2 near the pore wall to physically prevent the adsorption of O2. Through the change law of heating rate and kinetic analysis, it is found that CO2 can increase its activation energy by 5.3%-108.3% during the slow heating stage of coal, and reduce its heating rate. At around 120°C, coal loses the protective effect of CO2. From the changes of functional groups, it can be seen that when coal is cooled in CO2 atmosphere, mainly pyrolysis and condensation reactions occur due to the lack of O2. In addition, CO2 can also inhibit the chain reaction of coal's chemical adsorption of oxygen. This work provides a theoretical basis for CO2 prevention and control of coal spontaneous combustion.

Physical distancing and wearing a face mask are key interventions to prevent COVID-19. While this remains difficult to practice for millions of firefighters in fire engines responding to emergencies, the delayed forthcoming of evidence on the physical effectiveness of such safety interventions in this setting presents a major problem. In this field experimental study, we provided initial evidence to close this gap. We examined total aerosol burden in the cabin of a fire engine whilst manipulating crew size, natural ventilation, use of FFP2 respirators and use of SCBA full-face masks during 15-minute driving periods. At the same time, we controlled for crew activity and speaking, vehicle speed, cabin air temperature, pressure and humidity. Limiting the crew size, using FFP2 respirators and not donning SCBA full-face masks was associated with a reduction of the arithmetic mean of total aerosol burden of up to 49%. Natural ventilation as tested in this study was associated with both an increase and a decrease of total aerosol burden. This study provided initial evidence on the physical effectiveness of safety interventions in fire engines to reduce potential airborne transmission of SARS-CoV-2 through aerosols. More research about the physical and clinical effectiveness of such safety interventions is needed.

This paper proposes an Integrated Fire Management (IFM) framework that can be used to support communities and resource managers in finding effective and efficient approaches to prevent damaging fires, as well as maintain desirable fire regimes in Kenya. Designing and implementing an IFM approach in Kenya calls for a systematic understanding of the various uses of fire and the underlying perceptions and traditional ecological knowledge of the local people. The here proposed IFM framework allows an evaluation of the risks posed by fires, while balancing them with their beneficial ecological and economic effects, and thus developing effective fire management approaches. A case study of the proposed IFM framework was conducted in Gathiuru Forest that is part of the larger Mt. Kenya Forest Ecosystem. Focus group discussions were held with key resource persons, primary and secondary data on socio-economic activities were studied, fire and weather records were analyzed and the current fire management plans were consulted. Questionnaires were used to assess how the IFM is implemented in the Gathiuru Forest Station. The results show that the proposed IFM framework is scalable and can be applied in places with fire-dependent ecosystems as well as in places with fire-sensitive ecosystems in Kenya. The effectiveness is dependent on the active participation, formulation and implementation of the IFM activities by the main stakeholder groups (Kenya Forest Service (KFS), Kenya Wildlife Service (KWS), and the Community Forest Associations (CFA)). The proposed IFM framework helps in implementing cost-effective approaches to prevent damaging fires and maintain desirable fire regimes in Kenya.

Beaches are among the habitats most frequented by migratory birds for breeding and/or wintering. However, threats such as human pressure and sea level rise can reduce the availability of these habitats for different species. The presence of alternative areas, such as salt pans and brackish habitats, is essential for many migratory shorebird populations. This study addresses the post-breeding dispersal of the Kentish plover (Charadrius alexandrinus) in the Iberian Peninsula by analysing C and N isotopes in feathers. The study was conducted at six locations along the Iberian coast, which were categorized in three areas: NW Atlantic coast, the Atlantic coast of Andalusia and the Mediterranean coast. Although linear mixed models did not reveal any significant effects of sex or coastal area on isotopic levels, the variability in the data suggests different habitat-use strategies in the post-reproductive period. Birds from the northwest of the Iberian Peninsula exhibit greater fidelity to a single habitat type, i.e. coastal beaches, while populations from the Mediterranean coast and the Atlantic coast of Andalusia show different individual dispersal strategies, occupying coastal habitats and freshwater wetlands. The lack of alternative habitats for the northwest Iberian population, the reduction in available habitat due to rising sea levels and human pressure together pose a serious threat to the survival of this species, already with an unfavourable conservation status.

Background: Traumatic events adversely affect the clinical course of obsessive-compulsive disorder (OCD). Our investigation explores the correlation between prolonged interpersonal trauma and the severity of symptoms related to obsessive-compulsive and anxiety disorders. Methods: The study follows a cross-sectional and observational design, employing the International Trauma Questionnaire (ITQ) to examine areas linked to interpersonal trauma, the Hamilton Anxiety Rating Scale (HAM-A), and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) to assess anxious and obsessive-compulsive symptoms, respectively. Descriptive analysis, analysis of variance (ANOVA), and logistic regression analyses were conducted. Results: We recruited 107 OCD-diagnosed patients, categorizing them into subgroups based on the presence or absence of complex post-traumatic stress disorder (cPTSD). The ANOVA revealed statistically significant differences between the two groups in the onset age of OCD (p=0.083), psychiatric familial history (p=0.023), HAM-A, and Y-BOCS (p=0.000). Logistic regression indicated a statistically significant association between the presence of cPTSD and Y-BOCS scores (p=0.000). Conclusion: The coexistence of cPTSD in OCD exacerbates obsessive-compulsive symptoms and increases the burden of anxiety. Further advancements in this field are crucial for mitigating the impact of early trauma on the trajectory of OCD and associated anxious symptoms.

Background and aims: For many surgical procedures, spinal anesthesia is a reliable and efficient anesthetic approach. Numerous drugs have been reported to be administered to intrathecal local anesthetics as adjuvants to increase the efficacy of spinal anesthesia. There is little evidence of the effect of intrathecal dexmedetomidine on pain scores and the consumption of analgesia postoperatively. Methods: After obtaining ethical approval, demographical and clinical data of patients who underwent surgical procedures under spinal anesthesia with intrathecal dexmedetomidine or fentanyl was collected and analyzed. Results: In this study with 96 patients, intrathecal dexmedetomidine (group D) resulted in significantly lower post-operative pain scores compared to intrathecal fentanyl (group F) (p=0.000). Across various surgical types, including Orthopedic, General, Urology, and Obs/Gyne procedures, group D consistently displayed reduced pain scores (p&lt;0.001). The number of patients who needed post-operative analgesia was significantly higher in group (F) than in group (D) (40 vs 23, p=0.002). Conclusion: Compared to fentanyl, intrathecal dexmedetomidine as an adjuvant to local anesthesia was found to lower post-operative pain scores and decrease the need for post-operative analgesia.

ICT and digital technology adoption, sustainable development, community empowerment and local wisdom and destinations uniqueness are keywords that will be further explored in the de-velopment of tourism villages in Kenderan as the most importance of tourism destinations de-velopment from the village level. Therefor this research is aimed at developing suitable model for post smart or wise tourism village through proposing Culture and Tradition Festival and the application of a circular economy. Circular economy development in tourism villages focuses on the application of sustainable production principles in the tourism value chain, namely in creating tourism experiences together with tourists (co-creation of experience) and integrated in a tourism system that supports environmental sustainability. This research is applied research conducted with a sequential mixed method research by conducting qualitative research through expert judgment and quantitative research by circulating questionnaire to tourists visiting Kenderan village, while the collected data is analyzed by Structural Equation Modelling to see the rela-tionship between variables. The results of this research show that creative event as the locality aspects of tourist village, digital competence, and sustainability practice are the building blocks of post smart tourism village, while digital competence and sustainable practice have significant mediating effect of locality on post smart tourism village. To make tourism village possesses sustainable competitive advantages, the village must explore and promote its locality aspects to differentiate its tourist village by identifying the valuable, rare, inimitable and non-substitutable tourism resources. The implication of this research is that to develop smart tourism destination wiser and distinctive, tourist village should explore their local values and resources, embed them into its tourism basic components and core resources, and co create, distribute, deliver and promote it to global market through technology adoption and global sustainability value.

Objective: To assess the recovery of voice in patients with unilateral vocal cord paralysis after thyroid surgery following treatment with nursing intervention combined with voice training. Methods: Thirty patients with unilateral vocal cord paralysis and hoarseness for 6-12 months post-thyroid surgery were selected. They first underwent two weeks of psychological and cognitive intervention, followed by a psychological resilience assessment, and then proceeded with 12 weeks of voice training. This training primarily included muscle relaxation exercises, breathing training, and phonation exercises. A comparative analysis was conducted on the patients' voice parameters before and after the training, including jitter, shimmer, maximum phonation time (MPT), noise to harmonic ratio (NHR), and the Voice Handicap Index (VHI) scores. Results: After psychological and cognitive intervention, scores for optimism, resilience, and self-strength among the 30 patients increased. Post-voice training, reductions were observed in jitter, shimmer, NHR, and VHI scores, the Maximum Phonation Time (MPT) increased compared to pre-training, with the difference being statistically significant (P<0.05). Conclusion: Nursing intervention combined with voice training can effectively improve voice quality in patients with unilateral vocal cord paralysis after thyroid surgery.

Keywords: Post-Stroke; Hyperbaric oxygen therapy; Sequelae; Feasibility; Out-patient.

This study intricately explores the evolving tapestry of Christmas celebrations in a post-pandemic era, where tradition delicately intertwines with technology. The literature review presents a global panorama of Christmas observances, delving into varied religious perspectives. Within this exploration, a Southeast Asian country discreetly initiates its festivities as early as September—a nuanced response to the profound significance of Christmas. Navigating the digital age, the paper dissects the impact of virtual gatherings, the surge in e-commerce, and digital church services on festive traditions. Employing diverse research methods, including thematic analysis, nuanced insights are synthesized from extensive literature reviews, interviews, and observations. Scrutinizing challenges posed by the digital divide, the erosion of personal connections in virtual gatherings, and sustainability concerns in online celebrations, the qualitative research methodology reveals the interplay between tradition and technology. The paper contemplates the future of Christmas in this transformative era, offering implications for future celebrations, technology developers, policymakers, and beyond. This endeavor invites contemplation on the dynamic interplay shaping the festive landscape and prompting reflection on future celebrations.

In conclusion, this qualitative exploration has unveiled the profound and essential impact of music on psychological well-being, especially in the post-pandemic world. Through in-depth literature reviews, informal interviews, and observations with thirty CAS participants from SMC, the researcher uncovered ten salient themes that collectively illustrate music's multifaceted role as a potent remedy. These findings showcase how music serves as an emotional outlet, a cognitive enhancer, and a source of inspiration. The emotional depth and spiritual resonance participants associate with music underscore its capacity to address diverse human needs, making it an indispensable tool in navigating the complexities of our post-pandemic reality. Moreover, the cognitive benefits observed, such as improved concentration and focus, are particularly pertinent in the context of remote work and education, highlighting music's necessity in our daily lives. Additionally, this study emphasizes the vital role of virtual music communities in fostering social connections, even amidst physical isolation, further underscoring the enduring relevance of music in these challenging times. This research contributes to the expanding knowledge of music's impact on well-being, offering a holistic perspective encompassing spiritual, emotional, social, and cognitive dimensions. It enriches existing music psychology theories and invites further exploration into the mechanisms underpinning music's diverse effects. These insights have practical implications for fields such as mental health, education, and remote work, where music can be utilized as an essential tool for stress reduction and emotional regulation. This is highlighted further in the Suggested songs that can help sought the mind, body, spirit and soul. Looking ahead, future research could delve deeper into the long-term impact of music engagement on well-being and explore the universality of music's benefits through cross-cultural studies. Overall, music, as illuminated by this study, stands as a timeless and indispensable companion, offering solace, inspiration, vitality, and connection in the face of any contemporary challenges.

ACE2 impact on the severity of COVID-19 is widely discussed but still controversial. To estimate its role in aspects of the main risk factors and comorbidities, we involved post-COVID-19 patients in Ternopil region (Ukraine). Recruitment period was July 2020 to December 2021. Medical records, treatment modalities and outcomes were recorded and analyzed. Serum human ACE2 protein was measured with Cusabio ELISA kits (Houston, TX, USA). Statistical analysis was performed with SPSS21.0 software (SPSS Inc., Chicago, IL, USA). The level of ACE2 serum protein was significantly higher (p < 0.001) in patients with mild symptoms compared to more severe course of disease, and inversely had changed from 1 to 90 days after recovery. In patients with mild COVID-19, ACE2 level significantly decreased over time, while among critical patients, it increased by 34.1percent. Such results could be explained by ACE2 shedding from tissues into circulation. Loss of the membrane-bound form of the enzyme decreases the virus entry into cells. Our studies did not identify any sex-related ACE2 serum levels correlation. The most common comorbidities were hypertension, cardiovascular diseases, respiratory diseases and diabetes mellitus. All comorbidities except respiratory diseases contribute to the severity of disease and correlate with ACE2 blood serum level.

The long-term laboratory aspects of the effects of COVID-19 on liver function are still not well understood. Therefore, this study aimed to evaluate the hepatic clinical-laboratory profile of patients with up to 20 months of long-term COVID-19. A total of 243 patients of both sexes aged 18 years or older hospitalised in the acute phase of COVID-19 were included in this study. Liver function analysis was performed. Changes were identified in the mean levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), gamma-glutamyl transferase (GGT), and ferritin. Inflammatory markers such as ferritin > 300 U/L were observed in the group that presented more changes in liver function markers (ALT, AST, and GGT). Age ≥ 60 years, male sex, AST > 25 U/L, and GGT ≥ 50 or 32 U/L were associated with ALT > 29 U/L. There was a correlation between ALT and AST, LDH, GGT, and ferritin. Our findings suggest that ALT and AST levels may be elevated in patients with long-term COVID, especially in those hospitalised in the acute phase. In addition, ALT > 29 U/L was associated with other markers of liver injury, such as LDH, GGT, and ferritin.

Post-Shoah Christology is embedded in the unique relationship of Jews and Christians, especially Jesus’ Jewishness and the Jewish roots of Christianity, as well as Christian moral failures towards Jews before and during the Shoah. Essential for contemporary Christianity, a vibrant post-Shoah Christology confronts three main challenges, each demanding a different response. The first challenge is the reality that soon there will be no more first-generation witnesses to the Final Solution. Such is an inevitable challenge that has to be faced and prepared for. Religious pluralism is the second challenge, and includes a number of related threads, yet should ultimately be embraced. The third challenge is the (inevitable?) loss of memory, passion, and urgency, a willful forgetfulness by Christians towards the importance of the Jewish-Christian relationship, and especially, Christian failure in the Shoah. This challenge demands robust refutation and ongoing struggle. Before addressing these challenges, I will first further define and highlight the need for a post-Shoah Christology and will conclude this article with three general and three concrete hopes for a viable post-Shoah Christology.

Two ligands, 1, 3-bis(4-carboxyphenyl)imidazolium chloride and 4, 4՛-bipyridine, were employed to prepare nickel and zinc azolium based MOFs, 1 and 2 by the mixed ligand solvothermal approach. The positively charged azolium moieties in the imidazolium linker resulted in a charged environment in the as-synthesized frameworks. As a result, 1 and 2 demonstrated preferential adsorption of CO2 over methane molecules in the gas phase adsorption due to the higher quadruple moment of CO2, which interacts more with the positively charged frameworks. Besides, in aqueous media, 1 and 2 exhibited incredible adsorption efficiency for anionic dyes. In the following, MOF 1 was metallated at the carbene site of the azolium linker to generate the novel heterogeneous catalyst 1-Pd, which was successfully applied for Sonogashira and Suzuki-Miyaura coupling reactions without losing its activity after three cycles.

Post-mortem cardiac magnetic resonance (PMCMR) is an emerging tool supporting forensic medicine for the identification of the causes of cardiac death, as hypertrophic cardiomyopathy (HCM). We proposed a new method of PMCMR to diagnose HCM despite myocardial rigor mortis. Methods: we performed CMR in 49 HCM patients, 30 non-HCM hypertrophy and 32 healthy controls. In cine images, rigor mortis was simulated by the analysis of the cardiac phase corresponding to the 25% of diastole. Left ventricular mass, mean and standard deviation (SD) of WT, maximal WT, minimal WT and their difference, were compared for the identification of HCM. These parameters were validated at PMCMR, evaluating 8 hearts with HCM, 10 with coronary artery disease and 10 with non-cardiac death. Results: The SD of WT with a cut-off of > 2.4 had the highest accuracy to identify HCM (AUC 0.95, 95%CI 0.89-0.98). This was particularly evident in female population of HCM (AUC=0.998), with 100% specificity (95%CI 85-100%) and 96% sensitivity (95%CI 79-99%). Using this parameter, at PMCMR all the 8 patients with HCM were correctly identified with no false positive. Conclusions: PMCMR allows to identify HCM as cause of sudden death using the SD of WT >2.4 as diagnostic parameter.

n our previous paper, we showed that the so-called quantum entanglement also exists in classical mechanics. The inability to measure this classical entanglement was rationalized with the definition of a classical observer which collapses all entanglement into distinguishable states. It was shown that evidence for this primary coherence is Newton’s third law. However, in reformulating a "classical entanglement theory" we assumed the existence of Newton’s second law as an operator form where a force operator was introduced through a Hilbert space of force states. In this paper, we derive all related physical quantities and laws from basic quantum principles. We not only define a force operator but also derive the classical mechanic's laws and prove the necessity of entanglement to obtain Newton’s third law.

Data on pathologic changes of the 2019 novel coronavirus disease (COVID-19) are scarce. To gain knowledge about the pathology that may contribute to disease progression and fatality, we performed post-mortem needle core biopsies of lung, liver, and heart in four patients who died of COVID-19 pneumonia. The patients’ ages ranged from 59 to 81, including 3 males and 1 female. Each patient had at least one underlying disease, including immunocompromised status (chronic lymphocytic leukemia and renal transplantation) or other conditions (cirrhosis, hypertension, and diabetes). Time from disease onset to death ranged from 15 to 52 days. All patients had elevated white blood cell counts, with significant rise toward the end, and all had lymphocytopenia except for the patient with leukemia. Histologically, the main findings are in the lungs, including injury to the alveolar epithelial cells, hyaline membrane formation, and hyperplasia of type II pneumocytes, all components of diffuse alveolar damage. Consolidation by fibroblastic proliferation with extracellular matrix and fibrin forming clusters in airspaces is evident. In one patient, the consolidation consists of abundant intra-alveolar neutrophilic infiltration, consistent with superimposed bacterial bronchopneumonia. The liver exhibits mild lobular infiltration by small lymphocytes, and centrilobular sinusoidal dilation. Patchy necrosis is also seen. The heart shows only focal mild fibrosis and mild myocardial hypertrophy, changes likely related to the underlying conditions. In conclusion, the post-mortem examinations show advanced diffuse alveolar damage, as well as superimposed bacterial pneumonia in some patients. Changes in the liver and heart are likely secondary or related to the underlying diseases.

In 2010, Parties to the Convention on Biological Diversity (CBD) adopted the Strategic Plan for Biodiversity 2011–2020 to address the loss and degradation of nature. Subsequently, most biodiversity indicators continued to decline. Nevertheless, conservation actions can make a positive difference for biodiversity. The emerging Post-2020 Global Biodiversity Framework has potential to catalyze efforts to ‘bend the curve’ of biodiversity loss. Thus, the inclusion of a goal on species, articulated as Goal B in the Zero Draft of the Post-2020 Framework, is essential. However, as currently formulated, this goal is inadequate for preventing extinctions, and reversing population declines; both of which are required to achieve the CBD’s 2030 mission. We contend it is unacceptable that Goal B could be met while most threatened species deteriorated in status and many avoidable species extinctions occurred. We examine the limitations of the current wording and propose an articulation with robust scientific basis. A goal for species that strives to end extinctions and recover populations of all species that have experienced population declines, and especially those at risk of extinction, would help to align actors towards the transformative actions and interventions needed for humans to live in harmony with nature.

We aimed to evaluate the safety of maternal Tdap we assessed health events by examining the difference in birth and hospital-related outcomes of infants with and without fetal exposure to Tdap. This was a retrospective cohort study using linked administrative datasets. The study population were all live-born infants in New Zealand (NZ) weighing at least 400 grams at delivery and born to women who were eligible for the government funded, national-level vaccination program in 2013. Infants were followed from birth up to one year of age. There were a total of 69,389 eligible infants in the cohort. Of these, 8,299 infants were born to 8,178 mothers exposed to Tdap (12%), primarily between 28-38 weeks gestation as per the national schedule. Among the outcomes, we found a reduced risk for moderate to late preterm birth, low birth weight, small for gestational age, large for gestational age, respiratory distress syndrome, transient tachypnea of newborn, tachycardia or bradycardia, haemolytic diseases, other neonatal jaundice, anaemia, syndrome of infant of mother with gestational diabetes, and hypoglycemia in infants born to vaccinated mothers. There was no association between maternal Tdap and stillbirth, infant Apgar score at 5 minutes after birth, microcephaly, asphyxia, sepsis or infection, or hypoxic ischemic encephalopathy. Infant exposure to Tdap during pregnancy was associated with a higher mean birthweight (not clinically significant) and higher odds for ankyloglossia and neonatal erythema toxicum diagnoses. There were insufficient observations to allow examination of the effect of Tdap on extreme preterm and very preterm birth, and infant death. Overall, we found no outcomes of concern associated with the administration of Tdap during pregnancy.

Background: Whilst lack of concentration is a known symptom of anaemia, its association with post-stroke dementia is unclear. Methods: We used data from a UK regional stroke register. To be eligible, patient must have survived to discharge and had anaemia by WHO criteria. Dementia status and other prevalent co-morbidities were assessed using ICD-10 codes. Patients were followed till May 2015 (mean follow-up 3.7 years, total person years = 27,769). Hazard Ratio for incident dementia was calculated using Cox-proportional hazards model controlling for potential confounders. Fine and Gray model was additionally constructed using mortality as the competing risk. Results: A total of 7,454 stroke patients were included with mean age (SD) of 75.9(12.3) years (50.2% men). Those with anaemia were older, has higher disability and co-morbidity burden prior to stroke. We observed a large amount of variation in the dementia incidence rates over time and that the hazard ratio increased every year. The significant association between anaemia and dementia incidence was lost after controlling for pre-stroke Modified Rankin score (HR1.17(0.97,1.40)). With every 20g/dL increase in Hb was associated with a significant reduction in the risk of dementia after adjustment for age, sex, stroke factors and disability but lost significance after adjustment for vascular risk factors. Competing risk analyses showed similar results. Conclusion: Whilst we found no evidence of anaemia as a risk factor for post-stroke dementia, the findings may be limited by potential under recognition of post stroke dementia.

Soccer is the most played sport worldwide, with over 265 million participants. It is an incredibly demanding sport, with many different technical skills and physical loads placed on the body. This makes post-match recovery strategies amongst high level soccer players of great importance. The aim of this review is to summarize the existing literature on stretching for post-match recovery, examining its relation to injury prevention, Delayed Onset Muscle Soreness (DOMS), and performance. Scientific evidence of the highest quality and relevance was extracted and reviewed. Despite its common practice, evidence does not support static stretching as a modality to improve recovery post-match amongst soccer players. Larger trials with important outcome measures are needed to determine if a post-match stretching regimen to facilitate recovery exists.

The current urban environment is faced with the potential threat of frequent natural disasters, and the sustainable development of post-disaster community has become a global issue. As an intrinsic motivation influencing the social interaction and capital operation of community, social network is an important mechanism promoting such sustainable development. However, the difference in social network caused by different member structure, spatial arrangement and management mechanism of post-disaster communities in different reconstruction modes has influenced such sustainable development process. Therefore, reasonable selection of reconstruction mode is crucial. This paper applied analytic hierarchy process to comprehensively measure and compare the social network strength in post-disaster communities in the four reconstruction modes adopted by the government of China, i.e. unified planning and unified construction, unified planning and independent construction, in situ reconstruction and relocation resettlement, with communities after the 2008 Sichuan earthquake in Chengdu, China as study objects from the perspective of three social relations (the relations between residents and residents, residents and managers, and residents and servers). The results showed that strong connections are generally presented in the social network of post-disaster communities in unified planning modes, that the strength is significantly higher than that of those in non-unified planning modes, and that the strength of UPIC communities is the highest. Meanwhile, government intervention, residents’ free participation and market operation are positively correlated to government trust, community interaction and community service respectively. The positive impact of government intervention is the most significant, but it has a peak value. No government management and excessive government intervention will exert negative impacts. The coordination of government, society and market is the key contents of post-disaster community reconstruction. The reconstruction modes based on “government leadership, resident participation and market operation” may become a feasible path for such sustainable development.

Connexins are tetraspan transmembrane proteins that form gap junctions and facilitate direct intercellular communication, a critical feature for the development, function and homeostasis of tissues and organs. In addition, a growing number of gap junction-independent functions are being ascribed to these proteins. The connexin gene family is under extensive regulation at the transcriptional and post-transcriptional level, and undergoes numerous modifications at the protein level, including phosphorylation, which ultimately affects their trafficking, stability and function. Here, we summarize these key regulatory events, with emphasis on how these affect their multi-functionality in health and disease.

Background: We studied Riveaux Road Fire, which was ignited by multiple lightning strikes in January 2019 and burnt more than 637.19 km² in southern Tasmania, Australia. Aims: We focused on fire weather, such as identification of dynamic wind and vegetation type, in a valley of the study area. Methods: We employed two methods: numerical weather model vertical sounding (NWMVS) and the use of a fire simulator, to quantify and examine the contribution of dynamic winds to fire behaviour. The NWMVSs allow rapid diagnosis of changes in wind, temperature, dew point temperature and cloud coverage. Prototype 2 is a fire simulator based on the specification of Australian Fire Danger Rating System (AFDRS). Key results: We found fires to be guided by terrain-forced channelling primarily and by downslope wind conditionally in the valleys. In addition, the fire intensity periodically changed with the magnitude of surface wind, in buttongrass moorland, in which the fire often smoulders, during the fire period according to the satellite image. Conclusions and Implications: Therefore, there should be caution for not only terrain and dynamic wind but also vegetation type during fire spread in rugged terrain.

Project managers should balance a variety of resource elements in building projects while taking into account many major concerns, including time, cost, quality, risk, and the environment. This study presents a framework for resource trade-offs in project scheduling based on the Building Information Modeling (BIM) methodology and metaheuristic algorithms. First, a new metaheuristic algorithm called Fire Hawk Optimizer (FHO) is used. Using project management software and the BIM process, a 3D model of the construction is created. In order to maximize quality while minimizing time, cost, risk, and CO2 in the project under consideration, an optimization problem is created, and the FHO's capability for solving it is assessed. A predefined stopping condition is taken into account while doing 30 independent optimization runs to obtain the statistical metrics, such as the mean, standard deviation, and the required number of objective function evaluations. The results show that the FHO algorithm is capable of producing competitive and exceptional outcomes when it comes to trade-off various resource options in projects.

For traffic management under sudden disaster in high-density areas, the first and foremost step is to prevent traffic congestion in the disaster-affected area by traffic flow control, as to provide enough and flexible traffic capacity for emergency evacuation and emergency rescue. Catastrophe border identification is the foundation and the key to traffic congestion prediction under sudden disaster. This paper uses a mathematical model to study the regional traffic flow in the high-density area under sudden fire disaster based on the Cusp Catastrophe Theory (CCT). The catastrophe border is identified by fitting the CCT-based regional traffic flow model to explore the stable traffic flow changing to the instable state, as to provide a theoretical basis for traffic flow manage and control in disaster-affected areas, and to prevent the traffic flow being caught into disorder and congestion. Based on VISSIM simulator data by building simulation scenarios with and without sudden fire disaster in a Sudoku traffic network, the catastrophe border is identified as 439pcu/lane/h, 529pcu/lane/h, 377pcu/lane/h at 5s, 10s, 15s data collection interval respectively. The corresponding relative precision, which compares to the method of Capacity Assessment Approach (CAA), is 89.1%, 92.7% and 76.5% respectively. It means that 10s data collection interval would be the suitable data collection interval in catastrophe border identification and regional traffic flow control in high-density area under sudden fire disaster.

In this paper, we propose an adaptive duty-cycled hybrid X-MAC (ADX-MAC) protocol for energy-efficient forest fire prediction. The X-MAC protocol acquires the additional environmental status collected by each forest fire monitoring sensor for a certain period. And, based on these values, the length of sleep interval of duty-cycle is changed to efficiently calculate the risk of occurrence of forest fire according to the mountain environment. The performance of the proposed ADX-MAC protocol was verified through experiments the proposed ADX-MAC protocol improves throughput by 19% and was more energy-efficient by 24% compared to X-MAC protocol. As the probability of forest fires increases, the length of the duty cycle is shortened, confirming that the forest fires are detected at a faster cycle.

Purpose: Post-pandemic management of COVID-19 infections and any emergent outbreaks is as an endemic disease remains a public health concern. Vaccine hesitancy may continue to hamper efforts to respond any new disease outbreaks and future epidemics. This qualitative study aimed to explore factors influencing covid-19 vaccine acceptance and hesitancy in Kenya too gain deeper insights on this issue. Methods: The study was implemented in Western Kenya using key informant interviews. Fourteen (14) key informants were purposively selected for the study. All interviews were transcribed and analyzed using thematic analysis. Interpretation of findings was done within the framework of the Health Belief Model. Key findings: Knowledge was a critical factor in combatting misinformation and fostering vaccine acceptance among participants in this study. Misinformation included rumors that the vaccine lowers immunity and was intended for population control. Cues to action included influence from political and opinion leaders and observing the loss of life among unvaccinated individuals. Perceived barriers to vaccine uptake included fear of vaccine safety, side effects, long waiting times at that time of our study, fear of contracting the COVID-19 at vaccination sites, family/spousal influence on vaccine uptake and fear of the unknown with the vaccine. Conclusion: Findings from this study provides insight into areas for targeted strategies for managing Covid-19 vaccinations and future pandemics. Within the framework of the Health Belief Model, this study identified salient barriers and facilitators of COVID-19 vaccine hesitancy that may be helpful to inform future pandemic response.

Background: Scientific literature on COVID-19 is still limited about long-term impacts on the all-body systems and they treatments. The aim of the study was to create a safe protocol-based in-tervention to improve functional and equilibrium abilities in older adults impacted by COVID-19. Methods: The study completed 46 people (intervention group: n=26; control group: n=20). Re-sistance training (RT) was held twice a week, 60 min per session for 8 weeks. The postural stability and quality of life questionnaire (WHQOOL) were conducted during pre- and post-testing. Results: Results indicated significant differences in overall stability index (OSI) with eyes open (EO), ante-rior-posterior stability index (APSI) EO, fall risk index 6-2 (FRI6-2) values in males (p

Introduction: Hospitalization in a COVID-19 unit represents a significant source of stress and psychological distress for patients. Our study aims to determine the factors of psychological distress in the therapeutic and psychosocial management of patients hospitalized with a COVID-19 infection. Methods: This cross-sectional study was carried out over 8 months at the COVID-19 zone of the CHU HASSAN II of FES. 99 patients were evaluated within days of diagnosis by psychometric scales of anxiety, depression, and post-traumatic stress. In the course of this follow-up, we found the presence of psychological impacts in these patients, and we tried to find correlating factors between the occurrence of psychiatric disorders and the set of factors related to sociodemographic data, hospitalization course and treatments taken, as well as family support. Results: 35% of patients had scores in favor of post-traumatic stress disorder, 37% of the patients had definite depression and 50% had anxiety. Post-traumatic stress, depression, and anxiety were correlated with sociodemographic factors, hospitalization, treatments received, and length of stay. Conclusion: The prevalence of anxiety-depressive disorders and post-traumatic stress disorder was high in patients with COVID-19, hence the interest in providing psychological and psychosocial care in the emergency department.

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

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

Past research suggests a continuity between perception and memory, as reflected in influences of orienting of spatial attention by cues presented after a visual target offset (post-target cues) on target perception. Conducting two experiments, we tested and confirmed this claim. Our study revealed an elevated reliance on post-target cues for target detection with diminishing target visibility, leading to better performance in validly versus invalidly cued trials, indicative for contrast gain. We demonstrated this post-target cueing impact on target perception without a postcue response prompt, meaning that our results truly reflected a continuity between perception and memory rather than a task-specific impact of having to memorize the target due to a response prompt. We further showed an influence of attention by the post-target cues with cues presented away from a clearly visible target, meaning that visual interactions at the target location provided no better explanation of our results. Our results generalize prior research with liminal targets and confirm the view of a perception-memory continuum, so that visual target processing is not shielded against visuospatial orienting of attention elicited by events following offset of the visual target.

One of the main challenges of the globalization became the increased destabilization and frequent economic crises. In general, managing an economic crisis is a particularly difficult task for any economy (developed or developing, and regardless the size). In the context of globalization, the process faces additional challenges. On the one hand, the world economy witnessed a shift from traditional purely economic instruments to more financial mechanisms of economic development. Indeed, the liberalization of the economy since the 1990s complicated the traditional trends of the world market development, resulting in significant fluctuation of the growth rates between different countries and regions. To respond to this evolution, governments and international organizations changed well-established strategies. For example, financial sector found itself given expanded role in economic development, with, different financial mechanisms used as key variables to evaluate an economic growth. On the other hand, the increased role of financial sector in a globilised world, increased financial relations among individual states and thus, interdependences. This “financial globalization” causes important fluctuations in the system and, as a result, causes instability in socio-economic development. Thus, an economic crisis of any important economy soon becomes a global issue (financial crisis of 2008, economic crisis of 2020).The recent global economic crisis due to the Covid-19 world pandemic, appeared to be unique for several reasons. First, it highlighted the transnational and origin-specific nature of the crisis. Second, it appeared to be the first case when non-economic factors caused a major economic crisis. As a result, this crisis turned out to be particularly difficult to predict and to manage. In this case, the main strategy of the global post-crisis rehabilitation became the restoration of the economy's predictability and ensuring its ability to obey the classical principles. According to the Organic Law on "Economic Freedom" of the European Union (2011), any factor which increases the equilibrium amount of output is reflected in the economic rehabilitation plan. Such exogenous factors are primarily fiscal mechanisms, i.e. - Reduction of taxes and increase of state expenditures. This crisis caused important structural problems with their effects on public expenditures (especially health expenditures, to the public expenditures, economic growth, price stability and budget balance) in both, developed and developing countries. Nearly every state declared an increase in public debt, inflation, and unemployment rates, while an important decrease was shown in growth rates and capital outflows. As the crisis due to the world pandemic was radically different from previous economic crises, it was difficult to manage it efficiently at the initial stage. It was complicated to forecast the scenarios of the unknown crisis with non-standard nature which was more linked to epidemiologic factors than objective economic law. The dynamics of crisis resolution depended on correct forecasting and effective implementation of global, but especially country-based reforms. More importantly, this crisis showed the important role of individual states to manage the global crisis. The traditional function of a government to ensure country’s socio-economic growth and security, increases in an extraordinary environment, such as sharp economic fluctuations and crises. In such contexts, the centralized management functions are sharply activated. The global pandemic processes have updated the economic essence of the state. The large scale of the latest economic crisis due to the world pandemic has determined the need for mutually coordinated development of anti-crisis plans of different countries. In today's dynamic landscape, modern global systems are redefining the standards and priorities of national economic policies. The economic status of countries is changing significantly as a result of their participation in these systems. As a result of these changes, today's global economy is marked by the proliferation of regionalism and the emergence of spatial economic frameworks. Thus, classical economic concepts are evolving, giving rise to a new model known as economic nationalism. This paradigm shift is generating new risks, which are increasing in severity and scope. The overriding objective of economic policy is now to ensure and predict stable development. Reflections are underway to meet the challenges of economic equilibrium and its social and institutional sustainability.In addition to the decentralization of the unified governance system, the global economy is characterized by the activation of centralized governance elements within individual countries. This requires the development of new norms for global cooperation and the careful balancing of national integration and development factors. The question of government's influence on the economy and the delegation of its powers becomes relevant once again. Effective coordination of public administration is based on the principle of decentralized government, which is a key element of a democratic model of society and facilitates the transfer of management tools to the public. The key objectives of this research are focused on the optimal distribution of state functions and the study of hierarchical principles of territorial organization within the country, fiscal mechanisms for the distribution of powers, as well as the particularities of the structuring of the spatial economy and its budgetary provisioning mechanisms.The example of the last two economic crisis showed that contemporary anti-crisis strategies should reflect several considerations. First, it becomes impossible to develop a single unified model of crisis management. Even in the context of important economic and financial globalization, the current decentralization and new spatial economic processes make it necessary to find a balance between the local priorities and global interests. Second, the role of non-economic crisis-causing factors increases compared to economic determinants. That is why international and country-based reforms should aim at not only economic rehabilitation, but also on the social, cultural and environmental restorations. Third, it becomes difficult to correctly predict the consequences of the crisis and thus, the effects of the anti-crisis strategy. Consequently, the success of the post-crisis rehabilitation of the countries' economies depends significantly not only on the effective realization of their own plan, but also, in general, on the specificities of the global economy and on the ability of the world markets to overcome the negative consequences of a crisis. In this context, the development of complex post-crisis platforms and state post-crisis strategies is the priority. The most effective component in the anti-crisis strategy is the monetary instruments of economic management. As for the determinant of successful functioning of economy, the priority should be given to the regulation of exchange rate, interest rate and inflationary processes. A state anti-crisis programs should reflect the crisis prevention strategy, which, on its turn, should differentiate the economic functions of the state and crisis management mechanisms according to the specific trends of given processes. It should aim at gaining stable development of the economy. Additionally, an anti-crisis plan should reflect the role of the society in the development process and its mental changes under crisis conditions. The state should be responsible for establishing and monitoring anti-crisis management mechanisms, financial recovery of the country and formation of correct relations. It is especially important to ensure economic security, to stabilize the development process and standard of living, to support the private sector and small entrepreneurship, to increase economic freedom, to ensure effective distribution of labor and capital, and others. All strategies of the anti-crisis platform should be focused on social results, as it should contribute to a fair distribution of income and to poverty reduction.

Knowledge of post-larval swordfish (Xiphias gladius) ecology in the world’s oceans is incomplete as they are rarely found in ichthyoplankton samplings or commercial catches and individuals are difficult to observe in the marine ecosystem. Analyses of stomach contents of apex predators can provide otherwise unobtainable ecological insights. Two well-preserved bills of post-larval swordfish were identified among the partially digested stomach contents of an adult male dolphinfish (Coryphaena hippurus) caught in the northern Tyrrhenian Sea. The lower jaw to fork lengths of the two predated swordfish were estimated at respectively, 18 and 22 cm, corresponding to 81- and 99-day-old swordfish hatched in the 2022 spawning season. This analysis and recent information on the reproductive dynamics of swordfish in the same area reported in the literature shed light not only on the early stages of swordfish growth but also on dolphinfish ecology in the Tyrrhenian Sea. The two species share the same habitat and are both caught with commercial pelagic surface longlines. Environmental shifts associated with climate change could unpredictably modify the reproduction dynamics, growth, recruitment and distribution of both species. This knowledge is important for the sustainable management of regional fisheries.

The Hollow fiber membrane contactor (HFMC) is an intensification process that combines membrane and absorption technologies, being a technology in expansion, so the dynamics of this process is crucial for an increase in industrial scale-up. In this manuscript a rigorous dynamic model of an HFMC is developed and simulated in Python software for the absorption of post-combustion CO2 using a monoethanolamine (MEA) solution, which was validated using available data in literature in steady state. Dynamic simulations were performed to analyze the model's capability to predict the effect of disturbances on the responses of CO2 capture ratio and loading. Four distinct experiments were conducted by step changes and pulse disturbances at the following variables: gas and liquid volumetric flow rates, CO2 composition in flue gases, and CO2 lean load. The gas phase showed a faster response compared to the liquid. The CO2 capture ratio and rich loading presented opposite responses when disturbing both liquid flows, and for the composition and lean loading variations, the capture ratio presented an inverse response characteristic, while the loading showed a delayed response. As the model proved to be capable of returning to the reference state, it can potentially be used for control studies purposes.

The COVID-19 pandemic necessitated a profound shift to online education, impacting students across various educational levels. This research, drawing from a comprehensive survey of 1,000,000 students, delves into the surge in demand for online education during the pandemic and its potential enduring implications. The study scrutinizes factors steering this transition, the perceived effectiveness of online education, challenges encountered by students, and their anticipated preferences for the future. Results unveil nuanced perspectives among K-12, undergraduate, and postgraduate students, with safety, flexibility, and accessibility emerging as pivotal influencers. The findings offer valuable insights into challenges faced and future preferences, enlightening educational stakeholders about the dynamic needs of students and contributing to the ongoing evolution of the post-pandemic educational landscape.

Background: Alongside their long-term effects - post-concussion syndrome (PCS) - mild traumatic brain injuries (mTBI) are significant public health concerns. Currently, there is a lack of reliable biomarkers for diagnosing and monitoring mTBI and PCS. Exosomes are small extracellular vesicles secreted by cells that have recently emerged as a potential source of biomarkers for mTBI and PCS due to their ability to cross the blood-brain barrier and reflect the pathophysiology of brain injury. This study aimed to investigate the role of salivary exosomal biomarkers in mTBI and PCS. Methods: A systematic review using the PRISMA guidelines was conducted, and studies were selected based on their relevance to the topic. Results: Studies have shown that exosomal tau, phosphorylated tau (p-tau), amyloid beta (Aβ), and microRNAs (miRNAs) are potential biomarkers for mTBI and PCS. Specifically, elevated levels of exosomal tau and p-tau have been associated with mTBI and PCS, as well as with repetitive mTBI. Dysregulated exosomal miRNAs have also been observed in individuals with mTBI and PCS. Additionally, exosomal Prion cellular protein (PRPc), coagulation factor XIII (XIIIa), synaptogyrin-3, IL-6, and aquaporins have been identified as promising biomarkers for mTBI and PCS. Conclusion: Salivary exosomal biomarkers have the potential to serve as non-invasive and easily accessible diagnostic and prognostic tools for mTBI and PCS. Further studies are needed to validate these biomarkers and to develop standardized protocols for their use in clinical settings. Salivary exosomal biomarkers can improve the diagnosis, monitoring, and treatment of mTBI and PCS, leading to improved patient outcomes.

Background. There are few studies about post myocardial infarction follow-up using telemedicine. We organized a post-discharge telemedicine service with a dedicated team. To do this, it was necessary that all stakeholders involved in the organization and use of the telemedicine service were properly educated and informed. Methods. We designed a theoretical-practical mini-course, to train healthcare personnel and increase skills, with excellent learning outcomes and satisfaction. Thereafter, we enrolled patients affected by acute myocardial infarction with ST elevation (STEMI), MINOCA (myocardial infarction with no obstructive coronary atherosclerosis), Takotsubo syndrome or spontaneous coronary dissection, and high-risk acute myocardial infarction without ST elevation (NSTEMI). At discharge, the cardiology technician performed counselling for the patient; using regional platforms, televisit at 1 and 4 months monitored major adverse cardiac events (MACE), heart failure, arrhythmias, unstable angina and non-cardiovascular events, therapy adherence, target therapy and customer satisfaction. Results. Between November 2021 and February 2023, we enrolled 110 patients: 72% affected by STEMI, 22% by NSTEMI. At the 1-month follow up, 12 patients did not reach pressure target and 23 patients did not reach LDL target. We observed three in hospital readmission, three in hospital visits for further investigation and one death. To date, a four months follow up was performed for 54 patients. No readmissions or deaths occurred. We detect a rate of 96% of customer satisfaction. Conclusion. A health coordination center with a dedicated team makes televisit safe as a follow-up for post myocardial infarction patients. Before, it is fundamental for healthcare professionals the acquisition of theoretical knowledge and updates and the acquisition of manual, technical and practical skills.

With the rapid growth of large language models (LLMs), there is increasing demand for memory and computation for LLMs. Recent efforts on post-training pruning of LLMs aim to reduce the model size and computation, yet the performance is still sub-optimal. In this paper, we present a plug-and-play solution for post-training pruning of LLMs. The proposed solution has two innovative components: 1) **Relative Importance and Activations** (RIA), a new pruning metric that jointly considers the weight and activations efficiently on LLMs; and 2) **Channel Permutation**, a new approach to maximally preserve important weights under N:M sparsity. The proposed two components can be readily combined to further enhance the N:M structuredly pruned LLMs. Our empirical experiments show that RIA alone can already surpass all existing post-training pruning methods on prevalent LLMs, e.g., LLaMA ranging from 7B to 65B. Furthermore, N:M structured pruning with channel permutation can even outperform the original LLaMA2 70B on zero-shot tasks, together with practical speed-up on specific hardware.

COVID-19 generated a scenario for global health with multiple systemic impairments. This retrospective study evaluated the clinical, radiological, and pulmonary functional evolution in 302 post-COVID-19 patients. Regarding post-COVID-19 pulmonary symptoms, dry cough, dyspnea, and chest pain were the most frequent. Of the associated comorbidities, asthma was more frequent (23.5%). Chest Tomography (CT) initially showed a mean pulmonary involvement of 69.7%, and the evaluation in the subsequent months showed an improvement in the evolutionary image, and with less than six months post-pathology, there was a commitment of 37 .7%, from six to twelve months, 20% and after 12 months, 9.9%. And as for most of the sample, 50.3% of the patients presented CT normalization in less than six months after infection, 23% normalized between six and twelve months, and 5.2% normalized the images after twelve months, with one remaining. Percentage of 17.3% who maintained post-COVID-19 pulmonary residual sequelae. Regarding spirometry, in less than six months after the pathology, 59.3% of the patients already showed a regular exam; 12.3% normalized their function within six to twelve months, and 6.3% concluded a normal exam after twelve months of post-pathology evaluation. Only 3.6% of the patients still showed some alteration in this period.

Our aim was to evaluate the immune response of healthcare workers included in the RIPOVAC study, after receiving a booster dose (third dose), in terms of intensity and persistence of induced antibodies. In the second phase of RIPOVAC study, between December 2021 and January 2022, eight months after the second dose, 389 voluntary, immunocompetent, non-pregnant healthcare workers received a booster dose of SARS-CoV-2 vaccine, and a serum sample was obtained. Two groups of patients were established: with and without previous SARS-CoV-2 infection. In order to quantify anti-S1 IgG (AU/mL) we used CMIA (Abbott). All the health workers were anti-S IgG positive 8 months after receiving the booster dose of the vaccine, with a mean of 17040 AU/mL. In 53 patients without previous infection, antibody levels had increased by a mean of 10762 AU/mL. This figure is 7 times higher than the one produced after the second dose (1506 AU/mL). The booster dose produces a robust elevation of the antibody level, which persists at 8 months with levels up to values significantly higher than those reached after the second dose, that allow to predict a persistence of more than one year. The study demonstrates the efficacy of the booster dose of anti-SARS-CoV-2 vaccines.

COVID-19, the fear it engendered, and the policy measures to manage its spread have disproportionately impacted the wellbeing of children and adolescents (CAs). We present an intensive critical realist case study of the impact of COVID-19 on the health and wellbeing of CAs in Rwanda, seeing it as much a social and political crisis as a medical and public health one. To do this, we carried out interviews with a purposive sample of 25 leaders with a working knowledge of children and young people; they were more likely than the CAs themselves to observe changes across the CA population within their remit and more likely to be looking for general explanations rather than individual experiences. The findings show that CAs' responses to the changes wrought on their lives by Covid-19 were conditioned by their age, gender, social class and if they lived in urban or rural areas. However, Covid19 has not just revealed the structural weakness of the Rwandan health system but of education, social protection, child protection, employment, family, and financial systems. The pathway to (adverse) impacts of COVID-19 on CAs is conditioned by these institutions and their interactions together with structural socioeconomic inequalities both within Rwanda and globally.