The aim of this study was to compare the effect of using L-PRF in patients undergoing impacted lower third molar surgery with either primary or secondary closure techniques. Methods: This prospective, randomised, double-blind, split-mouth clinical trial was conducted in patients with bilateral lower impacted third molars of similar position. Primary closure was performed in group 1 and secondary closure in group 2. Group 1 closure technique was applied to one side of the patients and group 2 closure technique was applied to the other side at different times. Nine pa-tients were excluded from the study due to alveolitis and failure to attend regular control visits out of the 45 patients evaluated. Results: Of the 36 patients included in the study, 23 were female and 13 were male and the mean age was 22.42±3.36 years. The secondary closure group had lower VAS scores at hour 6 (p

HIV-associated neurocognitive disorders (HAND) persist under antiretroviral therapy as a complex pathology that has been difficult to study in cellular and animal models. Therefore, we generated an ex vivo human brain slice model of HIV-1 infection from surgically resected adult brain tissue. Brain slice cultures processed for flow cytometry showed >90% viability of dissoci-ated cells within the first three weeks in vitro, with parallel detection of astrocyte, myeloid, and neuronal populations. Neurons within brain slices showed stable dendritic spine density and mature spine morphologies in the first weeks in culture, and they generated detectable activity in multi-electrode arrays. We infected cultured brain slices using patient-matched CD4+ T-cells or monocyte-derived macrophages (MDMs) that were exposed to a GFP-expressing R5-tropic HIV-1 in vitro. Infected slice cultures expressed viral RNA and developed a spreading infection up to 9-days post-infection, which were significantly decreased by antiretrovirals. We also detected infected myeloid cells and astrocytes within slices and observed minimal effect on cellular via-bility over time. Overall, this human-centered model offers a promising resource to study the cel-lular mechanisms contributing to HAND (including antiretroviral toxicity, substance use, and aging), infection of resident brain cells, and new neuroprotective therapeutics.

Background: Eid al-Adha is celebrated every year in Muslim countries; however, it is a time when patients present to the emergency department with serious injuries. In our study, we examined current injuries at the time of Eid al-Adha in the largest patient population in one of the largest hospitals in Turkiye, including tendon injury map and maxillofacial injuries for the first time in the literature. Methods: Between 2019 and 2023, patients admitted to Ankara City Hospital during Eid al-Adha were examined. The demographic characteristics, injury patterns, and injury sites of the patients were evaluated by analyzing the patients admitted on the four days of Eid al-Adha. Statistical analysis were performed using IBM SPSS Statistics for Windows. Results: Six hundred and ten patients, including 101 female and 509 male patients, were included in this study. There was a statistically significant increase (p

Hard tissue apposition along the root canal walls is a slow, normally occurring physiological aging process. In response to tooth wear, local deposition of hard tissue may also occur in the pulp at a slow pace. Sometimes, the rate of hard tissue deposition acceleration may seem to be uncontrolled after dental trauma, autotransplantation, and orthodontic therapy, leading to rapid partial or total obliteration of the root canal space. This situation is called calcific metamorphosis (CM) or pulp canal obliteration (PCO). Although the incidence of pulpal necrosis in these teeth is believed to be infrequent, conventional endodontic therapy in severely calcified canals poses extreme difficulties and a higher risk for procedural accidents. This article aims to review the available approaches for the predictable negotiation of calcified canals and to introduce the buckling resistance activation test (BRAT) technique.

Background: A new access technique was developed to reduce postoperative adverse events after the extraction of impacted maxillary wisdom teeth. Hence, this study aimed to assess the occurrence of adverse events after extraction of maxillary impacted wisdom teeth using traditional or modified access. Methods: Two different surgical incision designs were used for bilateral wisdom tooth extractions in 30 patients. The traditional incision was performed distal to the second molar in the center of the tuberosity, followed by a buccal releasing incision. After tooth extraction the wound was secured by sutures. The new technique consists of an oblique incision from the distal palatal aspect of the tuberosity towards the buccal aspect of the second molar. After tooth extraction, cyanoacrylate glue was used on the wound. Results: Lower pain was reported by patients at the site treated with the new technique (p<0.01). Edema, postsurgical bleeding, and hematoma were similar in both groups. The surgical time was shorter for the new technique (p<0.01). Conclusions: The new technique applied for the extraction of impacted maxillary wisdom teeth reduced postsurgical pain and the duration of surgery.

Conducting quantitative research involving adolescents demands a thoughtful approach to the question of supervision, given that each option comes with its distinct set of implications. This study reviews these implications and empirically tests whether differences in data quality can be found among three modes of standardized survey research with medium sized groups of adolescents (12-17 years). Data basis is a quasi-experimental survey study testing different forms of digital, hybrid or in-person supervision, that took place in 2021 in secondary schools in Germany (N=923). Aim of this study is testing how aspects of data quality – item-nonresponse, interview duration, drop-out-rate and response patterns – differ between these forms of supervision. Results could help researchers surveying young people to decide (1) whether they allow confidants or other adults to be present during interviews, (2) if they can rely on teachers alone when surveying classrooms and (3) if it is cost-efficient to send out external supervisors for classroom sessions. While dropout-rates do not differ, item non-response, interview duration, and response patterns differ significantly, students supervised at home by external interviewers answered more questions, took more time to answer and are less likely to give potentially meaningless answers in grid questions. The implications drawn from the findings question the common approach to solely rely on teachers for survey administration without the support of external supervisors or adequate training. Recruiting respondents via schools and surveying them online in their homes during school hours shows to be a robust method with regard to the analyzed indicators.

The process of sexual reproduction in eukaryotes starts when gametes from two different sexes encounter each other. Paramecium, a unicellular eukaryote, undergoes conjugation and uses a gametic nucleus to enter the sexual reproductive process. The molecules responsible for recognizing mating partners, hypothetically called mating-type substances, are still unclear. We have identified an O3-type mating substance polypeptide and its gene sequence using protein chemistry, molecular genetics, immunofluorescence, RNA inter-ference, and microinjection. The O3-type substance is a polypeptide found in the ciliary membranes, located from the head to the ventral side of cells. The O3-type substance has a kinase-like domain in its N-terminal part located outside the cell and four EF-hand motifs that bind calcium ions in its C-terminal part located inside the cell. RNA interference and immunofluorescence revealed that this polypeptide positively correlated with the expression of mating reactivity. Microinjection of an expression vector incorporating the O3Pc-MSP gene induced additional O3 mating type in the recipient clones of different mating types or syngen. Phylogenetic analysis indicates this gene is widely present in eukaryotes and exhibits high homology among closely related species. The O3Pc-MSP gene had nine silent mutations compared to the complementary mating type of the E3 homologue gene.

Handedness reflects functional body and hemispheric lateralization, proving relevant to contextualize cognitive and behavioral profiles. This study aimed to determine the lateralization of the hands, feet and eyes in patients with various neurological disorders and to test the Edinburgh Handedness Inventory (EHI), a widely used handedness measure. The study design included a literature overview and a clinical study. The overview spanned the literature of the past 50 years since the EHI was developed. Three hundred seventy-four patients with immune-mediated (IM) or noIM neurological diseases and healthy subjects underwent personal and family history of handedness, stressful events and IM diseases, and EHI. The literature overview showed that handedness, which develops under the influence of genetic and acquired factors, is an indirect indicator of hemispheric lateralization; hemispheric lateralization is bidirectionally related to the immune system. In the clinical study, the EHI showed appropriate reliability and structural validity; its scores related to chronological age, onset age, and disease duration and helped distinguish patients with IM disease from other patients and healthy subjects. Therefore, handedness may change over the course of life under the influence of pathology and could predict IM neurological diseases. The EHI is an appropriate measure of handedness.

Health and well-being are a major concern for the elderly who experienced evacuation due to the 2011 Fukushima Daiichi Nuclear Power accident. This study examined the feasibility of a picture sound book with Ninja-essence to maintain or improve exercise habits and physical and mental conditions of the elderly affected by the Fukushima Daiichi Nuclear Power plant accident. We conducted a pre–post intervention study to evaluate a picture sound book with Ninja-essence for returnees and evacuees post lifting evacuation restrictions. In total, 29 people participated in this study. Residents in two groups, returnees and evacuees, were provided with the tool. Results of the pre–post changes were analyzed using descriptive statistics, i.e., Fisher’s exact test and t-test, and a significant difference was observed in both groups of participants between their left and right hand-grip strength, the maximum phonation time in the participants of the group that regularly engaged in exercise, and in the questions regarding swallowing exercises and singing songs or practicing words (p < 0.013 and 0.033); 16 of 29 participants reportedly enjoyed the program. The results demonstrated the future possibility of determining the improved outcome of this program in larger samples.

Entropy as a mathematical concept is the first of its own kind, and second to none. Barely one or two papers in literature have investigated fractal dimensions of very basic entropies, such as Shannon, Tsallis, and Rényi entropic expressions. This was a thoughtful inspiration to delve into a step forward towards a unified information- theoretic fractal theory. The storytelling of this current paper starts by introducing my third entropy formula, namely Ismail’s entropy, , as a novel generalization to Shannonian entropy with a visionary link to both long- and short-range interactions, (LRIs), (SRIs) respectively. Clearly, this would generate a fourfold unification with statistical mechanics as well as contemporary physics. Hence, this adds more credibility and weight for this study. The fractal dimension of , is identified in this paper. As an essential part of this work, it was influential to spotlight the importance of fractal geometry to space industry as well as education, which is crucial to develop our societies. Thus, some potential fractal applications to CubeSat Technologies and Education are highlighted. So, will the deep search for more ground-breaking research has come to an end. Certainly, not. This was another inspiration to propose new open problems to widen research gates to the scientific community for more research pathways. Consequently, the paper ends with closing remarks combined with some challenging open problems and the next phase of research.

(1) Background: Hand hygiene practice by using alcohol-based hand sanitizers was generalized in all sectors of activity, due the COVID-19 pandemic. The aim of this study was to organize and analyze the scientific data regarding occupational exposure to hand sanitizers, with a particular focus on their use and health effects on workplace settings. (2) Methods: A rapid literature review was carried out searching on the main scientific database, namely: Web of Science Core Collection, Medline, Scielo and Current Content Connect. (3) Results: All studies analyzed included samples from healthcare professionals and eczema as well as irritant contact dermatitis were the most reported skin lesions. (4) Conclusions: The adequate implementation of hygiene and disinfection programs in workplaces is essential to guarantee the workers safety and health. Further research is needed on the effectiveness of contingency plans in different sectors of activity, particularly, in industry.

Falls at height are among the major causes of fatal accidents at work, especially in the construction sector. Maintaining balance while performing a tool with both hands generates physical efforts and mental loading that needs to be managed for workers’ safety and health. The purpose of the study is to compare perceived (dis)comfort (overall and localized), the ergonomic risk and the perceived effort through the acquired postures that subjects assumed during the execution of simple and common tasks both on a ladder and on the ground. 26 subjects were asked to perform four tasks in both conditions: top screwing, frontal screwing, object picking from the bottom forward, and object picking from the bottom sideways. Subjective and objective data were gathered for assessing subjective experience (discomfort and effort, perceived) and ergonomic risk. Results highlighted few ergonomic risk differences among “on ladder” and “on ground” tasks, while subjective data reveal significant differences in different scenarios. Main results regard knees and neck areas as the most critical ones.

A three-arm, randomized, placebo controlled clinical study has been performed to evaluate the effects of a lyophilized pineapple extract titrated in bromelain (Brome-Inf®), and purified bro-melain on pain, swelling, trismus and quality of life (QoL) after the surgical removal of the lower third molars. Moreover, the need for non-steroidal anti-inflammatory drugs (NSAIDs) has also been evaluated and compared with a placebo group. The study included 42 people that required the extraction of a single mandibular third molar under local anesthesia. The patients were ran-domized and distributed to receive Brome-Inf®, purified bromelain or placebo and started the treatment the day of surgery and continued it for the next 7 days. The primary outcome was the requirement of NSAIDs in the three groups. The outcome variables were pain, swelling and trismus, which were measured postoperatively at 1, 3, and 7 days. The differences in the efficacy of the freeze-dried pineapple extract and single-component bromelain were also evaluated. At the end of the study, the assumption of ibuprofen (from days 1-7) was statistically higher in the placebo group (p

Over the last two decades, knowledge production, research and reconfiguration of universities have been understood as ways of giving new meanings to the university-society binomial. In this regard, humanities are the subject of multiple debates in the face of ideas about their impact in relation to the "other sciences". Based on these premises, this article sets out to explore possible meanings attributed by researchers to the concepts of commitment, mobilization and transfer of research in humanities in view of the debates on the university-society interaction and the third mission of the university (Alonso, Cuschnir and Napoli, 2021). The methodology used will address bibliographical analysis, theoretical background and statements from different institutions, as well as the analysis of material from four interviews. As a first instance, the preliminary results show that strengthening critical thinking as forms of commitment emerge as central senses, focusing on hungarian characteristics and productions in order to unravel the ways of understanding and imagining Eastern European reality. In this respect, the discussion of certain western knowledge is seen as a task associated with social commitment with public universities as a focus of resistance.

The thick functionally graded material (FGM) circular cylindrical shells with advanced varied shear correction coefficient and third-order shear deformation theory (TSDT) under advanced thermal vibration are studied by the method of generalized differential quadrature (GDQ). The coefficient of displacement model of TSDT is applied to derive the equations of motion for the thick FGM circular cylindrical shells. The stiffness in simpler forms of thick FGM circular cylindrical shells and temperature rise in linear expression of the heat conduction equation are used. The differential equations in dynamic equilibrium state of thick FGM circular cylindrical shells can be obtained and rewritten into displacements and shear rotations in partial derivative expressions under dynamic thermal loads in partial derivative expressions. Parametric effect studies including advanced nonlinear varied shear correction coefficient, nonlinear coefficient c1 value, power law index and thermal temperature difference of external heating loads on the displacements and stresses of thick FGM cylindrical shells under thermal dynamic vibration are investigated.

This paper provides an exhaustive narrative review of third-generation antipsychotics (TGAs), focusing on aripiprazole, cariprazine, brexpiprazole, and lurasidone for managing substance-induced psychosis. It includes a comprehensive literature review to evaluate the efficacy and tolerability of these medications. The paper emphasizes the distinct challenges in treating substance-induced psychosis, which is a psychiatric condition triggered by the misuse or withdrawal of various substances, leading to symptoms like hallucinations and delusions, and is distinct from primary psychotic disorders. It underscores the potential of TGAs in addressing both psychotic symptoms and substance-related issues, while highlighting the need for more research on long-term effects and advocating for an integrated approach combining pharmacological and psychological interventions

Background and Objectives: Impacted lower third molar extraction, is a common oral surgical pro-cedure. Pain, swelling and limitation of mouth opening that may occur in the postoperative pe-riod are factors that affect the daily routines of patients. In this study, it was aimed to evaluate the efficacy of polybutester and polypropylene sutures on postoperative complications after lower impacted third molar surgery. Materials and Methods: On 35 patients with bilateral impacted lower third molars included in the study; two different suture materials were used as polybutester suture in group 1 and polypro-lene suture in group 2. Measurements were made for the evaluation of edema and trismus be-fore the operation and on the 2nd and 7th day after the operation, and a visual analogue scale (VAS) was given to patients to fill in after the operation. Wound healing, suture related injury, and suture related discomfort in patients were noted. Results: According to the results of the study, the pain felt on the side using the polybutester su-ture on the 2nd postoperative day was less than the side using the polypropylene suture (p<0.05). On the 2nd postoperative day, it was observed that the suture on the side which the polybutester suture was used caused less discomfort to the patients than on the side which the polypropylene suture was used (p<0.05). It was observed that women experienced more pain (p<0.01) and more trismus (p<0.05) after the operation compared to men. Conclusions: On postoperative 2nd day, less pain was observed on the side where the polybutester suture was used and it was also found that the polybutester was better tolerated. These results support the use of polybutester suture in the surgery of im-pacted third molars.

A system to evaluate several facets of hand function for neuroprostheses-mediated tasks is proposed. It includes a platform that serves as a test bench, sensors for dynamometry, electromyography, sensorized glove, and interactive objects. The system methodically locates and assesses the motor points along the forearm, evaluates stimulation-induced fatigue, measures digit motion and forces exerted during ADL grasps, and evaluates nerve excitability to advance electrode designs. While the system is exclusively designed for neuroprostheses-mediated grasp, it can also be extended to generic grasp and object manipulation-based research.

The increasing complexity of the space flight program and the increase in the duration of missions require improvement of psychological monitoring tools for astronauts in orbit. The article summarizes the experience of using quantitative content analysis of communication between the crews and the Mission control center (MCC). This method allows to assess dynamics of astronaut’s psycho-emotional state, to identify the communicative style, and to detect the communication phenomena of board-MCC communication. The method is based on a combination of coping strategies approach by Lazarus and Folkman as well as B.F. Lomov’s concept about the three functions of communication. We found influence of workload on the structure and volume of communication, defined the main stable communication styles of crewmembers, and confirmed presence of the emotional transfer phenomenon. We detected that astronauts successfully solve problems that arise in orbit using the capabilities of their communication style. An ineffective MCC communication style the leads to the psycho-emotional ill-being manifesting in emotional transfer phenomenon. The presence of “third quarter” phenomenon was not confirmed by materials from six-month space flights.

Introduction: We under took an in-use evaluation of a novel hypochlorous acid-based hand hygiene product with in vitro sporicidal efficacy in a NHS Older Persons inpatient ward setting. Methods: The novel hand hygiene product was implemented for a trial period of seven weeks commending in September 2023. Healthcare worker (HCW) hands were sampled before and after direct patient care, and after the application of either an alcohol-based handrub (ABHR) (n=50) or the novel product (n=50). Samples were cultured to quantify the total aerobic count (TAC) and presence or absence of MRSA, ESBLs, CREs, and C. difficile. Trends in weekly observational hand hygiene audit results were reviewed, and a survey of HCW views about the new product undertaken. Results: HCW hands had a significantly greater TAC after ABHR (p=0.01) but not after the novel product (p=0.11) compared with their respective baseline counts. 3% of 100 samples grew MRSA or ESBLs after application of the alcohol-based or novel hand hygiene products. No C. difficile was cultured from healthcare worker hands. There was no significant difference in observed hand hygiene compliance. The majority of HCW surveyed preferred the novel product to the alcohol-based hand hygiene product. Discussion: The novel hand hygiene product was more effective than ABHR at reducing the TAC on HCW hands. Poor hand hygiene technique may explain the identification of antibiotic-resistant bacteria on staff hands after ABHR or the novel product. We were not able to evaluate sporicidal efficacy since no C. difficile was cultured from hands.

Mandibular third molar is the most frequently impacted tooth. Mandibular third molar impaction bears consequences on the adjacent mandibular second molar (MSM) like bone loss. It can be identified initially using orthopantomography (OPG). The objective is to compare the changes in the bone level distal to MSM between patients with extracted and non-extracted impacted man-dibular third molars (IMTM) using OPG. In this retrospective case-control study, 160 archived (OPGs) of 80 patients visiting the Dental Hospital of the University of Barcelona (HOUB) were randomly selected. The participants were stratified into two groups. The study group involved measuring the bone level distal to the mandibular second molar before and after the extraction of the IMTM. The control group, on the other hand, had bone levels measured twice within 3–6-month period without the extraction of the IMTM. The mean ages of patients in study and control groups were 35.5 ± 15.45 and 33 ± 16.49, respectively. Study group demonstrated signifi-cant (p < 0.05) bone gain after extraction, whereas control group demonstrated significant bone loss (p < 0.0001) after follow-up. Bone improvements were observed distal to the mandibular second molar after the extraction of the IMTM compared to those in control group.

Gesture recognition technology has been quickly developed in the field of human-computer interaction. The multiple-input multiple-output (MIMO) radar has been widely adopted in gesture recognition because of its notable spatial resolution. In this work, a highly accurate MIMO radar-based hand gesture recognition algorithm with very low complexity is proposed. To make the proposed system applicable in the industry and work well even when the size of the training data is limited, we applied several low-complexity adaptive signal processing methods to extract features and reduce the noise effect. First, spectrum analysis is applied to range-Doppler maps (RDMs) and a cell-averaging constant false alarm rate (CA-CFAR) with mirror filters is applied to improve the robustness to noise. Afterward, the features related to the distance, speed, direction, and the elevation angle of the moving object are determined by the proposed adaptive signal analysis techniques and the random forest is applied for classification. The proposed system has the capability to precisely distinguish and identify eight motions, including waving, moving to the left or right, patting, pushing, pulling, and rotating clockwise or anticlockwise, with an accuracy of 95%. Experiments demonstrate the capability of the proposed hand gesture recognition system to classify different movements precisely.

We report recent enhancements of the online atomic database at the Ohio State University, NORAD-Atomic-Data, that provides various parameters for radiative and collisional atomic processes dominant in astrophysical plasma. NORAD stands for Nahar Osu RADiative. The database belongs to the data sources, especially for the latest works, of the international collaborations of the Opacity Project and the Iron Project. The contents of the database are calculated values for energies, oscillator strengths, radiative decay rates, lifetimes, cross sections for photoionization, electron-ion recombination cross sections and recombination rate coefficients. We have recently expanded NORAD-Atomic-Data with several enhancements over those reported earlier. They are as follows. i) We continue to add energy levels, transition parameters, cross sections for atoms and ions with their publications. ii) Recently added radiative atomic data contains significant amount of transition data for photo-absorption spectral features corresponding to x-ray resonance fluorescence effect, prominent wavelength regions of bio-signature elements, such as phosphorus ions, and emission bumps of heavy elements, such as of lanthanides, that may be created in a kilonova event. We are including iii) collisional data for electron-impact-excitation, iv) experimental data for energies and oscillator strengths for line formation, v) experimental cross sections for photoionization that can be applied for benchmarking and other applications, and vi) introduction of a web-based interactive feature to calculate spectral line ratios at various plasma temperature and density diagnostics, starting with our recently published data for P II. We presented summary description of theoretical backgrounds for the computed data in the earlier paper. With introduction of experimental results, we present summary description of measurement of high resolution photoionization cross sections at Advanced Light Source of LBNL synchrotron set-up and briefly discuss other set-ups. These additions should make NORAD-Atomic-Data more versatile for various applications. For brevity, we provide information on the extensions and avoid repetition of data description of the original paper.

This paper explores the application of machine learning techniques for automated object grasping. Current electronic prosthetics often require extensive training for users to gain fine motor control over the prosthetic fingers, hindering their usability and acceptance. To address this challenge, this paper proposes an automated method that leverages computer vision-based techniques and machine learning algorithms. In this study, three reinforcement learning algorithms, namely Soft Actor-Critic (SAC), Deep Q-Network (DQN), and Proximal Policy Optimization (PPO), are employed to train agents for automated grasping tasks. The results indicate that the SAC algorithm achieves the highest success rate of 99% among the three algorithms at just under 200,000 timesteps. This research also shows that object’s physical characteristics can affect the agent’s ability to learn an optimal policy. Moreover, the findings highlight the potential of the SAC algorithm in developing intelligent prosthetic hands with automatic object gripping capabilities.

Background: Anthropometric measurements play a crucial role in medico-legal practices. Actually, several scanning technologies are employed in post-mortem investigations for forensic anthropological measurements. This study aims to evaluate the precision, in-ter-rater reliability, and accuracy of a hand-held scanner in measuring various body parts. Methods: Three independent raters measured seven longitudinal distances using an iPad Pro equipped with a LiDAR sensor and specific software. These measurements were sta-tistically compared to manual measurements conducted by an operator using a laser level and a meterstick (considered the gold standard). Results: The Friedman’s test revealed minimal intra-rater variability in digital measurements. Inter-rater variability analysis yielded an ICC=1, signifying high agreement among the three independent raters. Addi-tionally, the accuracy of digital measurements displayed errors below 2%. Conclusions: Preliminary findings demonstrate that the pairing of LiDAR technology with the Polycam app showcases high precision, inter-rater agreement, and accuracy. Hand-held scanners show potential in forensic anthropology due to their simplicity, affordability, and porta-bility. However, further validation studies under real-world conditions are essential to es-tablish the reliability and effectiveness of handheld scanners in medico-legal settings.

Objectives: Evaluate hand-held echocardiography (HHE) performed and interpreted by trained Advanced Practice Providers (APPs) on hospitalized CHF patients for image quality and interpretation, by comparing against expert echocardiographer and SE findings. Background: Congestive heart failure (CHF) is associated with increased hospital admissions and mortality. While standard echocardiogram (SE) is the gold standard for cardiac assessment, it is not readily available. Hospitalized CHF patients require rapid assessment for expedited treatment. Methods: Over 6 months, five trained APPs performed HHE on hospitalized CHF patients and interpreted: a) Left ventricular (LV) size, b) LV ejection fraction (LVEF), and c) right atrial pressure (RAP). The study echocardiographer reviewed and blindly interpreted HHE images and compared with APPs and SE findings. Kappa-statistics determined the degree of agreement between APPs and study echocardiographer interpretation of HHE images and SE. Results: 80 CHF patients [age 73±14 years, 58% males; LVEF (by SE) 45±19%; 36.3% body mass indexes ≥30 kg/m2] were enrolled. HHE interpretation by APPs had good agreement for LVEF (kappa 0.79) with study echocardiographer and SE (kappa 0.74), and good agreement for RAP (kappa 0.67) with study echocardiographer. Correlation between absolute LVEF interpretation by study echocardiographer on HHE and SE was r=0.88 (p<0.0001). Conclusions: Trained APPs obtained diagnostic-quality HHE images and interpreted LV function and RAP in CHF patients, with good agreement with the study echocardiographer. LVEF by HHE correlated with LVEF by SE. Our study suggests trained APPs can use HHE to evaluate LVEF and RAP in CHF patients leading to expedited and optimized treatment.

We conducted a monocentric observational study aimed at evaluating the pharmaceutical service provided at a Community Pharmacy (C.PH.) during pandemia in our Puglia Region in the period from 29.12.2021 to 12.03.2022 on 550 patients of various ages, sexes, and with concomitant diseases. We collected anamnestic data and any post-vaccination adverse reactions. Interviews with the integrated EQ5 method on evaluating the quality of the service offered and any therapy preference were also performed. As expected, the vaccines were reactogenic after the first dose in the patients with mild-moderate reactions with younger age and female gender as risk factors. Immune-allergic reactions of moderate-severe degree were observed in adult females. In the elderly, the vaccination procedure was well tolerated. Comirnaty showed a favorable O.R.<;1 vs other vaccines. No myocarditis and thromboembolic events in our population were observed. All treatments in May 2023 were correlated with a viremia trend, Paxlovid was prescribed in 3% of the patients in our center and in 1.46% in the Puglia Region with no effects in the hospitalization. It was distributed/dispensed by a novel on behalf of third parties distribution/dispensation (D.P.C.) protocol by the C.PH. The C.PH. resulted in a safe vaccination center providing appropriate patient inclusion during vaccination.

(1) Background: This study evaluated the spatial position and anatomical characteristics related to impacted third molars by map-reading strategy using cone beam computed tomography (CBCT). (2) Methods: To determine the positioning of impacted third molars on CBCT it was used Winter's and Pell &amp; Gregory's classifications, and the presence of external root resorption in mandibular second molars were based on Herman´s classification. The relationship between the mandibular third molar root apex and the mandibular canal was also analyzed. Fisher’s exact test was used to comparative statistical analysis. The significance level considered was 5%. (3) Results: The results showed that according to Winter's classification, 48.06 % of impacted teeth were in the mesioangular position. Using Pell &amp; Gregory's classification, 43.22% of the impacted molars were in the position B and C, and 54.2% of the teeth were class II. 69.7% of teeth showed an absence of contact between the root apex and the mandibular canal and there was no occurrence of external root resorption in the distal of second molar in 88.7%. (4) Conclusions: The map-reading strategy using CBCT scans for anatomical positions and characteristics of impacted third molars increases professional confidence and establishes a parameter of quality and safety in the surgical procedure for the patient.

Human-to-human communication via the computer is mainly done using a keyboard or microphone. In the field of Virtual Reality (VR), where the most immersive experience possible is desired, the use of a keyboard contradicts this goal, while the use of a microphone is not always desirable (e.g. silent commands during task force training) or simply not possible (e.g. if the user has a hearing loss). Data gloves help to increase immersion within the VR as they correspond to our natural interaction. At the same time, they offer the possibility to accurately capture hand shapes, such as those used in non-verbal communication (e.g. thumbs up, okay gesture, ...) and in sign language. In this paper, we present a hand shape recognition system using Manus Prime X data gloves, including data acquisition, data preprocessing, and data classification to enable nonverbal communication within VR. We investigate the impact on accuracy and classification time of using an Outlier Detection and a Feature Selection approach in our data preprocessing. To obtain a more generalized approach, we also studied the impact of artificial Data Augmentation, i.e., we create new artificial data from the recorded and filtered data to augment the training dataset. With our approach, 56 different hand shapes could be distinguished with an accuracy of up to 93.28%. With a reduced number of 27 hand shapes, an accuracy of up to 95.55% could be achieved. Voting Meta-Classifier (VL2) has proven to be the most accurate, albeit slowest, classifier. A good alternative is Random Forest (RF), which was even able to achieve better accuracy values in a few cases and was generally somewhat faster. Outlier Detection has proven to be a effective approach, especially in improving classification time. Overall, we have shown that our hand shape recognition system using data gloves is suitable for communication within VR.

Accurate determination of the concentration of alcohols and their metabolites is important in forensics and in several life science areas. A new method has been developed to quantify alcohols and their oxidative products using a headspace gas chromatography- mass spectrometer and isotope-labelled internal standards. This work demonstrates the application of this method, specifically in quantifying the concentration of oxidative products of alcohol and other minor alcohols found in hand sanitizers, which have become an essential household item since the COVID-19 pandemic. Apart from the major component, the minor alcohols found in hand sanitizers include methanol, isopropanol, and n-propanol. In ethanol-based hand sanitizers, a significant amount of acetaldehyde was observed as an oxidation product, while in isopropanol-based hand sanitizers, acetone was observed. The concentration of acetaldehyde in ethanol-based hand sanitizers significantly increased with storage time and temperature, whereas no such increase of acetone concentration was observed in isopropanol-based hand sanitizers with storage time and temperature.

Background: Patients’ effective hand hygiene helps to reduce healthcare-associated infections, prevents the spread of nosocomial infections and communicable diseases, such as COVID-19. This study aimed to describe effective hand hygiene decisions based on the Health Action Process Ap-proach (HAPA) and whether this pattern is invariant for mental health. Methods: Data were collected cross-sectionally from patients who had previously been admitted to a hospital (N=279; study 1) and longitudinally from psychosomatic rehabilitation patients (N=1,073; study 2). The fit of the HAPA framework and changes in hand hygiene decisions regarding com-pliance, as well as social-cognitive variables of the HAPA, and mental health status were examined. Results: The trimmed HAPA framework fitted the data well (χ2=27.1, df=12, p<.01, CMIN/df=2.26, CFI=.97, RMSEA=.08). According to multi-group structural equation modeling, the HAPA model with hand hygiene behavior were found to be invariant with regard to mental health. Conclusion: The trimmed HAPA framework revealed to be a generic framework in explaining so-cial-cognitive processes relating to hand hygiene decisions. Helping individuals to perform hand hygiene recommendation requires intention formation and bridging the intention-behavior gap. This can be done by promoting planning and self-efficacy. All processes appear generic to partic-ipants with and without mental health challenges.

On-chip integration of two-dimensional (2D) materials with unique structures and distinctive properties endow integrated devices with new functionalities and improved performance. With a high flexibility in modifying its properties and a strong compatibility with various integrated platforms, graphene oxide (GO) becomes an attractive 2D material for implementing functional hybrid integrated devices. Here, we demonstrate novel functionalities that go beyond the capabilities of conventional photonic integrated circuits, by harnessing the photo-thermal effects in 2D GO films integrated onto them. These include all-optical control and switching, optical power limiting, and non-reciprocal light transmission. The 2D layered GO films are on-chip integrated with precise control of their thicknesses and sizes. Benefitting from the broadband response of 2D GO films, all the three functionalities feature a very wide operational bandwidth. By fitting the experimental results with theory, we also extract the changes in material properties induced by the photo-thermal effects, which reveal interesting insights about 2D GO films. These results highlight the versatility of 2D GO films in implementing functional integrated photonic devices for a range of applications.

During the hand-eye calibration process of the manipulator, the Euclidean distance error of the calibration results cannot be calculated because the true values of the hand-eye conversion matrix cannot be obtained. In this paper, a new method of projection error analysis is presented. Error analysis is carried out by using a priori knowledge that the location of AR markers is fixed in the calibration process. The coordinates of the AR marker center point are reprojected to the pixel coordinate system, and then compared with the true pixel coordinates of the AR marker center point obtained by corner detection or manual labeling in order to obtain the Euclidean distance between the two coordinates as the basis for error analysis. Experimental results show that the proposed optimization method can greatly improve the accuracy of hand-eye calibration results.

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.

We discuss a formalism which allows for the calculation of a higher harmonic current response to an applied electric field for disordered superconducting systems described on the basis of tight-binding models. The theory is based on an expansion of the density matrix in powers of the field amplitudes where we solve the equation of motion for the individual components. This allows the evaluation of higher order response functions on significantly larger lattices than one can achieve with a previously used approach, which is based on a direct temporal integration of the equation of motion for the complete density matrix. In case of small lattices, where both methods can be applied by including also the contribution of collective modes, we demonstrate the agreement of the corresponding results.

Background: It is not clear whether rehabilitation after surgery for trigger finger is effective. The aim of this study was to reveal the effectiveness for trigger finger. Methods: This study was a randomized, controlled trial that included patients who underwent operations for trigger fingers. The patients in the rehabilitation group had postoperative occupational therapy (OT) for 3 months, while the patients in the control group were not referred for rehabilitation but received advice for a range of motion exercise. We evaluated the severity of trigger finger, Disability of Arm-Shoulder-Hand (DASH) score, pain-visual analogue scale (VAS), grip strength, whether they gained a full range of motion (ROM), and complications before and after surgery. Results: Finally, 29 and 28 patients were included in the control and rehabilitation groups, respectively. DASH score, grip strength, and ROM were significantly improved in the rehabilitation group from that preoperatively at final follow-up. Pain was significantly improved in both groups from that preoperatively at final follow-up. Subgroup analysis showed that there is a significant difference in the DASH score of patients doing housework or light work and those with a duration of symptoms &gt; 12 months between the control and rehabilitation groups at the final follow-up.

A stable driver state is essential in the process of manually transition control, which inevitably occurs in Level 3 automated driving situations. To this end, this paper proposed a CNN algorithm-based driver state monitoring system that uses multi-sensor data such as driver's face image, biometric information, and vehicle behavior information as input. This system calculates the probability of drowsiness for each of the four time periods using a convolutional neural network (CNN) based on ToF camera-based eye blinking, ECG information (pulse rate) embedded in the steering wheel, and vehicle information (steering angle data). In order to build a reliable and high-quality training dataset (Ground Truth) for the CNN algorithm, a baseline was established by matching the driver's face image with the electrocardiogram (ECG) and electroencephalogram (EEG) changes in the drowsy and normal states. In a simulation test of the proposed CNN algorithm using more than 20,000 driver image data acquired using a driving simulator, the TNR was 94.8% and the accuracy was 94.2%. Our proposed method is expected to minimize human errors that may occur when switching control by monitoring inappropriate driver state (drowsiness) in real time.

Background: Nurses are essential members of the healthcare workforce and were among the first line carers for patients in community and hospital settings during the COVID-19 pandemic. As a result, they were at a heightened risk of contracting the disease, resulting in a significant number of reported deaths among them. Several preventive measures were adopted to contain the spread of this potentially lethal virus. This study aims to explore the knowledge, attitudes, and practices (KAP) of nurses regarding hand hygiene, mask wearing, and social distancing measures in healthcare settings in Barbados during the COVID-19 pandemic. Method: An online survey of nurses working in public hospitals and polyclinics (public primary care clinics) of Barbados from December 2020 to July 2021, was conducted. Participants completed a questionnaire capturing socio-demographic information and knowledge and practices related to hand hygiene, using face masks, and social distancing . Each correct response received one mark. Overall knowledge scores were categorized as poor (<60%), average (60-80%), or good (>80-100%). Results: Of 192 participants, the majority were female (82.8%) and had >5 years of experience (82%). Findings revealed that 45.8% had poor knowledge of hand hygiene, and the knowledge of 43.8% of respondents was average. Multivariable logistic regression showed that, after adjustment for age and gender, registered nurses had 2.1 times increased odds (95% CI 1.0, 4.2) of having good knowledge compared to other nursing categories. Regarding mask-wearing, 53.6% of nurses had average and 27.1% had good knowledge. Multivariable logistic regression showed that, after adjustment for age and gender, registered nurses had 3.3 times increased odds (95% CI 1.5, 7.4) of having good knowledge compared to nursing assistants. 68.6% of respondents followed the correct steps of handwashing every time, and 98.3% wore a mask in public places. More than half of the nurses (51.2%) kept a safe distance from others to avoid spreading SARS-CoV-2; one-third were in a crowded place(s) in the past three months, and 55.8% usually followed guidelines for social isolation as recommended by WHO. Conclusion: The study identified knowledge deficiencies related to hand hygiene and wearing masks among nurses. It is imperative to provide additional training on infection control measures.

The present study was to investigate effects of total flavonoids from Taraxacum mongolicum Hand.-Mazz. (FT) on fermentation quality, antioxidant status and microbial community of Caragana korshinskii Kom. (CK) silage. CK was ensiled with no additive (CON), 1% FT and 2% FT on a fresh weight (FW) basis for 60 days. The results showed that 1% FT and 2% FT groups displayed higher DM content than CON group, and 2% FT group had the best effect on nutrient preservation. Compared with CON and 1% FT groups, 2% FT group exhibited the best silage fermentation quality and the highest antioxidant activity, including increased lactic acid, acetic acid concentrations and the activities of antioxidant enzymes, as well as decreased pH and the ammonia nitrogen (NH₃-N) concentration. Moreover, 2% FT addition significantly affected the microbial community, such as increased abundance of Lactobacillus and decreased abundances of Pseudomonas and unidentified Cyanobacteria. The abundances of Lactobacillus parafarraginis and Lactobacillus brevis were negatively correlated to pH, while they were positively correlated with T-AOC, GSH-Px and CAT activities. In conclusion, 2% FT may be used as additives to inhibit the growth of undesirable microorganisms and promote fermentation quality and antioxidant activity of CK silage.

Syndactyly is the most common congenital malformation of the hand, leading to the fusion of the digits, frequently affecting the ring and middle fingers. The incidence is one out of 2500 children, predominantly occurring in boys and Caucasians. Clinically, the malformation may present as soft tissue or bony fusion, resulting in the union of the fingers characterised as complete or incomplete. This fusion may involve the phalanges but may also extend to the carpal/tarsal bones, even to the metacarpal’s or metatarsal’s level, rarely to the distal end of the forearm and lower leg. Mostly isolated but may occur together with other disorders or malformations such as synostosis, acro-syndactyly, cleft hand, clinodactyly, or polydactyly. Syndromic syndactyly can be observed in cases of Apert Syndrome, Poland’s Syndrome, Pfeiffer Syndrome and many others. A girl born in June of 2019 was diagnosed with congenital malformation of the right hand at birth —affecting the right middle, ring and little fingers, respectively. After X-ray imaging, the fusion of the third and fourth proximal phalanges to a common metacarpal was identified, forming a unique diagnosis of clino-syndactyly with metacarpal aplasia. Surgical intervention was advocated for, including a wedge osteotomy to correct the synchondrosis at the phalangeal base and a dorsal flap to close the interdigital space created during the correction of the III and IV. fingers. A trapezoid flap for the release of the syndactyly of the IV and V. fingers was applied. The paper aims to present the surgical correction and its results regarding an atypical case of syndactyly with clinodactyly and metacarpal aplasia.

The functional capacity of the cervical spine plays a central role in healthy living. This study evaluated and created a comprehensive strength, range of motion (ROM), and musculoskeletal pain profile of the cervical spine in young adults. 60 physically active individuals (30 males/30 females; 19-24 year-old) participated in the study. Cervical ROM (forward flexion, extension, lateral flexion, and rotation), maximal isometric strength (forward flexion, extension, lateral flexion), and musculoskeletal pains were assessed using an electronic goniometer, a handheld dynamometer, and the Nordic questionnaire, respectively. Data analysis revealed that: a) fe-males had higher ROM values, during extension and lateral flexion, than males (p<0.05), b) males had higher absolute strength values than females in all movement directions, higher rela-tive strength values/body mass (at forward flexion) and flexion/extension ratio values (p<0.05), c) ROM and strength values were not significantly different between right-left sides (p>0.05), d) a great proportion (43.3%) of the participants had cervical pains (no sex-related differences) and e) cervical strength showed significant small negative correlation with pains (p<0.05; r=-0.225 to -0.345). The reference values created may be used by health and fitness professionals to exten-sively evaluate the cervical spine and to design specific exercise programs for injury prevention and rehabilitation.

Good hand hygiene has proven to be essential in reducing the uncontrolled spread of human pathogens. Cold atmospheric plasma (CAP) may provide an alternative to disinfecting hands with ethanol-based handrubs when hand washing facilities are unavailable. CAP can be safely applied to the skin if the energy is well controlled. In this study, RF and DC plasma sources was built with a pin-to-mesh electrodes configuration inside a fused silica tube of 5 mm of inner diameter. Microbiological assays based on EN 13697:2015+A1:2019 using Escherichia coli DSM 682 or Staphylococcus epidermidis DSM 20044 were used to examine the antimicrobial effect of various plasma conditions. Metal and silicone disks that model skin were used as inoculation matrices. The prototype air radio frequency (RF) CAP achieved significant disinfection in the MHz range on stainless steel and silicone substrates. This is equivalent to half the performance of direct current CAP, which is only effective on conductive substrates. Using only electricity and air CAP could, with further optimization, replace or complement current hand disinfection methods, and mitigate the economic burden of public health crises in the future.

There are several pathologies that can change the anatomy of the otic capsule and that can distort the bone density of the bony structures of the inner ear, but otosclerosis is one of the most frequent. Similar behavior has been shown in patients affected by osteogenesis imperfecta (OI), a genetic disease due to a mutation in the genes coding for type I (pro) collagen. In particular, we note that otosclerosis and OI can lead to bone resorption creating pericochlear cavitations in contact with the internal auditory canal (IAC). In this regard, in our experience we have collected 5 cases presenting this characteristic and their audiological data and clinical history were analyzed. This feature can be defined as a potential cause of a third-window effect, because it causes an energy loss during the transmission of sound waves from the OW away from the basilar membrane.

The surgical extraction of the impacted third molar is frequently associated with several complications. The purpose of this study is to assess how two different surgical protocols affect post-operative complications during the extraction of the lower third molars. In order to compare and evaluate two different techniques (triangular flap vs envelope flap), and the relative post-extraction complications, two groups of 150 patients each, underwent to surgical third molar extraction and 60 days of follow-up. A complication rate founded in two groups was respectively 14,00% in group A and 17,33% in group B. There was a strong association between smoking (OR:2.8) and the use of oral contraceptives (OR:1.75) with complications. The age and sex-related incidence of complications in hard tissue healing finds great variability in the literature; the analysis performed on our data did not show a statistically significant association between them. Even though related to a higher incidence of transient changes in sensitivity, it was found that the envelope flap saw a lower percentage of complications. There is still no clarity on which is the best protocol for the extraction of the lower third molar, and the choice often depends on the surgeon’s experience.

Breast cancer is the most common malignant disease in women. Preclinical studies have confirmed that the local anesthetic levobupivacaine has a cytotoxic effect on breast cancer cells. We examined whether postoperative wound infiltration with levobupivacaine influences survival in 120 patients who were operated on for breast cancer and underwent quadrantectomy or mastectomy with axillary lymph node dissection. Groups with continuous levobupivacaine wound infiltration, bolus wound infiltration, and diclofenac analgesia were compared. Long-term outcomes examined were quality of life, shoulder disability, and hand grip strength (HGS) after one year, and survival after 5 and 10 years. Groups that had infiltration analgesia had better shoulder function compared to diclofenac after one year. Levobupivacaine PCA group had the best preserved HGS after 1 year (P=0.022). The most significant predictor of the 5-year outcome was HGS (P=0.03). Although the best survival after 5 and 10 years was registered in the bolus levobupivacaine group, statistical significance was not reached (P=0.36). The extent of the disease at the time of surgery is the most important predictor of long-term survival. A larger prospective clinical study could better confirm the effect of levobupivacaine wound infiltration on outcomes after breast cancer surgery observed in this pilot study. Trial number NCT05829707

S100 is a family of over 20 structurally homologous, but functionally diverse regulatory (calcium/zinc)-binding proteins of vertebrates. The involvement of S100 proteins in numerous vital (patho)physiological processes is mediated by their interaction with various (intra/extra)cellular protein partners, including cell surface receptors. Furthermore, recent studies revealed the ability of specific S100 proteins to affect cell signaling via direct interaction with cytokines. Previously, we have revealed binding of ca. 71% of the four-helical cytokines by S100P protein due to the presence in its molecule of a cytokine-binding site, which overlaps with the binding site for S100P receptor. Here we show that another S100 protein, S100A6 (pairwise sequence identity with S100P of 35%), specifically binds numerous four-helical cytokines. We have studied affinity of recombinant forms of 35 human four-helical cytokines covering all structural families of this fold to Ca2+-loaded recombinant human S100A6, using surface plasmon resonance spectroscopy. S100A6 recognizes 26 of the cytokines from all families of this fold with the equilibrium dissociation constants ranging from 0.3 nM to 12 µM. Overall, S100A6 interacts with ca. 73% of the four-helical cytokines studied to date with selectivity equivalent to that for S100P protein, with the differences limited to binding of Interleukin-2 and Oncostatin-M. The molecular docking study evidences presence in S100A6 molecule of a cytokine-binding site, analogous to that found in S100P. The findings argue the presence in some of the promiscuous members of S100 family of a site specific to a wide range of the four-helical cytokines. This unique feature of the S100 proteins potentially allows them to serve as universal inhibitors of signaling of the four-helical cytokines, which could be of value for reduction of severity of the disorders accompanied by excessive release of the cytokines.

To achieve an acceptable level of security on the web, the Completely Automatic Public Turing test to tell Computer and Human Apart (CAPTCHA) was introduced as a tool to prevent bots from doing destructive actions such as downloading or signing up. Mobile devices have small screens, and therefore, using the common CAPTCHA methods (e.g. text CAPTCHAs) in these devices raises usability issues. To introduce a reliable, secure, and usable CAPTCHA that is suitable for mobile devices, this paper introduces a hand gesture recognition CAPTCHA based on applying Genetic Algorithm (GA) principles on Multi-Layer Perceptron (MLP). The proposed method improves the performance of MLP-based hand gesture recognition. It has been trained and evaluated on 2201 videos of the IPN Hand dataset, and MSE and RMSE benchmarks report the index values of 0.0018 and 0.0424, respectively. Comparison with the related works shows a minimum of 1.79% fewer errors, and experiments produced a sensitivity of 93.42% and accuracy of 92.27% – 10.25% and 6.65% improvement compared to the MLP implementation.

For a linear ordinary differential equation (ODE in short) of the third order, results are presented that supplement the theory of conjugate points and extremal solutions by W. Leighton, Z. Nehari, M. Hanan. It is especially noted the sensitivity of solutions to the initial data, which makes their numerical study difficult. Similar results were obtained for the third-order nonlinear equations of the Emden-Fowler type.

In Mexico, the incorporation of deaf people into education has been lacking since only 14% of the deaf population in the age group between 3 and 29 years access education with the support of a hearing aid. Additionally, those who have been incorporated frequently face inappropriate educational strategies which poorly develop the use of Mexican Sign Language (MSL) and therefore academical success and opportunities for insertion in the workplace are difficult. This research explores a novel mexican sign language lexicon video dataset containing the dynamical gestures most frequently used by MSL. Each gesture consists of a set of different versions of videos under uncontrolled conditions. MX-ITESO-100 data set is composed of a lexicon of 100 gestures and 5,000 videos from three participants with different grammatical elements. Additionally, the data set is evaluated in a two-step neural network model with an accuracy greater than 99%. and thus serves as a benchmark for future training of machine learning models in computer vision systems. Finally, this research provides an inclusive environment within society and organizations in particular for people with hearing impairment.

It is estimated that about 50% of geriatric rehabilitation patients suffer from sarcopenia. Thereby, malnutrition is frequently associated with sarcopenia and dietary intake is the main modifiable risk factor. During hospitalization, older adults are recommended to consume more dietary protein than the current recommended dietary allowance of 0.8 g/kg body weight per day to optimize the recovery of muscular strength and physical function. This prospective study examined the effect of a short-term protein supplementation with protein-enriched foods and drinks on hand-grip strength, nutritional status and physical function in older patients at risk of malnutrition during a three week inpatient orthopedic rehabilitation stay. The Mini Nutritional Assessment (MNA) was used to assess malnutrition. Patients with a MNA score ≤ 23.5 points were randomly assigned to an intervention group (goal: to consume 1.2–1.5 g protein/kg body weight per day) or a control group (standard care). Both groups carried out the same rehabilitation program. Physical recovery parameters were determined at admission and discharge. There was a trend for participants in the intervention group to consume more protein than the control group (P = 0.058): 95.3 (SD 13.2) g/day as compared to 77.2 (SD 24.2) g/day, which corresponds to a mean protein intake of 1.6 (SD 0.3) g/kg/day vs. 1.3 (SD 0.5) g/kg/day. Dietary protein supplementation increased body weight by an average of 0.9 (SD 1.1) kg and fat mass by an average of 0.9 (SD 1.2) kg as compared with baseline (P = 0.039 and P = 0.050, respectively). There was no significant change in hand-grip strength, body composition and physical function. In conclusion, a short-term intervention with protein-enriched foods and drinks enabled older patients at risk of malnutrition to increase their protein intake to levels that are higher than their required intake. In these older individuals with appropriate protein intake, dietary protein supplementation did not result in a greater improvement in physical recovery outcomes during short-term inpatient rehabilitation. The intervention improved dietary protein intake, but further research (e.g., a full-scale randomized controlled trial with sufficient power) is required to determine the effects on physical function outcomes.

Hand, foot and mouth disease (HFMD) is a childhood disease caused by enterovirus A71 (EV-A71) and coxsackievirus A16 (CV-A16). We hypothesize that capsid loops are important epitopes for EV-A71 and CV-A16. Seven chimeric EV-A71 (ChiE71) involving VP1 BC, DE, EF, GH and HI loops, VP2 EF loop, and VP3 GH loop were substituted with corresponding CV-A16 loops. VP3 GH loop is the most conserved (91.3%) while VP1 BC loop has only 45.5% similarity. Only ChiE71-1-BC, ChiE71-1-EF, ChiE71-1-GH and ChiE71-3-GH were viable. EV-A71 and CV-A16 antiserum neutralized ChiE71-1-BC and ChiE71-1-EF. Mice immunized with inactivated ChiE71 elicited high IgG, IFN-γ, IL-2, IL-4 and IL-10. Neonatal mice receiving passive transfer of WT EV-A71, ChiE71-1-EF and ChiE71-1-BC immune sera had 100%, 80.0% and no survival, respectively, against lethal challenges with EV-A71, suggesting that the substituted CV-A16 loops disrupted EV-A71 immunogenicity. Passive transfer of CV-A16, ChiE71-1-EF and ChiE71-1-BC immune sera provided 40.0%, 20.0% and 42.9% survival, respectively, against CV-A16. One-day-old neonatal mice actively immunized with WT EV-A71, ChiE71-1-BC, ChiE71-1-EF and CV-A16 achieved 62.5%, 60.0%, 57.1% and no survival respectively, after the EV-A71 challenge. Active immunization using CV-A16 provided full protection while WT EV-A71, ChiE71-1-BC, ChiE71-1-EF immunization showed partial cross-protection in CV-A16 lethal challenge with survival rates of 50.0%, 20.0%, and 40%, respectively. Taken together, the EV-A71 VP1 BC loop is essential in immunogenicity of EV-A71 and substitution with CV-A16 VP1 BC loop was insufficient to confer protection against CV-A16. The EF loop maintains the cross-protective immune responses. Disruption of a capsid loop could affect virus immunogenicity, and future vaccine design should include conservation of the enterovirus capsid loops.

Conductive hearing losses are typically present in disorders of the external/middle ear. However, there is a rare group of inner ear conditions called third windows that can also generate a conductive hearing loss. This is due to an abnormal connection between the middle and the inner ear or between the inner ear and the cranial cavity. X-linked gusher disorder is an extremely rare congenital inner ear dysplastic syndrome with such an abnormal connection due to a characteristic incomplete cochlear partition type 3 and an incomplete internal auditory meatus fundus. The disorder is inherited in an X-linked fashion due to the mutation of the POU3F4 gene. We present 2 siblings diagnosed with the condition and their long term follow ups. They both presented with audiovestibular symptoms and showed progressive mixed losses and bilateral vestibular weakness. They were treated with cochlear implant, digital amplification and with vestibular rehabilitation. Significant others around them were involved in their journey with the medical team and in both, a very favourable outcome was achieved. This is the first time that we are reporting evolving audiovestibular function with vestibular quantification in X-linked gusher disorder and emphasize on the multidisciplinary holistic approach to manage these children effectively.

Regenerative braking energy (RBE) recovery of trains can improve energy efficiency as well as reduce the overall greenhouse gases emissions of electric rail systems. The train's speed limit, track elevation, track curvature, and headway time can affect the amount of RBE recovered. This study aims to investigate the impacts of these parameters on the RBE recovery for a DC third rail system. A DC third rail system has been modeled using the ETAP-eTraX software based on the Malaysia Mass Rapid Transit Line 2 (MRT Line 2) traction power system. The effects of the change of speed limit, track elevation, track curvature, and headway time of the trains on the RBE recovery have been evaluated under various scenarios. The results showed that the track’s elevation has the most significant influence on the overall energy consumptions of the train while the speed limit has the most significant influence on the amount of RBE recovery.

In 2021, an operational research study in two tertiary hospitals, Freetown, showed poor hand hygiene compliance. Recommended actions were taken to improve the situation. Between February-April 2023, a cross-sectional study was conducted in the same two hospitals using the WHO Hand Hygiene tool to assess hand hygiene practices and compare hand hygiene compliance with that observed between June-August 2021. In Connaught hospital, overall hand hygiene compliance improved from 51% to 60% (P&lt;0.001), and this applied to both handwash actions with soap and water and alcohol-based-hand-rub: significant improvements were found in all hospital departments and amongst all healthcare worker cadres. In 34 Military Hospital (34MH), overall hand hygiene compliance decreased from 40% to 32% (P&lt;0.001), with significant decreases observed in all departments and amongst nurses and nursing students. The improvements in Connaught Hospital were attributed to more hand hygiene reminders, better handwash infrastructure and more frequent supervision assessments compared with 34MH where interventions were less well applied, possibly due to extensive hospital reconstruction at the time. In conclusion, improved distribution of hand hygiene reminders, better handwash infrastructure and frequent supervision assessments are effective, and need to be strengthened, scaled-up and combined with other innovative ways to promote good hand hygiene practices.

Introduction: Third molar surgery can cause post-operative complications to the patient due to the presence of wound from the incision. The study aimed to compare marginal flap with para-marginal flap on postoperative complications by the measurements on pre and post-surgical plaque index (PI), bleeding on probing (BoP), maximum opening of the mouth (MOM), pain perception (PP) and post-surgical tumefaction (PT). Methods: In this double-blind randomized clinical trial, 40 patients were recruited and randomly allocated in two groups. In Group 1, third molar extraction was carried out after a marginal flap design was performed, while in group 2 a para-marginal flap was per-formed. Plaque Index, Bleeding on Probing, Maximum Mouth Opening, and Distal Probing were assessed right before and one week after surgery, while Post-operative Pain Perception and Post-operative Swelling were accounted one week following sur-gery. Results: Statistically significant difference are reported between treatment groups, as the para-marginal flap led to better outcomes for all the measured indexes. Conclusion: The para-marginal flap design may decrease the occurrence of post-operative compli-cations and discomforts after mandibular third molar surgery, compared to marginal flap design.

Optical parametric amplification (OPA) represents a powerful solution to achieve broadband amplification in wavelength ranges beyond the scope of conventional gain media, for generating high-power optical pulses, optical microcombs, entangled photon pairs and a wide range of other applications. Here, we demonstrate optical parametric amplifiers based on silicon nitride (Si₃N₄) waveguides integrated with two-dimensional (2D) layered graphene oxide (GO) films. We achieve precise control over the thickness, length, and position of the GO films using a transfer-free, layer-by-layer coating method combined with accurate window opening in the chip cladding using photolithography. Detailed OPA measurements with a pulsed pump for the fabricated devices with different GO film thicknesses and lengths show a maximum parametric gain of ~24.0 dB, representing a ~12.2 dB improvement relative to the device without GO. We perform a theoretical analysis of the device performance, achieving good agreement with experiment and showing that there is substantial room for further improvement. This work demonstrates a new way of achieving high photonic integrated OPA performance by incorporating 2D materials.

The assessment of the prevalence of Subclinical Mastitis (SCM) in dairy farms is essential to validate the health status of the mammary gland. The aim of the study was to assess the prevalence of SCM in dual purpose livestock systems in Arauca, Colombian Orinoquia, through the analysis of the values found by the field diagnostic tests California Mastitis Test (CMT) and Electric Conductivity (EC). Milk samples were taken from the individual mammary quarters of 481 cows. The general prevalence, per affected room and the total number of rooms was determined according to the values obtained for each test using two methods of analysis. An ANOVA was performed to determine the difference between prevalence’s, a correlation analysis, and an analysis of sensitivity and specificity. The general prevalence was similar between the tests (CMT = 31.4%; EC = 29.7%) (p > 0.05). The prevalence of the total quarters was lower with EC (11.3% vs 14.2%) (p < 0.05). The correlations between tests were significant, but with low values (rs = 0.20-0.25). CMT and EC test concordance showed a sensitivity between 0.35-0.45 and a specificity of 0.75-0.90. The two tests showed positive results in detecting the same animals with or without the presence of the infection, although some animals that were positive for one test were not positive for the other test. The test EC classified animals and their quarters as SCM positive or negative in a more similar way to that obtained with CMT. The two diagnostic tests showed a general low prevalence of SCM in the livestock systems evaluated.

Bionic robotic hand can perform many movements similar to human hand. But there is still a significant gap in manipulation between robot and human hand. It is necessary to understand the finger kinematics and motion patterns of human hand to improve the performance of robotic hand. This study aimed to comprehensively investigate normal hand motion patterns by evaluating the kinematics of hand grip and release in healthy individuals. The data corresponding to rapid grip and release were collected from the dominant hand of 22 healthy people by sensory glove. The kinematics of 14 finger joints were analyzed, including the dynamic range of motion (ROM), peak velocity, joint sequence and finger sequence. The results show that the proximal interphalangeal (PIP) joint had a largest dynamic ROM than metacarpophalangeal (MCP) and distal interphalangeal (DIP) joints. Besides, the PIP joint had the highest peak velocity, both in flexion and extension. For joint sequence, the PIP joint moved prior to the DIP or MCP joints during flexion, while extension started in DIP or MCP joints, followed by PIP joint. Regarding the finger sequence, the thumb started to move before four fingers, and stopped moving after the fingers during both grip and release. This study explored the normal motion patterns in hand grip and release, which provided kinematic reference for the design of robotic hand and thus contribute to its development.

Identifying a vestibular source of pathology in patients complaining of post-traumatic brain injury (TBI) dizziness can be difficult. We describe a possible new method utilizing the reduction of post-TBI symptom (including dizziness) with the use of a noise cancellation device (NCD). This retrospective case series included patients with TBI and dizziness presenting to a binocular vision specialty clinic, who were diagnosed with a vertical heterophoria (VH). If they did not respond adequately to microprism lenses and/or if they experienced hyperacusis, they were evaluated with an NCD. If there was marked reduction of TBI symptoms (including dizziness), the patients were referred to a neuro-otologist for vestibular diagnostic evaluation and treatment. Fourteen patients were identified and found to have abnormalities on vestibular testing consistent with Third Mobile Window Disorder (TMWD). All were treated with a 6-week medical protocol (diuretics, no straining, low sodium/no caffeine diet). Five responded positively, requiring no further treatment. Nine required surgical intervention and responded positively. In conclusion, 14 patients with post-concussive dizziness and VH, a positive response to NCD was associated with abnormal vestibular testing, a diagnosis of TMWD, and symptom reduction/resolution with a medical or surgical approach. The removal of sound resulting in reduction or resolution of vestibular symptoms represents an Inverse Tullio Phenomena.

The paper describes a new formula for calculating the mutual inductance between a thin conical sheet inductor and a filamentary circular loop, which are coaxial. The presented formula is derived semi-analytically using the complete elliptic integrals of the first, second, and the third kind, along with the integral term which will be solved numerically. The results are validated using double and single integration methods, as well as the semi-analytical formula. The mutual inductance between a thin wall solenoid and a filamentary circular loop can be obtained using the new formula for the conical coil and circular loop. Presented formulas can be useful in various applications, such as broadband RF and wireless power transfer systems that utilize conical inductors. Overall, the paper presents a valuable contribution to the field of inductor design and can be useful in various applications involving conical inductors.

The more than thirty spacetime theorems developed over the past five decades establish that the universe and its spacetime dimensions have emerged from a cause/Causal Agent beyond the cosmos. Thus, to infer that this cause/Causal Agent may have intervened in the origin and history of Earth and Earth’s life resides well within the bounds of reason. Meanwhile, proponents of each of the three prevailing naturalistic models for the origin and history of Earth’s life have marshalled arguments and evidence that effectively undermine and refute the other two models. A biblical perspective and approach to Earth’s life can help resolve this impasse. While a superficial and pervasive appeal to divine intervention thwarts scientific advance, so does a rigid adherence to naturalism. A productive way forward is to identify which models (or parts of models), whether naturalistic, theistic, or a combination, most effectively narrow, rather than widen, knowledge gaps, minimize anomalies, offer the most comprehensive and detailed explanation of the data, and prove most successful in predicting scientific discoveries.

For technical or medical applications, the knowledge of the exact kinematics of the human hand is key to utilizing its capability to handle and manipulate objects and to communicate with other humans or machines. The optimal relationship between the number of measurement parameters, measurement accuracy as well as complexity, usability and cost of the measuring systems is hard to find. Biomechanic assumptions, the concepts of a biomechatronic system and the mechatronic design process as well as commercially available components are used to develop a sensorized glove. The proposed wearable can measure 14 of 15 angular values of a simplified hand model introduced in this paper. Additionally, five contact pressure values at the fingertips and inertial data of the whole hand with a degree of freedom of six are gathered. Due to the modular design and a hand size examination based on anthropometric parameters, the concept of the wearable is applicable for a large variety of hand sizes and adaptable to different use cases. Validations show a combined root-mean-square error of 0.99° to 2.38° for the measurement of all joint angles at one finger, surpassing the human perception threshold and the current state of the art in science and technology for comparable systems.

Childhood hygiene education has resulted in individuals engaging in hand washing and mask wearing to cope with COVID-19. Individuals can form sustainable development-related habits through childhood education.

All-optical signal processing based on nonlinear optical devices is promising for ultrafast information processing in optical communication systems. Recent advances in two-dimensional (2D) layered materials with unique structures and distinctive properties have opened up new avenues for nonlinear optics and the fabrication of related devices with high performance. This paper reviews the recent advances in research on third-order optical nonlinearities of 2D materials, focusing on all-optical processing applications in the optical telecommunications band near 1550 nm. First, we provide an overview of the material properties of different 2D materials. Next, we review different methods for characterizing the third-order optical nonlinearities of 2D materials, including the Z-scan technique, third-harmonic generation (THG) measurement, and hybrid device characterization, together with a summary of the measured n₂ values in the telecommunications band. Finally, the current challenges and future perspectives are discussed.

In previous works we have developed the concept of a relativistic engine taking into account the phenomena of retardation of electromagnetic fields. We have shown that Newton’n third law cannot strictly hold in a distributed system, where the different parts are at a finite distance from each other and thus force imbalance is created at the system’s center of mass. As the system is affected by a total force for a finite period, mechanical momentum and energy are acquired by the system. In previous works we relied on the fact that the bodies were macroscopically natural. Lately we relaxed this assumption and studied charged bodies, thus analyzing the consequences on a possible electric relativistic engine. On the first paper on this subject we investigated this phenomena in general but gave an example of a system only at the stage of reaching a stationary state, a second paper was devoted to the same but on the atomic scale, here we shall analyze the charge relativistic engine in a general time dependent setting.

American Sign Language is a popular language for deaf individuals. Communication is made easier for these people through sign language. However, in a digital era like today, there is a need for these people to be able to communicate online, and even get help from technology to communicate in person with non sign language speakers. This research will present a program able to translate American sign language to plain English. This study aims to use the OpenCV library to recognize hand signals, also a trained model to identify images so that the program can then translate them to words and letters. The program uses a data set of over 2000 images which will be in this case the largest data set available. With over 90\% of accuracy it results in a basic computer program with the largest data set available that would make possible for users to communicate with a wide variety of words and expressions.

This paper introduces a multi-class hand gesture recognition model developed to identify a set of defined hand gesture sequences in two-dimensional RGB video recordings. The work presents an action detection classifier that looks at both appearance and spatiotemporal parameters of consecutive frames. The classifier utilizes a convolutional-based network combined with a long-short-term memory unit. To leverage the need for a large-scale dataset, the model uses an available dataset to then adopt a technique known as transfer learning to fine-tune the model on the hand gestures of relevance. Validation curves performed over a batch size of 64 indicate an accuracy of 93.95% (± 0.37) with a mean Jaccard index of 0.812 (± 0.105) for 22 participants. The presented model illustrates the possibility of training a model with a small set of data (113,410 fully labelled frames). The proposed pipeline embraces a small-sized architecture that could facilitate its adoption.

HIV-associated neurocognitive disorder (HAND) is an array of neurocognitive changes associated with HIV infection, and the roles of microRNAs in HAND are not completely revealed yet. Based on published data and publicly available databases, we constructed an integrated miRNA-mRNA network involved in HAND. Bioinformatics analyses, including gene ontology, network analysis, and KEGG pathway analysis, were applied for further study of the network and the genes of the network. The axon guidance KEGG pathway, three genes NTNG1, EFNB2, CXCL12, and 17 miRNAs which regulates them, are spotlighted in our study. This study provides new perspectives to the knowledge of miRNAs’ roles in the process of HAND, and our findings provided potential therapeutic targets and clues of HAND.

Since 1974, when Heinz von Foerster made the distinction between “the cybernetics of observed systems” as first-order cybernetics (1oC) and “the cybernetics of observing systems” as second-order cybernetics (2oC), cybernetics has been dominated by this observer-centric paradigm that he claimed cannot be extended meaningfully to a third-order. Rather than attempting to extend his paradigm, we derive an alternative, model-centric paradigm from first principles of regulation that naturally extends to three orders, where the third order is ethical regulation. We thus consider a type of regulator that requires a third model and a third observer: If the third model is a model of acceptable (ethical) situations, then a third observer is a necessary element of the system’s “conscience” that prevents or detects any violations of the model of ethical situations. In this paradigm, the cybernetics of systems that are designed to exhibit ethical behaviour can be characterized as third-order cybernetics (3oC). By being able to extend the paradigm to include ethical systems, the model-centric paradigm brings clarity and utility that is not possible using the philosopher-friendly observer-centric paradigm and its under-specified (abstract) observers. Finally new definitions for cybernetics are proposed that clearly differentiate between the science and the philosophy, of cybernetics.

The present decade has witnessed numerous investigations focussed on the determination of the mechanical properties of Fly ash composites. These composites have attracted attention, especially in the form of reinforcements owing to their excellent tensile and compressive properties coupled with impact and hardness response. A number of techniques viz. in-situ deposition, hand-up lay and compo-casting techniques have been reported to fabricate these composites. However, in the context of these composites, a systematic structure-property correlation has not been established till date. The present review is aimed at highlighting the current state of research in the avenue of Fly ash composites from two different viewpoints, viz. (i) fabrication technique and (ii) mechanical properties of the fabricated composites. Moreover, the necessity of establishing systematic structure-property correlation in these materials has also been briefly discussed from the author’s viewpoint.

Since several years there is the discussion about dark matter in the halos of galaxies. This is aconsequence of observation of halo-velocity curves in dependence of distance which don‘t fulfillthe third Kepler-law. Maybe the ansätze are wrong. Shown is a simple physical model in classicalNewton-dynamics which fits qualitative the form of observation curves. Additional Parameters canbe used to fit the curves quantitative exactly without the hypothesis of dark matter.

A theoretical description of quantum jumps at the level of elementary particles is proposed, based on a micro-cosmological interpretation of their de Broglie phase. The third quantization formalism proposed in current literature for the description of baby universes in quantum cosmology is used here to describe the breakdown of unitarity in the transition from the pre-jump to the post-jump wave function. The corpuscular aspect manifested by the particle in the micro-interaction that originates the jump is represented by a pair of evanescent "micro-universes", respectively pre- and post-jump, connected by a wormhole. The latter represents the actual implementation of the interaction that leads to the projection on the outgoing state; this interaction is always local, even when the selected outgoing state is entangled. Therefore, the decoherence which leads to the emergence of classicality is originated by the same fundamental interactions of the Standard Model involved in the unitary evolution of the wave function. The objective nature of the reduction process admits implications on the possibility of using the formalism in the cosmological context, which are briefly discussed.

High molecular weight glutenin subunits (HMW-GS) and Low molecular weight glutenin subunits (LMW-GS) in mature grains play important roles in the formation of glutenin macropolymer and gluten quality. To characterize the expressed glutenin genes of the bread wheat variety Xinmai 26 during seed development, in this study, we measured the dough rheological properties of mature grains through farinograph and gluten testing system, and revealed its strong gluten quality. The compositions of HMW-GS and LMW-GS were analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). Further, a total of 18 full-length transcripts were obtained by third-generation RNA sequencing, including 5 transcripts of HMW-GS genes and 13 transcripts of LMW-GS genes (8 intact genes and 5 pseudogenes). The deduced protein structures of transcript sequences exhibit the typical HMW-GS and LMW-GS structural characteristics. Moreover, a specific functional marker was developed to make better use of the extra cysteine residue of 1Dx5 subunit. This study provides an efficient method to accurately identify glutenin genes in bread wheat through matching full-length transcripts to their spectrum of glutenin, which will be helpful to understand the contributions of glutenin genes to wheat quality.

Hand hygiene is among the most important factors of infection control in healthcare settings. Healthcare workers are considered the primary source of hospital acquired infection. We assessed the current state of hand hygiene knowledge, perception and practice among the healthcare workers in Qassim, Saudi Arabia. In this cross-sectional study we used the hand hygiene knowledge and perception questionnaire developed by the World Health Organization. Knowledge and perceptions were classified into good (80 – 100%), moderate (60 – 79%) and poor (<60% score). Majority of the healthcare workers had moderate knowledge (57.8%) and perception (73.4%) of hand hygiene. Males were less likely to have moderate/good knowledge compared to females (OR: 0.52, p<.05). Private healthcare workers were less likely (OR: 0.33, p<0.01) to have moderate/good perception compared to the government healthcare workers. Healthcare workers who received training on hand hygiene were 3.2 times likely (p<.05) to have good/moderate perception and 3.8 times likely (p<0.05) to routinely use alcohol-based hand-rub than the ones without such training. Physicians were 4.9 times likely (p<0.05) to routinely use alcohol-based hand-rub than the technicians. Our research highlighted gaps on hand hygiene knowledge and perception and practice among healthcare workers in Qassim and importance of training in this regard.

The emergence of the COVID-19 pandemic has propelled the use of alcohol-based hand sanitizers to the fore as a SARS-CoV-2 control measure. To be effective these products must comply with relevant quality parameters such as alcohol concentration, methanol limits and purity. The current study was designed to determine the quality of alcohol-based hand sanitizer products in the Nairobi metropolitan area. For this purpose, 74 commercially marketed samples were collected and subjected to analysis by gas chromatography. Only three samples (4.1%) complied with the regulatory specifications for alcohol content, methanol limits and pH. Five samples (6.8%) complied with the specification for alcohol content but did not meet methanol or pH limits. A total of 44 (59.5%) samples had methanol levels that exceeded threshold limits. Eleven samples (14.9%) were found with methanol substitution (i.e., methanol, instead of ethanol or isopropanol, was the main alcohol component). The results show that users of alcohol-based hand sanitizers are being exposed to substandard and falsified products which in addition to being non-efficacious pose harm due to unacceptable levels of toxic impurities. Regular, routine post-market surveillance is needed to prevent such products from reaching the market.

Cloud computing has become a prominent technology due to its important utility service; this service concentrates on outsourcing data to organizations and individual consumers. Cloud computing has considerably changed the manner in which individuals or organizations store, retrieve, and organize their personal information. Despite the manifest development in cloud computing, there are still some concerns regarding the level of security and issues related to adopting cloud computing that prevent users from fully trusting this useful technology. Hence, for the sake of reinforcing the trust between Cloud Clients (CC) and Cloud Service Providers (CSP), as well as safeguarding the CC’s data in the cloud, several security paradigms of cloud computing based on a Third-Party Auditor (TPA) have been introduced. The TPA, as a trusted party, is responsible for checking the integrity of the CC’s data and all the critical information associated with it. However, the TPA could become an adversary and could aim to deteriorate the privacy of the CC’s data by playing a malicious role. In this paper, we present the state-of-art of cloud computing’s privacy-preserving models (PPM) based on a TPA. Three TPA factors of paramount significance have been discussed: TPA involvement, security requirements, and security threats caused by vulnerabilities. Moreover, TPA’s privacy preserving models have been comprehensively analyzed and categorized into different classes with an emphasis on their dynamicity. Finally, we discuss the limitations of the models and present our recommendations for their improvement.

Universities have increasingly incorporated a third mission into their strategic planning. In addition to teaching and research, they have emphasised the training of entrepreneurs. However, there is still a lot of work to be done, as this process is facing resistance. The Entrepreneurial University covers all disciplines, including faculties of education. However, it has been shown that entrepreneurship tends to be more related to the faculties of economics and engineering, with a lesser presence in the faculties of education for various reasons: they consider entrepreneurship to be alien to their teaching role, there is a lack of entrepreneurial culture, and the objective of the Entrepreneurial University is unknown. The aim of this study is to analyse the level of entrepreneurship in Spanish faculties and schools of education. Forty deans and heads of education faculties in Spain took part in the survey. The results indicated a sufficient level of entrepreneurship; the dimensions related to active methodologies, and mission and strategy were the most developed, whereas entrepreneurship funding and entrepreneurship training for faculty employees were the least developed areas. Some deans noted that entrepreneurship was alien to their professional performance, although courses and good practices for the development of entrepreneurial initiative are gradually being implemented.

The greatest pandemic of the century, COVID-19, is an ongoing global public health problem. With a clinically approved treatment available only for those who are acutely ill and are hospitalized, the control of this disease in the general population is still largely dependent on the preventive measures issued by the World Health Organization. Among the general control measures other than immunization with the COVID-19 vaccines, handwashing with soap and water has been emphasized the most because it is cost-effective and easily accessible to the general public. Studies have reported that soaps offer unique chemical properties that can completely destroy enveloped viruses. However, the general public seems to be still uncertain about whether soaps can shield us from a highly contagious disease such as COVID-19. In an attempt to help eliminate the uncertainty, we analyzed the mechanisms underlying the efficacy of soap and its prospect for preventing the spread of COVID-19. In this paper, we provide an overview of the history and characteristics of the SARS-CoV-2 virus, the current global COVID-19 situation, the possible mechanisms of the deactivation of viruses by soaps, and the potential effectiveness of soap in eliminating coronaviruses including SARS-CoV-2.

Background: Selection and application of suture materials, has gained more importance especially with the increasing number of patients seeking oral surgeries. Since lying in a bacterial-filled environment, sutures make the tissue prone to infection. Suture material plays an important role in the reduction of the risk of infection. This study aimed to assess the success rate of an antibacterial suture named Vicryl Plus in preventing bacterial growth in the surgical site of the mandibular third molar. Methods: 27 patients were included in this double-blinded randomized clinical trial study. Surgical Extraction of the mandibular wisdom tooth was done and the incision was managed by randomly using Vicryl Plus and Vicryl sutures. After 7 days, sutures were removed and assessed microbiologically. Predominant species of Streptococcus mutans and Lactobacillus were assessed as well as the total number of colonies on each suture. Results: There was a significant difference between two suture materials in colony number-length ratio of lactobacillus (p-value= 0.031) and total bacterial colonies (p-value=0.016); but not for S. mutans species (p-value=0.201). Conclusion: Antibacterial Vicryl suture can be a useful tool for the reduction in the rate of surgical site infection in high-risk cases and situations.

Significant progress has been made in understanding the computational and neural architecture that mediates eye and hand movements made in isolation. However, less is known about the mechanisms that control these movements when they are coordinated. Here, we outline our computational approaches using accumulation-to-threshold and race-to-threshold models to elucidate the mechanisms that initiate and inhibit these movements. We suggest that, depending on the behavioral context, the initiation and inhibition of coordinated eye-hand movements can operate in two modes- coupled and decoupled. The coupled-mode operates when the task context requires a tight coupling between the effectors; a common command initiates both effectors, and a unitary inhibitory process is responsible for stopping them. Conversely, the decoupled mode operates when the task context demands weaker coupling between the effectors; separate commands initiate the eye and hand, and separate inhibitory processes are responsible for stopping them. We hypothesize that higher-order control processes assess the behavioral context and choose the most appropriate mode. This computational architecture can explain heterogeneous results observed across many studies that have investigated the control of coordinated eye-hand movements and may also serve as a general framework to understand the control of complex multi-effector movements.

Background: Globally, infections are the third leading cause of neonatal mortality. Predominant risk factors for facility-born newborns are poor hygiene practices that span both the facility and home environments. Current improvement interventions focus on only one environment and tar-get limited caregivers, primarily birth attendants and mothers. To inform the design of a hand hygiene behaviour change intervention in rural Cambodia, a formative mixed-methods research study was conducted to investigate the context specific behaviours and determinants of hand-washing among healthcare workers, maternal and non-maternal caregivers along the early new-born care continuum. Methods: Direct observations of hygiene practices of all individuals providing care to 46 newborns across eight facilities and associated communities were completed and hand hygiene compliance assessed in analysis. Semi structured interactive interviews were subsequently conducted with 35 midwives and household members to explore the corresponding cognitive, emotional, and environmental factors influencing the observed key hand hygiene behaviours. Results: Hand hygiene opportunities during newborn care were frequent in both set-tings (n = 1319) and predominantly performed by mothers, fathers and non-parental caregivers. Compliance to hand hygiene protocol across all caregivers, including midwives, was inadequate (0%). Practices were influenced by the lack of accessible physical infrastructure, time, increased workload, low infection risk perception, nurture-related motives, norms and inadequate knowledge. Conclusion: Our findings indicate that an effective intervention in this context should be multi-modal to address the different key behaviour determinants and target a wide range of caregivers.

The anarchic hand syndrome refers to an inability to control the movements of one’s own hand which acts as if it had a will of its own. The symptoms may differ depending on whether the brain lesion is anterior, posterior, callosal or subcortical, but the relative classifications are not conclusive. This study investigates the role of white matter disconnections in a patient whose symptoms are inconsistent with the mapping of the lesion site. A repeated neuropsychological investigation was associated with a review of the literature on the topic to identify the frequency of various different symptoms relating to this syndrome. Furthermore, an analysis of the neuroimaging regarding structural connectivity allowed us to investigate the grey matter lesions and white matter disconnections. The results indicated that some of the patient’s symptoms were associated with structures that, although not directly damaged, were dysfunctional due to a disconnection in their networks. This suggests that the anarchic hand may be considered as a disconnection syndrome involving the integration of multiple antero-posterior, insular and interhemispheric networks. In order to comprehend this rare syndrome better, the clinical and neuroimaging data need to be integrated with the clinical reports available in the literature on the topic.

Newton's third law states that any action is countered by a reaction of equal magnitude but opposite direction. The total force in a system not affected by external forces is thus zero. However, according to the principles of relativity, a signal cannot propagate at speeds exceeding the speed of light. Hence the action and reaction cannot be generated at the same time due to the relativity of simultaneity. Thus, the total force cannot be null at a given time. In a previous paper \cite{MTAY1}, we have shown that Newt\-on'n third law cannot strictly hold in a distributed system, where the different parts are at a finite distance from each other. This is due to the finite speed of signal propagation, which cannot exceed the speed of light in the vacuum. A specific example of two current loops with time dependent currents demonstrated that the summing of the total force in the system does not add up to zero. This analysis led to the suggestion of a relativistic engine \cite{MTAY3,AY1}. As the system is affected by a total force for a finite period, the system acquires mechanical momentum and energy. Now the question then arises how can we accommodate the law of momentum and energy conservation. The subject of momentum conversation was discussed in \cite{MTAY4}, while preliminary results regarding energy conservation were discussed in \cite{AY2,RY,RY2}. Previous analysis relied on the fact that the bodies were macroscopically natural, which means that the number of electrons and ions is equal in every volume element. Here we relax this assumption and study charged bodies, thus analyzing the consequences on a possible electric relativistic engine.

This paper discusses approaches to the numerical integration of the coupled nonlinear Schrödinger equations system in case of few-mode wave propagation. The wave propagation assumes the propagation of up to nine modes of light in an optical fiber. In this case, the light propagation is described by the non-linear coupled Schrödinger equation system, where propagation of each mode is described by own Schrödinger equation with other modes interactions. In this case, the non-linear coupled Schrödinger equation system solving becomes increasingly complex, because each mode affects the propagation of other modes. The suggested solution is based on the direct numerical integration approach, which is based on a finite-difference integration scheme. The well-known explicit finite-difference integration scheme approach fails, due to the non-stability of the computing scheme. Due to this fact, the combined explicit/implicit finite-difference integration scheme, based on the implicit Crank–Nicolson finite-difference scheme, is used. It allows ensuring the stability of the computing scheme. Moreover, this approach allows separating the whole equation system on the independent equation system for each wave mode at each integration step. Additionally, the algorithm of numerical solution refining at each step and the integration method with automatic integration step selection are used. The suggested approach has performance gains (or resolutions) up to three or more orders of magnitude in comparison with the split-step Fourier method due to the fact that there is no need to produce direct and inverse Fourier transforms at each integration step. The main advantage of the proposed method is the ability to calculate the propagation of an arbitrary number of modes in the fiber.

The present paper describes the development of a prosthetic hand based on the human hand anatomy. The hand phalanges are printed by using 3D printed with Polylactic Acid material. One of the main contributions is the investigation on the prosthetic hand joins; the proposed design enables to create personalized joins that allow the prosthetic hand a high level of movement by increasing the degrees of freedom of the fingers. Moreover, the driven wire tendons show a progressive grasping movement, being the friction of the tendons with the phalanges very low. Another important point is the use of force sensitive resistors for simulating the hand touch pressure. These are used for the grasping stop simulating touch pressure of the fingers. Surface Electromyogram (EMG) sensors allow the user to control the prosthetic hand grasping start. Their use may provide the prosthetic hand the possibility of classification of the hand movements. The practical results included in the paper prove the importance of the soft joins for the object manipulation and to get adapted to the object surface. Finally, the force sensitive sensors allow the prosthesis to actuate with more naturalness by adding conditions and classifications to the Electromyogram sensor.

Hand tracking enables controller-free interaction with virtual environments, which can, compared to traditional handheld controllers, make virtual reality (VR) experiences more natural and immersive. As naturalness hinges on both technological and user-based features, fine-tuning the former while assessing the latter can be used to increase usability. For a grab-and-place use case in immersive VR, we compared a prototype of a camera-based hand tracking interface (Leap Motion) with customized design elements to the standard Leap Motion application programming interface (API) and a traditional controller solution (Oculus Touch). Usability was tested in 32 young healthy participants, whose performance was analyzed in terms of accuracy, speed and errors as well as subjective experience. We found higher performance and overall usability as well as overall preference for the handheld controller compared to both controller-free solutions. While most measures did not differ between the two controller-free solutions, the modifications made to the Leap API to form our prototype led to a significant decrease in accidental drops. Our results do not support the assumption of higher naturalness for hand tracking but suggest design elements to improve the robustness of controller-free object interaction in a grab-and-place scenario.

The study aimed to estimate the prevalence and correlates of oral hygiene (OH) and hand hygiene (HH) behaviour among school adolescents in three Caribbean countries. In all, 7,476 school adolescents (median age 14 years), from Dominican Republic, Suriname and Trinidad and Tobago responded the cross-sectional “Global School-based Student Health Survey” (GSHS) in 2016-2017. The prevalence poor OH (tooth brushing <2 times/day) was 16.9%, poor HH (not always before meals) was 68.2%, poor HH (not always after toilet) was 28.4% and poor HH (not always with soap) was 52.7%. In adjusted logistic regression analysis, current cannabis use, inadequate fruit and vegetable intake, poor mental health and low parental support increased the odds for poor OH. Rarely or sometimes experiencing hunger, trouble from alcohol use, inadequate fruit and vegetable intake, poor mental health, and low parental support were associated with poor HH (before meals, and/or after toilet, and/or with soap). The survey showed poor OH and HH behaviour practices. Several sociodemographic factors, health risk behaviours, poor mental health and low parental support were found associated with poor OH and/or HH behaviour that can assist with tailoring OH and HH health promotion.

The global use of alcohol based hand sanitizers (ABHS) as a means of controlling the transmission of infectious disease increased dramatically in 2020 as governments and public health agencies across the world advocated hand hygiene as a preventative measure during the COVID-19 pandemic. Although the performance of these products is most commonly defined as a function of their alcohol concentration, they are multifaceted products in which an interplay of several factors is important in determining efficacy. The hand sanitizer tetrahedron, is a novel concept that considers both ABHS formulation factors and product performance factors from a multi-dimensional perspective. The four faces of the tetrahedron represent input/formulation factors: 1) the type and amount of alcohol, 2) inactive ingredients, 3) the type of formulation/delivery system and 4) manufacturing practices. The four corners of the tetrahedron represent output/product performance factors: 1) efficacy, 2) sensory characteristics, 3) usage, usability and compliance and 4) product safety/adverse effects. All factors are of importance to ensuring the effectiveness and utility of these products.

We search for limit cycles in the dynamical model of two-species chemical reactions that contain seven reaction rate coefficients as parameters and at least one third-order reaction step, that is, the induced kinetic differential equation of the reaction is a planar cubic differential system. Symbolic calculations were carried out using the Mathematica (or, Wolfram language) mathematical program package, and it was also used for the numerical verifications to show the following facts: the kinetic differential equations of these reactions each has two limit cycles surrounding the stationary point of focus type in the positive quadrant. In the case of Model 1, the outer limit cycle is stable and the inner one is unstable that appears in a supercritical Hopf bifurcation. Moreover, the oscillations in a neighborhood of the outer limit cycle are slow-fast oscillations. In the case of Model 2, the outer limit cycle is unstable and the inner one is stable. With another set of parameters, the outer limit cycle can be made stable and the inner one unstable.

Hand gestures may play an important role in medical applications for health care of elderly people, where providing a natural interaction for different requests can be executed by making specific gestures. In this study we explored three different scenarios using a Microsoft Kinect V2 depth sensor then evaluated the effectiveness of the outcomes. The first scenario utilized the default system embedded in the Kinect V2 sensor, which depth metadata gives 11 parameters related to the tracked body with five gestures for each hand. The second scenario used joint tracking provided by Kinect depth metadata and depth threshold together to enhance hand segmentation and efficiently recognize the number of fingers extended. The third scenario used a simple convolutional neural network with joint tracking by depth metadata to recognize five categories of gestures. In this study, deaf-mute elderly people execute five different hand gestures to indicate a specific request, such as needing water, meal, toilet, help and medicine. Then, the requests were sent to the care provider’s smartphone because elderly people could not execute any activity independently. The system transferred these requests as a message through the global system for mobile communication (GSM) using a microcontroller.

Whilst large-scale changes in population behaviour are required to reduce the transmission of the SARS-COV-2 virus, the emergency context is not conducive to the sort of careful communications planning that would normally be required to meet such a task. Rapid strategic communications planning in a pandemic by governments is, however, possible and necessary. Steps include setting up a dedicated communications task force, mobilising partners and resources, developing a creative brief and theory of change and overseeing the creation, testing, roll out and revision of content. In this short guide we argue that a minimum of strategic planning can be undertaken rapidly, and that good use can be made of simple principles of behaviour change, even during pandemics. Our aim here is to provide a blueprint that governments and their partners, especially in low-income settings, can follow to design, coordinate and resource national communications efforts to combat the COVID-19 pandemic immediately and for the longer term.

In this paper, inspired by recent articles of G. Anatriello and G. Vincenzi (see \cite{Ana}), and G. Cerda-Morales (see \cite{Cer1,Cer2}), we will introduce the third-order $\overline{h}$-Jacobsthal and third-order $\overline{h}$-Jacobsthal--Lucas sequences and their associated quaternions. The new results that we have obtained extend most of those obtained in \cite{Cer2}.

Background: The Micro Hand S robot is the first domestically produced surgical robot that has entered clinical use in China, and this is the first report of its application in colon cancer. Objective: This study aimed to validate the safety and efficacy of the domestically produced Chinese minimally invasive Micro Hand S surgical robot system in complex surgery, such as robotic complete mesocolic excision (R-CME). Methods: From March 2018 to December 2018, 30 patients with right hemicolon cancer underwent R-CME with the Micro Hand S robot system. The operative findings, morbidities, oncological findings and unique characteristics were summarizedwere analyzed. Result: 12 patients with right hemicolon cancer and 18 patients with sigmoid colon cancer underwent RCME with the Micro Hand S robot system. During the study period, the median operative duration was 209 (range, 180-255) min, and the median estimated blood loss volume was 35 (range, 25-75) ml. The median number of lymph nodes harvested was 42 (21-77), and the median postoperative hospital stay was 5 (range, 4-7) days. According to the Clavien-Dindo classification, there were no severe complications except for 7 cases of grade I complications and 5 cases of grade II complications. The conversion rate for all operations was 0%. There were no cases of 30-day readmission or 30-day mortality. Conclusion: Clinical application of domestically produced Chinese minimally invasive surgical robot system “Micro Hand S ” in selected colon cancer patients is technically feasible and safe.

Background: The Micro Hand S robot is the first domestically produced surgical robot that has entered clinical use in China, and this is the first report of its application in colon cancer.Objective: This study aimed to validate the safety and efficacy of the domestically produced Chinese minimally invasive Micro Hand S surgical robot system in complex surgery, such as robotic complete mesocolic excision (R-CME).Methods: From March 2018 to December 2018, 30 patients with right hemicolon cancer underwent R-CME with the Micro Hand S robot system. The operative findings, morbidities, oncological findings and unique characteristics were summarizedwere analyzed.Result: 12 patients with right hemicolon cancer and 18 patients with sigmoid colon cancer underwent RCME with the Micro Hand S robot system. During the study period, the median operative duration was 209 (range, 180-255) min, and the median estimated blood loss volume was 35 (range, 25-75) ml. The median number of lymph nodes harvested was 42 (21-77), and the median postoperative hospital stay was 5 (range, 4-7) days. According to the Clavien-Dindo classification, there were no severe complications except for 7 cases of grade I complications and 5 cases of grade II complications. The conversion rate for all operations was 0%. There were no cases of 30-day readmission or 30-day mortality. Conclusion: Clinical application of domestically produced Chinese minimally invasive surgical robot system “Micro Hand S ” in selected colon cancer patients is technically feasible and safe.

Electromyographic (EMG) signals provide information about a person's muscle activity. For hand movements, in particular, the execution of each gesture involves the activation of different combinations of the forearm muscles, which generate distinct electrical patterns. Conversely, the analysis of these muscle activation patterns, represented by EMG signals, allows recognizing which gesture is being performed. In this study, we aimed to implement an automatic identification system of hand or wrist gestures based on supervised Machine Learning (ML) techniques. We trained different computational models and determined which of these showed the best capacity to identify six hand or wrist gestures and generalize between different subjects. We used an open access database containing recordings of EMG signals from 36 subjects. Among the results obtained, we highlight the performance of the Random Forest model, with an accuracy of 95.39%, and the performance of a convolutional neural network with an accuracy of 94.77%.

In developed countries, especially the big-sized ones like Australia and the USA, a car is almost an inevitable necessity to carry out daily activities. Due to this, used cars have become a great alternative to brand new cars because of their cost effectiveness. In this work, estimation of prices of used cars based on numerous factors is studied statistically. Data is based on prices of used cars sold across Australia. Statistical methods like correlation and permutation tests using linear regression model, exact tests and non-parametric bootstrapping is implemented to study the relationship of price with mileage and year of manufacture of the car using p-values and null hypothesis. Predictions are also made on the price by calculating a 95% confidence interval (CI) of median prices in small portions of the dataset. The study presents potential ideas for understanding correlation between variables and parameters in business studies.

The evolution of manual grooming and its implications have received little attention in the quest to understand the origins of simian primates and their social and technical intelligence. All simians groom manually, whereas prosimians groom orally despite comparable manual dexterity between some members of the two groups. Simians also exhibit a variable propensity for the manipulation of inanimate, non-food objects, which has culminated in tool making and tool use in some species. However, lemuriform primates also seem capable of tool use with training. Furthermore, lemuriforms appear to understand the concept of a tool and use their own body parts as “tools”, despite not using inanimate objects. This suggests that prosimian primates are pre-adapted for proprioceptive object manipulation and tool use, but do not express these cognitive abilities by default. This essay explores the paleontological, anatomical, cognitive, ethological, and neurological roots of these abilities and attempts to explain this behavioural divide between simians and prosimians. Common misconceptions about early primate evolution and captive behaviours are addressed, and chronological inconsistencies with Machiavellian Intelligence are examined. A “licking to picking” hypothesis is also proposed to explain a potential link between manual grooming and object manipulation, and to reconcile the inconsistencies of Machiavellian Intelligence. Bayesian decision theory, the evolution of the parietal cortex and enhanced proprioception, and analogies with behavioural changes resulting from artificial selection may help provide new insights into the minds of both our primate kin and ourselves.

Objective: In this pilot study, we described the gross motor development of infants aged 4 to 24 months with congenital heart disease (CHD) and assessed through a systematic develop­mental screening programme, with individualised motor interventions. Methods: Thirty infants who had cardiac repair underwent gross motor evaluations using the AIMS at 4 months, and the Bayley-III at 12 and 24 months. Results: Based on AIMS, 80% of 4-month-old infants had a delay in gross motor development and required physical therapy. Gross motor abilities significantly improved by 24 months. Infants who benefited from regular physiotherapy tended to show better improvement in motor scores. Conclusion: Our study highlights the importance of early motor screening in infants with CHD and suggests a potential benefit of early physical therapy in those at-risk. Further research is needed to assess the effectiveness of systematic developmental screening and individualized inter­vention programmes at identifying at risk patients, and their impact on developmental outcomes.

This paper combines the Good Regulator Theorem with the Law of Requisite Variety and seven other requisites that are necessary and sufficient for a cybernetic regulator to be effective and ethical. The resulting Ethical Regulator Theorem provides a basis for systematically evaluating and improving the adequacy of existing or proposed designs for systems that make decisions that can have ethical consequences; regardless of whether the regulators are human, machines, cyberanthropic hybrids, organizations, corporations, or government institutions. The theorem is then used to define an ethical design process that has potentially far-reaching implications for society. A six-level framework is proposed for classifying cybernetic and superintelligent systems, which highlights the existence of a possibility-space bifurcation in our future time-line. The implementation of “super-ethical” systems is identified as an urgent imperative for humanity to avoid the danger that superintelligent machines might lead to a technological dystopia. Third-order cybernetics is defined as the cybernetics of ethical systems. Concrete actions, a grand challenge, and a vision of a super-ethical society are proposed to help steer the future of the human race and our wonderful planet towards a realistically achievable minimum viable cyberanthropic utopia.

Background and objectives: The language-induced grip force modulation (GFM) can be used to better understand the link between the language and motor functions as an expression of the embodied language. However, the contribution of each brain hemisphere to the language-induced GFM is still unclear. Using six different action verbs as stimuli, this study evaluated the GFM of the left hand in unimanual task to characterize the left- and right-hemisphere contributions. Materials and Methods: The left-hand GFM of 20 healthy consistent right-handers subjects was evaluated using the verbs “to write”, “to hold”, “to pull”(left-lateralized central processing actions), “to draw”, “to tie”, and “to drive” (bi-hemispheric central processing actions) as linguistic stimuli. The time between the word onset and the first interval of statistical significance regarding the baseline (RT) was also measured. Results: The six verbs produced language-induced GFM. The modulation intensity was similar for the six verbs, but the RT was variable. The verbs “to draw”, “to tie”, and “to drive”, whose central processing of the described action is bihemispheric showed a longer Rt compared to the other verbs. Conclusions: The possibility that an action is performed by the left-hand does not interfere with the occurrence of GFM when this action verb is employed as linguistic stimulus. Therefore, the language-induced GFM seems mainly rely on the left hemisphere, and the engagement of the right hemisphere seems to slow down the increase in the GFM intensity.