Among the possible improvements of Autonomous Emergency Braking (AEB) systems, reducing the intensity of the automatic braking process by studying the kinematics and general behavior of the pedestrian while crossing is crucial to determine the progressiveness of the braking, or replacing part of the braking process by an evasive maneuver when a collision is imminent. This paper proposes the integration of an autonomous avoidance system (Automatic Emergency Steering, AES) that acts directly on the steering system to generate an evasive maneuver and avoid a possible pedestrian collision (OPREVU-AES system), as well as the assessment of its effectiveness compared to a commercial AEB system. OPREVU and VULNEUREA are research projects in which INSIA and CEDINT have cooperated to improve driving assistance systems and the safety of pedestrians and cyclists through Virtual Reality (VR) techniques. The analysis of the kinematic and dynamic response of the OPREVU-AES system is conducted in CarSim© software. The effectiveness evaluation procedure is based on the reconstruction of a sample of road vehicle-to-pedestrian crashes (INSIA-UPM database), using the PCCrash® software, and taking as an indicator the probability of head injury severity (ISP). The results show that the AEB system would have prevented part of the collisions, especially after the incorporation of the OPREVU-AES system. In most of the cases where avoidance is not possible, a significant reduction of the ISP is achieved.

The article analyzes the transitional mode of movement of a passenger train caused by emergency braking by the driver. To study the possibility of derailment of passenger cars, a simulation model of the movement of a train consisting of a locomotive and twenty passenger cars was developed in the Universal Mechanism software environment, designed to study the dynamics and kinematics of mechanical systems, which include railway rolling stock. The developed model allows taking into account the longitudinal, transverse and vertical vibrations of all cars and locomotive. All bodies in the model are assumed to be absolutely rigid. The assumption of non-deformability of the bodies is based on the fact that the stiffness of the spring suspension and elastic connections is significantly less than the structural rigidity of the bogie frames and the bolster structure, and the frequency of elastic vibrations of these bodies is much higher than the frequency of their vibrations on the spring suspension. Passengers and cargo in a wagon are considered to be non-deformable and integral with the wagon body, similarly in the case of a locomotive body. Between the elements of the system, connections are involved that regulate certain relative movements of these elements.

Critically ill patients treated in the intensive care unit (ICU) can present many abdominal conditions that need a prompt diagnosis and timely treatment because of their general frailty. Clinical evaluation and diagnostic tools like ultrasound or CT scan are not reliable or feasible in these patients. Bedside laparoscopy (BSL) is a minimally invasive procedure that allows surgeons to assess the abdominal cavity directly in the ICU, thus avoiding unnecessary exploratory laparotomy or incidence related to intra-hospital transfer. We conducted a review of the literature to summarize the state-of-the-art of BSL. Medline, The Cochrane Central Register of Controlled Trials (CENTRAL), and Scopus databases were utilized to identify all relevant publications. Indications, contraindications, technical aspects, and outcomes are discussed. The procedure is safe, feasible, and effective. When other diagnostic tools fail to diagnose or exclude an intra-abdominal condition in ICU patients, BSL should be preferred over exploratory laparotomy.

In this paper, a new axial-type magnetic gear with auxiliary flux-enhancing structure (AFS-AMG) is proposed. Compared to conventional AFS-AMG, it has the higher torque density and higher permanent magnet (PM) utilization factor. Firstly, the design rules and operating principles of proposed AFS-AMG are elaborated. Then, the mapping relation between the radial-type magnetic gears (RMGs) and AMGs are elucidated. Compared to its counterpart in RMGs, AFS-AMGs achieve small size. Then, the geometrical parameters of AFS-AMGs are optimized to obtain the better electromagnetic performances, where the torque density per volume and per PM volume is adopted as the evaluation standard. Finally, three different AMG topologies are constructed in finite element analysis (FEA) software for comparison. It is proven that the AFS-AMG has the largest torque density per volume and per PM volume.

Introduction: Atrial fibrillation (AF) is a common cardiac arrhythmia whose prevalence rises with age and is linked to increased morbidity and mortality due to the risk of thromboembolism. Management typically involves anticoagulation and rhythm control, but the treatment of elderly patients with multiple comorbidities requires careful consideration of drug side effects and interactions. Cibenzoline, a Vaughan-Williams class IA antiarrhythmic, is effective against AF but has risks of toxicity, especially in older people and those with renal impairment, due to its renal excretion and prolonged half-life in these populations. Discussion: This paper presents a case of an 80-year-old woman with paroxysmal AF who suffered cardiac arrest due to cibenzoline toxicity despite receiving standard adjusted dosages. The patient's cibenzoline blood concentration was significantly higher than the therapeutic range, leading to cardiotoxicity, which was exacerbated by drug interactions with bisoprolol and edoxaban, both metabolized by the CYP3A4 enzyme. Venoarterial extracorporeal membrane oxygenation (V-A ECMO) and intra-aortic balloon pump (IABP) successfully managed the cardiac arrest. This case emphasizes the unpredictable pharmacokinetics of cibenzoline in elderly patients with renal impairment and the need for vigilant therapeutic drug monitoring to avoid adverse events. Conclusions: Cibenzoline can pose a significant risk of severe toxicity in elderly patients with renal impairment, and drug interactions may potentiate this risk. The paper underscores the importance of careful dose adjustment and monitoring of drug levels in this population. In cases of cibenzoline-induced cardiac arrest, V-A ECMO and IABP are effective treatment modalities. The case study serves as a critical reminder for clinicians to remain vigilant for drug-induced complications and to apply aggressive supportive treatments when necessary.

The Giant Babax, an endemic bird in China and a nationally protected wildlife species of Class Ⅱ, is primarily distributed in southern and southeastern Tibet. To investigate the factors influencing nesting site selection, this study conducted research on nest characteristics and nesting site preferences at four sample sites around Lhasa from March to October 2023y, using systematic search methods, tracking methods, and sampling methods. The research findings are as follows: (1) The average nest depth was (7.70±1.47)cm, nest height was (19.58±2.97)cm, inner diameter was (10.64±1.73)cm, outer diameter was (24.65±4.8)cm, average weight was (162.3±13.5)g, and average nest spacing within the plot was 396.93m. (2) The nests of Giant Babax were predominantly found on vegetation such as Salix longistamina (38%), Hippophae gyantsensis (20%), Rosa sericea Lindl. (14%), and Populus szechuanica Schneid(11%). They showed a preference for artificial secondary forests as nesting sites. (3) Giant Babax exhibited a preference for habitats with robust trees that had high canopies while being distant from houses and roads, but close to water sources; moreover, the canopy of the nesting tree played a crucial role in their choice of nesting sites. (4) The reproductive success rate reached 76%, with key factors affecting it being the canopy coverage of the nesting tree and the number of helpers. These research results provide fundamental data support for population conservation efforts and ecological resource management strategies concerning the Giant Babax.

C. auris is a newly emerging yeast, raising public health concerns due to its outbreak potential, lack of protocols for decontamination and isolation of patients or contacts, increased resistance to common antifungals and associated high mortality. This research aimed to describe the challenges related to identifying the outbreak, limiting further contamination, and treating affected individuals. We retrospectively analysed all cases of C. auris detected between October 2022 and August 2023, but our investigation focused on a three-month-long outbreak in the department of cardio-vascular surgery and the related intensive care unit. Along with isolated cases in different wards, we identified 13 patients who became infected or colonized in the same area and time, even though the epidemiological link could be traced only in 10 patients, according to the epidemiological investigation. In conclusion, our study emphasizes the substantial challenge encountered in clinical practice when attempting to diagnose and limit the spread of an outbreak. Therefore, it is crucial to promptly apply contact precaution measures and appropriate environmental cleaning, from the first case detected positive.

Synchronous electrical cardioversion is a relatively common procedure in the emergency department (ED), often performed for unstable supraventricular tachycardia (SVT) or unstable ventricular tachycardia (VT). However, it is also used for stable cases resistant to drug therapy, which carry a risk of deterioration. In addition to the inherent risks linked with procedural sedation, there is a possibility of malignant arrhythmias or bradycardia, which could potentially result in cardiac arrest following this procedure. Here, we present a case of complete heart block unresponsive to transcutaneous pacing and positive inotropic and chronotropic drugs for 90 minutes, resulting in multiple cardiac arrests. The repositioning of the transcutaneous cardio-stimulation electrodes, one of them placed in the left latero-sternal position and the other at the level of the apex, led to immediate stabilization of the patient. Extubation of the patient was performed the following day, while full recovery and discharge within 7 days, after insertion of a permanent pacemaker.

The importance of utilizing an optimal and efficient braking system is emphasized in this study. Braking system optimization and efficiency were practically determined through successive tests on the brake dynamometer, according to road safety regulations. Subsequently, the results were correlated with practical tests involving consecutive braking at different speeds, tracking both the time and distance of braking. The coefficient of friction (COF) was established for each braking instance by utilizing the braking force measured on the brake dynamometer. This paper aims to highlight the genuine impact of the braking system by measuring and establishing its braking efficiency depending on the car’s speed, time, and distance of braking.

This study aimed to evaluate the effect of three yeast strains, Pichia guilliermondii (Levica 27), Candida norvegensis (Levazoot 15), and a commercial product (Levucell® SC 10) containing Saccharomyces cerevisiae, on in vitro rumen fermentation of two substrates: corn stover and a total mixed ration (TMR). Samples were taken 24 hours post-fermentation to measure pH, ammonia nitrogen (NH3-N), gas production, and volatile fatty acid (VFA) concentrations. The addition of yeasts did not affect gas production at 24 hours for either diet. For pH, differences between yeast strains were noted when TMR was used. The lowest NH3-N concentration (6.1 mM) was recorded with corn stover, showing similar results across strains. Conversely, NH3-N levels with TMR ranged from 47 mM to 66 mM. The inclusion of all three yeast strains increased the molar concentrations of total VFA, as well as acetic (C2), propionic (C3), and butyric (C4) acids in the rumen fluid. The C2:C3 ratio remained unchanged with corn stover but decreased with the inclusion of Levica 27 and Levazoot 15 in the TMR. With the commercial product Levucell® SC 10, this ratio was comparable to the control treatment. In conclusion, Levica 27 and Levazoot 15 demonstrated a stimulatory effect on in vitro rumen fermentation for the evaluated diets, evidenced by increased VFA concentrations.

Background/Objectives: The 28-day mortality rate for septic shock is high, necessitating rapid and effective empiric antimicrobial therapy. This study investigates whether the rate of catecholamine dose reduction in septic shock can indicate bacterial susceptibility to initial antimicrobial therapy. Methods: This retrospective observational study involved 108 adult patients with bacteraemia and septic shock admitted at the intensive care unit of Nihon University Itabashi Hospital between January 2017 and December 2023. They were classified into the Susceptible or Resistant group based on the bacteria’s susceptibility to the initial empiric antimicrobial therapy. Catecholamine dosages were converted to norepinephrine equivalent (NEE) scores, with the time course from peak to end of administration measured at NEE reductions. Results: Of the 108 patients, 94 were in the Susceptible group and 14 in the Resistant group. The Susceptible group showed faster reductions in catecholamine doses: time to reduce the dose from the maximum NEE to 25% was 19 vs. 49.5 hours (p = 0.0057); and 0%, 29 vs. 54 hours (p = 0.0475). Conclusions: In septic shock with bacteraemia, faster catecholamine dose reduction indicates bacterial susceptibility to initial empiric antibiotics. This reduction rate can serve as an early clinical indicator of appropriate initial empiric therapy.

Preterm birth accounts for about 10% of births worldwide. Studying risk factors for perinatal brain damage is essential, as findings suggest that almost 20% of disabilities are linked to risks in the early stages of development. This research aimed to study longitudinal changes in intelligence from 6 to 8 years of age in a sample of 39 preterm children with a history of risk of brain damage and a control group of 35 children born at term. The Wechsler Intelligence Scale (WISC-IV) was used for cognitive measurement. The results showed that the preterm group obtained significantly lower scores than the control group. The working memory indicator significantly affected the interaction between age and prematurity. We consider that it is crucial to expand the knowledge we have about the neurocognitive development of premature infants both in specific cognitive domains and in age ranges so that the information obtained helps to predict the probability of presenting cognitive alterations from early stages and, therefore, to implement intervention strategies and programs based on scientific evidence and complemented in their design by clinical experience, empirical and theoretical knowledge of the different professionals involved in infant cognitive intervention.

Fever control is essential in patients with severe traumatic brain injury (TBI). The efficacy of therapeutic hypothermia (TH) in severe TBI has been investigated over the last few decades; however, in contrast to experimental studies showing benefits, no evidence of efficacy has been demonstrated in clinical practice. In this review, the mechanisms and history of hypothermia were briefly outlined, while the results of major randomized controlled trials (RCTs) and meta-analyses investigating TH for adult TBI are introduced and discussed. The retrieved meta-analyses showed conflicting results, with a limited number of studies indicating benefits of TH. Some studies have shown benefits of long-term TH compared with short-term TH. Although TH is effective at lowering elevated intracranial pressure (ICP), reduced ICP does not lead to favorable outcomes. Low-quality RCTs overestimated the benefits of TH, while high-quality RCTs showed no difference or worse outcomes with TH. RCTs assessing standardized TH quality demonstrated the benefits of TH. As TBI has heterogeneous and complicated pathologies, applying a uniform treatment may not be ideal. A meta-analysis of young patients who underwent early cooling and hematoma removal showed better TH results. TH should not be abandoned, and its optimal should be advocated on an individual basis.

Diacylglycerol kinase (DGK) is a lipid kinase that phosphorylates diacylglycerol (DAG) to generate phosphatidic acid (PA). Based on converting one important signaling molecule (DAG) to another (PA), DGK plays an important role in plant responses to abiotic stress including waterlogging stress. However, no studies have been reported on the characterization of the DGK gene family in the waterlogging-tolerant kiwifruit germplasm, Actinidia valvata Dunn. Here, we identified 18 AvDGK genes in the A. valvata genome. The phylogenetic analysis showed that AvDGKs can be classified into three clusters, and members within the same cluster have similar domain distribution, exon-intron structures and conserved motif compositions. Chromosome localization analysis revealed that all the AvDGK genes are located across 18 different chromosomes. There were 29 duplicated gene pairs in kiwifruit and all had undergone purifying selection during evolution. Promoter cis-element analysis revealed that the cis-elements within AvDGK genes are associated with multiple functions, including phytohormone signal transduction, stress response, and plant growth and development. The expression pattern analyses indicated that AvDGK play an important role in the fruit development and plant response to waterlogging stress. AvDGKs gene family in the tetraploid A. valvata genome might promote PA synthesis and subsequent signal transduction both under short-term and long-term waterlogging stress. These results provide information regarding the structural characteristics and potential function of DGK genes within kiwifruit and lay a fundamental basis for further research into breeding for enhancing the kiwifruit’s tolerance to waterlogging stress.

Fluoride (iF) is important inorganic pollutant in groundwater in central México. The aim of this study was estimated environmental risk exposure of iF in residents of Jerez Zacatecas México. Fifty-five tap water samples were collected from households to determine iF concentrations using the ion-selective electrode method. Based on these environmental values, the Hazard Quotient (HQ) was estimated following the methodology of the Pan American Health Organization (PAHO). Subsequently, risk maps were generated from these values to visualize the spatial distribution of high-risk areas within the city. iF in tap water ranger in concentration from 1.3 – 7.3 mg/L (ppm). We estimated HQ in a range of 0.63 to 3.73. iF ex-posure in tap water is a health problem that must be addressed, carrying out risk communication actions that allow the population to take care of their health through simple actions, avoiding future health costs.

Nanomagnetism and spintronics are currently active areas of research, with one of the main goals being the creation of low-energy-consuming magnetic memories based on nanomagnet switching. These types of devices could also be implemented in neuromorphic computing by crafting artificial neurons (ANs) that emulate the characteristics of biological neurons, through the implementation of neuron models such as the widely used leaky integrate-and-fire (LIF) with a refractory period. In this study, we have carried out numerical simulations of a 120 nm diameter, 250 nm length ferromagnetic nanowire (NW) with the aim of exploring the design of an artificial neuron based on the creation and destruction of a Bloch-point domain wall. To replicate signal integration, we applied pulsed trains of spin-currents to the opposite faces of the ferromagnetic NW. These pulsed currents (previously studied only in the continuous form) are responsible for inducing transitions between the stable single vortex (SV) state to the metastable Bloch point domain wall (BP-DW) state. To ensure the system exhibits the leak and refractory properties, the NW was placed in an homogeneous magnetic field of the order of mT in the axial direction. The suggested configuration fulfills the requirements and characteristics of a biological neuron, potentially leading to the future creation of Artificial Neural Networks (ANNs) based on reversible changes in the topology of magnetic NWs.

Introduction: Although aging is a natural phenomenon, in recent years it has accelerated. One key factor implicated in the aging process is oxidative stress. Oxidative stress play also role in frailty (frail) and metabolic syndrome (MetS). Methods: 66 elderly persons (65 years old and older) with no acute or severe chronic disorders were assessed: waist circumference (WC), arterial blood pressure, glycemia, glycated hemoglobin (HbA1c), plasma lipids and activity of erythrocyte superoxide dismutase (SOD-1). Patients were classified as NonMetS-Nonfrail (n=19), NonMetS-frail (n=20), MetS-Nonfrail (n=17), and MetS-frail (n=10). Results: There were no significant differences in superoxide dismutase activity among investigated elderly groups. However, the data suggests that MetS individuals, both frail and nonfrail, have higher risk factors for cardiovascular disease compared to NonMetS individuals. The correlations analyses of SOD-1 and other metabolic indices suggest that SOD-1 levels may be influenced by age, total cholesterol, HDL cholesterol, and fasting glucose levels in certain groups of seniors. Conclusions: Aging is associated with decreased antioxidant enzyme SOD-1 activity with glucose alteration in frailty syndrome as well as with lipids disturbances in metabolic syndrome.

ACL instability poses a significant challenge in traumatology and orthopedic medicine, often requiring accurate diagnosis for appropriate treatment. While the pivot-shift test offers a crucial means of assessment, its reliance on subjective interpretation underscores the need for supplementary imaging studies. This study aims to address this limitation by developing a Bayesian classification algorithm tailored for integration into a mobile application. Using the built-in inertial sensors of smartphones, this new approach aims to dynamically evaluate rotational stability during knee examinations. Orthopedic specialists conducted knee evaluations on 52 subjects, with subsequent analysis revealing interesting insights. Intraobserver and interobserver analyses, as measured by ICC, demonstrated strong agreement both in terms of timing between maneuvers (ICC = 0.94) and signal amplitude (ICC = 0.71-0.66). Notably, the Bayesian algorithm successfully classified 95% of joint hypermobility cases, with an additional 7 cases of hyperlaxity identified by the Pivot-Shift Meter (PSM). These findings highlight the practicality and effectiveness of implementing a Bayesian classification algorithm within a mobile application for assessing and categorizing signals captured by smartphone inertial sensors during the pivot-shift test.

Out-of-hospital cardiac arrest (OHCA) represents a significant global public health burden, characterized by low survival and few established diagnostic tools to guide intervention. OHCA presents with a wide variety of etiologies in a heterogeneous population, posing a clinical challenge to care teams. In this review, we describe evolving research focused on diagnostic approaches to OHCA following resuscitation, including electrocardiography, coronary angiography, computed tomography, ultrasonography, and serologic biomarker assessment. These diagnostic tools have been employed in post-resuscitative efforts for diagnosing ischemic and non-ischemic cardiac, respiratory, neurologic, vascular, traumatic, and metabolic causes of arrest.

This six-year multicentre study investigated acute intentional poisoning with substances of abuse in adolescents to identify changes and patterns in substance use. Data from 568 adolescents were collected from three paediatric poison centres in Romania between January 2017 and December 2022. The study analysed the epidemiological and sociodemographic characteristics of the adolescents, including age, gender, place of residence, history of substance abuse, psychiatric history, and history of institutionalized care. The findings revealed that cannabis and new psychoactive sub-stances (NPSs) are the most commonly implicated substances, each with distinct profiles among adolescents. Cannabis was involved in 45.6% of cases, with a significant association with urban residency. NPSs were identified as the second most prevalent substance, accounting for 38.9% of cases. These were more prevalent in rural areas and among patients with psychiatric disorders. Cannabis and NPSs were also the most commonly implicated substances in acute intentional poisoning cases with substances of abuse. These substances have distinct profiles among adolescents, including age, gender, residency area, history of substance abuse, psychiatric history, and institutional care. These findings underscore the necessity of targeted public health interventions and integrated care approaches to address substance use and related mental health issues in adolescents.

Background and objective: Iliopsoas abscess (IPA) is a rare condition with varied symptomology and etiology. Less than one-third of patients with IPA present on the emergency department (ED) admission with the traditional triad of fever, back pain, and restricted hip motion (or limp), leading to delays in diagnosis and management. This case report aims to bring awareness among healthcare professionals regarding the atypical presentation and introduce a potential differential diagnosis when evaluating patients with fever and back pain. The intention is to provide insights into the signs and symptoms that may indicate the presence of an iliopsoas abscess and prompt additional investigations. Case report: Here, we describe a case of primary iliopsoas abscess associated with drug-induced acute liver failure in our ED. The patient complained of pain in the left lumbar region and fatigue that started two weeks before this presentation, claiming that, during the previous night, the pain suddenly worsened. She had a fever, pain at palpation in the right hypochondriac and left lumbar regions, accompanied by fever and vomiting, jaundiced skin, and sclera at the examination in ED. On abdominal ultrasonography, the diagnosis of acute cholangitis was suspected. The laboratory test shows leukocytosis with neutrophilia, thrombocytosis, hepatocytolysis syndrome, and hyperbilirubinemia with the predominance of indirect bilirubin. We performed then abdominal and pelvic computed tomography, which confirmed the diagnosis of cholelithiasis observed with the diameter of the bile duct within normal limits but also showed an abscess-like collection fused to the interfibrillar level of the left iliopsoas muscle; a diagnosis we most likely would have been missed. After that, the patient was hospitalized in the General Surgery Department, and surgery drainage of the abscess was performed. The patient's evolution was excellent; she was discharged after 11 days. Conclusions: The case presented here exemplifies how iliopsoas abscess, a rare cause of back pain, can quickly go unrecognized, especially in the emergency department. Our experiences will raise awareness among doctors in emergency departments about this uncommon but essential diagnosis. With advancements in diagnostic tools and techniques, we aspire that more cases of iliopsoas abscess will be accurately diagnosed.

Purpose: The deterioration of oral function has been getting much attention as “Oral frailty”. This study evaluated the change in tongue pressure, one of the objective items of oral frailty, to examine the relationship between body position and tongue pressure. Methods: This study was prospective, observational study in a single-center. The participants were categorized by Clinical Frailty Scale (CFS). Tongue pressure was measured in the following positions: dorsal, sitting, and sitting with plantar grounding. Differences in tongue pressure between CFS and between body positions were statistically analyzed. Results: A significant decrease in tongue pressure was demonstrated in CFS4 compared to CFS3. Furthermore, in CFS5 and CFS6, tongue pressure decreased in the sitting po-sition compared to that in the dorsal position and recovered to the dorsal level with plantar grounding. Conclusions: Tongue pressure decreased as the progression of frailty. It decreased by sitting, and this decrease was alleviated by plantar grounding.

We analyze the transformation of a very broad class of metrics that can be put in terms of static coordinates. Starting from a general ansatz, we obtain a relation for the parameters in which one can impose further symmetries, or restrictions. One of the simplest restrictions leads to FLRW cases, while transforming from the initial static to other static-type coordinates can lead to near horizon coordinates, Wheeler-Regge, isotropic coordinates, among others. As less restrictive cases, we show an indirect route for obtaining Kruskal-Szekeres within this approach, as well as Lema\^{\i}tre coordinates. We use Schwarzschild spacetime as prototype for testing the procedure in individual cases. However, application to other spacetimes, such as de-Sitter, Reissner-Nordstr\"{o}m or Schwarzschild de Sitter, can be readily generalized.

Current trends in systemic risk literature provide new insights into multi-hazard risks that interact and compound with built environments, creating more significant impacts on socio-economic and human systems. Recurrent natural hazards and extreme weather events are more likely to compound and cascade into more impactful events, especially in vulnerable societies. In small-island communities (SICS), including large archipelagos and Small Island Developing States (SIDS), the long-term impact of multi-, compounding-, and cascading-hazards (MCC hazards) can result in persistent vulnerability and residual risks. This is due to delayed responses, limited resources, poverty, fewer evacuation options, and inadequate markets and infrastructure. Using Ternate, a densely populated small volcanic island in North Maluku, Indonesia, as a case study, this paper assesses the impacts of seven types of natural hazards: flash floods, landslides, extreme weather, extreme waves and abrasion, earthquakes, tsunamis, and volcanic eruptions. The research focuses on the multi-hazard impact on population, land use, and infrastructure exposures in 60 villages in Ternate. The findings highlight population density, land use, and infrastructure exposure to multi-hazard risks, providing valuable information on potential losses in future hazard events.

Background: Pediatric patients with polyuria polydipsia syndrome (PPS) represent a diagnostic challenge for clinicians because of the technical difficulties in performing the gold standard water deprivation test (WDT). Copeptin, a stable biomarker representing the C-terminal portion of the polypeptide chain of antidiuretic hormone, proves to be a more reliable diagnostic tool. Objective: To assess the diagnostic accuracy of copeptin baseline dosing, arginine/saline copeptin stimulation tests, and WDT. Establishing the diagnostic utility of copeptin in pediatrics, for differentiating central and nephrogenic diabetes insipidus, and primary polydipsia. Methods: comparative and non-comparative primary studies, relating to children, were included and searched for in PubMed, Cochrane Library, WOS, ScienceDirect, Scopus, Google Scholar, up to August 2024. QUADAS-2 tool was used to assess risk of bias and applicability. Meta-analyses used fixed effect models due to low heterogeneity and the HSROC model. Results: 11 studies included, with an overall Low bias, no significant applicability concerns. The mean pooled sensitivity = 0.98 (95% CI: 0.936–1.025), pooled specificity=0.947 (95% CI: 0.920–0.973), and AUC=0.972 (95% CI: 0.952–0.992), indicating excellent diagnostic accuracy. Conclusion: Stimulation methods for copeptin dosing represent effective and less invasive diagnostic test for children with PPS, and future development of standard copeptin testing protocols are needed.

The rationale of this study is to explore underlying sustainability assessment constructs in the context of WCSM implementation as a key focus by manufacturing industries in the journey of achieving world-class status in their manufacturing operations. This study primarily intends to collect primary data from 143 plant managers and supervisors through the structured questionnaires at select manufacturing companies in south India on the basis of area-cum-purposive sampling technique. The survey questionnaire is designed exclusively to reflect the sustainability assessment dimensions in terms of social, economic and environmental issues to examine the impetus of WCSM implementation on the competitive advantage of manufacturing companies. The empirical findings of this study clearly revealed that sustainable manufacturing practices, sustainability programs, creation of sustainable products, safety for employee, community and product, operational efficiency and integration of sustainability goals in day-to-day manufacturing activities were considered to be the key indicators by the manufacturing firms in their never-ending journey towards becoming the world class. Moreover, the WCSM practices & techniques adopted by sample manufacturers have a substantial positive influence on the achievement of competitive advantage in their manufacturing and business operations.

This paper presents a novel normative framework for assessing granular base materials in rigid pavements, incorporating evaluations of California Bearing Ratio (CBR) alongside hydraulic conductivity tests. A critical component of this research adheres to Federal Highway Administration (FHWA) standards, which specify a permeability coefficient range of 0.05 to 0.20 cm/sec. Our investigations indicate that increased compaction energy inversely affects permeability, highlighting a sophisticated interplay between compaction dynamics and hydraulic characteristics. The study further elucidates that CBR values are profoundly impacted by the content of coarse-grained soil, advocating for a tailored approach to base layer assessment. Multivariable CBR analysis facilitated the identification of an optimal water content, underscoring that maintaining a minimum 80% CBR—while minimizing water content—can mitigate fatigue effects and enhance structural performance under heightened energy conditions. This research proposes bespoke, scientifically validated standards that integrate local geotechnical nuances, aimed at refining material selection processes and extending the durability of pavement infrastructures through foundational yet meticulous geotechnical evaluations.

The thermal degradation of brakes has a significant impact on the stability of pure electric commercial vehicles during long downhill braking. Based on road slope and using fuzzy control method, design strategies for motor regenerative braking force and friction braking force distribution, with the aim of reducing friction braking force, improving braking stability, and recovering braking energy. By establishing driving conditions on roads with different slopes and using numerical analysis methods to verify the proposed control strategy. the results show that under the 6% constant slope driving condition, the vehicle maintains a constant speed of 30km/h downhill driving, and the braking energy recovery rate reaches 50.93%; Under the condition of 3% -6% gradient driving, the vehicle speed fluctuates slightly, but it can still be maintained at a constant speed of 30km/h for downhill driving through the adjustment of the motor's reverse drag characteristic, with a braking energy recovery rate of 49.97%; During the process of driving downhill at a constant speed, the frictional braking force does not participate in braking; The braking energy recovery rate is determined by the slope and braking deceleration.

Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder characterized by renal tubular cystic dilatations. The cysts can develop anywhere along the nephron and over time the cystic dilatation lead to kidney enlargement. On the other hand, the cysts begin to reduce the number of functional nephrons as a consequence of cystic expansion that further contributes to the decline in renal function over the years. The pressure exerted by the dilated cysts lead to compensatory mechanisms that further contribute to the decline in renal function. These structural changes are responsible of glomerular hyperfiltration states, albuminuria, proteinuria, and haematuria. However, the presentation of ADPKD varies in children from a completely asymptomatic child with incidental ultrasound detection of cysts to a rapidly progressive disease. There have been reports of early onset of ADPKD in children younger than 2 years that showed a more rapid decline in renal function. ADPKD is caused by mutation in PKD1 and PKD2 genes. Today, the PKD1 gene mutation seems to account for up to 85% of the cases worldwide, and it is associated with worse renal outcomes. Individuals with PKD2 gene mutation seem to present a milder form of the disease, with a more delayed onset of end stage kidney disease. The cardinal sign of ADPKD is the presence of renal cysts during renal ultrasound. The current guidelines provide the clinicians the recommendations for genetic testing in children with a positive family history. Given that the vast majority of children with ADPKD present with normal or supra normal kidney function we explored the glomerular filtration rates dynamics and the renal ultrasound adjusted percentiles. 14 out of 16 patients had kidney percentile over 90%. The gene mutations were equally distributed among our cohort. In addition, we compared the modified Schwartz formula to the quadratic equation after adjusting the serum creatinine measurements. It seems that even though children with ADPKD have enlarged kidneys, the renal function is more likely normal or near normal when the quadratic estimation of glomerular filtration rate is used (qGFR tended to be lower, 111.95 ± 12.43 ml/min/1.73m2 compared to Schwartz eGFR 126.28 ± 33.07ml/min/1.73m2, p=0.14). Also, when the quadratic equation was employed, not even a patient reached the glomerular hyperfiltration thresholds. The quadratic formula showed that glomerular filtration rates are linear or slightly decreasing after 1-year of follow-up (Quadratic ΔeGFR=0.32±5.78ml/min/1.73m2) as opposed to Schwartz formula that can falsely classify children in a hyperfiltration state ΔeGFR=7.51±19.46ml/min/1.73m2), p=0.019.

The automobile industry is often believed to be moving towards electric vehicles. Hybrid electric vehicles (HEVs) and electric vehicles (EVs) are anticipated to dominate the automotive industry. Regenerative braking is one of the modern approaches that recharge the battery by extracting the kinetic energy from the braking thus improving the vehicle range. However, the rate of current supplied by regenerative braking to the battery is a major concern as lithium-ion (Li-ion) is susceptible to failure due to the intensity of the charging-discharging rate, and operating temperature. So, this review article focuses on the effect of regenerative braking on the life of the battery and measures being taken to protect the battery from higher charging during regenerative braking. Various research articles are considered for observing the effect of regenerative braking on battery life. It is found that longer duration charging current obtained from regenerative braking that is irrespective of current intensity is the prominent factor of battery deterioration. If the SOC and the temperature are not in the optimal range, the Lithium plating rate increases. However, a higher level of regenerative braking increases the battery life even at high SOC and temperature by reducing the Depth of Discharge (DOD) and by using shorter recharging periods.

The shape of the knee is a chain-like structure of an ellipsoid. This suggests that, in the latest study, in addition to rolling, there is slippage in the motion of the knee. This paper selects a mechanical braking model for cattle based on two mechanical structures in different directions at the joints. The experimental results show that the modified dynamical system has strong chaotic properties. This can be one of the basis for judging various health states.

Recently, design of electric scooters (ESs) has commonly adopted brushless DC motors (BLDCMs) in place of brushed DC motors. This invention develops a new anti-lock braking system (ABS), based on a slip-ratio estimator, for ES utilizing the braking force generated by the BLDCM when electrical energy releases to the load yielding an analogous effect of ABS control in gas-engine vehicles. Comparing to mechanical ABS, the design possesses the advantages of rapid torque responses due to fast actuating response. The electrical ABS is realized by associating with kinematic and Short-circuit braking. A current controller is used to adjust the braking force, while the sliding mode control strategy is adopted to regulate the slip ratio for best road adhesion while braking. Real-world experiments have been conducted for functional and performance verification.

In Mexico, 1.9% of child mortality among children aged 3 to 15 years is attributed to waterborne gastrointestinal diseases (WGD). This study employs a generalized bivariate logit econometric model to simulate the relationships between mortality risks and seven explanatory variables. Based on the model results and sensitivity analysis of the estimated parameters, a set of policies was designed to reduce the likelihood of child mortality. The proposed strategy involves im-plementing the following public policies, primarily targeting communities with extreme and high marginalization: increasing access to drinking water, improving housing conditions, expanding parental basic education coverage, and providing nutrition and healthcare to children from an early age. The findings reveal that children who speak an indigenous language face a mortality risk from WGD that is three times higher than those who do not, while children who receive medical services have a 29% lower risk of mortality compared to those who do not have access to them. It is recommended to offer free medical care in indigenous languages within high-marginalization communities. The combined impact of these policies is expected to signifi-cantly reduce child mortality due to WGD.

Road cracks significantly affect the serviceability and safety of roadways, especially in mountainous terrain. Traditional inspection methods, such as manual detection, are excessively time-consuming, labor-intensive, and inefficient. Additionally, multi-function detection vehicles equipped with various sensors are expensive and not suitable for mountainous roads due to poor conditions. To address these challenges, this study proposes a customized Unmanned Aerial Vehicles (UAV) inspection system designed for automatic crack detection. The system focuses on enhancing autonomous capabilities in mountainous terrains by incorporating embedded algorithms for route planning, autonomous navigation, and automatic crack detection. The slide window method is proposed to enhance the autonomous navigation of UAV flights by generating path planning in mountainous roads. This method compensates for GPS/IMU positioning errors, particularly in GPS-denied or GPS-drift scenarios. Moreover, the YOLOv8 algorithm is introduced to conduct autonomous crack detection from UAV imagery in the offboard module. To validate our UAV inspection system's performance, we conducted several experiments to assess its accuracy, robustness, and efficiency. The experimental results demonstrate that our UAS inspection system accurately estimates the flight trajectory along the mountainous road for autonomous navigation. Furthermore, the experimental detection results also demonstrate that the YOLOv8 algorithm achieves higher recognition accuracy compared to the YOLOv5, and YOLOv7-tiny algorithms, exceeding 3.1%,and 6.8% of mAP, respectively. In summary, the UAV inspection system proposed in this study can provide a useful tool and technological guidance for the regular inspection of mountainous roads.

As coastal and marine ecosystems, even the inland waters can be deeply affected by human-driven impacts. Consequently, the internal waters belonging to closed or semi-closed basins due to their hydrographic and morphological conditions can be subject to even more dramatic consequences in terms of conservation and overall ecosystem functioning maintaining. Despite the Albano Lake is listed among the Natura 2000 network sites (IT6030038), several elements of its landscape complexity have already experimented clearly visible alterations: from certain landscape features alterations to the loss of some iconic vegetal and animal species characterizing the lake environment in the past. Therefore, a virtuous commitment awaits us and we have the moral duty of acting in order to restore such degraded habitats. Each environmental restoration intervention and/or clean up session can be considered relevant in order to give back the right dignity to one of the most naturalistically relevant environments of Central Italy. For each field session a plethora of data can be acquired both onshore and underwater by diving operators. Therefore, the data management of a huge temporal and spatial variability can be remarkable. It can be made easier relying on artificial intelligence (AI) supporting geospatial databases for GIS analysis to be run for their role as decision-supporting tools. On this perspective AIs can be used to model environmental systems, greatly helping to reduce use conflicts and human-driven impacts, whilst understanding the ecological characteristics and related ecosystem functioning.

Incisional hernias have a particular dynamic related both to the repair method and to the absence or presence of a prosthetic material. The incidence of incisional hernias is estimated at 9.8% after 21 months and increases to 18.7% after ten years. This study presents a surgical method for the repair of recurrent incisional hernias, through open surgery and the use of existing mesh. The selection criteria regarding the use of this method are: the prosthesis is well integrated, without granulomas, suppurations, defect appearing on the same prosthetic abdominal area. The analyzed factors were the location of the incisional hernias, the duration of the operation, the duration of hospitalization, identified complications, the size of the parietal defect. The retrospective study carried out focused on recurrences of incisional hernias from a group of 631 patients operated on for incisional hernias in a general surgery department of Dr. Constantin Andreoiu County Emergency Hospital, Ploiești, Romania, during January 2018 - December 2022. Of the total of 18.22% relapses, 13.6% were relapsed eventrations after prosthetic procedures. Following the application of the selection criteria, several 8 patients with recurrent eventrations were operated by the open method using the existing mesh. In the case of recurrences after prosthetic procedures of incisional hernias, the recurrence can be solved by open surgery using the existing well-integrated prosthesis, without tension, absence of suppuration in the wound, and the peritoneal cavity. For the presented case, the return to daily activities occurred after 22 hours of hospitalization.

Placenta accreta spectrum (PAS) disorders are characterized by abnormal trophoblastic invasion into the myometrium, leading to significant maternal health risks. PAS includes placenta accreta (invasion <50% of the myometrium), increta (invasion >50%), and percreta (invasion through the entire myometrium). The condition is most associated with previous cesarean deliveries, and its incidence increases with the number of cesareans. Other risk factors include advanced maternal age, multiparity, and various uterine surgeries. The increasing global cesarean rates heighten the importance of early PAS diagnosis and management. The study reviewed molecular mechanisms driving PAS, focusing on signaling pathways, genetic expression, biomarkers, and non-coding RNAs involved in trophoblastic invasion. It explored genetic expression and key regulatory processes such as apoptosis, cell proliferation, invasion, and inflammation. The manuscript was compiled from recent scientific literature (2014 – 2024) from the Scopus, PubMed, Google Scholar, and Web of Science databases. Placenta Acreta Spectrum; acreta; increta; percreta; trophoblast invasion; miRNAs, lncRNAs; genetic expression; biomarkers; signaling pathways were the employed keywords to compile relevant literature. The PAS is an important obstetric health problem that challenges maternal health risks associated with abnormal trophoblastic invasion that relies on abnormal placentation, uterine scarring, and impaired decidualization. Identifying new biomarkers like AFP, sFlt-1, β-hCG, PlGF, and PAPP-A aids early detection and management. Understanding genetic expression and non-coding RNAs is crucial for unraveling PAS complexities. Besides, aberrant signaling pathways like Notch, PI3K/Akt, STAT3, and TGF-β offer potential therapeutic targets to modulate trophoblastic invasion. This review underscores the need for interdisciplinary care, early diagnosis, and ongoing research into PAS biomarkers and molecular mechanisms to improve prognosis and quality of life for affected women.

Heart failure is a global major healthcare problem with millions of hospitalizations annually and with a very high mortality. There is an increased interest in finding new and reliable biomarkers for the diagnostication, prognostication and therapeutical guidance of patients hospitalized for acute heart failure. There is data to sustain the role of CA 125, a worldwide used marker of ovarian cancer, in patients with heart failure. Several studies have shown links between CA 125 levels and congestion seen in acute heart failure, high mortality and readmission rates at 6 months follow up after discharge from acute heart failure and also a role of CA 125 in the guidance of heart failure therapy. There are also clinical trials that showed that several particularities of CA 125 make it even better than NTpro BNP ( a classical and more utilised marker of heart failure) in several scenarios of acute heart failure.

Currently, agro-industrial residues have been used to obtain bioactive compounds. The fermentation process is an alternative for the use of these residues and to be able to accumulate metabolites that may be of interest to different industrial sectors. The aim of this study was to evaluate solid-state fermentation conditions using pineapple waste as substrate with Aspergillus niger spp., to release polyphenolic compounds using a Plackett-Burman exploratory design. Temperature, humidity, inoculum, NaNO3, MgSO4, KCl and KH2PO4 conditions in the fermentation process were evaluated. The results revealed that the Aspergillus niger HT3 strain reached a hydrolyzable tannins accumulation of 10.00 mg/g, while Aspergillus niger Aa20 reached a condensed tannins release of 82.59 mg/g. The KH2PO4 affect the release of condensed tannins with A. niger Aa20 and MgSO4 affect the release of hydrolyzable tannins with A. niger HT3. In addition, a positive antioxidant activity was demonstrated for the DPPH, ABTS and FRAP technique. The HPLC analysis was able to identify compounds in the fermented pineapple peel such as 3-feruloylquinic acid, caffeic acid, lariciresinol and 3-hydroxyphloretin 2'-O-xylosyl-glucoside, among others. The solid-state fermentation process is a biotechnological alternative for the release of bioactive compounds.

Federated learning is an effective approach for preserving data privacy and security, enabling machine learning to occur in a distributed environment and promoting its development. However, an urgent problem that needs to be addressed is how to encourage active client participation in federated learning. The Shapley Value, a classical concept in cooperative game theory, has been utilized for data valuation in machine learning services. Nevertheless, existing numerical evaluation schemes based on the Shapley Value are impractical as they necessitate additional model training, leading to increased communication overhead. Moreover, participants’ data may exhibit Non-IID characteristics, posing a significant challenge to evaluating participant contributions. Non-IID data weakens the marginal effects of participants, which in turn affects model accuracy and leads to underestimated contribution measurements. Current works often overlook the impact of heterogeneity on model aggregation. This paper presents a fair federated learning contribution measurement scheme that addresses the need for additional model computations. By introducing a noval aggregation weight, it enhances the accuracy of contribution measurement. Experiments on the MNIST dataset show that the proposed method can accurately compute the contributions of participants. Compared to existing baseline algorithms, the model accuracy is significantly improved, with a similar time cost.

To characterize the fecal microbiota of lactating Bactrian camels, this study employed a random selection of camels, assigning them to three groups: the first parity group, the third parity group, and the fifth parity group. The fecal microbial community of lactating camels was assessed using 16S rRNA amplicon sequencing, and the resulting library was sequenced on an Illumina NovaSeq platform. The first parity group was characterized by Verrucomicrobiaceae as a distinctive bi-omarker, whereas Clostridiaceae exhibited a similar role to the third parity group. In terms of functional analysis, the relative abundance of the Steroid biosynthesis pathway was highest in the first parity group, whereas the fifth parity group demonstrated a higher relative abundance of the Tuberculosis pathway compared to the other groups. The first parity group exhibited the greatest presence of seven types of enzymes, whereas the fifth parity group displayed the highest levels of two specific enzymes. Additionally, a positive association was observed between the relative abundance of the Steroid biosynthesis pathway and Verrucomicrobiaceae. Furthermore, the relative abundance of the Tuberculosis pathway displayed positive correlations with 14 enzymes. In conclusion, this study revealed that different parity was associated with distinct fecal microbial ecologies in lactating Bactrian camels.

Background: In recent years, whole blood parameters and derivatives have been used as prognostic criteria in the course of the disease in various diseases. The prognostic nutritional index (PNI), the systemic immune-inflammation index (SII), the neutrophil-lymphocyte ratio (NLR) have been adapted as an indicator of inflammation and have been widely studied to define the severity of inflammation in some diseases. The aim of this study was to evaluate the relationship between parameters such as NLR, SII, PNI, controlling nutritional status (CONUT) score, nutritional risk index (NRI) and with immunonutrition status and disease activity in patients with ischemic stroke of small vessel, large vessel and other etiologies. Methods: We retrospectively evaluated the records of 1454 consecutive ischemic stroke patients hospitalized in the emergency department of Gaziosmanpasa Education and Research Hospital from 2019 to 2023. Results: Of the 1350 SVO patients included in the study, 58.8% had small vessel, 29.3% had large vessel and 11.9% had other etiologies. There was a significant difference between the 3 etiology groups for PNI and CONUT. The median PNI was 47.03 (41.33-52.85) in the other etiology group, 35.29 (33.69-37.25) in the small vessel group, and 34.11 (30.23-36.87) in the large vessel group. The CONUT median was 5(5-6) in the small vessel group, 5(4-6) in the large vessel group and 4(4-4) in the other etiology group. In addition, CONUT and PNI were also found to be independent risk factors for death. A negative significant correlation was observed between PNI and NLR (r:-0.692), SII (r:-0.591), CONUT (r:-0.685). Significant correlations were observed between CONUT and NLR (r:0.402), SII (r:0.312). Conclusion: PNI and SII were significantly associated with disease activity. PNI, CONUT and NRI as a more accurate prognostic indicator of nutritional status in patients with ischemic stroke of small vessel, large vessel and other etiologies. NLR and SII may be important predictive markers in the course and prognosis of stroke.

Injury to the peritoneum during surgery is followed by a healing process that frequently results in the attachment of adjacent organs by a fibrous mass, referred to commonly as adhesions. Because injuries to the peritoneum during surgery are inevitable, one must understand the mechanisms of adhesion formation to prevent its occurrence. This requires a thorough understanding of the molecular sequence that results in the attachment of injured peritoneum and the development of fibrous tissue. Recent data show that fibroblasts from the injured peritoneum may play a critical role in forming adhesion tissues. Therefore, identifying changes in gene expression patterns in the peritoneal fibroblasts during the process may provide clues to the mechanisms by which adhesion develops. This review presents many papers discussing genes implied in peritoneal adhesion.

The expansion of food production is getting more important due to a rising world population, which is relying on food security on a regional and local scale. Intensive food production systems create a negative impact on the regional ecosystem because of agrochemical pollution and nutrient rich water discharges into nearby rivers. Furthermore, these systems are highly depending on regional water resources causing water scarcity and soil erosion due to the overexploitation of natural resources in general. The objective of this article is to review the water usage in the two most water intensive food production systems, agriculture and aquaculture showing lacking areas, like system management and climate change, which must be considered in the implementation of sustainable water footprint. In addition, the review includes an analysis if the combination of both production system into aquaponic food production and the possibilities of water saving. There are a variety of water footprint analyses for crop and aquatic animal production, but there is also a lack of information about the system management including irrigation systems, system cleaning processes, water substitution, pond removal, evaporation due to climate change and especially in aquaculture, the water footprint of industrial elaborated fish feed.

Introduction Emergency laparotomy is a surgical procedure associated with significantly higher mortality rates compared to elective surgeries. Awake laparotomy under neuraxial anaesthesia has recently emerged as a promising approach in abdominal surgery to improve patient outcomes. This study aims to evaluate the feasibility and potential benefits of using lumbar spinal anaesthesia as the primary anaesthetic technique in emergency laparotomies. Methods We conducted a case series involving 16 patients who underwent emergency laparotomy for bowel ischemia, perforation, or occlusion. Lumbar spinal anaesthesia was employed as the main anaes-thetic technique. We analysed patient demographics, clinical characteristics, intraoperative details, and postoperative outcomes. The primary outcome measures included the adequacy of postoper-ative pain control, the incidence of postoperative complications, and mortality rates. Results Among the 16 patients, adequate postoperative pain control was achieved, with only 2 patients requiring additional analgesia. Postoperative complications, including sepsis, wound dehiscence, and pneumonia, were observed in 7 patients (44%). The observed mortality rate was relatively low at 6% (1 patient). Notably, conversion to general anaesthesia was not necessary in any of the cases, and no early readmissions were reported. Discussion Our findings highlight the feasibility and potential benefits of using neuraxial anaesthesia in emergency laparotomies. The observed low mortality rate and the avoidance of conversion to general anaesthesia suggest that lumbar spinal anaesthesia may be a useful alternative in emer-gency settings. However, the occurrence of postoperative complications in 44% of patients indi-cates the need for cautious patient selection and close monitoring. Further research with larger sample sizes is warranted to fully elucidate the efficacy, safety, and potential impact of this tech-nique on patient outcomes in emergency laparotomies.

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

Chronic conditions like type 2 diabetes mellitus (T2DM), arterial hypertension (HTN), and obesity are major global health issues, causing significant morbidity and mortality. In Latin America, these conditions contribute to millions of premature deaths annually, posing challenges exacerbated by limited healthcare access and poor primary care quality, particularly in Mexico. Complementary medicine presents a potential solution, offering minimally invasive techniques to improve physical, mental, and spiritual well-being. Effective treatment adherence, crucial for positive outcomes, is influenced by self-efficacy, the ability to manage one's behavior in response to medical conditions. However, treatment adherence rates remain low, indicating a pressing public health concern. This study aimed to explore how perception of complementary medicine and treatment adherence predict self-efficacy among individuals with chronic conditions in Mexico. Analyzing data from 113 participants revealed significant correlations between variables, with treatment adherence positively associated with self-efficacy and perception of holistic medicine negatively correlated with self-efficacy. Regression analysis showed that incorporating perception of complementary medicine and treatment adherence significantly explained self-efficacy levels, suggesting the potential of complementary therapies in holistic healthcare approaches. However, collinearity between variables highlights the need for further research to better understand these relationships and their implications for improving healthcare outcomes in Mexico. Integrating complementary therapies with conventional treatments could enhance overall well-being and treatment adherence, offering promising avenues for addressing chronic conditions in the region. These findings underscore the importance of comprehensive healthcare approaches that integrate both conventional and complementary modalities to optimize health outcomes and quality of life for individuals with chronic conditions in Mexico and beyond.

Form deviation generated during the milling profile process poses challenges to the precision and functionality of industrial fixtures and product manufacturing across various sectors. The inspection of contour profile quality often relies on commonly employed contact methods for measuring form deviation, but these methods frequently face limitations that can impact the reliability and overall accuracy of the inspection process. This paper introduces a novel approach, the novel intelligent inspection method (NIIM), developed to accurately inspect and categorize contour profiles in machined parts manufactured through the milling process by computer numerical control (CNC) machines. The NIIM integrates a calibration piece, a vision system (RAM−StarliteTM), and machine learning techniques to analyze the line profile and classify the quality of contour profile deformation generated during CNC milling. The calibration piece is specifically designed to identify form deviations in the contour profile during the milling process. The RAM−StarliteTM vision system captures contour profile images corresponding to curves, lines, and slopes. An algorithm generates a profile signature, extracting Fourier descriptor features from the contour profile to analyze form deviations when compared to an image reference. A feed-forward neural network is employed to classify contour profiles based on quality properties. Experimental evaluations involving 60 machined calibration pieces, resulting in 356 images for training and testing, demonstrate the accuracy and computational efficiency of the proposed NIIM for profile line tolerance inspection. Results demonstrate that the NIIM offers 96.99% accuracy, low computational requirements, 100% inspection capability, quality classification.

This paper systematically discusses the application of reinforcement learning in automatic driving system. Reinforcement learning frameworks show significant advantages in optimizing decision making, predictive perception, path planning, and controller design, exceeding the limitations of traditional supervised learning methods. The paper highlights the critical role of components such as scene understanding, positioning, and map making in autonomous driving systems, which provide reliable environmental awareness through deep learning and sensor fusion technologies to support intelligent decision-making in complex urban environments. In addition, the paper discusses innovative approaches to safety reinforcement learning to reduce risk in autonomous driving and ensure that systems adhere strictly to safety constraints while maximizing expected rewards. These findings provide an important theoretical and practical basis for further improving algorithm robustness, managing multi-agent interactions, and integrating ethical considerations in the future.

Background and Objectives: Renal cell carcinomas and upper tract urothelial carcinomas are types of malignancies that originate in the kidneys. Each of these examples shows an increasing trend in the frequency and the mortality rate. This study aims to comprehensively define carcinomas by analysing clinical, paraclinical, and histological aspects to predict aggressiveness and mortality. Materials and Methods: We conducted a retrospective investigation on a group of patients suspected with kidney cancers. Results: We identified 188 cases. We observed a higher mortality rate and older age in individuals with urothelial carcinomas. Anemia, acute kidney injury, hematuria and perineural invasion were the main risk factors that predicted their mortality. Tumour size in renal cell carcinomas correlates with the presence of necrosis and sarcomatoid areas. Factors that indicate a higher rate of death are older age, exceeding of the renal capsule, the lesion that includes the entire kidney, lymphovascular invasion, acute kidney injury, and anemia. Conclusions: Even if they originate at the renal level, and the clinical-paraclinical picture is similar, the histopathological characteristics make the difference. In addition, to these are added the previously mentioned common parameters that can represent important prognostic factors. In conclusion, the characteristics commonly identified in one type of cancer may act as risk factors for the other tumor. The detected data include threshold values and risk factors, making a significant contribution to the existing literature.

Introduction: Most industrialized and developed countries now working to implement more advanced transportation systems. These include autonomous vehicle(AV) systems of various forms, such as delivery vehicles, which eliminate the crashes, injuries, and fatalities associated with human-operated machinery. Self-driving vehicles have the potential to make roads safer, but some safety concerns need to be addressed. Before AV systems become commonplace in developing countries, society needs to determine how safe they truly are. Objectives: This paper provides brief descriptions and examines the realities for AV in developing countries using results from infrastructure-based assessment of countries worldwide and from a questionnaire-based survey. Methods: Relevant research papers, articles, reports, and departmental websites were used as the main data sources. Ethiopia was chosen as a representative case. Different aspects of AV infrastructure, its current status in developing countries, and perspectives on AV systems are explored through interviews with approximately 1500 randomly selected individuals. The main variables in the assessment were physical infrastructure, digital infrastructure, and societal perceptions on AV systems. Results: Surprisingly, the results indicated that 55.82%, 78.58%, 87.78%, and 86.09% of Ethiopian interviewees agreed with statements regarding high ease of use, usefulness, positive attitude, and benefits, respectively, of AV. However, it should be noted that some interviewees did not provide a response to certain questions.

This paper introduces a quantitative methodology for assessing drone pilot performance, aiming to reduce drone-related incidents by understanding the human factors influencing performance. The challenge lies in balancing evaluations in operationally relevant environments with those in a standardized test environment for statistical relevance. The proposed methodology employs a novel virtual test environment that records not only basic flight metrics but also complex mission performance metrics, such as the video quality from a target. A group of Belgian Defence drone pilots were trained using this simulator system, yielding several practical results. These include a human performance model linking human factors to pilot performance, an AI co-pilot providing real-time flight performance guidance, a tool for generating optimal flight trajectories, a mission planning tool for ideal pilot assignment, and a method for iterative training improvement based on quantitative input. The training results with real pilots demonstrate the methodology’s effectiveness in evaluating pilot performance for complex military missions, suggesting its potential as a valuable addition to new pilot training programs.

Mining wastes generate a high environmental impact, and population exposure to metals and metalloids. Phytoremediation is a technology that uses plants to remediate polluted sites, one of its limitations is seed germination in soil with high content of metals and metalloids. B. dactyloides is a native specie from semiarid regions, while C. dactylon is an introduced specie, both are tolerant to drought and low temperatures. Owing, the objective of this research was to evaluate the germination of both species, exposed to a multi-polluted soil with As, Cd, Pb and Zn of a mining site, pondering different pH conditions (from 5.0 to 9.0). The study considered 4 repetitions by type of seed and soil pH. B. dactyloides showed higher germination percentage (83%) with pH 7.8; while the greater germination of C. dactylon was 34 % at pH 6.0. In the soil at pH 5, the germination in both species was not reached, owing that metals are more bioavailable in an acid environment. C. dactylon is less tolerant to As, Cd, Pb and Zn, so it is considered not effective for phytoremediation process. B. dactyloides has a high phytoremediation potential for multi-polluted sites, but further experiments are needed.

Background and Objectives: High job strain is worsening the outcome in coronary artery disease, CAD. Severe dissatisfaction on workplace, imbalance between high demands , and low rewards, are affecting the quality of life, and diminishing the duration of life, especially in CAD patients. Our study included two samples : CAD patients (experimental group), and without CAD patients, but with traditional risk factors (control group). The main objective of the study was the role played by high sensitivity C reactive protein, hs CRP, and microalbuminuria, as mediators of job strain and CAD relationship. Secondary objectives were the following: identification of the most vulnerable patients( with significant job strain) and intervention towards this category, for cardiovascular events prevention (primary or secondary). Materials and Methods: The utilized methods were the following : clinical exam; electrocardiogram; echocardiogram; non contrast enhanced computed chest tomography; laboratory findings ( lipid profile, glycemia, hs CRP, microalbuminuria); type D scale, DS 14; depression questionnaire, PHQ-9; and satisfaction with work scale, SWWS. Results: The highest values for hs CRP and microalbuminuria were noticed in patients with the lowest Likert score, for both samples CAD, and without CAD patients. The highest job strain was noticed in females. More than half of CAD patients ,with low Likert scores, revealed myocardial infarction. Conclusions: Microalbuminuria and hs CRP were statistical significant in the study as intercessors, in job strain and CAD relationship. The most vulnerable patients for vascular events were females, in both groups : CAD and “CAD waiting desk”. In CAD sample, the vascular vulnerability was also increased by high job strain.

Background and Objectives: The purpose of the study was to analyze the relationships between several clinical and biological factors, but also the tumor topography and surgical strategies used in patients with colorectal cancer. Materials and Methods: We designed an analytical, observational, retrospective study that included patients admitted to our emergency surgical department and diagnosed with colorectal cancer. The study group inclusion criteria were: patients admitted during 2020-2022; patients diagnosed with colorectal cancer (including the ileocecal valve); patients who benefited from a surgical procedure, either in emergency or elective. Results: In our study group, consisting of 153 patients, we accounted for 56.9% male patients and 43.1% female patients. The most common clinical manifestations were pain (73.2% of the study group), followed by abdominal distension (69.3% of the study group) and absence of intestinal transit (38.6% of the study group). A number of 69 patients were operated in emergency (45.1%), while 84 patients (54.9%) benefited from elective surgery. The most frequent topography of the tumor was the sigmoid colon, with 19.60% of the patients, followed by the colorectal junction, with 15.68% of the patients and superior rectum and inferior rectum, with 11.11% of the patients in each subcategory. The most frequent type of procedure was right hemicolectomy (21.6% of the study group), followed by rectosigmoid resection (20.9% of the study group). The surgical procedure was finished by performing an anastomosis in 49% of the patients, an ostomy in 43.1% of the patients, while for 7.8% of the patients, a tumoral biopsy was performed. Conclusions: Colorectal cancer remains one of the most frequent cancers in the world, with a heavy burden that involves high mortality, alterations in the quality of life of the patients and their families, and also the financial costs of the medical systems.

(1) Background: Cardiac resynchronization therapy (CRT) is essential for patients with heart failure and ventricular conduction abnormalities. Cardiomyopathy often includes left bundle branch block (LBBB) marked by delayed activation of the LV lateral wall and a widened QRS complex. Following CRT, patients with heart failure and LBBB have better outcomes and quality of life improvements. Various electrocardiographic and clinical parameters are thought to predict this improvement. The Kansas City Cardiomyopathy Questionnaire (KCCQ) is a reliable tool for measuring the quality of life in these patients. (2) Methods: We performed an observational prospective study over 69 individuals diagnosed with cardiac failure and dilatative cardiomyopathy with low FE and major LBBB and analyzed the correlations between patient outcomes after the procedure and the demographic, clinical, and electrocardiographic parameters, which include systolic blood pressure, ECG morphology elements, QRS duration, QRS area and associated comorbidities. (3) Results: Following our analysis a correlation between QRS area, intraprocedural systolic blood pressure, QRS duration and CRT outcomes assessed by the KCCQ score was observed which reflected that CRT has a hemodynamic impact and also affects the severity of ventricular asynchrony.; (4) Conclusions: The significant correlations observed with the KCCQ score show how CRT therapy impacts patients' quality of life, symptom burden, and functional status.

The advancement of autonomous capabilities in maritime navigation has gained significant attention, with a trajectory moving from decision support systems to full autonomy. This push towards autonomy has led to extensive research focusing on collision avoidance, a critical aspect of safe navigation. Among the various possible approaches, Dynamic Programming is a promising tool for optimizing collision avoidance maneuvers. This paper presents a DP formulation for collision avoidance of autonomous vessels. We set up the problem framework, formulate it as a multi-stage decision process, define cost functions and constraints focusing on the actual requirements a marine maneuver must comply with, and propose a solution algorithm leveraging parallel computing. Additionally, we present a greedy approximation to reduce algorithm complexity. Through case studies, we demonstrate the effectiveness of the proposed approach in navigating complex scenarios, contributing to the future of autonomous maritime navigation. Through case studies, we show the efficacy of our approach in navigating complex scenarios.

Aiming at effectively generating safe and reliable motion paths for quadruped robots, a hierar-chical path planning approach driven by dynamic 3D point cloud is proposed in this article. The developed path planning model is essentially constituted of two layers: global path planning layer and local path planning layer. At the global path planning layer, a new method is proposed for calculating terrain potential field based on point cloud height segmentation. Variable step size is employed to improve the path smoothness. At the local path planning layer, a real-time prediction method for potential collision area and a strategy for temporary target point selection is developed. Quadruped robot experiments were carried out in an outdoor complex environment. The experi-mental results verified that, for global path planning, the smoothness of the path is improved and the complexity of the passing ground is reduced. The effective step size is increased by a maxi-mum of 13.4 times, and the number of iterations is decreased by up to 1/6, compared with the traditional fixed step size planning algorithm. For local path planning, the path length is short-ened by 20%, more efficient dynamic obstacle avoidance and more stable velocity planning are achieved by using the improved dynamic window approach (DWA).

Background: Having a laboratory renal profile for medical imaging examinations requiring contrast media (CM) administration is strongly advised. Creatinine helps identify patients at risk of contrast-induced nephropathy (CIN). GEM® Premier™ ChemSTAT (Werfen) is a point-of-care (POC) analyzer with 12 emergency parameters including creatinine assay. The aim of this study consists to compare ChemSTAT with the central analytical solution of the University Hospital of Clermont-Ferrand and to evaluate the interest of the POC creatinine in the emergency department (ED) in optimizing the flow of patients, especially if CM used. Methods: More than 200 whole blood (WB) samples from the ED were evaluated on the ChemSTAT analyzer. As comparative methods, the plasma aliquots from the same samples were assayed on an Atellica® CH (Siemens Healthineers). The clinical concordance was assessed ac-cording the decision cut-offs of the French Society of Radiology for the risk of CIN. The availability times of biological results between ChemSTAT and the central laboratory were studied. Results: WB results from ChemSTAT correlated well with those from Atellica® CH, except for tCO2 (known bias between Siemens and Cobas Roche methods predicting ChemSTAT values). The results of creatinine assay allow to have identical medical decisions compared to the renal risk cut-offs. The availability of biological results is reduced by 50 min on average with ChemSTAT vs the central laboratory. Computed tomography was performed for 44.7% of patients including the injection of the CM in 68% of cases. For these patients, the availability of creatinine results relative to imaging time is faster with the ChemSTAT on average of 45.2 min. Conclusions: Great analytical and clinical correlations for creatinine assay allow safe iden-tification of patients at risk of CIN and improve patient flow in ED especially for those requiring computed tomography with use of CM.

Larrea tridentata is an endemic plant from the Mexican highlands used in traditional medicine to treat hypertension and kidney stones, among many ailments. This study evaluated a vasorelaxant compound: 5- Hydroxy-2-(4-hydroxy-3-methoxyphenyl)-6,7,8-trimethoxy-4H-1-benzopyran-4-one (also known as 8-Methoxycirsilineol: 8-M) which we purified from an extract of this plant. Mesenteric artery rings were isolated from male guinea pigs for isometric force measurements. Freshly isolated smooth muscle cells from mesenteric artery were used for ionic current measurement for calcium and potassium. 10 μM 8-M completely relaxed vascular rings contracted with phenylephrine in a dose-dependent fashion with an EC50 = 4.26 ± 1.16 10-6 M and 4.56 ± 1.64 10-6 M for endothelium intact and endothelium-free tissue, respectively. The relaxant effect of 8-M was not affected by maximal doses of nifedipine, verapamil or iberiotoxin. Nevertheless, the relaxant effect was partially abolished by addition of 10 mM Tetraethylammonium (TEA). In accordance to this, calcium currents evoked by depolarization were not affected by 8-M, whereas TEA-sensitive potassium currents, were increased upon its addition. Vasorelaxation due to 8-M is partly due to activation of KV currents in an endothelium independent mode.

To assess the usefulness of an attachable video laryngoscope (AVL) by attaching a camera and monitor to a conventional Macintosh laryngoscope (CML). Normal and tongue edema airway scenarios were simulated using a manikin. Twenty physicians performed tracheal intubations using CML, AVL, Pentax AWS® (AWS), and McGrath MAC® (MAC) in each scenario. Ten physicians with more than 10 cases of clinical experience with tracheal intubation using CML were included in the skilled group. Ten physicians with less than 10 cases of clinical experience with tracheal intubation using CML were included in the unskilled groups. The time required to intubate and the success rate were recorded. The degree of difficulty of use and glottic view assessment scored by participants. All 20 participants successfully completed the study. There was no difference in the success rate and time required for tracheal intubation in the normal airway scenarios. For the skilled group, in the tongue edema airway scenario, the AWS had the highest success rate (100%) followed by AVL (60%), MAC (60%), and CML (20%) (p = 0.001). The time required to intubate with the AWS was significantly shorter than with AVL (10.2 vs 22.3 s; p=0.002) or MAC (10.2 vs 23.7 s; p=0.001). There was no significant (p > 0.05) difference between AVL and MAC. The degree of Difficulty of Use for AVL was significantly lower than that for CML (7.8 vs 2.8; p < 0.001). There was no significant (p > 0.05) difference between AVL and other video laryngoscopes. AVL had a higher rate of successful tracheal intubation than CML in the tongue edema scenario. AVL showed a similar success rate and time of tracheal intubation to the MAC. Therefore, AVL may be a possible alternative video laryngoscope device.

Introduction: Lower respiratory tract infections, including pneumonia, are one of the leading causes of child mortality, especially in low-resource settings. Current guidelines rely on clinical signs for diagnosis, leading to over-prescription of antibiotics, which in turn contribute to antimicrobial resistance. Lung point of care ultrasound (L-POCUS) offers potential to improve diagnostic accuracy and reduce unnecessary antibiotic use, but lacks standardized guidelines for diagnosis and management of paediatric pneumonia. Methods and Analysis: This study utilizes a modified Delphi process to develop expert consensus guidelines for L-POCUS interpretation in paediatric pneumonia that would constitute a framework for effective guidelines for judicious antibiotic prescribing. The 5-stage iterative process includes: i) creation of a literature summary and conceptual framework, ii) first round of online surveys for expert feedback, iii) virtual meetings to discuss survey results and refine guidelines, iv) second round of online surveys, v) final analysis and development of consensus guidelines. A panel of 12-15 experts, chosen for their paediatric POCUS experience, geographic diversity, and gender balance, will participate. Consensus will be defined as ≥75% agreement. Ethics and Dissemination: Participation is voluntary, with consent obtained at the start and the option to withdraw at any time. The protocol was approved by the Ethics Commission of Bern, Switzerland. Findings will be disseminated through open access publication.

Monitoring training load, recovery, and wellness in maturation ages is even more relevant than in adulthood, especially during congested schedules. The objective of this study was to quantify and describe the differences in external and internal load, recovery, and perceived wellness in elite under-16 female players during a period of three competitions in seven days, based on their participation during matches. An observational design was used to quantify external load (total distance, high-speed distance, and PlayerLoad), internal load (differential sRPE), as well as recovery and wellness of 18 international under-16 players during a development tournament. The external load pattern of the starting players was undulating, with matches showing the highest internal load values compared to training sessions and non-starters. Non-starters players (whether training or matches) showed similar external load and differential sRPE values throughout the tournament (p>0.05). Starting players experienced higher internal load than non-starters during matches (p<0.037), without differences between training sessions (p>0.05). No changes were seen in wellness or recovery (all p-values >0.05), except for non-starters in session 3 compared to session 7 (p=0.024). Starting players had more weekly total minutes (p=0.018), differential sRPE (breath: p=0.002; leg: p=0.002; cognitive: p=0.003), total distance (p=0.003), and PlayerLoad (p=0.008) than non-starters. Our results indicate differing load patterns between starters and non-starters, which do not affect wellness and recovery differently. Starters accumulate more weekly total load. Coaches can use these findings to guide decisions and load compensations in high competition contexts for young female soccer players.

Lane detection is a foundational technology for autonomous driving systems. It involves identifying the boundaries of lanes on the road and ensuring the vehicle stays within these boundaries. Accurate lane detection is crucial for safety, navigation and traffic management. This paper presents an artificial intelligent based autonomous road lane detection and navigation system for vehicles. The system can detect and analyze road lanes accurately and efficiently in real-time, with frame rates of up to 17 FPS. By utilizing image processing techniques, the system can identify the location and boundaries of road lanes and obstacles on the road and provide accurate and reliable navigation guidance to the driver. The system is integrated with sensors and actuators to provide comprehensive autonomous navigation. The efficiency of the proposed system is demonstrated using accuracy of lane detection on straight and curve lanes covering frames per second and motor of the speed as parameters for assessment. Results show that the proposed system detects lane as entire lane detection, partial lane detection and no detection status on different settings.

(1) Background: Allergic reactions and angioedema are important immunologic conditions in acute care settings. Prior data indicate an association between the severity of symptoms and maximum lysis (ML) in thromboelastography. We aimed to evaluate the dynamics of ML after two hours of observation after admission to the emergency department. (2) Methods: We deter-mined ML with thromboelastography using extrinsic testing (EXTEM, ROTEM®, Werfen GmbH, Munich, Germany) at the presentation of patients with immunologic reactions and approximately two hours thereafter. The median test was used to compare the extent of ML between individuals who were still symptomatic at follow-up and those who were asymptomatic. (3) Results: We pro-spectively enrolled 16 individuals (10 (63%) female, mean age 50±14 years). Of these, 6 (38%) were still symptomatic at follow-up. Patients who had persistent symptoms had significantly higher ML than those who were asymptomatic (14% (IQR 12-17) vs. 8% (IQR 4-10), p=0.002). (4) Conclusions: ML is elevated in patients who are still symptomatic two hours after presenting to the emergency department due to an immunologic reaction.

Candida spp. is rarely found in the etiology of neonatal early-onset sepsis (EOS). However, candidemia is associated with increased mortality and morbidity, as in late-onset sepsis. Congenital candidiasis may present as mucocutaneous infection or, more rarely, as a systemic infection in term and preterm infants. Material and methods: Case reports of two cases of congenital systemic candidiasis (CSC) produced by Candida albicans and a review of the data in the literature. Results: Both neonates were male, born vaginally, with risk factors for congenital candidiasis. One of the infants was born at term and presented with an almost generalized maculopapular rash at birth; C. albicans grew in the blood culture sampled at 36 hours; parenteral fluconazole was started immediately, and no complications were noted. The other infant was born preterm, at 28 weeks of gestation, and presented signs of respiratory distress on the 4th day of life after initial successful treatment of the respiratory distress syndrome with surfactant and non-invasive respiratory support. C. albicans was present in the neonatal blood and gastric aspirate cultures, and in the maternal vaginal cultures (all sampled at birth); parenteral fluconazole therapy was administered for 30 days as investigations revealed both liver and renal involvement and the infant development bronchopulmonary dysplasia. Conclusion: As data in the literature suggests, despite occurring at any gestational age, CSC may present various clinical pictures, the rash may mimic many other neonatal conditions, and the systemic dissemination cannot be distinguished from bacterial EOS. Careful anamnesis and a high index of suspicion are important for the prompt recognition and treatment of CSC, optimizing the short- and long-term outcomes.

To address the issue of reduced orbit estimation accuracy resulting from discrepancies between in-orbit measured geomagnetic field values and IGRF model values in autonomous orbit estimation of microsatellites based on geomagnetic field measurements, this study introduces an adaptive cubature H-infinity filtering algorithm. Firstly, it presents the low-altitude orbital dynamics model and geomagnetic field measurement model for microsatellites. Subsequently, within the adaptive cubature H-infinity filtering algorithm, a spherical simplex rule and a second-order Gaussian-Legendre quadrature criterion are employed to compute the spherical surface integral and radial integral. Additionally, a spherical simplex-radial quadrature rule is proposed to enhance the approximation accuracy of nonlinear Gaussian weighted integrals. Furthermore, by integrating extended H-infinity filtering based on game theory with the cubature quadrature rule, an inverse proportional relationship between constraint level and filtering innovation is established. This allows for adaptive adjustment of the constraint level to enhance robustness against model errors. Finally, through semi-physical simulation experiments, it is demonstrated that compared with traditional algorithms, the proposed algorithm improves autonomous orbit estimation position accuracy of microsatellites by 7.49%, while also enhancing velocity accuracy by 3.1%, thus validating its effectiveness.

Traumatic pneumothorax (PTX) occurs in up to 50% of patients with severe polytrauma and chest injuries. Patients with traumatic PTX with clinical signs of tension physiology and hemodynamic instability are typically treated with an urgent decompressive thoracostomy, tube thoracostomy, or needle decompression. There is recent evidence that non-breathless patients with hemodynamically stable traumatic PTX can be managed conservatively through observation or a percutaneous pigtail catheter. We present here a 52-year-old woman who presented to the emergency department with 55 mm traumatic PTX. Following aspiration of 1500 ml of air, clinical improvement was immediately observed, allowing the patient to be discharged shortly thereafter. In hemodynamically stable patients with posttraumatic PTX, without specific risk factors or oxygen desaturation, observation or simple needle aspiration can be a reasonable approach. We aimed in this article to review the available literature on needle aspiration and conservative treatment of traumatic pneumothorax. A total of 12 studies were selected out of 190 articles on traumatic PTX, where conservative treatment versus chest tube decompression was compared. Our case report demonstrated that even a large PTX in a hemodynamically stable patient without other risk conditions, can be successfully treated conservatively with simple needle aspiration to avoid tube thoracostomy complications.

The incidence of diabetes mellitus (DM) continues to rise worldwide and one of the most serious microvascular complications is diabetic kidney disease (DKD), which is the leading cause of end-stage renal disease. Current bi-omarkers such as urinary albumin excretion rate have limitation for early detection of DKD. In our study we used ultra-high-performance liquid chromatography coupled with electrospray ionization-quadrupole-time of flight-mass spectrometry (UHPLC-QTOF-ESI+-MS) techniques to quantify previously analyzed metabolites, such as tryptophan, kynurenic acid, taurine, l-acetylcarnitine, glycine, and tiglylglycine. We performed the targeted analy-sis of metabolites from urine and serum samples, collected from 110 subjects. Of these, 90 patients with type 2 DM (T2DM) were divided according to the urinary albumin/creatinine ratio (UACR) into normoalbuminuria 300 mg/g groups, respectively, while 20 subjects were rep-resented by healthy controls. Through various validation methods, we identified several metabolites as potential biomarkers, such as kynurenic acid, glycine, and l-tryptophan in serum and l-acetylcarnitine, tiglylglycine, and tau-rine in urine.

Sinonasal carcinomas are aggressive neoplasms that present a high morbidity and mortality rate with unfavorable prognosis. This group of tumors exhibits morphological and genetic diversity. Genetic and epigenetic alterations in these neoplasms are currently targets for diagnosis and treatment. The most common type of cancer originated in the sinonasal tract are sinonasal squa-mous cell carcinomas (SNSCC), which presents different histological patterns and variable his-tological aggressiveness. A significant number of alterations have been reported in sinonasal tu-mors, including deficiencies in the SwItch/Sucrose non-fermentable (SWI/SNF) chromatin remod-eling complex. In the sinonasal tract, deficiencies of the subunits SMARCB1/INI1, SMAR-CA4/BRG1 and SMARCA2 have been noted in carcinomas, adenocarcinomas, and soft tissue tu-mors with distinctive high-grade morphology and fatal prognosis. Objective: To identify the status of the SWI/SNF complex using immunohistochemistry in sinonasal squamous cell carci-nomas and its association with morphology and survival. Methods: A total of 1582 SNSCC cases were analyzed, selecting those with high-grade malignancy morphology, which were then evalu-ated immunohistochemically for SMARCB1 and SMARCA4 proteins. Their expression was compared with the biological behavior and survival of the patients. Results: Among the SNSCC, 47% corresponded to the non-keratinizing squamous cell carcinoma (NKSCC) type with high-grade characteristics, 40% were keratinizing squamous cell carcinomas (KSCC), 9% were SMARCB1-deficient carcinomas, and 4% were SMARCA4-deficient carcinomas. Mosaic expres-sion for SMARCB1 (NKSCC 33%, KSCC 21.9%) and SMARCA4 (NKSCC 14.6%, KSCC 12.2%) was identified, showing an impact on tumor size and progression. Conclusions: We identified that the mosaic expression of INI1 in NKSCC exhibited a worse prognosis compared to intact carcinomas and was similar to SMARCB1-deficent carcinoma.

Autonomous navigation in dynamic environments poses a significant challenge in the field of ro-botics with the primary goals of ensuring both smooth and safe movement. This study introduces control strategy based on an Adaptive Neuro-Fuzzy Inference System (ANFIS) to enhance au-tonomous robot navigation in dynamic environments, emphasizing on collision-free path plan-ning. This strategy employs, a path planning technique to develop a trajectory that allows the ro-bot to navigate smoothly while avoiding collisions with both static and dynamic obstacles. The developed control system incorporates four ANFIS controllers: two are tasked with guiding the robot toward its end point, and the other two are activated for obstacle avoidance. The experi-mental setup conducted in CoppeliaSim involves a mobile robot equipped with ultrasonic sensors navigating in an environment with static and dynamic obstacles. Simulation experiments are conducted to demonstrate the model's capability in ensuring collision-free navigation, employing a path planning algorithm to ascertain the shortest route to the target destination. The simulation results highlight the superiority of the ANFIS-based approach over conventional methods, partic-ularly in terms of computational efficiency and navigational smoothness.

The working environment of mining electric locomotives is wet and muddy coal mine 1 roadway. There may be idling or slipping between the wheels and rails of mining electric locomotives 2 due to low friction between the wheel and rail and insufficient utilization of creep rate. Therefore, it 3 is necessary to control the creep rate within a reasonable range. In this paper, the autonomous control 4 algorithm for mining electric locomotives based on improved ε-greedy is theoretically proven to be 5 convergent and effective firstly. Secondly, after analyzing the contact state between the wheel and rail 6 under wet and slippery road conditions, it was concluded that the value of creep rate is an important 7 factor affecting the autonomous driving of mining electric locomotives. Therefore, the autonomous 8 control method for mining electric locomotives based on creep control is proposed in this paper. 9 Finally, the effectiveness of the proposed method was verified through simulation. The problem of 10 wheel slipping and idling caused by insufficient friction of mining electric locomotives in coal mining 11 environments is effectively suppressed. Autonomous operation of vehicles with optimal driving 12 efficiency can be achieved through quantitative control and utilization of the creep rate between 13 wheels and rails

In this paper, we investigated the formation isolation regulation issue regarding multiple autonomous underwater vehicles (AUVs) characterized by a "leader-follower" framework. Considering the cooperative-competitive relationship among the follower AUVs and the impact of unknown external disturbances, an extended state observer was designed based on backstepping to mitigate these disturbances, and an event-triggered control scheme was designed to realize the two-part consensus control within the multi-AUV system. Through rigorous theoretical analysis, it is shown that the system achieves asymptotic steadiness and is free from zeno behavior under the proposed event-triggered control scheme. Finally, numerical simulations confirm the efficiency of the regulation strategy in achieving formation separation within the multi-AUV, where the trajectory tracking errors of individual AUVs gather in a compact vicinity close to the source and the structure converges was achieved, with the absence of zeno behavior also demonstrated.

No consensus exists on whether acute aerobic exercise alters the glomerular filtration rate in older adults. Objective: To assess the immediate effects of three aerobic exercise intensities on the estimated glomerular filtration rate (eGFR) in healthy, sedentary older adults. Methods: Eighteen healthy, sedentary older adults (12 men and eight women) voluntarily participated in the study. The participants underwent three standardized aerobic exercise tests (100%, 80%, and 60% of the maximal heart rate) on a bicycle ergometer. Blood samples were collected to determine cholesterol, triacylglycerol, glucose, serum creatinine (Cr), Cystatin C (CysC) concentrations, and eGFR. Results: eGFR and serum concentrations of Cr and CysC were not modified at any exercise intensity. There was a negative correlation between blood total cholesterol vs. eGFR (R= -0.512, R= -0.582, R= -0.531; p <0.05) at rest, 60%, and 100% of the maximal heart rate, respectively. Besides, a negative correlation existed between age vs. eGFR at 60% of the maximal heart rate (R= -0.516; p <0.05). Conclusion: Short-time aerobic exercise of low, moderate, and vigorous intensity did not significantly affect eGFR and is considered safe for kidney function in healthy, sedentary older adults.

This study investigates the permeability and California Bearing Ratio (CBR) of base course materials for flexible pavements, focusing on materials from local quarries in Querétaro and Puebla, Mexico. Recognizing the fundamental role of the base layer in load distribution and hydraulic conductivity, the research evaluates these properties at different grain sizes and moisture contents. The objective is to define an optimal range that maximizes both drainage and mechanical resistance, crucial to extending the useful life of the pavement. Four different quarries were selected for material sampling and extensive testing was performed to determine permeability and CBR values under different conditions. The findings reveal the need for broader experimentation and methodological improvements, particularly in the measurement of hydraulic conductivity, a parameter not yet regulated for these materials in Mexico. The results demonstrated permeability values ranging between 1.2810^-3 and 1.9010^-3 cm/s, highlighting the significant impact of the percentage of fine material and its plasticity on the hydraulic and mechanical performance. Despite achieving permeability rates lower than the optimal value suggested in American manuals (0.35 cm/s), even with a fine material content of less than 5%, the study highlights the potential of local materials to meet the international standards with proper processing and testing. This research contributes to the global body of knowledge in pavement engineering by linking local geomaterial properties to broader applicable engineering practices. It suggests that even locally sourced materials, when appropriately evaluated and used, can significantly influence overall pavement solutions, promoting sustainability and cost-effectiveness in pavement construction.

Self-administered pre-participation screening for physical activity (PA) requires an instrument that should be easily used and identify individuals at high risk. The Physical Activity Readiness Questionnaire (PAR-Q+) has been used for many years. Its ease of use and ability to identify those not fit to undergo PA has not been assessed. This study was to determine the rates of the PAR-Q+ in identifying adults who may not be fit for moderate or intense PA and obtain feedback on the use of this tool. A public on-line voluntary survey on the PAR-Q+ was carried out obtaining participants’ bio-characteristics, them completing the PAR-Q+ form and providing feedback. With 1019 participants, about 57.8% engaged in at least 150 minutes of PA weekly. This decreased with increasing number of co-morbidities. Increasing age was associated with more co-morbidities. About 33.1% of the participants using the PARQ+ would have required further medical evaluation. Only 3 of the 7 main PAR-Q+ questions were easily understood. Difficulties were encountered with 39 of the 44 follow-up questions, especially amongst those with co-morbidities. The large number of technical terms was also a source of concern. The PAR-Q+ would need extensive simplification before it may be recommended for use.

Background We aimed to evaluate the effectiveness of the ALRYNGO channel-type video laryngoscope with an AI-based glottis guidance system in senior emergency medicine residents for endotracheal intubation. Methods We enrolled twenty patients would be adequate for each device (direct laryngoscope, Pentax-AWS, and ALRYNGO). Before intubation, six senior residents wore a personal protective equipment. To randomize the device in this clinical study, a sealed envelope containing a device-specific identification card was utilized. When intubation began, the person who measured the intubation time divided the total intubation time into three-time intervals. The primary outcome was the intubation time. The secondary outcomes were the glottis view using the Cormack-Lehane grade (C-L grade) and the glottis guidance performance of ALRYNGO’s artificial intelligence. Results In Pentax-AWS and ALRYNGO, all intubations were successful, but the intubation time was longer than with the direct laryngoscope. And among the three, the ALRYNGO and Pentax-AWS had the highest frequency of C-L grade I (easiest intubation) at 80%, and the direct laryngoscope had the lowest frequency of 10%. Conclusions Even if healthcare professionals without experience with the channel-type video laryngoscope improve their performance on airway mannequins after training, their intubation performance may differ when applied to actual patients.

Larus michahellis increased its population throughout the 20th century in its worldwide distribution area. The increase in the Salinas de San Pedro del Pinatar has produced changes in the habitats due to the contribution of guano, predation on birds, incidents with workers, and the production of salt. The objective is to analyze the impacts of L. michahellis on the landscape, habitats, waterfowl, salt production, and workers, as well as to evaluate the effectiveness of control activities. Censuses of wintering L. michahellis have been carried out between 1990-2021, of nesting aquatic birds between 1994-2021, and nests and eggs of L. michahellis have been eliminated between 2000-2021. The result has been a decrease in pairs of L. michahellis, recovery of waterfowl populations, colonization of others, absence of incidents with workers, and reduction of damage to salt production. However, to reach a definitive solution, measures should be adopted to prevent L. michahellis from accessing the main sources of human food: urban solid waste dumps, aquaculture farms, and fish discards.

Following technological advances, autonomous and remote-controlled ships are performing trials in some sea areas; a mandatory goal-based MASS code, expected to enter into force on 1 January 2032, is under discussion in the International Maritime Organization (IMO). However, there are no unified standards regarding verification methods to define operating limitations for cutting-edge technologies, which are expected to be elements of MASS, so it is difficult to assess the risk factors for the management and operation of MASS. This paper outlines the regulatory framework for MASS, followed by a discussion of its application, considering the differences between MASS and automated driving, and how to develop safety management and operation using standards for automated driving. A requirements management framework developed as a system and software engineering standards to build safety management and operation of MASS is proposed. It is also suggested that the requirements management framework could be used not only for MASS development but also for regulatory review from a requirements management view.

The advancement of autonomous driving technology is becoming increasingly vital in the modern technological landscape, promising notable enhancements in safety, efficiency, traffic management, and energy use. Despite these benefits, conventional deep reinforcement learning algorithms often struggle to navigate complex driving environments effectively. To tackle this challenge, we propose a novel network called DynamicNoise, designed to significantly boost algorithmic performance by introducing noise into the Deep Q-Network (DQN) and Double Deep Q-Network (DDQN). Drawing inspiration from the NoiseNet architecture, DynamicNoise uses stochastic perturbations to improve the exploration capabilities of these models, leading to more robust learning outcomes. Our experiments demonstrate a 57.25% improvement in navigation effectiveness within a 2D experimental setting. Moreover, by integrating noise into the action selection and fully connected layers of the Soft Actor-Critic (SAC) model in the more complex 3D CARLA simulation environment, our approach achieved an 18.9% performance gain, substantially surpassing traditional methods. These results confirm that the DynamicNoise network significantly enhances the performance of autonomous driving systems across various simulated environments, regardless of their dimensionality and complexity, by improving their exploration capabilities rather than just their efficiency.

This is a single tertiary center in southwest Romania, population-based, study. We retrospectively compared data obtained in two periods: January 2008 - December 2013 and January 2018 - De-cember 2023, respectively. The global incidence of transposition of great arteries (TGA) - the ter-minated cases added to the ones resulting in live-born pregnancies, remained almost constant. The live-born incidence of TGA decreased (0.34% to 0.013%). The prenatal detection rate increased slightly (71.42% to 87.5%). The median gestational age at the diagnosis decreased, from 29.3 ges-tational weeks (mean 25.4) to 13.4 weeks (mean 17.2). The proportion of terminated pregnancies significantly increased (14.28% to 75%, p = 0.019).

The rapid growth of the sharing economy has propelled shared mobility to the forefront of attention. The continuous advancement of autonomous driving technology also brings new opportunities and challenges to the shared mobility market. This study comprehensively analyzes the market potential concerning autonomous vehicles (AVs) to provide shared mobility services, utilizing SWOT analysis, PESTLE analysis, and Porter’s Five Forces. The findings reveal that AVs can provide improved shared mobility services by increasing transportation safety, reducing emissions, reducing costs, enhancing traffic efficiency, and increasing customer satisfaction and the profitability of shared mobility services. However, challenges such as technological and policy uncertainties, safety concerns, high initial costs, inadequate public communication infrastructure, and the absence of standardized regulations can hinder the widespread adoption of AVs. The benefits are also restricted with a low market penetration rate of AVs. To promote AVs in the shared mobility market, this study also provides implications for AV stakeholders tailored to the evolving shared mobility market dynamics.

Ideas about Artificial Intelligence appeared about half a century ago, but only now is it becoming an essential element of everyday life. The data provided is getting bigger and bigger and, in this case, we need artificial intelligence that helps us with superhuman powers. The interaction with medicine is getting closer and closer, medicine being a field that continues to be perfected. Machine learning, deep learning, neural networks, computer vision are some of the mechanisms that are already applied in medicine, becoming a trend in healthcare worldwide. Artificial intelligence will be the thing that will change contemporary medicine. Developed countries such as Japan, France, Germany have already implemented artificial intelligence in their medical systems. The help is in medical diagnosis, patient monitoring, personalized therapy, and workflow optimization. Artificial intelligence will help surgeons to perfect their skills, to standardize techniques, to choose the best surgical technique. The goal is to predict complications, reduce diagnostic time, diagnose complex pathologies, guide the surgeon intraoperatively and reduce medical errors. We are at the beginning but the potential is enormous.

Introduction Atherosclerotic disease is a major contributor to heart failure, stroke, and myocardial infarction, significantly lowering the quality of life and life expectancy, with a significant burden on healthcare. Not all lesions deemed non-significant are benign, and conversely, not all significant lesions are causative of ischemia. Fractional flow reserve (FFR) provides a functional assessment of coronary lesions, while optical coherence tomography (OCT) offers detailed imaging of plaque morphology, aiding in therapeutic decision-making. The objective of this study was to evaluate the utility of OCT and FFR as adjunctive tools in the catheterization laboratory for guiding therapeutic decisions in patients with multivessel disease for non-culprit vessels. Specifically, we aimed to assess how OCT and FFR influence therapeutic decision-making in patients with multi-vessel coronary artery disease. Methods 36 patients with acute coronary syndrome (ACS) and multivessel disease were randomized 1:1 into two groups: one guided by FFR alone, and the other by a combination of FFR and OCT. For the FFR group, revascularization decisions for non culprit lesions were based solely on FFR measurements. If the FFR was >0.8, the procedure concluded, and the patient received maximal medical treatment. If the FFR was ≤0.8, a stent was placed. For the FFR + OCT group, if the FFR was >0.8, the revascularization decision was based on OCT findings. If there were no vulnerable plaques (VP), the procedure concluded, and the patient received maximal medical treatment. If OCT imaging indicated VP, then the patient underwent revascularization. If the FFR was ≤0.8, the patient underwent revascularization regardless of OCT findings. Results OCT imaging altered the therapeutic decision in 11 cases where FFR measurements were above 0.8, but the lesions were characterized as VP. Analyzing the total change in the decision to stent, 4 cases in the FFR group and 15 cases in the FFR and OCT group (4 based on FFR and 11 on OCT) revealed a statistically significant difference (p = 0.0006; Relative Risk = 0.2556; 95% CI: 0.1013 to 0.5603). When analyzing the change in the total decision both to stent and not to stent, we observed a statistically significant difference, with Group 1 having 7 cases and Group 2 having 15 cases (p = 0.0153; Relative Risk = 0.4050; 95% CI: 0.2004 to 0.7698) Conclusion Based on the findings of this study, OCT significantly increases the percentage of stenting procedures by identifying vulnerable lesions. The use of intracoronary imaging facilitates the timely identification and treatment of these vulnerable lesions. This underscores the crucial role of OCT in enhancing the precision of coronary interventions by ensuring timely intervention for vulnerable lesions, thereby potentially improving patient outcomes Acknowledgment funding „This work was supported by the University of Medicine, Pharmacy, Science and Technology ,, George Emil Palade’’ of Targu Mures Research Grant number 510/14/17.01.2022”

Background: The skin prick test (SPT) is used to diagnose sensitization to antigens. This study proposes a deep learning approach to infer wheal dimensions, aiming to reduce dependence on human interpretation. Methods: A dataset of SPT images (n=5844) was used to infer a convolutional neural network for wheal segmentation (ML model). Three methods for inferring wheal dimensions were evaluated: the ML model; the standard protocol (MA1); and approximation of the area as an ellipse using diameters measured by an allergist (MA2). The results were compared with assisted image segmentation (AIS), the most accurate method. Bland-Altman, distribution analyses, and correlation tests were applied to compare the methods. The study also compared the percentage deviation among these methods in determining the area of wheals with regular geometric shapes (n = 150) and with irregular shapes (n=150). Results: The Bland-Altman analysis showed that the difference between methods was not correlated with the absolute area. The ML model achieved a segmentation accuracy of 85.88% and a strong correlation with the AIS method (ρ=0.88), outperforming all other methods. Additionally, MA1 showed significant error (13.44±13.95%) for pseudopods. Conclusions: The ML protocol can potentially automate the reading of SPT, offering greater accuracy than the standard protocol.

Most crops are fertilized with high amounts of nitrogen, and have an alarmingly low utiliza-tion efficiency. For this reason, the coordination between the fertilizer contribution and the ni-trogen requirements of the crop is very important. Therefore, the objective of this study was to determine the nitrogen use efficiency, and create new NUE indices that can determine and calculate the final destination of the assimilated nitrogen, for the formation and development of green bean plant organs, fertilized with molybdenum nanofertilizer applied foliarly and combined with soil fertilization of ammonium nitrate. The plants were grown in a greenhouse covered with anti-aphid mesh and irrigated with nutrient solution. Three sources of foliar Molybdenum (Nano fertilizer, Molybdenum Chelate and Sodium Molybdate) were applied in four doses of 0, 5, 10 and 20 ppm Mo, complemented with edaphic fertilization of NH4NO3 (0, 3, 6 and 12 mM of N). As results, the NUE indices showed that with the application of the nanofertilizer, the total biomass production increased 41.65% more than with the application of the chelate, and 36.84% more than with the application of molybdate. Finally, it is con-cluded that the use of NUE indices is an important approach that evaluates the fate of nitro-gen and accurately estimates plant yield.

Athlete’s heart is characterised by structural, functional, and electrical remodelling. During an exercise session, the heart increases the use of oxygen, which is associated with decreased vascular resistance in the lungs’ circulation. Left ventricular hypertrophy is an echocardiographic modification especially met in endurance athlete’s heart. Moreover, left atrial dilatation represents another important characteristic of endurance athletes. Electrical modulation in the athletic heart induces neurological modifications leading to sinus arrhythmia, bradycardia, early repolarisation, and first-grade atrioventricular (AV) blocks. Athletes' nutritional status involves the assimilation of macronutrients such as proteins, carbohydrates, and fats. Depending on the duration of physical exercise, ATP can be obtained in aerobic or anaerobic conditions. This systematic review aims to find correlations between different evaluative methods of cardiac adaptation and present the metabolism in performance athletes.

Polypharmacy, the use of multiple medications, is a prevalent issue globally that contributes to increased healthcare costs and places additional burdens on patients' organs. This study aims to reduce the incidence of polypharmacy in the emergency department. We conducted a retrospective review of randomly selected medical records from the Internal Medicine Department of Taipei MacKay Emergency Department, spanning from August 1, 2023, to October 31, 2023. For cases identified as involving polypharmacy, pharmacists provided medication education using the TRM Polypharmacy Interview Guide, while social workers contacted patients via phone to recommend follow-up visits for deprescribing. Patients experiencing polypharmacy were significantly older than those on appropriate medication regimens (79.8 vs. 67.3 years, p=0.002). After deprescribing interventions, the average number of medications for polypharmacy patients was 5.9 higher than for those receiving appropriate prescriptions (9.2 vs. 3.3, p=0.001). The most common conditions associated with polypharmacy were diabetes mellitus, hypertension, and arrhythmia. Polypharmacy poses a significant medication management challenge, with affected patients taking an average of 6.9 more medications than those on appropriate treatment regimens. Our team’s resource management module successfully reduced the incidence of polypharmacy by 8.4% in the emergency department.

Three autonomous communities have been the ones that, in the 2022-2023 season, anticipated the document approved by the Public Health Commission, recommending influenza vaccination for all children aged 6 to 59 months. The main objective of this work is to evaluate the attitude of healthcare professionals towards the first universal vaccination campaign in our region, as well as the acceptability of the vaccines used and the attitude towards the piloting of school vaccination. Cross-sectional, survey-based, descriptive study. All healthcare professionals involved in the campaign were invited to participate. The 91.9% of surveyed professionals thought that flu vaccination from 6 to 59 months was important or very important. 89.8% had previous experience regarding the intramuscular vaccine. The professionals valued the intranasal vaccine significantly more positively; however, there were no differences when asking for each of the vaccines without comparison. The inhaled vaccine was preferred by 97.5% for the following campaign. Piloted school vaccination showed 75% acceptance. The inhaled vaccine was preferred by most professionals and the piloted school vaccination was highly accepted, and independently associated to the importance of vaccination as considered by physicians, being a medical doctor, and participation in the pilot program.

This study assesses the predictive performance of six machine learning models in forecasting tumor dynamics within three months following Gamma Knife Radiosurgery (GKRS) in 77 brain metastasis (BM) patients. The analysis meticulously evaluates each model before and after hyperparameter tuning, utilizing accuracy, AUC and other metrics derived from confusion matrices. Initial findings highlighted that XGBoost significantly outperformed other models with an accuracy of 0.95 and an AUC of 0.95 before tuning. Post-tuning, the Support Vector Machine (SVM) demonstrated the most substantial improvement, achieving an accuracy of 0.98 and an AUC of 0.98. Conversely, XGBoost showed a decline in performance after tuning, indicating potential overfitting. The study also explores feature importance across models, noting that features like “control at one year”, “age of the patient”, and “beam on time for volume V1 treated”, were consistently influential across various models, albeit their impacts were interpreted differently depending on the model’s underlying mechanics. This comprehensive evaluation not only underscores the importance of model selection and hyperparameter tuning but also highlights the practical implications in medical diagnostic scenarios, where the accuracy of positive predictions can be crucial.

We conclude that Hbr not only favored growth, but also colonization with R. intraradices and consequently biomass production, and N and P content in plant tissue. The growth response and nutrient exchange suggest interdependence between brassinosteroids and the endomycorrhizal fungus.

The integration of advanced image analysis using artificial intelligence (AI) is pivotal for the evolution of autonomous vehicles (AVs). This article provides a thorough review of the most significant datasets and the latest state-of-the-art AI solutions employed in image analysis for AVs. Datasets such as Cityscapes, NuScenes, and CARLA form the benchmarks for training and evaluating different AI models, with unique characteristics catering to various aspects of autonomous driving. Key AI methodologies, including Convolutional Neural Networks (CNNs), Recurrent Neural Networks (RNNs), Transformer models, and Generative Adversarial Networks (GANs), are discussed. The article also presents a comparative analysis of various AI techniques in real-world scenarios, focusing on semantic image segmentation, 3D object detection, and vehicle control in virtual environments. Simultaneously, the role of multisensor datasets and simulation platforms like AirSim, TORCS, and SUMMIT in enriching the training data and testing environments for AVs is highlighted. By synthesizing information on datasets, AI solutions, and comparative performance evaluations, the article serves as a crucial resource for researchers, developers, and industry stakeholders. Offering a clear view of the current landscape and future directions in autonomous vehicle image analysis technologies.

The algorithm described in this paper inherits the concepts of layered fusion, insertion, and set from four convex hull-based heuristic algorithms. It summarizes relevant definitions and theorems, proposes valuable research hypotheses, combines grouping and insertion, and innovatively introduces the practice of "grouped insertion."

Environmental monitoring programs rely on periodic spot sampling at specific locations, followed by laboratory analysis, aiming at the evaluation of water quality at a catchment scale. For this purpose, automatic telemetric stations for specific parameters have been installed by the Institute of Marine Biological Resources and Inland Waters of Hellenic Centre for Marine Research (IMBRIW-HCMR) within several Greek rivers and lakes, providing continuous and temporal monitoring possibilities. Nevertheless, the employment of unmanned surface vehicles (USV) equipped with integrated sensors represents a tool valuable to several monitoring strategies, offering enhanced temporal and spatial coverage over specific timeframes, allowing for targeted examination of sites or events of interest. The USVs have been deployed by Athens Water and Sewerage Company (EYDAP) as a cost-effective tool for the environmental monitoring of surface water bodies of interest, with emphasis on the spatial fluctuations of chlorophyllα, electrical conductivity, dissolved oxygen and pH, observed in Koumoundourou Lake and rivers Acheloos, Asopos and Kifissos. The effectiveness of an innovative heavy metal (HM) system installed in the USV for thein situ determination of copper and lead was also evaluated herewith. The results obtained demonstrate that both the timely detection of potential pollution from both anthropogenic activities and natural processes as well as the monitoring of inland waters are made feasible through the employment of USV.

Procedural Sedation and Analgesia (PSA) in the Emergency Department (ED) presents a crucial aspect of emergency medicine, enabling the execution of painful or distressing procedures with minimal patient discomfort. This narrative review delineates the pharmacological framework, methodologies, and clinical considerations integral to optimizing PSA, with a particular focus on pediatric and geriatric populations. Through a comprehensive review and analysis of current practices, this work evaluates the pharmacokinetics and pharmacodynamics of widely utilized sedatives and analgesics, including propofol, ketamine, dexmedetomidine, fentanyl, midazolam, etomidate, nitrous oxide, and remimazolam. Special attention is dedicated to the selection criteria based on patient-specific risk factors, procedural requirements, and the management of potential adverse effects. The manuscript also explores innovative sedation techniques and the integration of new pharmacological agents, emphasizing evidence-based approaches to enhance patient safety and outcome. Results underscore the significance of tailored sedation strategies, especially for vulnerable groups such as pediatric and geriatric patients, highlighting the need for meticulous pre-procedural assessment and monitoring to mitigate risks. Conclusions drawn advocate for a nuanced application of PSA, guided by current evidence and clinical guidelines, to improve the quality of care in emergency settings. This research reinforces the imperative for ongoing education, skill development, and adaptation of new evidence into clinical practice to advance procedural sedation and analgesia in the ED.

The vehicles number continuously growing lead to increasingly intense and congested traffic and it will additionally demand the braking system, and drivers behave more aggressively and as result is required that the braking system to be durable and efficient. For this is necessary the study the braking system behavior in conditions of intense and moderate traffic to increase the safety of traffic participants, respectively to demonstrate the need for more frequent replacement of some braking system elements. Thus, on a vehicle were performed a series of successive tests, through which the degree of wear of the brake pads and discs was monitored periodically and as a result the efficiency evolution of the braking system. The tests were carried out both in laboratory (on dynamometer) and in traffic to establish the efficiency of the braking system according to some parameters considered essential. The experimental tests showed that the recommendations regarding the frequency of replacement of brake pads and disks are inconsistent with their actual wear. Therefore, the aim of this paper is the establishment of the braking system efficiency of an auto-vehicle, subject to testing depending on the auto-vehicle mass, travel speed, distance driven, and braking time, based on experimental on stand and in-traffic tests, according the road safety regulations.

Linear Hashing is an important algorithm for many key-value stores. Spiral Storage was invented to overcome the poor fringe behavior of Linear Hashing, but after an influential study by Larson, seems to have been discarded. Since almost 50 years have passed, we repeat Larson’s comparison with in-memory implementation of both to see whether his verdict still stands. Our study shows that Spiral Storage has slightly better look-up performance, but slightly poorer insert performance.

Background: Before the COVID-19 outbreak, food microbiology was crucial in identifying and preventing foodborne pathogens like Salmonella and E. coli. The pandemic underscored the importance of this discipline, highlighting the need for enhanced surveillance and microbiological control in the food chain to prevent future global public health threats. This research aimed to advance knowledge management in Bioeconomy, focusing on Eco-Intensification and biotechnology applications that directly affect food microbiology, especially in the context of the COVID-19 crisis. Methodology: The study involved a comprehensive literature review grounded in the epistemological principles of Bioeconomy, utilizing the Bibliometric Scopus database. This approach facilitated the exploration of the development of eco-intensification and biotechnology applications within food safety and nutrition microbiology. Results: The findings emphasize the importance of understanding the social and economic impacts of microbiological activities in food intake through a Bioeconomy lens. The research highlights the need for integrating microbiological insights into broader bioeconomic frameworks to address food safety and sustainability challenges effectively. Conclusion: Recommendations are provided for decision-makers to enhance public health agendas from a bioeconomic perspective. These recommendations aim to strengthen the focus on Bioeconomy and improve the management of interactions between food microbiology and the challenges exacerbated by the COVID-19 pandemic.

In the context of global climate change, the frequency of sudden natural disasters is increasing. Assessing traffic road damage post-disaster is crucial for emergency decision-making and disaster management. Traditional ground observation methods for evaluating traffic road damage are limited by the timeliness and coverage of data updates. Relying solely on these methods does not adequately support rapid assessment and emergency management during extreme natural disasters. Social media, a major source of big data, can effectively address these limitations by providing more timely and comprehensive disaster information. Motivated by this, we utilized multi-source heterogeneous data to assess the damage to traffic roads under extreme conditions and established a new framework for evaluating traffic roads in cities prone to flood disasters caused by rainstorms. The approach involves several steps: First, extracting the surface area affected by precipitation using a threshold method constrained by confidence intervals derived from microwave remote sensing images; Second, collecting disaster information from the Sina Weibo platform, where social media information is screened and cleaned. A quantification table for road traffic loss assessment was defined, and a social media disaster information classification model combining text convolutional neural networks and attention mechanisms was proposed (TextCNN-Attention Disaster Classification); Finally, matching traffic road information on social media with basic geographic data, visualizing the classification of traffic road disaster risk levels, and completing the assessment of traffic road disaster levels based on multi-source heterogeneous data. Using the "7.20" rainstorm event in Henan Province as an example, this study categorizes the disaster impact on traffic roads into five levels: particularly severe, severe, moderate, mild, and affected, as interpreted from remote sensing images. The evaluation framework for flood disaster traffic roads based on multi-source heterogeneous data provides important data support and methodological support for enhancing disaster management capabilities and systems.

The application of space robotic manipulators and heightened autonomy for ios represents a paramount pursuit for leading space agencies, given the substantial threat posed by space debris to operational satellites and forthcoming space endeavors. This work presents a guidance algorithm based on drl to solve for the space manipulator path-planning during the motion synchronization phase with the mission target. The goal is the trajectory generation and control of a spacecraft equipped with a 7-dof robotic manipulator, such that its end effector remains stationary with respect to the target point of capture. The ppo drl algorithm is used to optimize the manipulator’s guidance law, and the autonomous agent generates the desired joints rates of the robotic arm, which are then integrated and passed to a model-based feedback linearization controller. The agent is first trained to optimize its guidance policy and then tested extensively to validate the results against a simulated environment representing the motion synchronization scenario of an ios mission.