Abstract: Objective: This study aimed to estimate adherence to methotrexate in patients with rheumatoid arthritis and identify specific nonadherence risk factors. Methods: A cross-sectional study included 111 patients (age mean 56.2±10.6 years, 78.4% female, and disease duration mean 6 (3-13) years). Three adherence self-assessment questionnaires were used: the Compli-ance-Questionnaire-Rheumatology (CQR19), the Medication Adherence Reports Scale (MARS-5), and the Visual Analogue Scale (VAS). We also collected demographic data, disease and treatment characteristics, and anxiety/depression estimation results (Hospital Anxiety and Depression Scale- HADS). Results: Adherence was identified in 48.6% of patients (COR19), 70.3% (MARS-5), and 82.9% of patients in the VAS questionnaire. All three questionnaires displayed a significant positive mutual correlation: CQR19 with MARS-5 and VAS (r =0.364, r=0.329 respectively, p<0.001 for both), between VAS and MARS-5 score (r=0.496, p<0.001). A significant positive prediction was shown for urban residence (0.347 (0.134-0.901), p=0.030), using the MARS-5 scale, female sex (0.264 (0.095-0.730), p=0.010) according to CQR19 and for a dose of methotrexate (0.881 (0.783-0.992), p=0.036) in VAS scale, while negative prediction were shown for comorbidity number (3.062 (1.057-8.874), p=0.039), and depression (1.142 (1.010-1.293), p=0.035) using MARS-5 scale and for older age (1.041 (1.003-1.081), p=0.034) according to CQR19. The use of steroids was a significant positive predictor in all three questionnaires and remained an independent predictor for metho-trexate adherence in multivariant logistic regression. Conclusion: We showed nonadherence to methotrexate in a significant number of patients using all three questionnaires. Concomitant steroid therapy emerged as an independent positive predictor for adherence.

Initiatives to safeguard athletes from interpersonal violence (IV) are rapidly growing. In Belgium, the knowledge on the magnitude of IV in sport is based on one retrospective prevalence study from 2016 (n=2.043 adults), who participated in organized sport before 18 years. Data on victimization rates in current youth sport populations are lacking. This study aimed to investigate the magnitude of IV in a sample of 769 athletes (13-21 years old), using the Violence Towards Athletes Questionnaire (VTAQ). All types of IV are prevalent in this sample, ranging from 27% (sexual violence) to 79% (psychological violence and neglect). Boys reported significantly more physical violence, while girls reported significantly more sexual violence. IV perpetrated by peer athletes was reported to the same degree as IV perpetrated by a coach (70%), while IV perpetrated by a parent in the context of sport was somewhat less common, but still prevalent (48%). These findings, including factors associated with elevated exposure rates, can serve as a baseline measurement to monitor and evaluate current and future safeguarding interventions in Belgian sport.

Diagnosis of Awake Bruxism (AB) is problematic due to the inability to use continuous recordings during daytime activities. Recently, a new semi-instrumental approach was suggested, viz., an Ecological Momentary Assessment (EMA), with the use of a smartphone application. With the application subjects are requested to report, at least 12 times per day, the status of their masticatory muscle activity (relaxed muscles, jaw bracing without tooth contact, teeth contact, teeth clenching or teeth grinding). The aim of the present study was to compare the EMA to the assessment of AB as defined by a single point self-report. The most frequent condition recorded by the EMA was relaxed muscles (ca. 60%) and the least frequent one - Teeth grinding (0.6 %). The relaxed muscle condition also showed the lowest coefficient of variance over a 7day period of report. Additionally, only the relaxed muscles and the Jaw bracing conditions presented an acceptable ability to discriminate between AB positive and AB negative subjects, as defined by single point self-report questions. The combination between self-report and EMA may have a potential to promote our ability to diagnose AB. We suggest to re-consider the conditions of Teeth contact and Teeth grinding while using EMA to evaluate AB.

Quantification of physical activity (PA) depends on the type of measurement and analysis method making it difficult to compare adherence to PA guidelines. Therefore, test-retest reliability, criterion validity, and stability for self-reported (i.e. questionnaire and diary) and device-based measured (i.e. accelerometry with 10/60 second epochs) PA was compared in 32 adults and 32 children from the SMARTFAMILY study to examine if differences in these measurement tools are systematic. PA was collected during two separate measurement weeks and the relationship for each quality criteria was analyzed using Spearman correlation. Results showed the highest PA values for questionnaires followed by 10-second and 60-second epochs measured by accelerometers. Levels of PA were lowest when measured by diary. Only accelerometry demonstrated reliable, valid, and stable results for the two measurement weeks, the questionnaire yielded mixed results and the diary showed only few significant correlations. Overall, higher correlations for the quality criteria were found for moderate than for vigorous PA and the results differed between children and adults. Since the differences were not found to be systematic, the choice of measurement tools should be carefully considered by anyone working with PA outcomes, especially if vigorous PA is the parameter of interest.

The Safe Drinking Water Act Amendments of 1996 require community water systems in the United States to send consumers Consumer Confidence Reports (CCRs). CCRs contain information on detected contaminants and required educational information about drinking water. The authors of this study developed a survey to evaluate how utilities track consumer feedback, understanding, and the role of the CCR in shaping consumer perceptions about water quality. Responses from this survey indicate it is common for utilities to indirectly track the effectiveness of their CCRs, but few utilities indicated directly evaluating consumer understanding or the effect of CCRs on consumer perceptions.

It is important to be familiar with the presentation of Turner syndrome and to understand the common causes of death associated with the disease. Using the autopsy case as an example, this case report will outline the classic presentation of Turner syndrome, go over its physiology, epidemiology, pathogenesis and explain the cause of death in this particular case while also highlighting other common causes of death/risk factors within Turner syndrome. Differential diagnosis and mimicking disease processes will also be discussed. This report will also highlight the molecular tests used for the diagnosis of Turner syndrome, discuss developments using in situ hybridization, and discuss why this method is best for the determination of Turner syndrome over conventional karyotyping.

Objective: This study assessed hearing aid benefits for people with a normal audiogram but hearing-in-noise problems in everyday listening situations. Design: Exploratory double-blinded case control study whereby participants completed retrospective questionnaires, ecological momentary assessments, speech-in-noise testing, and mental effort testing with and without hearing aids. Twenty-seven adults reporting speech-in-noise problems but normal air-conduction pure-tone audiometry took part in the study. They were randomly separated into an experimental group who trialled mild-gain hearing aids with advanced directional processing and a control group fitted with hearing aids with no gain or directionality. Results: Self-reports showed mild-gain hearing aids reduce hearing-in-noise difficulties and provide a better hearing experience (i.e., improved understanding, participation, and mood). Despite the self-reported benefits, the laboratory tests did not reveal a benefit from the mild-gain hearing aids, with no group differences on speech-in-noise tests or mental effort measures. Further, participants found the elevated cost of hearing aids to be a barrier for their adoption. Conclusions: Hearing aids benefit the listening experience in some listening situations for people with normal audiogram who report hearing difficulties in noise. Decreasing the price of hearing aids may lead to greater accessibility to those seeking remediation for their communication needs.

Inert gas asphyxiation is a rarely observed form of suffocation in which the decedent breathes in an inert chemical, such as helium or nitrogen, in the absence of oxygen. The ultimate cause of death is not a result of the chemical itself, but rather from the oxygen starvation as the inert gas displaces vital oxygen. In this case report, a 66-year-old Caucasian female with a history of gastroparesis, degenerative disc disease, and chronic pain was found deceased with a plastic bag secured around her head. Plastic tubing terminated inside the bag and connected to a nearby canister of nitrogen gas. This case study discusses the challenges in determining inert gas asphyxiation as the cause of death in a postmortem setting and emphasizes the importance of understanding the decedent’s history and context of the environment in which they were found.

This paper report presents the interdisciplinary science showcased at the Young Scientists Retreat 2019. The retreat was jointly organized by young researchers from Instituto Gulbenkian de Ciência (Portugal) and Institut Curie (France) and took place in Pedrógão Pequeno, a small village in the central region of Portugal in September 2019. Three keynote speakers were invited to present their work, Alfonso Martinez-Arias, Biola Javierre Martínez, and Sara Magalhães. In addition, accepted talks and posters from young researchers were presented at the retreat. Talks were organized in sessions, which included: epigenetics and evolution, immunology, cell biology and metabolism, biostatistics and public health, biophysics, proliferation and morphogenesis, and cell polarity. A post-retreat survey, complied both by IGC attendees as well as a sample of non-attendees, discovered the existence of barriers that prevented the full participation of some junior scientists, especially female postdocs and postdocs with families. We discuss ways in which future retreats could help address this and additional issues common to young researchers in general.

Background: To our knowledge, the sudden onset of symptomatic pulmonary hypertension after COVID-19 vaccination has not been described. Both cases presented here resulted in functional limitations and likely permanent organ damage. Case Summary: We report two cases of acute onset pulmonary hypertension in previously healthy adult males within three weeks of receiving the second dose of the Pfizer (BNT162b2) mRNA COVID-19 vaccine from different lots. Both patients experienced the sudden onset of severe fatigue and dyspnea on exertion with negative COVID-19 PCR testing. The diagnosis was made by serial transthoracic echocardiography in the first case and by both transthoracic echocardiography and right heart catheterization in the second. Discussion: Pulmonary hypertension is a serious disease characterized by damage to lung vasculature and restricted blood flow through narrowed arteries from the right to left heart. The onset of symptoms is typically insidious, progressive and incurable, leading to right heart failure and premature death. The World Health Organization (WHO) classifies pulmonary hypertension into 5 categories and recently re-defined as a resting mean pulmonary artery pressure greater than 20 mmHg. Sudden onset pulmonary hypertension would only be expected in the settings of surgical pneumonectomy or massive pulmonary emboli with compromise of at least 50% of the lung vasculature.

Introduction: Lack of certainty or knowledge in health professions generates uncertainty, affecting clinical practice in decision-making (diagnostic or therapeutic), intervention design and therapeutic communication. In nursing, the lack of information to predict prognosis and outcome of interventions generates uncertainty: recognizing and managing it is essential for individualized, safe, and effective care. Objective: to assess uncertainty and the perception of a debriefing within the same shift ("intrathoracic pass") as a proposal for improvement. Method: ad-hoc survey of nursing professionals and Auxiliary Nursing Care Technicians (ANC). Variables: age, work experience, PRU scale (Physisicians' Reactions to Uncertainty) and additional question on intrathoracic pass. Results: Sample: 61 nurses and 10 TCAE (90.14 % female, 9.86 % male; mean age 35.18, standard deviation SD=13.04). Mean professional experience 11.74 years (SD=12.21); 56.33% had ≤4 years of experience. Origin: 49.30% Intensive Care Units (ICU), 11.27% Hospitalization, 7.04% Emergency, 1.41% Primary Care and 30.99% Other Services. The mean level of uncertainty was 27.99 points (max. possible 75; SD=7.50), with stress (mean=25.55, max. possible: 40; SD=5.24) and anxiety (mean=15.80, max. possible: 25; SD=3.05) as major manifestations. The association uncertainty-age (r=0.339; p=0.004) and uncertainty-experience (r=0.391; p=0.001) correlated negatively (the older and more experienced, the less uncertainty), with no significant differences between degrees or services. 91.55% stated that the intra-day pass was useful to reduce uncertainty during the working day. Conclusion: Uncertainty is frequent in nursing, and implementing the intrashift pass is perceived as a competent strategy.

Vaccination against SARS-CoV-2 has significantly contributed to the recent pandemic control. COVID-19 vaccines are available with different platforms and the primary clinical trials results presented acceptable safety profile of the approved vaccines. Nevertheless, the long-term assessment of the adverse events or rare conditions need to be investigated. The present systematic review, aimed at classification of Iranian case reports following COVID-19 immunization. To achieve this goal, the related published case reports were explored via PubMed, Web of Science and Google scholar according to PRISMA guideline and available up to 14th Dec, 2022. Out of 437 explored studies, the relevant data were fully investigated which totally led to 40 studies including 64 case reports with a new onset of a problem. The cases were then classified according to the various items such as the type of adverse event manifestations and COVID-19 vaccine. The reported COVID-19 vaccines in the studied cases included Sinopharm, AstraZeneca, and COVAXIN. The results showed that the adverse events presented in 8 different categories from which cutaneous problems accounted as the most prevalent manifestations (43.7%) in which rare diseases were also screened such as Steven-Johnson syndrome, Morphea and Toxic Epidermal Necrolysis. Notably, almost 60% of the cases had no comorbidities. Moreover, the obtained data revealed nearly half of the incidences occurred after the first dose of injection and the mean duration of improvement after the symptom onset was 18.72±24.69 days. 73% of all the cases were either significantly improved or fully recovered. Although the advantages of COVID-19 vaccination is undoubtedly significant, the high risk individuals including those with a history of serious disease or comorbidities immunodeficiency conditions should be vaccinated with the utmost caution.

Despite the number of studies on bankruptcy prediction using financial ratios, very little is known about how external audit information can contribute to anticipating financial distress. A handful of papers show that a combination of ratios and audit data can provide significant predictive purposes, but a recent paper by Muñoz-Izquierdo et al. (2018) provided an 80% predictive accuracy solely by using the disclosures of audit reports. We complement this study. Applying an artificial intelligence method (the PART algorithm), we examine the predictive ability of more easily extracted information from the report and suggest a practical implication for each user. Simply by (1) finding the audit opinion, (2) identifying if a matter section exist, (3) and the number of comments disclosed, then any user may predict a bankruptcy situation with the same accuracy as if they had scrutinised the whole report. In addition, we also provide an extended literature review about previous studies on the interaction between bankruptcy prediction and the external audit information.

Introduction: Ehlers-Danlos syndromes (EDS) constitute a rare entity of genetic disorders, affecting the collagen of all types all. Herein, we describe a case of vascular type of EDS, with coexisting segmental absence of intestinal musculature, while performing simultaneously a narrative review of the existing literature. Case Presentation: A 23-year-old male patient with a history of multiple abdominal operations due to recurrent bowel perforations and the presence of high-output enterocutaneous fistula was admitted to our surgical department for further evaluation and treatment. After detailed diagnostic testing, the diagnosis of vascular type of EDS (vEDS) was made and a conservative therapeutic approach was adopted. In addition, a comprehensive review of the international literature was carried out by applying the appropriate search terms. Results: The diagnosis of vEDS was molecularly confirmed by means of genetic testing. The patient was treated conservatively, with parenteral nutrition and supportive methods. Thirty-four cases of bowel perforation in vEDS have been reported so far. Interestingly, this case is the second one ever to report with co-existence of vEDS with Segmental Absence of Intestinal Musculature. Conclusions: Establishing the diagnosis of vEDS promptly is of vital significance in order to ensure that patients receive appropriate treatment. Due to initial non-specific clinical presentation, EDS should always be included in the differential diagnoses of young patients with unexplained perforations of the gastrointestinal tract.

Background: Although persistent systemic inflammation is considered to be predictive for future cardiovascular events, it remains unclear whether or not C-reactive protein (CrP) plays an active role in coronary-plaque instability. Here, we report a case of a patient with failed and super-infected renal allograft as a source for systemic inflammation presenting with repeat acute coronary syndromes. Case presentation: A 52-years-old male type-2 diabetic with a failed kidney transplant who was hospitalized for acute urinary-tract infection. In the presence of other, classic cardiovascular risk factors, peak values of CrP coincided with episodes of unstable angina treated by percutaneous coronary interventions. Besides pyelonephritis, the histological examination of the kidney transplant revealed signs of chronic rejection and the presence of a renal cell carcinoma in situ. Once the renal allograft has been removed, systemic inflammation was attenuated, the patient was not re-hospitalized for acute-coronary syndrome within the next 12 months. Conclusion: In this case, systemic inflammation was paralleled by instability of coronary plaques as documented by repeat percutaneous coronary interventions.

Background Indicators to evaluate progress towards timely access to safe surgical, anaesthesia, and obstetric (SAO) care were proposed in 2015 by the Lancet Commission on Global Surgery. Despite being rapidly taken up by practitioners, datapoints from which to derive them were not defined, limiting comparability across time or settings. We convened global experts to evaluate and explicitly define - for the first time - the indicators to improve comparability and support achievement of 2030 goals to improve access to safe affordable surgical and anaesthesia care. Methods and findings The Utstein process for developing and reporting guidelines through a consensus building process was followed. In-person discussions at a two day meeting were followed by an iterative process conducted by email and virtual group meetings until consensus was reached. Participants consisted of experts in surgery, anaesthesia, and obstetric care, data science, and health indicators from high, middle, and low income countries. Considering each of the six indicators in turn, we refined overarching descriptions and agreed upon data points needed for construction of each indicator at current time (basic data points), and as each evolves over 2-5 (intermediate) and >5 year (full) timeframes. We removed one of the original six indicators (one of two financial risk protection indicators was eliminated) and refined descriptions and defined data points required to construct the 5 remaining indicators: geospatial access, workforce, surgical volume, perioperative mortality, and catastrophic expenditure. Conclusions To track global progress toward timely access to quality SAO care, these indicators – at the basic level - should be implemented universally. Intermediate and full evolutions will assist in developing national surgical plans, and collecting data for research studies.

In this retrospective report we present five cases of critically ill pregnant or newly delivered women positive for Covid-19 admitted to our obstetrical departments at Karolinska University Hospital. They compose 6% of eighty-three pregnant women that tested positive for SARS-CoV-2 during the period March 25 to May 4, 2020. Three patients were at the time of admission in gestational week between 21+4 to 22+5 and treated during their antenatal period, meanwhile the other two were admitted within 1 week postpartum. All of them were in a need of intensive care, one was treated with high flow oxygen therapy, the other four with invasive mechanical ventilation (three with endotracheal intubation and one with extra corporeal membrane oxygenation). Age above thirty, overweight and gestational diabetes are notable factors in the cases presented. At the time of admission, they all presented with symptoms as fever, cough and dyspnea. Chest imaging with computer tomography scan was performed in each case and demonstrated multifocal pneumonic infiltrates in all of them but no pulmonary embolism was confirmed in any. Neither did the echocardiogram indicates any cardiomyopathy. Four of the patients have been discharged from the hospital, with an average of 20 hospital days. One antenatal pregnant woman needed prolonged ECMO therapy, in gestational week 27+3 she went into cardiac arrest, resulting in an urgent c-section on maternal indication. At the time of writing she is still hospitalized. In coherence with other published reports our cases indicate that critically ill pregnant women infected by SARS-Cov-2 may develop severe respiratory distress syndrome requiring prolonged intensive care. The material is limited for conclusions to be taken, more detailed information on symptoms, treatment, and outcomes for pregnant and postpartum women managed in intensive care is therefore needed.

Background. Ovarian cysts are common in premenopausal women but can present with vague, non-specific symptoms, making discovery more challenging. Most are benign and resolve spontaneously; however, they can present, as in this case, as ovarian torsions, which is a gynecological emergency. Case presentation. A twenty-year-old female had presented over 3–4 times per year for the last 6 years to her primary doctor citing intermittent abdominal pain, irregular menstruation, dyspnea, and an enlarging abdomen circumference. The doctor stated, she was “just fat” and could, benefit from a “special camp to lose weight”, so she stopped mentioning her concerns. Upon presenting to the emergency department with acute onset abdominal pain, a computed tomography scan showed a large cyst lesion filling the abdominal and pelvic cavity. Its origin appeared to be from the left adnexa. Surgery was performed, and an acute ovarian torsion caused by a 36 cm craniocaudal left ovarian cyst was found and removed along with the left fallopian tube and 16 L of fluid. Conclusions. The value of respecting the “third presentation” rule indicates to health care providers that any patient who presents with any /or other symptoms or complaint needs to be thoroughly investigated. In this case the patient presented recurring pelvic/abdominal concerns, irregular menstruation, which warranted further investigation to safeguard fertility and prevent errors of omission. It is important to consider the differentials and be aware of vague symptoms that may lead to early recognition and effective management to prevent adverse consequences, complications, or even death.

Background: Student-specific stress is pervasive and impairs health and attainment. Experimentally induced self-affirmation can reduce stress, but little is known about the mechanisms underlying this effect, and the role of individual differences. The present study explores the relationship between spontaneous self-affirmation, student-specific stress, and overlapping constructs of positive self-regard during the COVID-19 pandemic. Methods: The study investigated inter-relationships between spontaneous self-affirmation, student-specific perceived stress and potential covariates including self-esteem, self-integrity and habitual positive self-thought. University students (N = 151) aged 18 to 50 responded to an online questionnaire including the Spontaneous Self-Affirmation Measure, College Student Stress Scale, Rosenberg Self-Esteem Scale, Habitual Index of Positive Thinking and Self-Integrity Scale. Results: Unexpectedly, regression analysis revealed that spontaneous self-affirmation was a positive predictor of student-specific stress, seemingly driven by relational affirmations. Self-esteem and habitual self-thought were negative predictors of student-specific stress, whilst self-integrity was not a predictor. Conclusions: Habitual positive self-thought may offer a sustainable solution to student-specific stress, but spontaneous self-affirmation does not. A reduction in defensive responses, elicitation of negative emotions, or use of conditional relationships in relational affirmation

In this paper I tentatively answer 50 questions sampled from a pool of over 10,000 weekly questions formulated by students in a course entitled “The Self”. The questions pertain to various key topics about self-processes, such as self-awareness, self-knowledge, self-regulation, self-talk, self-esteem, and self-regulation. The students’ weekly questions and their answers highlight what is currently know about the self. Answers to the student questions also allow for the identification of some recurrent lessons about the self. Some of these lessons include: all self-processes are interconnected (e.g., prospection depends on autobiography), self-terms must be properly defined (e.g., self-rumination and worry are not the same), inner speech plays an important role in self-processes, controversies are numerous (are animals self-aware?), measurement issues abound (e.g., self-reflection as an operationalization of self-awareness), deficits in some self-processes can have devastating effects (e.g., self-regulatory deficits may lead to financial problems), and there are lots of unknowns about the self (e.g., gender differences in Theory-of-Mind).

Neonatal diffuse cutaneous mastocytosis (NDCM) is defined as the infiltration of the epidermis by a clonal proliferation of mast cells, observed at birth, without initial signs of systemic involvement. The typical driver mutation is located in the KIT gene. We report a rare case of a boy, born at term, presenting already at birth with generalized subcutaneous nodules, on the face, scalp, trunk, back, hands, and feet. The spleen, liver and inflammatory markers were normal at birth. Tryptase was significantly elevated. Bone marrow biopsy showed no mast cell involvement at age 2 months. A punch biopsy at age 2 months revealed CD117-positive cells diffusely infiltrating the skin, with subsequent DNA NGS sequencing for the formalin fixed paraffin embedded tissue (FFPE) identifying the pathogenic NM_000222.3:c.1504_1509dup; p.(Ala502_Tyr503dup) variant in the KIT gene previously associated with cutaneous mastocytosis. At 2 years follow-up, he had splenomegaly and multiple cervical, and inguinal adenopathy while the skin nodules persisted especially on the scalp with accompanying pruritus. He received oral and local sodium cromoglycate, oral antihistamines, antibiotic cream for skin infection, and iron supplementation, however compliance to treatment was relatively low. The prognosis is difficult to predict, as he developed systemic involvement, failure to thrive and mild psychomotor delay. A case aggregation of NDCM reported in the literature was performed to provide a comprehensive overview of this rare pathology, to better understand the prognosis. NDCM is a life-threatening disease with severe complications. Almost half had severe complications, such as mast hepatosplenomegaly, adenopathy, bacterial infections, mast cell leukaemia, and systemic involvement.

While the debate on the association between Enterobius vermicularis (E. vermicularis) and acute appendicitis has not been settled, a few case reports of this very rare encounter are beginning to come to light. While E. vermicularis is one of the most common parasitic infestations around the world, acute appendicitis, on the other hand, is also a commonly encountered condition in general surgery. However, the association between the two remains controversial. Here we present a case report of a young woman with appendicitis associated with (E. vermicularis).

Consumer rhythm-monitoring devices, such as the Apple Watch, are becoming more readily available. Irregular pulses can be detected using an optical sensor built into the wearable device. The Apple Watch (Apple Inc., Cupertino, CA, USA) is a class II medical device with pulse rate and electrocardiography (ECG) monitoring capabilities. Here we report a case in which an arrhythmia that was conventionally perceived but undiagnosed was identified as atrial fibrillation by self-acquisition of ECG data using an Apple Watch.

The problem of filling the bone cavity-forming after tooth extraction remains relevant in maxillo-facial surgery. There is a large selection of osteotropic materials of various natures for filling bone defects. In this article, our experience in the treatment of patients with combined mandible angle fracture and radicular cyst and fractures is introduced. A feature of the treatment is to fill the bone defect with the osteotropic material. Using collagen osteotropic material, possessing osteoconductive property can improve the treatment of patients with mandibular fractures within the dentition. This is due to both the stabilization of the fracture line, a decrease in the likelihood of displacement of fragments along with fixation with devices, and a reduction in the time of bone tissue regeneration, which reduces the rehabilitation period and allows further orthopedic treatment of patients after 4-5 months without additional bone grafting operations.

Background: After allogeneic hematopoietic stem cell transplantation (allo-HSCT), acute leukemia relapse is common, and asymmetric bone marrow recurrence hasn’t been reported. Because the anatomical distribution of acute leukemia clones in the bone marrow after allo-HSCT is presumed to be diffuse, bone marrow aspirations are performed in single site. Case presentation: We identified two acute leukemia patients, whose leukemic burden in bilateral bone marrow specimens differed significantly. The first case was a 20-year-old man who was diagnosed with acute myelomonocytic leukemia and received haploidentical allo-HSCT. He had been in complete remission for two years and off immunosuppressive medications for a year, with normal peripheral blood count. Routine bone marrow biopsy of his left posterior iliac bone marrow showed 52% leukemia blasts, while the right side had 0% blasts ten days later. Due to the discordant results, the patient refused further intervention and died of high leukocyte syndrome four months later. The second case was a 23-year-old woman who was diagnosed with acute B lymphoblastic leukemia and received HLA-identical sibling allo-HSCT. Although 62% of blasts were found in her left iliac marrow on day +122, 0 % of blasts were found on a sample obtained from the right iliac crest on day +128. Whole-body 18F-FDG PET/CT scans confirmed that the leukemic infiltration in her bone marrow was asymmetric. Considering the higher leukemic burden on the left, we chose the left posterior iliac crest aspiration for further response evaluation. After chemotherapy combined with donor lymphocyte infusion, she achieved transient hematologic complete remission. She died of septic shock with heart failure at +258 days after allo-HSCT before infusion of anti-CD19 donor chimeric antigen receptor T cells. Conclusions: To our knowledge, these are the first case reports of asymmetric bone marrow infiltration of blasts in acute leukemia patients after allo-HSCT. Bilateral posterior iliac crest aspirations or 18F-FDG-PET/CT scans may help distinguish such distribution. If discordant bone marrow specimens are observed, physicians should restrict future bone marrow studies to the more involved side.

Vitrimers are covalent network materials, comparable in structure to classical thermosets. Unlike normal thermosets, they possess a chemical bond swap mechanism that makes their structure dynamic and suitable for activated welding and even autonomous self-healing. The central question in designing such materials is the trade-off between autonomy and material stability: The swap mechanism facilitates the healing but it also facilitates creep, which makes the perfectly stable self-healing solid a hard goal to reach. Here, we address this question for the case of self-healing vitrimers made from star polymers. Using coarse-grained molecular dynamics simulations, we study the adhesion of two vitrimer samples and find that they bond together on timescales that are much shorter than the stress relaxation time. We show that the swap mechanism allows the star polymers to diffuse through the material through coordinated swap events, but the healing process is much faster and does not depend on this mobility.

Self-assembly is a spontaneous process through which macroscopic structures are formed from basic microscopic constituents (e.g. molecules or colloids). By contrast, the formation of large biological molecules inside the cell (such as proteins or nucleic acids) is a process more akin to self-organization than to self-assembly, as it requires a constant supply of external energy. Recent studies have tried to merge self-assembly with self-organization by analyzing the assembly of self-propelled (or active) colloid-like particles whose motion is driven by a permanent source of energy. Here we present evidence that points to the fact that self-propulsion considerably enhances the assembly of polymers: self-propelled molecules are found to assemble into polymer-like structures, the average length of which increases towards a maximum as the self-propulsion force increases. Beyond this maximum, the average polymer length decreases due to the competition between bonding energy and disruptive forces that result from collisions. The assembly of active molecules might have promoted the formation of large pre-biotic polymers that could be the precursors of the informational polymers we observe nowadays.

To the best of the author’s knowledge, studies of mature plasmacytoid dendritic cell proliferation associated with T lymphoblastic lymphoma were extremely rare in the literature. Here, we report a patient who underwent both mature plasmacytoid dendritic cell proliferation and T lymphoblastic lymphoma. With the findings of lymph node biopsy taken from the right cervical and inguinal regions, we identified eye-catching mature plasmacytoid dendritic cells that were considered to be responsible for this lesion at the beginning, until the immunostaining of Ki67 and TDT showed a small group of positive cells hiding in these plasmacytoid dendritic cells. Bone marrow biopsy was also performed in this patient. Microscopically, the hematopoietic tissue was almost completely replaced by lymphoblastoid cells with condensed chromatin, inconspicuous nucleoli and scanty cytoplasm, which were basically the same as those seen in the lymph nodes in morphology. However, there was no sign of plasmacytoid dendritic cells or Langerhans cells in the bone marrow biopsy. With the help of bone marrow biopsy, our final diagnosis of the lymph node was T lymphoblastic lymphoma coexisting with mature plasmacytoid dendritic cell proliferation . Although accumulations of plasmacytoid dendritic cells may occur in some infections or reactive lymphadenopathy, the presence of extensive nodules or infiltration of plasmacytoid dendritic cells strongly reminds the pathologist to carefully evaluate the bone marrow or peripheral blood status of the patient to exclude a hidden myeloid or other neoplasm.

Atopic dermatitis (AD) is a chronic skin disease marked by inflammation, erythema, dryness and pruritic lesions. Due to the intermittent nature of the disease, management strategies for AD focus on flare prevention following remission. A 24-year-old patient with mild-to-moderate AD lesions, previously non-responsive to topical corticosteroids (TCS), was treated with pimecrolimus for 12 days and emollient plus cream (EC) every day. After the initial 12-day treatment course, the patient was advised to use pimecrolimus if his symptoms reoccured. AD symptoms improved substantially between Weeks 0 and 12 with daily use of EC. However, by Week 12, his symptoms had relapsed, necessitating retreatment with pimecrolimus. Overall, the patient experienced flare-free periods between Weeks 3 and 12 and between Weeks 13 and 16. No tolerability issues were reported. This case report demonstrates the use of a complementary approach of daily administration of maintenance EC and intermittent application of pimecrolimus for flare management, which was effective for treating a patient with mild-to-moderate AD resistant to TCS.

Background. Neoplastic diseases and infections have become the leading causes of death in SLE in recent decades. Cancers and infections were also precipitating factors in the development of catastrophic APS. Case summary. We describe two patients: one of them had definite antiphospholipid syndrome (APS) and melanoma and the other had definite systemic lupus erythematosus (SLE) with APS, melanoma, infiltrative tuberculosis and severe Herpes Zoster (HZ). Management of patients with SLE concurrent with APS is a rather difficult task in rheumatology practice. In addition to kidney damage and cardiovascular disease, infections and malignancies are a significant cause of death in this cohort. The risk of malignancy in SLE is of considerable interest, since the immune and genetic pathways underlying the pathogenesis of this disease, as well as the immunosuppressive therapy, can significantly alter the risk. Both patients still had reliable APS, confirmed by triple-positive aPL. Both were at high risk of thrombosis. Patients ' adherence to treatment with direct oral anticoagulants and relapse of thrombosis on the background of rivaroxaban were noted. Conclusion. The cases where cancer or tuberculosis develops in the presence of rheumatic diseases are not so common and complicate the possibilities of therapeutic approaches, limiting the use of drugs that are not regulated by clinical recommendations.

The present paper reports an exact approach quantifying the electromagnetic contribution to the anomalous magnetic moment occurring in isolated system comprised of non-composite particle carrying elementary electric charge. Essential averaging procedure and regularization of the electromagnetic field potentials necessary when quantifying the electromagnetic self-interactions and when deriving equations of motion without singularities and obeying the conservation laws are thoroughly discussed. The study shows that the dynamics of the considered system is associated to unique classical transcendental equations of motion satisfied by the particle's velocity and the electromagnetic contribution to the anomalous $g$-factor known from the quantum electrodynamics. The equations of motion lead to an exact analytical expression for the anomalous $g$-factor that provides more accurate result than that calculated with the aid of quantum electrodynamics. It matches the experimentally measured value reported in the literature to a one part per trillion. We obtain a_e=0.00115965218000(65) thus reveling the potential of non-perturbative, non-probability methods in predicting the electron's anomalous g-factor.

Background: The adoption of self-care behaviors among patients with arterial hypertension (AH) plays an important role in the management of their health condition. However, a lack of scales assessing self-care is observed. We aimed to develop and validate the Hippocratic hypertension self-care scale. Methods: From a pool of questions derived from a literature review, 18 items were included in the scale and reviewed by a committee of experts. Participants indicate the frequency at which they follow the self-behavior prescribed in each statement on a five-point Likert scale. Data were collected between April 2019 and December 2019. Re-sults: 202 consecutive adult patients with AH were enrolled in the study. The internal consistency of the scale was found to be 0.807, using Cronbach’s alpha coefficient. An exploratory factor analysis identified two do-mains that accounted for 92.94% of the variance of the scale items; however, each sub-scale could not be used as an independent scale. Finally, the test- retest of the scale showed a significant strong correlation (r=0.0095, p<0.001). Conclusion: Our data indicate that the scale is a reliable and valid tool for assessing self-behaviors in patients with AH. Health professionals can use it in their clinical practice to improve the management of patients’ health condition.

: BACKGROUND: The prevalence of smoking among students is a growing concern, particular-ly among medical students. Being associated with stress, competitiveness, and various social in-fluences, smoking can have detrimental effects on self-esteem and self-efficacy and may create a vicious cycle that may contribute to students’ well-being and academic performance out-comes.METHODS: A cross-sectional study on 456 medical students was conducted via an online survey using structured questionnaires on socio-demographic characteristics, smoking habits, nicotine dependence, self-esteem, and self-efficacy. RESULTS: The prevalence of smoking was 31.1% The scores of self-esteem and self-efficacy were positively correlated with smoking habits (W1=0.957, W2=0.975, P<0.05). Students presented rather low smoking addiction with male stu-dents having slightly higher scores than female students on self-esteem and self-efficacy, mili-tary students had higher self-esteem scores than civilians with physical activity having a posi-tive correlation with non-smoking behavior. CONCLUSION: According to our results, self-esteem and self-efficacy were slightly positively correlated with smoking habits. Furthermore, there was no statistically significant association between other social factors and smoking. Our results may develop a theoretical basis for medical students’ psychological variables studying for further implementation of university educational programs and preventive interventions em-powering students towards an overall better quality of life, addressing, among others, smoking behaviors.

Self-enhancement (SE) is often overlooked as a fundamental cognitive ability mediated via the Pre-Frontal Cortex (PFC). Here we present research that establishes the relationship between the PFC, SE, and the potential evolved beneficial mechanisms. Specifically, we believe there is now enough evidence to speculate that SE exists to provide significant benefits and should be considered a normal aspect of the self. Whatever the metabolic or social cost, the upside of SE is great enough that it is a core and fundamental psychological construct. Furthermore, though entirely theoretical, we suggest that a critical reason the PFC has evolved so significantly in Homo sapien is to, in part, sustain SE. We therefore elaborate as to its proximate and ultimate mechanisms.

While the desire to uncover the neural correlates of consciousness has taken numerous directions, self-face recognition has been a constant in attempts to isolate aspects of self-awareness. The neuroimaging revolution of the 1990’s bought about systematic attempts to isolate the underlying neural basis self-face recognition. These studies, including some of the first fMRI (functional Magnetic Resonance Imaging) studies, revealed a right hemisphere bias for self-face recognition in a diverse set of regions including the insula, the Dorsal Frontal Lobe, the Temporal Parietal Junction and Medial Temporal Cortex. Confirmation of these data (which are correlational) was provided by TMS (Transcranial Magnetic Stimulation) and patients in which direct inhibition or ablation of right hemisphere regions leads to a disruption or absence of self-face recognition. These data are consistent with a number of theories including a right hemisphere dominance for self-awareness and/or a right hemisphere specialization for identifying significant social relationships including to oneself.

Background: Myeloid sarcoma (MS), also known as granulocytic sarcoma or chloroma, is a rare disease entity characterized by the emergence of an extramedullary tumour which may be antecedent, coexisting or manifest secondarily to an ongoing malignancy of lymphoid origin. Owing to its low prevalence, scientific reports addressing this matter comprise mainly retrospective studies with a limited number of participants, rather low-quality research and only few case reports. Despite MS’s rarity, the need for enhancing diagnostic tools and refinement of therapeutic regimens is broadly recognised among physicians. Case summary: In this case series, we present the clinical histories of two patients diagnosed with MS. The former (Case 1) exhibited MS of the sternum alongside chronic myeloid leukemia (CML), while in case of the latter (Case 2) MS was the initial manifestation of a current acute myeloid leukemia (AML). Regardless of treatment institution comprising chemotherapy (CHTH) and radiotherapy (RT), the patient afflicted by CML did eventually pass due to cardiorespiratory insufficiency secondary to an infection, whereas the second one is in clinical remission up to this date, that is 16 months since MS had been diagnosed. Furthermore, a comprehensive analysis of previously reported cases was conducted which involves MS in patients with AML and CML. Conclusion: The objective of this report is to emphasize the heterogeneity among the clinical manifestations of MS, to underline the relevance of histopathological and molecular diagnostic tools in opting for the appropriate therapy and that, in spite of it occurring rather uncommonly, physicians should think of MS in presence of pathological masses in patients under risk of hematological malignancies.

A single coronary artery is a very rare condition, commonly associated with other congenital anomalies. It could be generally classified as neither benign nor malignant form of congenital coronary artery anomalies since its pathophysiological and clinical implications grossly depend on different anatomical patterns defined by the site of origin and distribution of the branches. By presenting the patient with an isolated single coronary artery, who underwent successful combined aortic valve replacement and coronary artery bypass grafting surgery, we intend to distinguish casual from causal in this extremely rare clinical and surgical scenario. This is the first-ever case published, combining such underlying pathology, clinical presentation, and surgical treatment.

Rigid-body visual tracking is an active research field with many practical applications including visual surveillance and intelligent transport system. In this paper, we define a new problem domain, called visual growth tracking, to track different parts of an object that grow non-uniformly over space and time for application in image-based plant phenotyping. The paper introduces a novel method to detect and track each leaf of a plant for automated leaf stage monitoring. The method has four phases: optimal view selection, plant architecture determination, leaf tracking and generation of a leaf status report. The proposed method uses a graph theoretic approach to reliably detect and track individual leaves by overcoming the challenge of leaf-losses based on temporal image sequence analysis for automatically generating the leaf status report containing the following phenotypes, i.e., the emergence timing of each leaf, total number of leaves present at any time, the day on which a particular leaf stopped growing, and the length and relative growth rate of individual leaves. The proposed method demonstrates high accuracy in detecting leaves and tracking them through the early vegetative stages of maize plants based on experimental evaluation on a publicly available benchmark dataset.

We report the development of an extrinsic self-healing coating system that shows no fluorescence from the intact coating, yellowish fluorescence in cracked regions, and greenish fluorescence in healed regions, thus allowing the separate monitoring of cracking and healing of coatings. This fluorescence monitoring self-healing system consisted of a top coating, an epoxy matrix resin containing mixed dye-loaded in single microcapsule. The dye-loaded microcapsules consisted of a poly(urea-formaldehyde) shell encapsulating a healing agent containing MAT-PDMS and styrene, a photo-initiator and a mixture of two dyes, one that fluoresces only in the solid state (DCM) and a second that fluoresces dramatically increased in the solid than solution state (4-TPAE). A mixture of the healing agent, photo-initiator and the two dyes was yellow due to fluorescence from DCM. On UV curing of this mixture, however, the color changed from yellow to green and the fluorescence intensity increased due to fluorescence from 4-TPAE in the solid state. When a self-healing coating embedded with microcapsules containing the DCM/4-TPAE dye mixture was scratched, the damaged region exhibited a yellowish color that changed to green after healing. Thus, the self-healing system reported here allows the separate monitoring of cracking and healing based on changes in fluorescence color.

Online education allows learners to develop knowledge and skills flexibly and conveniently—such observation among students whose characteristics involve student engagement, self-regulation, and self-efficacy. However, studies to characterize Filipino online learners seem lacking. Thus, this study aimed to characterize science education tertiary students in the Philippines concerning their online student engagement (OSE), self-regulated learning (SRL), and online learning self-efficacy (OLSE). The unprecedented events brought by COVID-19 pandemic also urged the implementation of online modalities while there is no available information on students’ online learning profiles. Hence, researchers used a survey research employed through ex post facto approach to determine the effects of the demographic profile on OSE, SRL, and OLSE. The survey was participated by N=373 respondents who answered the questionnaire with informed consent administered via Google Forms. Results revealed that OSE indicators moderately characterized students, while SRL and OLSE indicators are true of them, substantiated by the overall mean M=3.85(SD=0.90), M=3.86(SD=0.92), and M=3.14(SD=0.73), respectively. Also, multivariate tests showed no significant effect among the independent groups (p&gt;0.05), except for gender and OLSE interaction (p&lt;0.05) so, only in OLSE was a significant difference found in gender. In conclusion, Filipino online learners are moderate across aspects of student engagement, self-regulation, and self-efficacy.

Secure attachment, developed through consistent relationships with attachment figures in childhood, is a crucial factor in fostering healthy interpersonal relationships and a positive self-perception. This research aimed to assess how perceived security, as an indicator of secure attachment, predicts adult self-concept through the mediating effects of resilience and positive self-esteem. A quantitative, cross-sectional, and non-probabilistic study was conducted with 383 participants, of whom 76.2% were females, aged between 17 and 86 years (M = 28.52, SD = 12.23). Correlational analyses revealed significant positive associations between perceived security, self-concept, resilience, and positive self-esteem. Path analysis demonstrated that resilience and positive self-esteem sequentially mediate the relationship between perceived security during childhood and adult self-concept (Total Effect R2 = .34, F(1,381) = 193, p < .001; Indirect effect of sequential mediation b = .02, CI 95% [.01, .04]). Findings suggest that the ability to cope with ad-versity and personal acceptance underlie the impact of perceived security on self-concept. It is recommended to promote not only secure attachment in family interventions but also resilience and self-esteem in programs targeting adolescents, youth, and adults.

Purpose: To identify the impact of dealing with COVID-19 patients in clinical areas on nurses' professional self-concept and self-confidence. Background: Professional self-concept is considered a critical factor in the recruitment/retention process in nursing, nursing shortage, career satisfaction, and academic achievements. Professional self-confidence is also a crucial determinant in staff satisfaction, reducing turnover, and increasing work engagement. Design: Descriptive, comparative study. Methods: The study was conducted between February to May 2021 by utilizing a convenience sampling technique. A total of 170 nurses from two facilities were recruited from two COVID-19 and non-COVID-19 designated facilities. The level of professional self-concept and self-confidence was assessed by utilizing the Nurses' Self-Concept Instrument and Self-Confidence Scale. Results: The professional self-concept level among the exposed group to COVID-19 patients was lower than the comparison group, while the professional self-confidence level among the exposed group to COVID-19 patients was similar to the comparison group. On the other hand, the satisfied staff and those who received professional training in dealing with COVID-19 patients reported a higher level of professional self-concept. Conclusions: Dealing with COVID-19 patients has an impact on professional self-concept; the exposure group was lower than those who did not deal with COVID-19 patients, while the professional self-confidence level among the exposed group was similar to the comparison group. Getting professional training in dealing with COVID-19 patients and being satisfied at work were significant factors in improving the professional self-concept. Policymakers should create strategies that target the improvement of professional training in dealing with COVID-19 patients.

Background: Level of perceived competence as a basic psychological need could trigger achievement of diabetes self-management goals. Due to lack of a specific data collection tool to measure level of self-competence among Persian speaking patients with diabetes this study was conducted for cross-cultural adaptation and psychometric assessment of the Persian version of Perceived Competence Scale for Diabetes (PCSD-P). Methods: Standard translation/back-translation procedure was carried out to prepare a preliminary draft of the PCSD-P. Content and face validity of the early draft were checked by an expert panel including 15 scholars in the field of health education and promotion as well as nursing education with experience of working and research on diabetes. The final drafted questionnaire was completed by 177 randomly selected patients with type 2 diabetes. Based on the collected data structural validity of the contrived version was appraised using exploratory and confirmatory factor analysis (EFA, CFA). Cronbach's alpha and Intraclass Correlation coefficients (ICC) were used to check the scale’s reliability and internal consistency. ; (3) Results: The estimated measures of Content Validity Index (CVI= 0.95) and Content Validity Ratio (CVR= 0.8) were in the range of acceptable recommended limits. The EFA analysis results demonstrated a single factor solution according to the items’ loadings for the component. The model fit indices i.e. RMSEA= 0.000, CFI=1, TLI=1, GFI= 0.998, NFI= 0.999 RFI= 0.995 confirmed consistency of the hypothesized one-factor solution. Values of the internal consistency and reliability coefficients were also in the vicinity of acceptable range (α= 0.892, ICC=0. 886, P= 0.001). Conclusions: The study findings revealed good internal validity and applicability of the PCSD-P to measure degree of self-competence among Persian speaking type 2 diabetes patients to manage the chronic disease. Due to unrepresentativeness of the study sample future cross-cultural test of PCSD-P on diverse and broader Persian speaking populations is recommended.

This paper addresses the development of knowledge and assessment-centered learning approaches within a reflective learning framework in a first year physics class in a university faculty. The quality of students’ reflections was scored using a Self-reporting Reflective Learning Appraisal Questionnaire at the end of each learning approach. The results showed the differences between the approaches based on reflections on the learning control through self-knowledge, by connecting experience and knowledge, as well as through self-reflection and self-regulation. Assessment-centered activities fundamentally help students identify aspects of their attitudes towards, as well as regulate, their sustainability learning education.

Simple cysts (SCs) within the testes are rare in adults. The testicular SC lining comprises mesothelial cells. This report presents a case involving the accidental discovery of a castration-worthy SC in the right testis of a Japanese man in his 90s who was diagnosed with prostatic adenocarcinoma. Microscopic analysis revealed that the cystic wall was covered with flat to cuboidal mesothelial cells. Immunohistochemistry demonstrated mesothelial cell positivity for calretinin, Wilms tumor 1 (WT-1), Hector Battifora mesothelial epitope-1 (HBME-1), and cyclin-dependent kinase inhibitor p16 (p16INK4a). Notably, no human papillomavirus (HPV) in situ hybridization was detected. This report outlines an exceptionally rare instance of a simple cyst within the testis, suggesting the possibility of its origin from ectopic rete testis epithelium. This marks the inaugural documentation in the English literature of an SC within the testis found incidentally during castration for prostatic cancer.

(1) Background: The aim of this study is to investigate the diagnostic-therapeutic problem of pelvic recurrence of rectum cancer, highlighting current surgical standards and the possible role of the minimally invasive approach. This retrospective analysis of our surgical case study wishes to enter this debate while suggesting a possible line of action, based on the site of recurrence; (2) Methods: We examined, retrospectively, all the patients diagnosed, between 2008 and 2018, with cancer of the rectum at the "Pietro Valdoni" Department of Surgery and monitored their follow-up for 5 years. The sample consisted of 368 patients with rectal neoplasm, 136 females and 232 males, with an average age of 65.8 (ranging from 37 to 86); (3) Results: In 103 of the cases, the neoplasm was located in the upper rectum (28%), in 119 cases in the middle rectum (32.3%), in 102 cases in the lower rectum (27.7%), in 31 cases (8.4%) at the level of the right/sigma junction and in 13 cases it was not possible to define the site with certainty (3.5%); (4) Conclusions: The discussion re-mains open as to which approach is best at surgical level, whether laparoscopic, robotic or open-air. Our experience informs us that the most dangerous site remains on the anastomotic site.

Background: no reports have examined the profile of drug-induced dysphagia in detail. The goal of this study was to investigate if there are any differences in the profiles of drug-induced dysphagia. Methods: This study used the Japanese Adverse Drug Event Report (JADER) database. Further, reported odds ratios (RORs) were used to analyze data on adverse drug events from 2004 to 2021. The top ten drugs with the most drug-induced dysphagia occurrences were used as target drugs. The association between RORs and drug-induced dysphagia caused by the target drugs was evaluated, and the age distribution and time of onset of drug-induced dysphagia for each drug were compared. RORs were the primary endpoint. Moreover, age and time of onset of drug-induced dysphagia were secondary outcomes. Results: In total, 756,965 reports were analyzed. All the target drugs were associated with drug-induced dysphagia. Among them, cevimeline was a novel finding, as no dysphagia was observed during the clinical trial. For most drugs, the onset of drug-induced dysphagia was occurring within approximately 25 days of administration. However, even after long-term use, paroxetine and milnacipran were associated with drug-induced dysphagia. Conclusion: The onset profile of drug-induced dysphagia may differ from one drug to the next.

Considering the harmful effects of cannabis on individuals with a severe mental disorder and the limited effectiveness of current interventions, this case report showcases the beneficial results of a 10-session Avatar intervention for cannabis use disorder (CUD) on a polysubstance user with a comorbid schizoaffective disorder. Virtual reality allowed the creation of an Avatar representing a person significantly related to the patient’s drug use. Avatar intervention for CUD aims to combine exposure, relational, and cognitive behavioral therapies while practicing real-life situations and learning how to manage negative emotions and cravings. Throughout therapy and later on, Mr. C managed to maintain abstinence from all substances. Also, an improvement in the severity of CUD as well as a greater motivation to change consumption, were observed after therapy. As observed by his mother, his psychiatrist, and himself, the benefits of Avatar intervention for CUD extended to other spheres of his life. The drastic results observed in this patient could be promising as an alternative to the current treatment available for people with a dual diagnosis of cannabis use disorder and psychotic disorder, which generally lack effectiveness. A single-blind randomized control trial comparing the treatment with a classical intervention in a larger sample is currently underway to evaluate whether the results are reproducible on a larger sample.

BACKGROUND Krukenberg tumor is a rare metastatic tumor of the ovary with characteristic histopathological features known as signet-ring cells. It usually presents in women around 45 years of age, however, we present an uncommon case in a 38-year-old pregnant woman. We report this case because of the unusual findings, the uncommon presentation in this younger age bracket, its diagnostic challenge, and poor prognosis. CASE PRESENTATION We describe an unusual case of a young woman with a history of painful vaginal bleeding at 13 weeks of pregnancy and treated for abruptio placentae. In her routine prenatal visit at week 20 of pregnancy, she was found to have a uterine fundus greater than her gestational age and referred to the hospital to discard polyhydramnios. At her admission a pelvic ultrasound was performed with normal findings of a 25 weeks pregnancy, also showing bilateral enlarged ovaries with heterogeneous echogenicity. The MRI showed a left tumoral lesion with dimensions of 22.1 x 13.6 x 16.3 cm, with lobulated regular contours with displacement of peripheral structures and mild compression of the bladder, the left ureter, and the inferior vena cava. The lesion was heterogeneous with irregular borders. The patient was programmed for a cesarean section; during the operation, the abdominal cavity showed bilateral tumors compatible with MRI findings, the ovarian tumors were sent to pathology and the results showed poorly differentiated mucinous adenocarcinoma (WHO III) with extensive signet-ring cells, an indicative of Krukenberg tumor. CONCLUSION: The case presented is rare due to its presentation in a pregnant woman without identifiable risk factors for gastric cancer. The incidental finding suggests the pregnancy masked the clinical presentation of gastric cancer, and the rapid deterioration of the patient is consistent with the aggressiveness described in the literature. The limited descriptions of this neoplasm in our country and the torpid evolution of this case highlight the importance of further studies of this cancer in Mexico.

Organisms are adapted to each other and the environment, not as tradition would have it, because natural selection made them that way, but because there is inbuilt striving towards stability and equilibrium. A General Theory of Behaviour connects imagery, affect and action with the central executive system we call Consciousness. The General Theory is founded on the assumption that the primary motivation of all of Consciousness and intentional behaviour is Psychological Homeostasis. Psychological homeostasis is as important to the organisation of mind and behaviour as Physiological Homeostasis is to the organisation of bodily systems. Consciousness processes quasi-perceptual images independently of the input to the retina and sensorium. Consciousness is the “I-Am” control centre for integration and regulation of (my) thoughts, (my) feelings and (my) actions with (my) conscious mental imagery as foundation stones. Imagery vividness, a combination of clarity and liveliness, is essential to imagining, remembering, thinking, predicting, planning and acting. Assessment of vividness using introspective report is validated by objective means such as fMRI. A significant body of work shows that vividness of visual imagery is determined by the similarity of neural responses in imagery to those occurring in perception of actual objects and performance of activities. I am Conscious, therefore I am.

Self-compacting concrete (SCC) production is a complex operation that requires finding a good combination and a suitable dosage of each of its constituents. Several formulation methods have been developed to meet the workability requirements of SCC. In this paper, the relationships between the fresh properties of SCC based on local metakaolin (MK) and the spreading of its mortar was investigated. The results showed the existence of good correlations between the spreading of the mortar and the fresh state properties of the related SCC and that the MK substitution rate did not affect these correlations. The choice of the mortar flow rate should target appropriate fresh properties of the SCC and a viscosity enhancing agent (VEA) could be used if the mix is too fluid and present an instability.

Based on the sensitive sum frequency generation cross-correlation frequency-resolved optical gating (SFG-XFROG) measurement setup, besides the pulse broadening, blue shift, red shift and obvious pulse acceleration, we observed the soliton evolution when the low energy soliton pulse with wavelength of 1555nm transmit through the Si photonic crystal waveguide. The measurements were nicely matched with the simulation results, which are achieved with an optimized nonlinear Schrödinger equation (NLSE) modeling. The effects of various parameters of the silicon photonic crystal waveguides and the incident pulses on the pulse transmission were also analyzed, including the nonlinear effects and dispersion such as the self-phase modulation (SPM), self-steepening (SS) and intra-pulse Raman scattering(IRS). The results help us understand further the ultra-fast nonlinear dynamics of soliton in silicon-based waveguides, and even open a novel way for soliton-based functional elements in CMOS-compatible platforms.

Building on the Sustainable Happiness Model, this study examined how congruency between ideal self-image and brand image influence a sense of happiness. The findings show that when ideal self-image and ideal social self-image are congruent with brand image a sense of happiness can be enhanced through brand identification and positive emotions. This study contributes to literature as it reveals the mechanism of how congruency between ideal self-image and brand image positively affect happiness.

Purpose: This study aims to analyze the factors that affect the behavior of user-defined avatars in different virtual environments, and compare the differences in public self-awareness, self-expression, and emotional expression among customized avatars in multiple virtual contexts. Methods: Using a between-subjects experimental design, two random groups of participants were asked to customize avatars for themselves in two contexts, a multiplayer online social game (MOSG) and a virtual meeting (VM). i.e. a relaxed and a serious social environment. Results: When subjects perceived a more relaxed environment, the customized avatars had less self-similarity, and the subjects exhibited a stronger self-disclosure willingness and enhanced avatar wishful identification; nevertheless, public self-consciousness was not increased. When subjects perceived a more serious environment, the customized avatars exhibited a higher degree of self-similarity, and the subjects exhibited a greater self-presentation willingness, along with enhanced identification of avatar similarity, and increased public self-consciousness. Conclusions: Participants expressed positive emotions, suggesting that avatars play a positive role in various virtual contexts. The virtual context affects the self-similarity of user-customized avatars, and avatar self-similarity affects self-presentation and self-disclosure willingness, and these factors will affect the behavior of the user-customized avatar. This study contributes suggestions to the Metaverse avatar customization platform design.

Using low-cost portable air quality (AQ) monitoring devices is a growing trend in personal exposure studies enabling a higher spatio-temporal resolution and identifying acute exposure to high concentrations. Comprehension of results by participants is not guaranteed in exposure studies. However, information on personal exposure is multiplex, which calls for participant involvement in information design to maximise communication output and comprehension. This study describes and proposes a model of a user centred design (UCD) approach for preparing a final report for participants involved in a multi-sensor personal exposure monitoring study performed in seven cities within the EU Horizon 2020 ICARUS project. Using a combination of human-centred design (HCD), human-information interaction (HII) and design thinking approaches, we iteratively included participants in the framing and design of the final report. User needs were mapped using a survey (n=82), and feedback on the draft report was obtained from a focus group (n=5). User requirements were assessed and validated using a post-campaign survey (n=31). The UCD research was conducted amongst participants in Ljubljana, Slovenia and the results report was distributed among the participating cities across Europe. The feedback received made it clear that the final report was well-received and helped participants better understand the influence of individual behaviours on personal exposure to air pollution.

Health self-tracking is an ongoing trend as software and hardware evolve, making the collection of personal data not only fun for users but also increasingly interesting for public health research. In a quantitative approach we studied German health self-trackers (N=919) for differences in their data disclosure behavior by comparing data showing and sharing behavior among peers and their willingness to donate data to research. In addition, we examined user characteristics that may positively influence willingness to make the self-tracked data available to research and propose a framework for structuring research related to self-measurement. Results show that users' willingness to disclose data as a "donation" more than doubled compared to their "sharing" behavior (willingness to donate= 4.5/10; sharing frequency= 2.09/10). Younger men (up to 34 years), who record their vital signs daily, are less concerned about privacy, regularly donate money, and share their data with third parties because they want to receive feedback, are most likely to donate data to research and are thus a promising target audience for health data donation appeals. The paper adds to qualitative accounts of self-tracking but also engages with discussions around data sharing and privacy.

The recommendations of the panel of experts on the further development of the ‘High-Tech Strategy’ of the Government of the Federal Republic of Germany designate the biologization of economic processes along with digitization as the central driver of societal change. Various fields such as the 'biologization of materials research' were then defined in the 'Bio-Agenda' in order to walk the path from biology to innovation. In view of this perspective, we describe how the use of biological materials and mechanisms can lead to resource conservation, the production of intelligent materials and new technological and medical applications. Our strategy, based on research on ‘Biointerfaces in Technology and Medicine’, aims at the development of modular biohybrid systems that could be used as 'biofactories of the future' for sustainable production processes. To achieve this goal, in a first phase already known technologies have to be further refined and integrated in order to obtain and apply compartmentalized reaction systems on different length and time scales. In a second phase, the resulting functional units will be employed to develop dissipative systems useful for biomedical applications and advanced production processes. From a technical point of view, future success in creating 'something entirely new' will depend crucially on robust and complementary research capabilities. Since the close connection of engineering and life sciences at KIT provides an excellent basis for this endeavor, we consider the above perspectives to be feasible.

Toby Walsh in “The Singularity May Never Be Near” gives six arguments to support his point of view that technological singularity may happen but that it is unlikely. In this paper, we provide analysis of each one of his arguments and arrive at similar conclusions, but with more weight given to the “likely to happen” probability.

Dementia is a public health priority, in which memory impairments are prevalent and affects an individual’s daily activities. Research has tried to find ways to support memory problems of individuals with dementia. Self reference effect (SRE) has been shown to benefit memory in healthy, non-dementia group. The study aimed to investigate if SRE will improve memory performance of individuals with dementia. We used ecologically valid Ownership Procedure and the Remember/Know Paradigm to examine the Self-Reference Effect (SRE) on memory. It was hypothesised that participants living with dementia will perform differently in the recall of items that were self-referentially encoded compared to items other-referentially encoded and that the memory will be different in control participants than in those that live with dementia. The research found that self-referential processes did not have effect on memory in individuals with dementia. We suggest that impaired self-awareness may have contributed to the lack of this effect. However, we had a small sample size and these findings should be treated with caution.

Q-switched laser radiation at wavelengths of 355 nm, 532 nm, and 1064 nm from a Nd: YAG laser was used to generate plasma in laboratory air at the target surface made of compressed nano-silver particles of size 95 ± 10 nm. The emitted resonance spectra from the neutral silver at wavelengths of 327.9 nm and 338.2 nm indicate existence of self-reversal in addition to plasma self-absorption. Both lines were identified in emission spectra at different laser irradiation wavelengths with characteristic dips at the un-shifted central wavelengths. These dips are usually associated with self-reversal. Under similar conditions, plasmas at the corresponding bulk silver target were generated. The recorded emission spectra were compared to those obtained from the nano-material target. The comparisons confirm existence of self-reversal of resonance lines that emerge from plasmas produced at nano-material targets. This work suggests a method for recovery of the spectral line shapes and discusses practical examples. In addition, subsidiary calibration efforts that utilize the Balmer series Hα-line reveal that other Ag I lines at 827.35 nm and 768.7 nm are optically thin under variety of experimental conditions and are well-suited as reference lines for measurement of the laser plasma electron density.

Good health and the promotion of well-being for all is the third of the 17 Global Goals included in the 2030 Agenda for Sustainable Development. Contributing to this goal, the current study aimed to examine the relationships between one kind of athletes’ well-being, namely state organic self-talk, with personality traits, and basic psychological need satisfaction and frustration within their sport. Athletes (N = 691; mean age 21.65) from a variety of individual (n = 270) and team sports (n = 421) completed a multisection questionnaire capturing the targeted variables. Three-step hierarchical regression analyses revealed that: In step 1, all personality traits were to some extent a significant predictor of athletes’ organic, spontaneous self-talk dimensions and goal-directed self-talk functions. In step 2, need satisfaction significantly contributed to all spontaneous self-talk dimensions and goal-directed self-talk functions (except for creating functional deactivated states) over and above personality. Finally, in step 3, need frustration significantly contributed to negative spontaneous self-talk dimensions, and to all goal-directed self-talk functions (except for instruction) over and above personality and need satisfaction. Overall, our results indicate the importance of personality traits as personal antecedents, and perceptions of basic psychological need satisfaction and frustration as social-environmental antecedents, in shaping athletes’ state organic self-talk.

Cyber Physical Systems (CPS) has been a popular research area in the last decade. The dependability of CPS is still a critical issue, and rare survey has been published in this domain. CPS is a dynamic complex system, which involves various multidisciplinary technologies. To avoid human error and to simplify management, self-management CPS (SCPS) is a wise choice. And to achieve dependable self-management, systematic solution is necessary to verify the design and to guarantee the safety of self-adaptation decision, as well as to maintain the health of SCPS. This survey first recalls the concepts of dependability, and proposes a generic environment-in-loop processing flow of self-management CPS, and then analyzes the error sources and challenges of self-management through the formal feedback flow. Focus on reducing the complexity, we first survey the self-adaptive architecture approaches and applied dependability means; then we introduce a hybrid multi-role self-adaptive architecture, and discuss the supporting technologies for dependable self-management at the architecture level. Focus on dependable environment-centered adaption, we investigate the verification and validation (V&V) methods for making safe self-adaptation decision and the solutions for processing decision dependably. For system-centered adaption, the comprehensive self-healing methods are summarized. Finally, we analyze the missing pieces of the technology puzzle and the future directions. In this survey, the technical trends for dependable CPS design and maintenance are discussed, an all-in-one solution is proposed to integrate these technologies and build a dependable organic SCPS. To the best of our knowledge, this is the first comprehensive survey on dependable SCPS building and evaluation.

A phenotype is the composite of an observable expression of a genome for traits in a given environment. The trajectories of phenotypes computed from an image sequence and timing of important events in a plant’s life cycle can be viewed as temporal phenotypes and indicative of the plant’s growth pattern and vigor. In this paper, we introduce a novel method called FlowerPhenoNet which uses deep neural networks for detecting flowers from multiview image sequences for high throughput temporal plant phenotyping analysis. Following flower detection, a set of novel flower-based phenotypes are computed, e.g., the day of emergence of the first flower in a plant’s life cycle, the total number of flowers present in the plant at a given time, the highest number of flowers bloomed in the plant, growth trajectory of a flower and the blooming trajectory of a plant. To develop a new algorithm and facilitate performance evaluation based on experimental analysis, a benchmark dataset is indispensable. Thus, we introduce a benchmark dataset called FlowerPheno which comprises image sequences of three flowering plant species, e.g., sunflower, coleus, and canna, captured by a visible light camera in a high throughput plant phenotyping platform from multiple view angles. The experimental analyses on the FlowerPheno dataset demonstrate the efficacy of the FlowerPhenoNet.

Only by understanding the ability to take third-person perspective can we begin to elucidate the neural processes responsible for one’s inimitable conscious experience. The current study examined differences in hemispheric laterality during a first-person perspective (1PP) and third-person perspective (3PP) taking task, when using Transcranial Magnetic Stimulation (TMS). Participants were asked to take either the 1PP or 3PP when identifying the number of spheres in a virtual scene. During this task, single-pulse TMS was delivered to the motor cortex of both the left and right hemispheres of 10 healthy volunteers. Measures of TMS-induced motor-evoked potentials (MEPs) of the contralateral abductor pollicis brevis (APB) were employed as an indicator of lateralized cortical activation. The data suggest that the right hemisphere is more important in discriminating between 1PP and 3PP. These data add a novel method for determining perspective taking and add to the literature supporting the role of the right hemisphere in meta representation.

This study is a synthesis of 159 articles that were selected for their relevance to comprehend key aspects of the Massive Open Online Courses (MOOCs) phenomenon, from a discourse analysis perspective. Since 2011, MOOCs are expanding worldwide so that the number of subscribers outpointed 101 million at the end of 2018. This paper explores the question whether the MOOCs are the embodiment of the global one-world classroom or whether, instead, they represent a low-cost alternative tailored to a segment that doesn´t have enough time or resources to attend a brick-and-mortar college. In addition, the review tackles the link between motivation and low completion rates. Finally, we discuss the need to devise better methods to assess the pedagogical value of MOOCs.

Background: Although electronic health records (EHR) provide useful insights into disease patterns and patient treatment optimisation, their reliance on unstructured data presents a difficulty. Because of their narrative structure, echocardiography reports, which provide extensive pathology information for cardiovascular patients, are particularly challenging to extract and analyse. Although natural language processing (NLP) has been utilised successfully in a variety of medical fields, it is not commonly used in echocardiography analysis. Objectives: To develop an NLP-based approach for extracting and categorizing data from echocardiography reports by accurately converting continuous (e.g. LVOT VTI, AV VTI, and TR Vmax) and discrete (e.g. Regurgitation severity) outcomes in semi-structured narrative format into structured and categorized format, allowing for future research or clinical use. Methods: 135,062 Trans-Thoracic Echocardiogram (TTE) reports were derived from 146967 baseline Echocardiogram reports and split into three cohorts: Training and Validation (n = 1075), Test Dataset (n = 98) and Application Dataset (n = 133,889). The NLP system was developed and iteratively refined using medical expert knowledge. The system was used to curate a moderate-fidelity database from extractions of 133,889 reports. A hold-out validation set of 98 reports was blindly annotated and extracted by two clinicians for comparison with the NLP extraction. Agreement, discrimination, accuracy and calibration of outcome measure extractions were evaluated. Results: Continuous outcomes including LVOT VTI, AV VTI, and TR Vmax exhibited perfect inter-rater reliability using intra-class correlation scores (ICC=1.00, P< 0.05) alongside high R2 values, demonstrating an ideal alignment between the NLP system and clinicians. Good level (ICC =0.75-0.9, P<0.05) of inter-rater reliability were observed for outcomes such as LVOT Diam, Lateral MAPSE, Peak E Velocity, Lateral E' Velocity, PV Vmax, Sinuses of Valsalva, and Ascending Aorta diameters. Furthermore, the accuracy rate for discrete outcome measures was 91.38% in the confusion matrix analysis, indicating effective performance. Conclusions: The NLP-based technique yielded good results when it came to extracting and categorising data from echocardiography reports. The system demonstrated a high degree of agreement and concordance with clinician extractions. This study contributes to the effective use of semi-structured data by providing a useful tool for converting semi-structured text to structured echo report that can be used for data management. Additional validation and implementation in healthcare settings can improve data availability and support research and clinical decision-making.

(1) Background: Retroareolar breast tumors are common, but they rarely progress to malignancy. This report presents a case of a 41-years-old woman with a superficial breast tumor, emphasizing the significance of considering a wide range of options when evaluating breast lumps. (2) Methods: The patient presented with a steadily growing, ulcerating superficial tumor in her left breast. To determine the nature of the tumor, a diagnostic assessment was conducted, which included a positron emission tomography (PET) scan and histological analysis. (3) Results: The diagnostic assessment confirmed the presence of a malignant Grade II superficial infiltrating ductal carcinoma. Following the diagnosis, the patient underwent a modified radical mastectomy under general anesthesia. Subsequently, she received four cycles of adjuvant chemotherapy, followed by taxol administrations. (5) Conclusions: This case report underscores the importance of conducting a thorough examination and maintaining a high index of suspicion for breast tumors. By documenting this case, the report contributes to the existing knowledge on various manifestations of breast cancer and highlights the necessity of early identification and aggressive treatment. This knowledge can be applied to identify and manage similar cases in the future, leading to improved patient outcomes.

This article is a scoping review analyzing advances in experimental studies on bacterial self-healing of concrete. From Scopus, ScienceDirect, Web of Science and Google Scholar search engine databases, 54 studies were selected for analysis, and an increasing trend of publications since 2015 was found, with India as the country with the largest research presence. Different ma-terials are used as replacement or admixture in concrete, such as fibers, particles and recycled material from construction waste. It was found that the most commonly used bacteria are Bacillus subtilis and Bacillus sphaericus, which can improve the strength of concrete by generating calcite and sealing cracks. In addition, it was found that the presence of materials such as fibers, ashes and construction recyclates can protect bacteria in an alkaline environment. The designs usually in-clude more than two experimental groups and a control. In summary, this study highlights the importance of bacterial self-healing in concrete and provides information on advances in this field of research.

This review article delves into the intricate psychology behind galivanting, absenteeism, and self-denial among college students. By conducting a meticulous analysis of relevant books, journals, and articles, key psychological factors come to light. The review examines the influence of exploration and identity formation, social motivation, coping mechanisms, lack of motivation or engagement, time management, and self-denial on these behaviors. By addressing gaps in the literature, it provides a deeper understanding of the phenomena at hand. The implications of this study extend to the development of interventions and strategies that address self-denial tendencies, promote effective time management, and foster a supportive learning environment. By shedding light on the intricate interplay of these factors, this paper opens doors for future research and targeted interventions, ultimately aiming to enhance academic engagement, reduce absenteeism, and support the overall well-being and success of college students.

Background: Nursing services provided by nurses are based on knowledge and competence in the field of nursing science developed in accordance with Client needs, scientific developments, and the demands of globalization. These health services include nursing services that are carried out responsibly, accountably, with quality, and safely by nurses who have obtained registration and permission to practice. Nursepreneur is innovation and courage to take risks and is ready to work hard to achieve goals with optimism. Which has important components namely: 1) quality, 2) role, 3) option and success. The post-pandemic new world, especially in the health care system, continues to grapple with the demands of costs to provide patient care and safety. By using the application of the nursing theory model. Purpose :. Assessing scientific studies on the application of evidence-based intervention in wound care using nursing theory, identifying the important role of telenursing in improving nursing services in Nerspreneurship, Method: literature study Conclusion: Telenursing in nursing focuses on providing nursing care through information technology, such as telephone, computers, and the Internet that can be used to improve treatment outcomes among older people, especially those with low literacy skills and low financial status (Esmaeilpour-BandBoni et al., 2020). The statement from the results of the study refutes that Telenursing is intended for patients who have higher education and middle and upper economic states.

Background: Indonesia is an archipelago with various cultured, will bee affects all aspects of people's lives, including beliefs related to health behavior and health care. One problem that needs serious attention is the elderly group because the elderly are a vulnerable group who have a high risk of experiencing health problems, such as anemia with hypertension, so they need good care management. The research objective was to determine self-management intervention for hypertensive elderly. Methods: This research is a literature review with five databases (Scopus, CINAHL, ScienceDirect, PubMed, Proquest), the study design used is an experimental, descriptive, cross-sectional, and review systematic, in March 2021. Guidelines for using JBI to measure quality and listing check out Prisma in this review guide. A feasibility study based on title, abstract, full text, and research methodology. The data analysis used narrative analysis based on the research findings. Results: Twelve articles met the predefined review inclusion criteria. The study found eight interventions for self-management in elderly hypertension, namely: 1) Knowledge of hypertension, 2) Regulation of physical activity, 3) Limitation of alcohol and cigarette consumption, 4) Sleep rest and stress management, 5) Diet and body weight management, 6) Blood pressure control, 7) Family and social support, 8) Adherence to therapy regimens. Conclusion: The conclusion of the study results obtained eight elderly self-management interventions, this done properly will affect compliance in optimizing the health of the elderly.

Background: Since the beginning of the 20th century, the importance of creating healthy work environments and promoting the health of workers in the healthcare sector to create Healthy and Resilient Organizations has been emphasized. In this context, self-esteem is an essential construct which influences health and healthy life styles, and therefore, the general wellbeing of nurses. The objective of this study was to analyze the mediating role of reasons for exercising in the effect that self-esteem has on uncontrolled eating by nursing professionals. Methods: The sample was made up of 1094 nurses who were administered the Rosenberg General Self-esteem Scale, the Goal Content for Exercise Questionnaire and the Three-Factor Eating Questionnaire-R18. Results: Bivariate correlation analysis and multiple mediation analysis showed that self-esteem has direct and indirect effects on uncontrolled eating. More so, self-esteem predicts doing physical exercise to improve one’s image, recognition and social affiliation, although the effects on uncontrolled eating were only significant through image. Conclusions: The results have important practical implications in the framework of Positive Occupational Health Psychology (POHP) as it emphasizes self-esteem, physical exercise and eating as essential aspects of the health and wellbeing of employees in the healthcare sector, highlighting the importance of creating organizations committed to promoting the psychosocial health of their workers.

We develop an optimized force-field for poly(3-hexylthiophene) (P3HT) and demonstrate its utility for predicting thermodynamic self-assembly. In particular, we consider short oligomer chains, model electrostatics and solvent implicitly, and coarsely model solvent evaporation. We quantify the performance of our model to determine what the optimal system sizes are for exploring self-assembly at combinations of state variables. We perform molecular dynamics simulations to predict the self-assembly of P3HT at ~350 combinations of temperature and solvent quality. Our structural calculations predict that the highest degrees of order are obtained with good solvents just below the melting temperature. We find our model produces the most accurate structural predictions to date, as measured by agreement with grazing incident X-ray scattering experiments.

Partial differential representation of self-similarity feature has been derived from notion of the homogenous function in general sense. This representation allows consideration of stochastic self-similar systems. As well as the partial differential representation allows consideration of Stochastic Partial Differential Equation.

Though Cyber Physical Systems (CPS) become very popular in last the decade, dependability of CPS is still a critical issue and related survey is rare. We try to spell out the jigsaw of technologies and figure out the technical trends of dependable self-managing CPS. This survey first recalls the motivation and the similar concepts. By analyzing four generic architectures, we summarize the common characteristics and related assurance technologies, and propose a more generic environment-in-loop processing flow of CPS and a formal interaction flow between physical space and cyber space. Further, the similarity between correctness and dependability is formally analyzed and the new five research questions of dependable self-managing CPS are presented. Then we review the critical technologies and related correctness verification & validation (V&V) methods, the architectures for dependable self-managing CPS. Further, the detail dependability management and V&V technologies are surveyed, which covers the areas of running-time fault management methods and whole life cycle V&V technologies, maintenance and available tool sets. For holistic CPS development, Modeling techniques and MDE (model driven engineering) based V&V methods are analyzed in detail. Then we complete the jigsaw of technologies and figure out the missing part. Further, we propose the technical challenges and the further direction. To our best knowledge, this is the first comprehensive survey on dependable self-managing CPS development and evaluation.

Background and Objective: Intimate relationships hold significant importance during emerging adulthood. This study aimed to investigate the critical determinants of perceived well-being in friendship relationships during emerging adulthood.Method: Using a quantitative approach, a sample of 726 undergraduate students from the Ferdowsi University of Mashhad were selected through convenience sampling. They completed the Interpersonal Behaviors Questionnaire (IBQ), the Compassionate and self-image goals scale (CSIGS), the Basic Need Satisfaction in Relationships Scale (BNS-RS), the Interpersonal Needs Questionnaire (INQ-10), Friendship Self-Regulation Questionnaire (SRQ-F), Interpersonal Behaviors Questionnaire-Self (IBQ-self), State Level Subjective Vitality Scale (SVS-SL), the Perceived Relationship Quality Component (PRQC), and the Basic Empathy Scale (BES). Data analysis was conducted using Partial Least Squares Structural Equation Modeling (PLS-SEM).Results: The results indicated that the critical determinants in predicting perceived well-being in friendship relationships were, in order, goals in friendship relationships, friendship self-regulation, perceived support of basic psychological needs by friends, satisfied basic psychological needs, frustrated psychological needs, and supporting the basic psychological needs of friends.Conclusion: The findings demonstrate that self-determination theory (SDT) provides a coherent framework for explaining perceived well-being in friendships.

The current article examined stoma self-care and health-related quality of life in patients with drainage enterostomy, describe clinical and sociodemographic variables and analyze the relations between all of them. Trained interviewers collected data using a standardized form that queried sociodemographic and clinical variables, collected from the electronic medical record, in addition to the Specific Self-Care for Ostomized Patients Questionnaire (CAESPO) and Stoma Quality of life (S-QoL) from January 2016 to January 2017. This was a multicenter, cross sectional study conducted in four hospitals of the province of Castellon (Spain) where 120 participants were studied. Significant differences were found in Self Care according to sex (p = .043); married participants show higher score (p < .01); also, significant differences according to work activity were observed (p < .01). Regarding the clinical variables, differences were observed according to the autonomy of care, the presence of complications in the stoma, the use of irrigation and the type of effluent (p < .01). We can highlight the importance of the skills related to self-care by ostomized patients has for a good level of quality of life related to health. In this learning process, the figure of the stoma therapist plays a very important role.

X-rays production through betatron radiation emission from electron bunches is a valuable resource for several research fields. The EuAPS (EuPRAXIA Advanced Photon Sources) project, within the framework of the EuPRAXIA project, aims to provide 1-10 keV photons (soft X-rays) developing a compact plasma-based system designed to exploit self-injection processes that occur in highly nonlinear laser-plasma interaction (LWFA) to drive electron betatron oscillations. Since the emitted radiation spectrum, intensity, angular divergence, and possible coherence strongly depend on the properties of the self-injected beam, accurate preliminary simulations of the process are necessary to evaluate the optimal diagnostic device specifications. Dedicated tools for these tasks are under development: electron trajectories from particle-in-cell (PIC) simulations are currently undergoing numerical analysis through the calculation of retarded fields and spectra for various plasma and laser parameter combinations. At the same time, an analytical approach is being examined to obtain an expression for the emitted spectrum, assuming linear or quadratic electron energy variation. Code structure and some trajectories analysis results are presented.

Self-selecting the intensity of aerobic training is a perspective that allows practitioners to develop autonomy (choice of pace), improve physical fitness and achieve weight loss. To compare the effect of four aerobic training protocols on cardiometabolic and psycho-affective responses in physically inactive adult men and women. The sample consisted of 11 individuals aged 56 ± 10 years and BMI 29.2 ± 2.4 kg/m2 performed four different treadmill aerobic training protocols, including: 1-individual with self-selected intensity (ISS), 2-individual with prescribed intensity (IPI) (64-76% of HR max), 3-small group with self-select. selected intensity (SGS) and 4-small group prescribed intensity (SGP) (64-76% of HR max). Heart rate (HR), lactate (LACT), perceived exertion (RPE), affective response (FS), activation scale (FAS), enjoyment (PACES) and intention to repeat the session (INT) were analyzed. Statistical analysis used ANOVA with Tukey's post hoc test (p&lt;0.05). HR, LACT and RPE analyzes did not show significant differences between protocols. The FS showed a smaller decline in the SI protocol (p&lt;0.05), and the intention to repeat the training session was greater in the SI protocol (p&lt;0.05). Conclusion: The data allow us to conclude that the SI training protocol produced superior results in affective response, pleasure and intention to repeat the session.

Background Coronavirus disease 2019 (COVID-19) almost ceased to spread across the globe, but post Covid psychological experiences are rarely documented. It is essential to understand the individual psychological needs and challenges regarding working during the covid-19 pandemic and resilience and psychological health to continuing work in the aftermath of this crisis. Objective To explore the psychological transformation of staff nurses after COVID-19 Methods A phenomenological and purposive sampling approach was employed. Registered nurses working at the largest health organization in Qatar includes 14 health facilities were invited to participate in this study. 17 nurses who were working in the facilities and were deployed during the first, second and third wave of Covid 19 participated in the interview. Data were collected through semi-structured face-to-face interviews using quarantine measures. The interview data were analyzed using inductive thematic analysis. Results The psychological transformation of participants was summarized into three themes fear zone, Learning zone and growth zone. These themes were classified into 10 sub-themes Fear and anxiety, Influence of media and news, Frequent change in policies and guidelines were the fear zone factors .Secondly Coping mechanism, teamwork, establishing compassionate care, social acceptance, personal and professional benefits helps them learn psychologically. Thirdly growth factors such as confident & resilient, Sense of purpose and Change life perception and meaning Conclusion Working during COVID-19 imposed many challenges on nurses such as workload and stress. However, the different waves of the pandemic may increase the resilience, confidence and life meaning in nurses. Their previous experiences in handling difficult situations during the pandemic may make the nurses become more confident in dealing with stressful situations and working under pressure.

The production associated with geopolymers is more environmentally friendly because it does not emit as much carbon dioxide as when OPCs are used. In addition, research has been initiated to produce a geopolymer with very good mechanical properties without the need to cure it at high temperatures. Bio-additives such as honey, cotton or molasses were found to have a good effect on the properties of the geopolymer. The purpose of this study was to develop a composition of geopolymer modified with bioaddi-tives (introduction of plant-derived materials containing sugars) in order to improve the strength para-meters of geopolymers cured at ambient temperature or to accelerate their setting process, and to identify whether it is possible to produce geopolymers with good strength parameters without the need for annealing. In this study, fly ash (FA)-based materials were made and addi-tionally modified with cane molasses and beet molasses in varying amounts. The made samples were subjected to surface morphology analysis (SEM), mechanical properties analysis - compres-sive and flexural strengths, phase composition analysis (XRD) and absorption analysis.

In response to escalating environmental concerns and the surge in eco-friendly sports activities, this study investigates the determinants of sustained intention to participate in plogging, a prac-tice that combines jogging and litter collection. The study seeks to discern the effects of autonomy, competence, and relatedness experiences, as suggested by Self-Determination Theory, on the intent to persist in plogging. Additionally, the study probes the moderating role of eco-friendly attitudes, thereby propelling the confluence of sports and environmental research. The research methodology encompassed surveying plogging participants and analyzing their responses. The validation of these relationships was executed using multi-group structural equation modeling. The results revealed that autonomy and competence did not significantly sway extrinsic motivation, but relatedness surfaced as the most influential factor. This suggests that plogging, primarily viewed as a volunteering activity, serves more as a prosocial behavior that bolsters relationships rather than a means to enhance physical competence. The study also found that the value participants derived from plogging and their intention to continue varied based on their eco-friendly attitudes. The study concludes that voluntary participation and socializing are the core values of plogging, and understanding these values can foster healthier and more sustainable behaviors. The findings offer valuable insights for academic, practical, and policy perspectives in promoting eco-friendly sports activities.

In the study, it was aimed to develop a valid and reliable scale in order to determine the self-efficacy perceptions of classroom teachers in the field of mathematics learning difficulties. In the development process of the scale, the basic resources and the scale development studies in the literature were examined. First, a pool of substances was created. Content validity was ensured by taking the opinions of 21 expert participants in the 24 question areas determined in the item pool. Content validity index was used in content validity. In this analysis, two questions were removed from the scale. Preliminary application was made with 44 participating teachers who are experts in their fields and exploratory factor analysis was started. For exploratory factor analysis, 359 people consisting of classroom teachers in Sakarya province were studied. In the explanatory factor analysis, 5 items were removed from the scale by looking at the factor load. The factor loadings for the 17 items in the scale vary between 0.508 and 0.976. Among the comparative fit indices obtained as a result of confirmatory factor analysis, RMSEA=0.067 and Cmin/DF=1.568 were calculated. The Cronbach alpha reliability coefficient of the measurements is 0.970. The data obtained were analyzed with statistical methods using SPSS 25, AMOS 24 and Microsoft Excel programs. The validity and reliability criteria of the scale developed within the scope of the study were met.

Research for novel vaccine adjuvants remains a critical need to improve the immune responses to a recombinant vaccine antigen. Emulsion adjuvants such as AS03 and MF59, particularly in the area of Influenza vaccines, have shown antigen dose sparing and allowed reduced immunizations. It was previously demonstrated that these emulsion adjuvants can be formulated using a simpler, low shear process of self-emulsification. The role of alpha tocopherol as an immunomodulator in emulsion adjuvants is evident from the success of AS03 in the on-going covid-19 pandemic. Although, it was a challenge to formulate alpha tocopherol with a low shear process to get closer to the AS03 composition, the self-emulsified version referred as self-emulsifying adjuvant systems (SE-AS) showed comparable immune responses to AS03 when co-administered with a Quadrivalent influenza virus (QIV) vaccine. In this paper, we first optimized the SE-AS with alpha tocopherol referred to as SE-AS44 to allow sterile filtration. We compared the in vitro cytokine profile with self-emulsifying adjuvant 160 (SEA160), a squalene-only self-emulsified adjuvant with composition similar to MF59. We compared SE-AS44 and SEA160 co-administered with a recombinant cytomegalovirus (CMV) pentamer antigen, which is a less immunogenic antigen, in vivo to compare the antibody and T-cell responses, in different adjuvanted groups, in C57BL/6 mice.

Self-healing is the capability of materials to repair themselves after damage has occurred, usually by interaction between molecules or chains. Physical and chemical processes are applied for the preparation of self-healing systems. There are different approaches for these systems such as heterogeneous systems, shape memory effects, hydrogen bonding or covalent-bond interaction, diffusion and flow dynamics. Self-healing mechanisms can occur in particular by heat and light exposure or by reconnection without direct effect. The applications of these systems display an increasing trend in both R&D and industry sectors. Moreover, self-healing systems and their energy storage applications are currently getting great importance. This review aims to provide general information on recent developments in self-healing materials and their energy applications in view of the critical importance of self-healing systems for lithium-ion batteries (LIBs). In the first part of the review, an introduction about self-healing mechanisms and design strategies of self-healing materials is given. Then, selected important healing materials in the literature for the anodes of LIBs are mentioned in the second part. The results and future perspectives are stated in the conclusion section.

Background: HIV self-testing (HIVST) is one of the recommended approaches for HIV testing services, particularly for helping reach populations who would not normally access facility-based HIV testing. HIVST must be tailored to different populations to ensure uptake. Objective: The main objective of this study was to develop an acceptable HIVST delivery strategy to help improve urban men’s engagement with HIV services. Methods: We invited key stakeholders for urban men’s HIV services to participate in a co-creation workshop aimed at developing HIVST delivery approaches for urban men, using eThekwini municipality as a study setting. We conducted purposive sampling to include health care users and health care providers, representing a range of views across the public sector and voluntary sector. We employed the Nominal Group Technique (NGT) method for data collection. The NGT workshop was conducted in two consecutive phases: phase one was focused on determining barriers for men’s engagement with the current/facility-based HIV testing services; phase two was aimed at determining HIVST delivery strategies. We used the results of the NGT to design a tailored HIVST strategy for urban men in eThekwini District. Results: Participants identified the following psychological factors as the most important barriers to uptake of HIV testing services by urban men: stigma, ignorance about the importance of testing and testing process as well as fear of positive test results. Key stakeholders suggested internal motivation strategies as a potentially effective approach to support HIVST delivery strategy. Guided by the NGT results, we designed a HIVST delivery strategy that is supported by a risk communication approach Conclusion: We designed an evidence-based risk communication mobile health (mHealth) strategy coupled with SARS COV-2 self-testing tailored to improve men’s uptake of HIVST. A follow-up study to evaluate the feasibility of implementing these approaches is recommended.

Our brains process information using a layered hierarchical network architecture, with abundant connections within each layer and sparse long-range connections between layers. As these long-range connections are mostly unchanged after development, each layer has to locally self-organize in response to new inputs to enable information routing between the sparse in- and output connections. Here we demonstrate that this can be achieved by a well-established model of cortical self-organization based on a well-orchestrated interplay between several plasticity processes. After this self-organization, stimuli conveyed by sparse inputs can be rapidly read out from a layer using only very few long-range connections. To achieve this information routing, the neurons that are stimulated form feed-forward projections into the unstimulated parts of the same layer and get more neurons to represent the stimulus. Hereby, the plasticity processes ensure that each neuron only receives projections from and responds to only one stimulus such that the network is partitioned into parts with different preferred stimuli. Along this line, we show that the relation between the network activity and connectivity self-organizes to a biologically plausible regime. Finally, we argue how the emerging connectivity may minimize the metabolic cost for maintaining a network structure under the above described constraints.

This proposal describes the design and development of an interoperable application that supports green open access with long-term sustainability and improved user experience of article deposit. Introduction: The lack of library resources and unfriendly repository user interface are two significant barriers that hinder green open access. Tasked to implement the open access mandate, librarians at an American research university developed a comprehensive system called Easy Deposit 2 to automate the support workflow of green open access. Implementation: Easy Deposit 2 is a web application that is able to harvest newly publications, outreach for manuscript on behalf of the library, and facilitate self-archiving to IR. It is developed and maintained by the library and integrated with the IR. Results and Discussion: The article deposit rate is about 25% with Easy Deposit 2, which increases significantly comparing to the previous period. It also serves as a local database for faculty publications with open access status. The lesson learned is that library cannot rely on a single commercial provider for publication data due to mismatched priorities. Conclusion: Recent IT developments provides new opportunities of innovation like Easy Deposit 2 in supporting open access. Academic librarians are vital in promoting "openness" in scholarly communication such as transparency and diversity in the sharing of publication data.

The study aimed to understand the experiences of adolescent smokers who participated in a smoking cessation program based on self-reflection, and to develop the theoretical basis for constructing similar programs. The participants, ten students from middle and high schools located in cities G and S, were interviewed after the program ended. Data were collected from August to November 2019 and analyzed using a phenomenological approach to understand participant experiences in depth. The analysis revealed five major themes: ‘Uniqueness of the Program,’ ‘Perception of Smoking Cessation,’ ‘Positive Reflection on Life,’ ‘Understanding Others,’ and ‘A Search for Hope and Vision in Life.’ The findings revealed that the smoking cessation program facilitated the development of self-identity and vision, which may indirectly strengthen the motivation for adolescent smokers to quit smoking. These findings suggest the need for a life-changing smoking cessation program that enhances self-concept and self-esteem. Moreover, it highlights the importance of follow-up research to ensure effectiveness, and the need to develop programs with creative content.

While some researchers have suggested that the self-employment (SE) sector is a haven during a financial Crisis, others believe that SE is not necessarily the desired outcome, but an indicator that the labor market is tightening for some groups. Few researchers have compared the SE sector before and after the occurrence of a significant financial Crisis, especially in developed countries. This paper analyzes the determinants of entry into self-employment during the 2008 Spanish Crisis. Using data from the Encuesta de Presupuesto Familiar (EPF), results show that although the rate of SE did not experience a significant change during this time the Crisis affected people differently based on gender, with being females more affected than males. Results also suggest differences between Comunidades Autonomas in how the self-employment sector behaved during the Crisis.

Due to limitation of the binding energy of a self-gravitating matter, the radius of a body is at least twice larger than the Schwarzschild radius. The total energy is adsorbed at the body surface, giving rise of a size-dependent surface tension. Since the Hawking temperature appears to be the critical one, the black holes possess zero surface tension. Microscopic neutrino stars are also introduced.

This study aimed to know the conditioning factors of the transition process to the self-care of women diagnosed with HIV/AIDS. This qualitative study was carried out from June to September 2015 with seven seropositive women, users of a specialized service in sexually transmitted diseases in the municipality of Imperatriz, Maranhão State, Brazil. For the data collection, an individual interview was used, and data analysis was performed by content analysis delineated by Hsieh and Shannon (2005). The resources that influence the self-care in the transition process of women with HIV/AIDS are represented by personal conditioning factors, such as the meaning they attribute to the living with the disease, personal attitudes and cultural beliefs, socioeconomic status, preparation and knowledge about the disease, and by conditioning factors found in the community and society. The transition theory can provide important insights about the resources present in the adaptation process of women diagnosed with HIV so that they can perform their self-care satisfactorily.

To better understand the shape memory materials and self-healing materials, a new series of liquid-crystalline shape memory polyurethane (LC-SMPU) composites, named SMPU-OOBAm, were successfully prepared by incorporating 4-octyldecyloxybenzoic acid (OOBA) into the PEG-based SMPU. The effect of OOBA on the structure, morphology and properties has been carefully investigated. The results demonstrate that SMPU-OOBAm have liquid crystalline properties, triple-shape memory properties and self-healing properties. The incorporated OOBA promotes the crystallizability of both soft and hard segments of SMPU, and the crystallization rate of the hard segment of SMPU decreases when the OOBA-content increases. Additionally, the SMPU-OOBAm forms a two-phase separated structure (SMPU phase and OOBA phase), and it shows two-step modulus changes upon heating. Therefore, the SMPU-OOBAm shows triple-shape memory behavior, and the shape recovery ratio decreases with an increase in the OOBA content. Finally, SMPU-OOBAm shows self-healing properties. The new mechanism can be ascribed to the heating-induced “bleeding” of OOBA in the liquid crystalline state and the subsequent re-crystallization upon cooling. This successful combination of liquid crystalline properties, triple-shape memory properties and self-healing properties make the SMPU-OOBAm composites with many promise applications in smart optical devices, smart electronic devices and smart sensors.

: Glaucoma is the most common cause of blindness, which significantly reduces quality of life. Most glaucoma cases are primary glaucoma; nevertheless, many patients suffer from glaucoma caused by drugs, such as corticosteroids. A comprehensive review of the risks associated with corticosteroid-induced glaucoma is limited. Therefore, we used the Japanese Adverse Drug Event Reporting Database (JADER) published by the Pharmaceuticals and Medical Devices Agency (PMDA) to analyze the risk factors associated with glaucoma and the trends and characteristics of corticosteroid-induced glaucoma. We did not find sex or age differences associated with the onset of glaucoma. Hierarchical clustering and principal component analysis revealed that triamcinolone acetonide and betamethasone sodium phosphate, which are used around the eyes in Japan, are more likely to induce intraocular pressure (IOP) elevation compared with other corticosteroids. Increased IOP is a direct cause of glaucoma. Based on these findings, it may be necessary to limit or avoid the use of these corticosteroids.

The introduction of ventricular shunts dramatically changed the outcome and quality of life of hydrocephalic patients. However, shunt surgery continues to be associated with numerous adverse events. Headache is one of the most common complications after shunt operation. It is often over a prolonged duration, the symptoms resemble migraine, and pain does not respond to medication. We propose invasive peripheral nerve stimulation as a possible solution in the treatment of patients suffering from chronic headache associated with shunted hydrocephalus. A young woman with daily holocephalic headache with diffuse pain exacerbated by lying down. Imaging revealed panventricular enlargement and possible stenosis of the aqueduct. When a ventriculoperitoneal shunt was placed, clinical symptoms resolved. Nevertheless, she gradually exacerbated after a second valve replacement due to wound infection. Imaging revealed decompressed ventricles and appropriate shunt placement. The diagnosis of chronic post-intracranial disorder headache was set. Therefore, occipital nerve stimulation was applied and considering that the patient had not a total response, bilateral parietal stimulation was added. Three months after the combined PNS she experienced total remission of headache. Combined PNS eases refractory headaches much more than occipital nerve stimulation alone and could be considered as a solution for shunted hydrocephalus associated headache.

This work is the first part of a series of papers on a comprehensive analysis of the processes of prebiotic self-organization and protophotosynthesis on the surface of semiconductor minerals and in systems of natural dispersed semiconductors. Comprehensive analysis within the framework of the "semiconductor world" concept allows integrating a variety of models on a single physical basis - from ZnS world and FeS world (based on inorganic semiconductors) to the PAH world and aromatic world (including organic semiconductors). Thus, we do not put forward a new alternative hypothesis of chemical evolution - a new "chemical world", but only integrate the evolutionary and geochemical criteria of different "chemical worlds" into a single "physical world", which gives one the opportunity to reconstruct and predict the directions of chemical evolution according to the uniform principles of physical chemistry. In the first part of this series we consider photoinduced self-organization and "photo-controlled" evolution of the early protobiological systems performing solar energy conversion on the surface of dispersed semiconductor minerals capable of (photo)catalyzing and photosensitizing prebiological processes. The latter include a transition from the elementary cycles of photocatalytic reactions on the surface of semiconductors to protophotometabolic cycles and protophotosynthesis, from photophysical processes on the surface of mineral semiconductors to photoinduced membrane potentials, from photocontrolled sorption on the surface of such minerals to the formation of photosensitive protomembranes and selection of photosynthetic structures. The evolutionary approach to the analysis of protobiological mechanisms and protobioenergetics within the framework of the "semiconductor world" concept provides a new approach to the study of the last common point of divergence of protobiological systems, where the emergence principles of different energy supply schemes (like the energy source-specific photoautotrophy and substrate-specific chemoautotrophy) merge at the physicochemical level. The proposed integrating scheme is consistent with most biological, geological, and physicochemical concepts, which ensures its complete cross-checking and internal consistency.

In 2015, the Self-Action Leadership Theory—a qualitative, nomological expansion of self-leadership theory rooted in atmospheric and astronomical metaphor aimed at expanding the personal freedom of individuals, organizations, and nations by bolstering the existential growth of individuals through a series of Maslow-esque stages of holistic, personal development. This article introduces an accompanying, practitioner-based Model of Self-Action Leadership (SAL) aimed at the implicit enhancement of a holistic range of administrative processes through explicit training, mentoring, and coaching in the model’s general and universally-applicable principles and practices. The SAL model produces an original construct of personal leadership practice that builds upon the extant self-leadership academic canon, which dates back to 1983 (Manz, 1983). It also provides an analogue to four of the five core processes of Project Management by positioning a self-action leader (an individual) as the ongoing “project” at hand. The SAL Model is rooted in action research and was developed through a variety of self-oriented, action research projects in conjunction with a comprehensive, qualitative, analytical autoethnographic study of a scholar’s life experiences.

Nanometer-curved surfaces are abundant in biological systems as well as in nano-sized technologies. Properly functionalized polymer-grafted nanoparticles (PGNs) adhere to surfaces with different geometries and curvatures. This work explores some of the energetic and mechanical characteristics of the adhesion of PGNs to surfaces with positive, negative and zero curvatures using Coarse-Grained Molecular Dynamics (CGMD) simulations. Our calculated free energies of binding of the PGN to the curved and flat surfaces as a function of separation distance show that curvature of the surfaces critically impacts the adhesion strength. We find that the flat surface is the most adhesive, and the concave surface is the least adhesive surface. This somewhat counterintuitive finding suggests that while a bare nanoparticle is more likely to adhere to a positively curved surface than a flat surface, grafting polymer chains to the nanoparticle surface inverts this behavior. Moreover, we studied the rheological behavior of PGN upon separation from the flat and curved surfaces under external pulling force. The results presented herein can be exploited in drug delivery and self-assembly applications.

The goal of this work is to show that the underlying symmetries of effective field theory can be traced to the onset of self-similarity. In particular, we argue that the scale-free structure of fractal geometry lies at the heart of invariance principles in classical and Quantum Field Theory.

Background and Objectives: Although there has been growing interest in the association of ADHD with anxiety, depression, suicidal ideation, and self-esteem, there is a lack of consistent results and these associations remain unclear. This study investigated the differential patterns of anxiety, depression, suicidal ideation, and self-esteem with regard to the presence of ADHD. Materials and Methods: The subjects were divided into a patient group and a control group. The patient group included 49 patients diagnosed with ADHD at the department of psychiatry of one university hospital. For the control group, 3,727 students were invited to complete a questionnaire. Of the 1,717 students who responded to the questionnaire, 245 were selected for patient-controlled studies. All the subjects were instructed to complete the Beck Suicide Ideation Scale, Children's Depression Inventory, Beck’s Depression Inventory, State-Trait Anxiety Inventory, and Rosenberg Self-Esteem Scale. Results: ADHD subjects experienced more anxiety, depression, and suicidal ideation as well as lower self-esteem compared to the control group comprising participants without ADHD. Conclusions: These findings suggest that ADHD symptoms may contribute to greater suicidal ideation through experienced depression, anxiety, and low self-esteem in school-aged children. Therefore, appropriate ADHD symptom management is necessary to reduce suicidal ideation among school-aged children with ADHD symptoms.