Acute and chronic respiratory diseases impose a significant economic and health burden. Distal small airway assessment requires invasive procedures such as a bronchoscopy and bronchoalveolar lavage. The Particles in Exhaled Air (PExA) device provides a non-invasive means of assessing small airways; it captures distal airway particles sized around 0.5-7m and contains particles of respiratory tract lining fluid (RTLF) that originate during airway closure and opening. The PExA device can measure particle count and mass according to particle size. Subsequent capture of particles in a thin membrane enables application of various analytical methods to assess a broad range of biomolecules including phospholipids, proteins, inflammatory profile, and other metabolites to characterise inflammation and diseases processes such as asthma, chronic obstructive pulmonary disease, acute respiratory distress syndrome, lung cancer, and more recently acute infections such as COVID-19. PExA analysis provides a promising alternative to traditional investigative methods in the assessment, diagnosis, and management of respiratory conditions. By evaluating specific biomarkers in the RTLF associated with airway inflammation, PExA may offer a more accurate and comprehensive understanding of the molecular-level changes in the small airways of patients with acute and chronic lung diseases.

The accurate identification of bacterial infections is critical for effective treatment in intensive care units (ICUs), yet current diagnostic methods face limitations in sensitivity and specificity, along-side cost and accessibility issues. Consequently, there's a pressing need for a marker that is economically feasible, rapid, and reliable. Presepsin (PSP), also known as soluble CD14 subtype (sCD14-ST), has emerged as a promising biomarker for early sepsis diagnosis. PSP, derived from soluble CD14, reflects the activation of monocytes/macrophages in response to bacterial infec-tions. It has shown potential as a marker of cellular immune response activation against patho-gens, with plasma concentrations increasing during bacterial infections and decreasing post-antibiotic treatment. Unlike traditional markers such as procalcitonin (PCT) and C-reactive protein (CRP), PSP specifically indicates monocyte/macrophage activation in bacterial infections. While limited studies in critical illness have explored PSP's role in sepsis, its diagnostic accuracy varies with threshold values, impacting sensitivity and specificity. Recent meta-analyses suggest PSP's diagnostic potential for sepsis, yet its standalone effectiveness in ICU infection management remains uncertain. This review provides a comprehensive overview of PSP's utility in ICU set-tings, including its diagnostic accuracy, prognostic value, therapeutic implications, challenges, and future directions.

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.

Iron is an essential nutrient for humans and microbes, such as bacteria. Iron deficiency occurs commonly in critically ill patients, but iron replacement therapy is not considered during the acute phase of critical illness, since it increases iron availability for invading microbes and oxidative stress. However, persistent iron deficiency in the recovery phase is harmful with potential adverse outcomes such as cognitive dysfunction, fatigue and cardiopulmonary dysfunction. Therefore, it is important to treat iron deficiency timely and efficiently. This article reviews current knowledge about iron-related biomarkers in critically ill patients and provides possible criteria to guide decision-making for iron supplementation in the recovery phase of critical illness.

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.

Poverty has long been associated intricately with neurological disorders. Majority of the previous studies designed to describe the effects of poverty on neurological ailments have mostly linked the association of hypoxic ischemic encephalopathy and nutritional deficiency disorders with poverty. Authors herein try to delve deeper into this issue. The association of begging with neuropsychiatric disorders is robust. The burden of probable autosomal dominant neurological ailments is very common among beggars; followed by neurological disorders with social stigma like abnormal movements, facial dysmorphism and gait unsteadiness. Dearth of support from family members in autosomal dominant neurological disorders (as family members are likely to be suffering from similar neurodegenerative disorder ) and poor perception about neurological diseases, misconceptions, myths and low educational attainment at large in the society can be implicated as the often overlooked but important factors underneath this association of begging and neurological disorders.

Mechanical ventilation (MV), used in patients with acute lung injury (ALI), induces diaphragmatic myofiber atrophy and contractile inactivity, termed ventilator-induced diaphragm dysfunction. Phosphoinositide 3-kinase- (PI3K-) is crucial in modulating fibrogenesis during the reparative phase of ALI; however, the mechanisms regulating the interactions among MV, myofiber fibrosis, and PI3K- remain unclear. We hypothesized MV with or without bleomycin treatment would increase diaphragm muscle fibrosis through the PI3K- pathway. Five days after receiving a single bolus of 0.075 units bleomycin intratracheally, C57BL/6 mice were exposed to 6 or 10 mL/kg MV for 8 h after receiving 5 mg/kg of AS605240 intraperitoneally. In wild-type mice, bleomycin exposure followed by MV 10 mL/kg prompted significant increases in disruptions of diaphragmatic myofibrillar organization, transforming growth factor-1, oxidative loads, Masson’s trichrome staining, extracellular collagen levels, positive staining of -smooth muscle actin, PI3K- expression, and myonuclear apoptosis (P < 0.05). Decreased diaphragm contractility and peroxisome proliferator activated receptor- coactivator-1 levels were also observed (P < 0.05). MV-augmented bleomycin-induced diaphragm fibrosis and myonuclear apoptosis were attenuated in PI3K-γ-deficient mice and through AS605240-induced inhibition of PI3K- activity (P < 0.05). MV-augmented diaphragm fibrosis after bleomycin-induced ALI is partially mediated through PI3K-γ. Therapy targeting PI3K-γ may ameliorate MV-associated diaphragm fibrosis.

Critical illness has been recognized to acutely influence bone metabolism and, consequently, bone mineral density. The main purpose of this study was to describe bone metabolism changes in adult survivors of critical illness in the attempt to correlate changes with severity scores. It is an open, prospective, observational, monocentric study on patients admitted to the ICU was conducted, evaluating bone metabolism at baseline (within 72 hours of ICU admission), 6 months, and 12 months. Fifty-nine patients admitted to the ICU (63% males), mean age 58 ± 16 years, were enrolled. Of these, 20 patients (34%) completed the one-year follow up. At baseline, bone resorption showed an increase, which was maintained at 6 months, with normalization at 12 months. Patients showed, in a majority of cases, hypovitaminosis D with hyperparathyroidism at baseline with subsequent normalization. A trend towards a correlation was described between severity scores and serum 25(OH) vitamin D and bone turnover marker levels. These results contribute to the confirmation of a positive association between critical illness requiring ICU and bone metabolism changes. This study poses the bases for further studies to evaluate bone health in ICU patients.

Merkel cell carcinoma (MCC) is a rare, highly aggressive skin cancer characterized by two etiologies: the first one, observed in most cases, is attributed to Merkel cell polyomavirus (MCPyV), a DNA tumor virus, while the second one is due to ultraviolet (UV) radiation exposure. Currently, there are limited diagnostic, prognostic, and therapeutic biomarkers available for MCC. MicroRNAs (miRNAs) are small RNA molecules that do not code for proteins but regulate various cellular processes, including cell cycle progression, proliferation, differentiation, and apoptosis. The dysregulation of miRNAs has been associated with a wide range of cancers since they can act as either tumor suppressors or oncogenes. This paper aims to collect, summarize and re-organize the recent discoveries concerning miRNAs, whose dysregulation in the pathogenesis and progression of MCC is slowly emerging. Furthermore, the potential clinical applications of miRNAs as diagnostic biomarkers, possible differentiation between MCPyV-related and unrelated MCC, predictors of response to therapy and prognostics are also discussed. From this review, it emerges that miRNAs may have, in the near future, the potential to become clinically significant in improving the diagnostic accuracy, prognostic evaluation, and therapeutic options of MCCs. Finally, the new perspectives on the poorly explored field of artificial intelligence in MCC are provided.

The urbanization effects on land surface phenology (LSP) have been investigated by many studies, but few studies focused on the temporal variations of urbanization effects on LSP. In this study, we used the MODIS EVI, MODIS LST data and China’s Land Use/Cover Datasets (CLUDs) to investigate the temporal variations of urban heat island intensity and urbanization effects on LSP in Northeast China during 2001–2015. Land surface temperature (LST) and phenology differences between urban and rural areas represented the urban heat island intensity and urbanization effects on LSP, respectively. Mann-kendall nonparametric test and Sen's slope were used to evaluating the trends of urbanization effects on LSP and urban heat island intensity. The results indicated that the average land surface phenology (LSP) during 2001–2015 was characterized by high spatial heterogeneity. The start of the growing season (SOS) in old urban area had become earlier and earlier than rural area and the differences of SOS between urbanized area and the rural area changed greatly during 2001–2015 (−0.79 days/year, p < 0.01). Meanwhile, the length of the growing season (LOS) in urban and adjacent areas had become increasingly longer than rural area especially in urbanized area (0.92 days/year, p < 0.01), but the differences of the end of the growing season (EOS) between urban and adjacent areas did not change significantly. Next, the UHII increased in spring and autumn during the whole study period. Moreover, the correlation analysis indicated that the increasing urban heat island intensity in spring contributed greatly to the increases of urbanization effects on SOS, but the increasing urban heat island intensity in autumn did not lead to the increases of urbanization effects on EOS in Northeast China.

Background: The aim of this experimental work was to confirm the individual uniqueness of lip prints, to verify the presence of recurrent patterns according to the Suzuki and Tsuchihashi classification and to search for characteristics that can be used in establishing the sex of a subject. Methods: Lip prints were taken from a sample of 172 volunteers using liquid lipstick and transparent adhesive tape and were digitally analyzed. Results: 59 prints (35.3%) were not considered for Suzuki and Tsuchihashi classification due to quality errors and the impossibility of visualizing lip wrinkles in one or more sextants, all the digitized prints revealed themselves to be unique after having been analyzed using superimposition. Qualitatively valid prints indicated a prevalence of Type II in both male and female and the presence of sex-linked features. A major problem was that the analysis of the same print by different operators often resulted in a different attribution of a Type. Conclusions: The potential of cheiloscopy lies mainly in the matching of prints, given their uniqueness, and can be a valid tool in gender determination but the absence of a database greatly limits its use. It is necessary to establish an acquisition protocol for taking and analyzing prints that could reduce the errors committed by the operator.

In critically ill patients with COVID-19, concomitant abnormalities of coagulation have been seen with an unusually high incidence. Standard coagulation tests are limited in their ability accurately to reflect the severity of the pro-thrombotic phenotype observed in severe COVID-19 infections. In this narrative review we consider the role of rotational thromboelastometry (ROTEM) as a near bedside test allowing a more comprehensive assessment of haemostatic function in the context of COVID-19 infection. Comprehensive literature search was conducted on PubMed, revealing 13 publications on the subject. The coagulopathy of this disease process appears to be insufficiently represented with often normal conventional coagulation test parameters. Whilst not the perfect substitute for in vivo coagulation, studies utilising rotational thromboelastometry assays in COVID-19 patients have demonstrated increased maximum clot firmness (consistent with hyper-coagulability) and reduced maximum lysis (consistent with “fibrinolytic shutdown”). ROTEM appears to be a possible tool for risk stratification and to monitor the potential modulation of fibrinogen-dependent coagulation processes with enhanced anti-coagulation strategies. Precisely how these coagulation abnormalities can be modified by optimum, individualised medical interventions to improve clinical outcome, however, remains unclear.

Abstract: Laryngoscopy for tracheal intubation has been developed for many decades. Among various conventional laryngoscopes, videolaryngoscopes (VL) have been applied in different patient populations, including difficult airways. The safety and effectiveness of VL have been repeatedly studied in both normal and difficult airways. The superiority of VL then has been observed and is advocated as the standard of care. In contrast to laryngoscopy, the development of video-assisted intubating stylet (VS, also named as styletubation) has been noticed two dec-ades ago. Since then, sporadic clinical experiences of use have appeared in literature. In this re-view article, we presented our vast use experiences of the styletubation (more than 55,000 pa-tients since 2016). We found this technique is swift (the time to intubate: from 3 s to 10 s), smooth (first-attempt success rate: 100%), safe (no airway complications), and easy (high subjective satis-faction and fast learning curve for the novice trainees) in both normal and difficult airway sce-narios. We therefore propose styletubation technique can be feasibly applied as universal rou-tine use for tracheal intubation.

Quantitative determination of the critical size of inclined coal pillar in old goaf water affected area is of great significance for water damage prevention and safe mining. The critical size of inclined waterproof coal pillar is derived by using theoretical analysis, numerical calculation and field engineering practice for the stability of the waterproof coal pillar in old goaf water affected area of 1303 working face of Dananhu I mine in Xinjiang region. Firstly, a force model of inclined waterproof coal pillar was established to reveal the law that the critical size of the coal pillar increases with the increase of coal seam inclination under the action of asymmetric load. Then, numerical simulation was applied to reveal the dynamic evolution process of plastic deformation-destabilization-destruction of section coal pillar under the influence of mining and single-side water pressure, and the critical size of waterproof coal pillar in study area was determined to be 19.09m. Finally, measures such as pumping and pressure relief and slurry reinforcement were adopted to reduce the deformation rate of the roadway on side of waterproof coal pillar, which ensured the stability of the coal pillar and roadway and the safe recovery of the working face.

This study aimed to determine shifts in microbial populations regarding richness and diversity from daily use of a popular over-the-counter nasal spray. In addition, the finding of nasal commensal bacterial species that overlap with the oral microbiome may prove to be potential probiotics for the “gateway microbiomes.” Nasal swab samples were obtained before and after using the most popular over-the-counter (OTC) nasal spray in 10 participants aged 18–48 years. All participants were healthy volunteers with no significant medical histories. The participants were randomly assigned a number by randomizing software and consisted of five men and five women. The sampling consisted of placing a nasal swab atraumatically into the nasal cavity, which is similar to the sampling performed for COVID-19 testing, with only very slight discomfort, if any. The samples were preserved and sent to Northwestern University Sequencing Center for whole-genome deep sequencing. After 21 days of OTC nasal spray use twice daily, the participants returned for further nasal microbiome sampling. The microbial analysis included all bacteria, archaea, viruses, molds, and yeasts via deep sequencing for species analysis. The Northwestern University Sequencing Center utilized artificial intelligence analysis to determine shifts in species and strains following nasal spray use that resulted in changes in diversity and richness.

Many people in the USA have lost their lives or become addicted to opioids via prescription opioids given for chronic pain. The chronic pain epidemic has emerged due to a convergence of factors, including the medicalization of pain as well as injuries happening in the workplace, in the home, or during recreation. Opioid prescriptions rose precipitously from the late 1990’s through to approximately 2020, and despite public awareness, still are increasing. This review examines literature on integrative approaches to chronic pain as delineated by pain type. The review is organized by the most common causes of chronic pain, and randomized controlled trials, meta-analyses and systematic reviews are extracted for each cause of chronic pain. Several promising interventions may alleviate chronic pain of some causes, and some interventions may work across pain causes. Lowering inflammation through dietary or lifestyle regimens may be a general way of reducing pain. Pain can be alleviated through several adjunctive and integrative treatment approaches, which may serve to lower the need for opioid medication.

Obsessive–compulsive disorder (OCD) is believed to follow a waxing and waning course, often according to environmental stressors. During the COVID-19 pandemic, pre-existing OCD symptoms were reported to increase and to change from checking to washing behaviors, while new-onset symptoms were predominantly of the hoarding type. In the present study, we followed the evolution of OCD symptoms, anxiety, depression, and insight of illness in forty-six OCD patients throughout the pandemic. Clinical measures were collected at four different time points before and during the COVID-19 pandemic in Italy. Within-subject comparisons were used to compare clinical scale scores across time, and correlations were examined between patients' baseline characteristics and changes in clinical scores. We found that all clinical measures increased during the first Italian lockdown, with respect to the pre-pandemic values. Anxiety decreased during the temporary elimination of restriction provisions, whereas severity of OCD symptoms and insight returned to pre-pandemic values during the second mandatory lockdown. These results were observed only in two sub-groups of patients: those taking benzodiazepines and those with shorter illness duration. Our findings suggest the need of additional clinical attention to these specific sub-groups of OCD patients in case of particularly distressing circumstances, while pointing to a possible adaptive role of their OCD symptoms when the environment requires a higher care of hygiene and extraordinary supply of essential resources.

In steel structures, oblique thin steel plates serve as panel zones in structures spanning large spaces (e.g., warehouses and gymnasiums). Considerable research has been conducted on the shear buckling of panels due to seismic loads acting on a structure. Conversely, under snow or wind loads, the panel zone may experience compressive and tensile stresses simultaneously from two directions. Considering the economic preference for thin steel plates, evaluating the elastic critical local buckling stresses in the panel zone under biaxial normal stress may provide essential information to structural engineers. In this study, an elastic buckling analysis based on the energy method is performed to clarify the impact of panel geometry and boundary conditions on the elastic local buckling stresses of oblique panel zones. As confirmed, the buckling stresses derived from the energy method could simulate the local buckling stresses with accuracy comparable to that of finite element analysis, and an engineer-friendly design formula was proposed. Finally, we determined the correlation of the buckling stresses under biaxial stresses and presented a method for evaluating this correlation. Engineers can utilize the provided design equations to more efficiently and accurately calculate buckling loads, facilitating safer and more economical design of structures with oblique plates.

Molnupiravir, a prodrug known for its broad antiviral activity, demonstrated efficacy in animal models of Covid-19, prompting clinical trials where initial results indicated a significant effect against the disease. However, subsequent clinical studies did not confirm these findings, leading to the rejection of molnupiravir for permanent market authorization in many countries. This report critically assessed 19 studies published in 17 reports that investigated the efficacy of molnupiravir in animal models of Covid-19 with the purpose of determining how well the design of these models informed human studies. We found that the administered doses of molnupiravir in most studies involving animal Covid-19 models were disproportionately higher than the dose rec-ommended for human use. Specifically, when adjusted for body surface area, half of the doses of molnupiravir used in the animal studies were more than twice as high as the human dose. Addi-tionally, the drug was frequently given prophylactically or shortly after SARS-CoV-2 inoculation in these models, in contrast to clinical trials where such timing is not consistently achieved. Furthermore, the recommended five-day treatment duration for humans was exceeded in several animal studies. Collectively, we suggest that these design elements in the reported animal studies contributed to a bias favoring molnupiravir, and thus inflated expectations for its efficacy against Covid-19. Addressing these elements may offer avenues to enhance the clinical efficacy of mol-nupiravir for treatment of Covid-19 that include dose increment, early treatment, and admin-istration by inhalation along with use of molnupiravir in antiviral combination therapy.

The aging populations observed across numerous countries worldwide necessitate a thorough exploration of interventions aimed at promoting healthy aging. As individuals age, they undergo significant physiological changes that impact their functional capacity and often necessitate increased reliance on external support systems. Enhancing the autonomy and well-being of elderly individuals emerges as a critical imperative, serving not only individual interests but also broader societal goals. This review investigates various interventions designed to optimize the health and independence of aging populations, offering insights into effective strategies for promoting healthy aging and mitigating the societal burdens associated with an aging demographic.

Densely urbanized areas, with a low percentage of green vegetation, are highly exposed to Heat Waves (HW) which nowadays are increasing in terms of frequency and intensity also in the middle-latitude regions, due to ongoing Climate Change (CC). Their negative effects may combine with those of the UHI (Urban Heat Island), a local phenomenon where air temperatures in the compact built up cores of towns increase more than those in the surrounding rural areas, with significant impact on the quality of urban environment, on citizens health and energy consumption and transport, as it has occurred in the summer of 2003 on France and Italian central-northern areas. In this context this work aims at designing and developing a methodology based on aero-spatial remote sensing (EO) at medium-high resolution and most recent GIS techniques, for the extensive characterization of the urban fabric response to these climatic impacts related to the temperature within the general framework of supporting local and national strategies and policies of adaptation to CC. Due to its extension and variety of built-up typologies, the municipality of Rome was selected as test area for the methodology development and validation. First of all, we started by operating through photointerpretation of cartography at detailed scale (CTR 1: 5000) on a reference area consisting of a transect of about 5x20 km, extending from the downtown to the suburbs and including all the built-up classes of interest. The reference built-up vulnerability classes found inside the transect were then exploited as training areas to classify the entire territory of Rome municipality. To this end, the satellite EO HR (High Resolution) multispectral data, provided by the Landsat sensors were used within a on purpose developed "supervised" classification procedure, based on data mining and “object-classification” techniques. The classification results were then exploited for implementing a calibration method, based on a typical UHI temperature distribution, derived from MODIS satellite sensor LST (Land Surface Temperature) data of the summer 2003, to obtain an analytical expression of the vulnerability model, previously introduced on a semi-empirical basis.

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.

Knowledge and attitude towards mental illness play major role in the recognition, management, sociocultural factors and health seeking behavior among those with mental disorders. The study aim was to determine the knowledge and attitude among Nyamagana community members towards mental illness, Tanzania; A descriptive cross-sectional quantitative study involving 384 participants from sample population aged 18 years and above who were mentally health and semi-structured questionnaires was used to collect data. The results 110 (28.8%) respondents have good knowledge toward mental illness, about 292(76%) have negative attitude towards mentally ill people, 92(24%) respondents have positive attitude toward people who are mentally ill. More over about 318 (82.9%) respondents agreed that care and support of family and friends, could help people with mental illness to get rehabilitation while 66(17.1%) respondents disagreed on the care and support of the family and friends could help mentally ill people to get rehabilitation; The findings show most have poor knowledge and negative attitudes towards people with mental illness and may impair their social reintegration in the community. There’s need to develop strategies to enlighten the public regarding nature of mental illness so as to foster acceptance of people with mental illness by the community members.

Coronavirus disease 2019 (COVID-19) has affected medical practice. More than 7,000,000 patients died worldwide after being infected with COVID-19; however, no specific laboratory markers have yet been established to predict death related to this disease. In contrast, electrocardiographic changes owing to COVID-19 include QT prolongation and ST-T changes; however, there have been no studies on ambulatory electrocardiographic markers of COVID-19. We encountered three patients diagnosed as having COVID-19 who did not have a prior history of significant structural heart diseases. All had abnormalities in ambulatory echocardiogram parameters detected by high-resolution 24-h electrocardiogram monitoring: positive late potentials (LPs) and T-wave alternans (TWA), abnormal heart rate variability (HRV), and heart rate turbulence (HRT). Case 1 involved a 78-year-old woman with a history of chronic kidney disease, Case 2 a 76-year-old man with hypertension and diabetes, and Case 3 a 67-year-old man with renal cancer, lung cancer, and diabetes. None of them had a prior history of significant structural heart disease. Although no significant consistent increases in clinical markers were observed, all three patients died, mainly because of respiratory failure with mild heart failure. LP, TWA, HRV, and HRT were all positive in three cases with no significant structural cardiac disease at the initial phase of admission. There is a possibility that LP, TWA, HRV, and HRT have the potential to be risk stratifiers of COVID-19 pneumonia in the early phase of admission. Further accumulation of data regarding ambulatory electrocardiographic markers in patients with COVID-19 is needed.

Antidepressants are among the most used medications in the US, with significant deleterious effects on people’s well-being. At any given time, depression impacts approximately 1 in 10 Americans, causing wide and broad societal costs. Interest is developing for non-pharmacological treatments and preventative measures. We summarize the literature on non-invasive dietary and lifestyle approaches for treating depression, including recent work with the psychedelic treatment of depression. This review aims to inform future research and treatment programs for depression. This review provides an evidentiary summary of integrative therapeutic approaches for depression.

A review of quantitative risk assessment (QRA) models of L. monocytogenes in produce was carried out, with the objective of appraising and contrasting the effectiveness of the control strategies placed along the food chains. Despite nine of the thirteen QRA models recovered focused on fresh or RTE leafy greens, none of them represented important factors or sources of contamination in the primary production, such as type of cultivation, water, fertilisers or irrigation method/practices. Cross-contamination at processing and during consumer’s handling was modelled using transfer rates, which were shown to moderately drive the final risk of listeriosis; highlighting therefore the importance of accurately representing the transfer coefficient parameters. Many QRA models coincided in the fact that temperature fluctuations at retail or temperature abuse at home were key factors contributing to increasing the risk of listeriosis. In addition to a primary module that could help assess current on-farm practices and potential control measures, future QRA models for minimally-processed produce should also contain a refined sanitisation module able to estimate the effectiveness of various sanitisers as a function of type, concentration and exposure time. Finally, L. monocytogenes growth in the products down the supply chain should be estimated by using realistic time-temperature trajectories, and validated microbial kinetic parameters, both of them currently available in the literature.

Fused deposition modeling (FDM) is a rather new technology in the production of personalized dosage forms. Melting and printing of polymer–active pharmaceutical ingredient (API) – mixtures can be used to produce oral dosage forms with different dosage as well as release behavior. This process is utilized to increase the bioavailability of pharmaceutically relevant active ingredients that are poorly soluble in physiological medium by transforming them into solid amorphous dispersions (ASD). Release from such ASDs is expected to be faster and higher compared to the raw materials and thus enhance bioavailability. Printing directly from powder while forming ASDs was realized. Different techniques to change release patterns as well as a non-destructive way for determination of API distribution were shown. By measuring the melt viscosities of mixtures printed a rheological model for the printer used is proposed.

Background & Objective: Acne Vulgaris is a common skin disease, with 5 % prevalence in Pakistan and has a significant physiological, psychological, emotional and social impact on the population, our study aims to estimate its annual economic burden per person in Pakistan.Methodology: Economic burden was estimated by using Cost of Illness analysis. All types of costs, including direct medication costs, direct non-medical costs and indirect costs due to loss of work. Data were collected from online databases and literature reviews. Results: Cost of illness analysis estimated that the cost of Acne Vulgaris treatment varies for mild, Moderate and severe acne. Acne is causing an annual economic burden of PKR 1,92,366 PKR per person (direct cost is PKR 1,86,366 and indirect cost 6,000) for an expensive treatment and PKR 53,550 (direct cost is PKR 47550 and indirect cost 6,000) for a cheap treatment. Limitation: Being an LMIC, Pakistan needs extensive study on the pharmacoeconomic analysis of Acne for proper and rational allocation of resources. Conclusion: Acne has a significant economic burden in Pakistan. Even with significant impact of Acne, there is very minute work done about Acne in Pakistan.

Dreams and positive symptoms of schizophrenia are similar in many aspects, such as bizarre-ness, impairment of reality testing, intense emotional participation. Hallucinations, delusions, and disorganized thoughts have been proposed to be an intrusion of the dreaming state in wake-fulness: conversely, psychotic patients’ abnormal cognitive and behavioral features could over-flow into sleep, transferring peculiar features to their dreams which would differ, in quantity and quality, from those of healthy people. Here we assess this latter hypothesis by analyzing the dreams of 46 patients, hosted in a residential facility or in a day-treatment center, affected by disorders of the schizophrenic spectrum with psychotic symptoms, versus those of 28 healthy controls, in terms of several quantitative and qualitative characteristics. In patients, we also in-vestigated whether dream variables correlated with the severity of symptoms assessed via the Brief Psychiatric Rating Scale. Overall, patients reported fewer and shorter dreams than controls, with a reduction of many ele-ments like characters and settings. The greatest differences regarded emotions, which were less frequent in patients and inversely correlated with symptoms’ severity. This evidence supports the hypothesis that dreams are crucial for emotion regulation during wakefulness and that this func-tion could be totally or partially ineffective in psychoses.

In the brain, astrocytes regulate shape and functions of the synaptic and vascular compartments through a variety of released factors and membrane-bound proteins. An imbalanced astrocyte activity can therefore have drastic negative impacts on brain development, leading to the onset of severe pathologies. Clinical and pre-clinical studies show alterations in astrocyte cell number, morphology, molecular makeup and astrocyte-dependent processes in different affected brain regions in neurodevelopmental (ND) and neuropsychiatric (NP) disorders. Astrocytes proliferate, differentiate and mature during the critical period of early postnatal brain development, a time window of elevated glia-dependent regulation of a proper balance between synapse formation/elimination, which is pivotal in refining synaptic connectivity. Therefore, any intrinsic and/or extrinsic factors altering these processes during the critical period may result in an aberrant synaptic remodelling and onset of mental disorders. The peculiar bridging position of astrocytes between synaptic and vascular compartments further allows them to “compute” the brain state and consequently secrete factors in the bloodstream, which may serve as diagnostic biomarkers of distinct healthy or disease conditions.Here, we collect recent advancements regarding astrogenesis and astrocyte-mediated regulation of neuronal network remodelling during early postnatal critical periods of brain development, focusing on synapse elimination. We then propose alternative hypotheses for an involvement of aberrancies in these processes in the onset of ND and NP disorders. In light of the well-known differential prevalence of certain brain disorders between males and females, we also discuss putative sex-dependent influences on these neurodevelopmental events.From a translational perspective, understanding age- and sex-dependent astrocyte-specific molecular and functional changes may help to identify biomarkers of distinct cellular (dys)functions in health and disease, favouring the development of diagnostic tools or the selection of tailored treatment options for male/female patients.

The intensive care units in North West London are part of one of the oldest critical carenetworks in the UK, forming a mature and established strategic alliance to shareresources, experience and knowledge for the benefit of its patients. North WestLondon saw an early surge in COVID-19 admissions, which urgently threatened thecapacity of some of its intensive care units even before the UK government announcedlockdown. The pre-existing relationships and culture within the network allowed itsmembers to unite and work rapidly to develop agile and innovative solutions, protectingany individual unit from becoming overwhelmed, and ultimately protecting its patients.Within a short 50-day period 223 patients were transferred within the network todistribute pressures. This unprecedented number of critical care transfers, combinedwith the creation of extra capacity and new pathways, allowed the region to continue tooffer timely and unrationed access to critical care for all patients who would benefitfrom admission. This extraordinary response is a testament to the power and benefitsof a regionally networked approach to critical care, and the lessons learned maybenefit other healthcare providers, managers and policy makers, especially in regionscurrently facing new outbreaks of COVID-19.

Respiratory tract infections (RTIs) are one of the main causes of hospitalization and mortality causing substantial economic burden to healthcare systems globally. As opposed to the previous belief that respiratory infections are caused by a single pathogen, studies have shown that most RTIs are a result of a combination of bacterial and/or viral pathogens infecting the host. The clinical manifestation of RTIs is very similar (i.e., syndrome), often showing Influenza-like illness (ILI) symptoms. While COVID-19 has dominated ILI over the past few years, there are many other pathogens that are responsible for ILI. In addition, it is not uncommon to have coinfections with multiple pathogens in patients presenting with ILI and that such coinfections can even exacerbate the disease severity of RTIs. Therefore, an insight into coinfections can help with accurate disease prognosis, patient care management and outcomes. The goal of this study was to identify the different organisms in symptomatic patients presenting with ILI.

This research investigates the relationship among human knowledge, behavior, and risk as they relate to urban chicken husbandry in the U.S. Concern over zoonotic diseases has been on the rise, especially with increasing contact. In particular, avian influenza, or bird flu, Salmonella enterica (salmonella), and Escherichia coli (E. coli), can all cross species lines between people and poultry. This study analyzed knowledge and practices in urban chicken husbandry to assess how they relate to risk of disease acquisition, hypothesizing that certain practices associated with a lessened knowledge base may heighten the risk. This study used social surveys to examine the self-reported knowledge base of individuals involved in chicken husbandry as they relate to beliefs and behaviors associated with the care of these animals. These results identify key factors that may heighten the risk of disease transmission, and demonstrate that an increased knowledge base could act to lessen this risk.

Molecular studies regarding regulatory elements such as small ncRNAs and their mechanisms are poorly understood in infectious diseases. Tuberculosis is one of the oldest infectious diseases of humanity, and it is still a challenge to prevent and treat it. The control of the infection as well as its diagnosis are still complex, and treatments used are linked to several side effects. This study aimed to investigate miRNA’s expression profile to identify possible biomarkers for tuberculosis. We applied NGS techniques to investigate miRNA’s global expression profile from blood samples of infected patients with tuberculosis, their respective healthy physicians, and external healthy individuals as controls. Samples from 22 individuals run through a differential expression, target genes, gene set enrichment, and miRNA-gene network analysis. We observed 153 altered miRNAs, among which, only three DEmiRNAs (hsa-let-7g-5p, hsa-miR-486-3p and hsa-miR-4732-5p) were found between the investigated patients and their respective physicians. These DEmiRNAs are suggested to play an important role in granuloma regulation and their immune physiopathology. Our results propose that miRNAs may be involved in immune modulation, regulating the repertoire of genes expressed in the immune system’s cells. Our findings encourage the application of miRNAs as potential biomarkers for tuberculosis.

Between 25 and 30% of the nearly one million military personnel who participated in the 1991 Persian Gulf War became ill with chronic symptoms ranging from gastrointestinal to nervous system dysfunction. This disorder is now referred to as Gulf War Illness (GWI) and the underlying pathophysiology has been linked to exposure-based neuroinflammation caused by organophosphorous (OP) compounds coupled with high circulating glucocorticoids. In a mouse model of GWI we developed, corticosterone was shown to act synergistically with an OP (diisopropylflurophosphate) to dramatically increase proinflammatory cytokine gene expression in the brain. Because not all Gulf War participants became sick, the question arises as to whether differential genetic constitution might underlie individual differences in susceptibility. To address this question of genetic liability, we tested the impact of OP and glucocorticoid exposure in a genetic reference population of 30 inbred mouse strains. We also studied both sexes. The results showed wide differences among strains and overall that females were less sensitive to the combined treatment than males. Furthermore, we identified one OP-glucocorticoid locus and nominated a candidate gene—Spon1—that may underlie the marked differences in response.

Keywords: Barriers; Facilitators; Sepsis; Sepsis Six Guidelines; Nurses.

In this study we discuss critical issues in modelling the structure and function of lymph nodes (LNs), with emphasis on how LN physiology is related to its multi-scale structural organization. In addition to macroscopic domains such as B-cell follicles and the T cell zone, there are vascular networks which play a key role in the delivery of information to the inner parts of the LN, i.e., the conduit and blood microvascular networks. We propose object-oriented computational algorithms to model the 3D geometry of the fibroblastic reticular cell (FRC) network and the microvasculature. Assuming that a conduit cylinder is densely packed with collagen fibers, the computational flow study predicted that the diffusion should be a dominating process in mass transport than convective flow. The geometry models are used to analyze the lymph flow properties through the conduit network in unperturbed- and damaged states of the LN. The analysis predicts that elimination of up to 60–90 % of edges is required to stop the lymph flux. This result suggests a high degree of functional robustness of the network.

A critical analysis of the classical definition of outsiders is given. Some examples show that this notion is not universal and has at least two drawbacks. Particularly, the set of outsiders may have the probability arbitrary close to one half. On the other hand, the deleting of the set of outsiders may dramatically change the value of the median.

DNA Topoisomerase IIa (Top2A) is a nuclear enzyme that is a cancer drug target, and there is interest in identifying novel sites on the enzyme to inhibit cancer cells more selectively and to reduce off-target toxicity. The C-terminal domain (CTD) is one potential target, but it is an intrinsically disordered domain, which prevents structural analysis. Therefore, we set out to analyze the sequence of Top2A from 105 species using bioinformatic analysis including the PSICalc algorithm, entropy analysis, and other approaches. Our results demonstrate that large (10th-order) interdependent clusters are found including non-proximal positions across the major domains of Top2A. Further, CTD-specific clusters of 3rd, 4th, and 5th-order were identified that included positions that had been previously analyzed via mutation and biochemical assays. Some of these clusters coincided with positions that when mutated either increased or decreased relaxation activity. Finally, sites of low entropy (i.e., high information content) were identified and mapped as key positions in the CTD. Included in the low entropy sites are phosphorylation sites and charged positions. Together, these results help to build a clearer picture of the critical positions in the CTD and provide potential sites/regions for further analysis.

Delivery of drugs through the nasal route provides an alternative, yet highly efficacious modality for administering both large and small pharmaceutic molecules. This method proves particularly advantageous for drugs that are unstable during oral administration, as they undergo significant degradation in the gastrointestinal tract or metabolization through the first-pass effect in the liver. Nasal administration stands as a viable alternative to parenteral therapy and is also suitable for long-term medical management. The nasal mucosa, characterized by high vascularity and permeability, facilitates rapid pharmaceutical absorption, ensuring a swift onset of therapeutic action. Despite its noninvasive nature, the nasal delivery technique finds broad applicability for both local treatment and systemic therapy, as the drug directly enters systemic circulation. This article explores the feasibility of a novel spray delivery mechanism for intranasal drug deposition. The study aims to determine whether users can correctly follow the state-of-the-art application instructions for a nasal spray with an optimal nozzle placement angle (namely, 12-15°) at the nostril while maintaining sufficient safety and efficacy, and without engaging in preventable usage errors that could harm the user. Additionally, the study evaluates the effectiveness of device labeling, instructions for use, and a short video in supporting the correct application of the nasal spray at the optimal angle (12-15°) and assesses whether users can differentiate the product from others with similar appearances. We have also performed physical spray tests to experimentally evaluate drug penetration to the nasopharynx (a key target site for viral infections) for two different nozzle placements – one for current package instructions coming with over-the-counter spray products and the other for the optimal spray usage procedure to enhance targeted drug delivery. Human Factors (HF) validation studies were also conducted, instructing users to follow the application instructions of the nasal spray bottle with the nozzle placed at the optimal angle to target the nasopharynx. The experimental tests consistently confirmed improved penetration with the 12-15° nozzle placement, with visual cues proving effective when used in tandem with written instructions for guiding the study participants to adhere to the recommended usage procedures.

We discuss methods for calculation of critical indices and amplitudes from the perturbative expansions. Several important examples of the Stokes flow through 2D and 3D channels are brought up. Power series for the permeability derived for small values of amplitude are employed to calculation of various critical exponents in the regime of large amplitudes. Special nonlinear approximations valid for arbitrary values of the wave amplitude are derived from the expansions. The technique developed for critical phenomena is applied then for relaxation phenomena. The concept of time-translation invariance is discussed, its spontaneous violation and restoration considered. Emerging probabilistic patterns correspond to a local breakdown of time-translation invariance. Their evolution leads to the timetranslation symmetry complete (or partial) restoration. We estimate typical time extent, amplitude and direction for such restorative process. The new technique is based on explicit introduction of origin in time. After some transformations we come to the exponential and generalized, exponential-type solution with explicit finite time scale, which was only implicit in initial parametrization with polynomial approximation. The concept of crash as a relaxation phenomenon, consisting of time-translation invariance breaking and restoration, is put forward. COVID-19 related mini-crash in the time series for Shanghai Composite is discussed as an illustration.

This work provides critical commentary on and corrections of a recently published taxonomy of Montiaceae. Valid citation and publication dates of novel taxa per the International Code of Nomenclature for Plants, Algae, and Fungi are summarized.

Objectives: The purpose of this systematic review was to ascertain critical care nurses’ understanding and experiences of patient advocacy in adult critical care settings. The specific objectives were to identify how critical care nurses define patient advocacy, to explore the understanding and experiences of critical care nurses regarding patient advocacy, to explore critical care nurses’ role in patient advocacy, and to ascertain the barriers to encouraging advocacy in the critical care setting. Research design: Systematic literature search of CINAHL and Medline databases, Google Scholar, and Cochrane Database of Systematic Reviews, as well as grey literature search, was conducted. Search dates were restricted from January 2005 to 2015 in both CINAHL and Medline. Findings: 62 studies were identified, of which 6 qualitative research papers were included. Nurses gave varied definitions of patient advocacy, which were categorized into three themes: communication, protection, and doing. Nurses perceive advocacy as truly listening to patients and their families. Conclusion: For critical care nurses to be effective advocates, there must be support, collaboration, and improved working relationship between professional groups. Moreover, nurses must be empowered to be able to give power to patients and family.

Oxidative stress (OS) is reported in several chronic diseases. Extra-cellular superoxide dismutase (ec-SOD) catalyzes the dismutation of superoxide anion with a protective role on endothelial cells. In chronic kidney diseases (CKD), OS and thyroid dysfunction (low T3 syndrome) are fre-quently present, but their relationship has not been investigated. This cohort study evaluated ec-SOD activity in CKD patients during haemodialysis, divided into: “acute hemodialytic pa-tients” (AH, 1-3 months of treatment) and “chronic hemodialytic patients” (CH, treated for a longer period). We also evaluated plasmatic total antioxidant capacity (TAC) and the relation-ships with thyroid hormones. Two basal samples (“basal 1”, 3 days after the last dialysis and “basal 2”, 2 days after the last dialysis) were collected. On the same day of basal 2, a sample was collected 5 and 10 min after the standard heparin dose and at the end of the procedure. The ec-SOD values were significantly higher in CH vs AH in all determinations. Moreover, they pre-sented lower TAC values. Dividing CH patients into two subgroups according to fT3 levels (nor-mal or low) we found significantly lower ec-SOD values in the group with low fT3 at basal, 5 and 10 min samples. Finally, a significant correlation was observed between fT3 and ec-SOD in the basal 1 samples. These data, confirming OS and low T3 syndrome in CKD, suggest that low fT3 concentrations can influence ec-SOD activity and therefore contribute to possible endothelial oxi-dative damage in such a situation.

New information suggests female autistic spectrum disorder (ASD) is much more common than previously thought, with a likely prevalence of 6% and with 80% undiagnosed at the age of 18. ASD then becomes a common comorbidity of female mental illness with nearly one in five women who develop a mental illness being autistic. ASD has heretofore been regarded as a pediatric condition and though now thought to be life long it is still not well recognized by adult health services. Most mental illness first presents in the teens and early twenties. Comorbid ASD is more difficult to diagnose due to diagnostic overshadowing, and ASD comorbidity maks the mental illness more severe and mor difficult to treat. Recognized ASD is readily treatable with an approach sympathetic to neurodiversity. Improving the pathway from adolescence to adulthood by increasing knowledge of autism in adult health services would dramatically improve female mental health at surprisingly little extra cost. It is low hanging fruit in a very fraught area of healthcare. This paper will examine the extent of the problem. It will explore solutions and quantify the gains of appropriate therapy.

Hereditary hemochromatosis (HH) is the main genetic cause of iron overload and is regarded as metal-related human toxicosis. HH may result from HFE and non-HFE gene mutations causing hepcidin deficiency or hepcidin resistance. The disorder has a high biochemical penetrance, but a low clinical prevalence. Unfortunately, the majority of patients with HH remain undiagnosed at their disease-curable stage. The main aim of HH therapy is to prevent iron overload in the early-phase disease and elimination of excess iron from the body by phlebotomy in its late stage. Raising global awareness of HH among health professionals, their training to pay attention to early HH signs and symptoms, and strict patient monitoring are critical management strategies for preventing treatment delays, upgrading its efficacy, and improving patient prognosis.

To clarify the relationships among critical temperature, critical magnetic field, and critical current density, this paper describes many-body interactions of quantum magnetic fluxes (i.e., vortices) and calculates pinning-related critical current density. All calculations are analytically derived, without numerical or fitting methods. Afteralculating a magnetic flux quantum mass, we theoretically obtain the critical temperature in a many-body interaction scenario (which can be handled by our established method). We also derive the critical magnetic field and inherent critical current density at each critical temperature. Finally, we determine the pinning-related critical current density with self-fields. The relationships between the critical magnetic field and critical temperature, inherent critical current density and critical temperature, and pinning critical current density and temperature were consistent with experimental observations. From the critical current density and critical magnetic field, we clarified the magnetic field transition. It appears that a magnetic flux quantum collapses when the lattice of magnetic flux quanta melts. Our results, combined with our previously published papers, provide a comprehensive understanding of the transition points in high-T_c cuprates.

We review extrapolation methods for calculation of critical points and indices from the perturbative expansions by means of Pad\'{e}-based techniques and their various post-Pad\'{e} extensions by means of root and factor approximants. Factor approximants are applied to finding critical points. Roots are employed within the context of finding critical index. Additive self-similar approximants are discussed and $DLog$ additive recursive approximants are introduced as their generalization. They are applied to the problem of interpolation.

The Munich ChronoType Questionnaire (MCTQ) has now been available for more than 15 years; its original publication has been cited 1,240 times (Google Scholar, May 2019); its online version, which was available until July 2017, has produced almost 300,000 entries from all over the world (MCTQ database). The MCTQ has gone through several versions, has been translated into 13 languages and has been validated against other more objective measures of daily timing in several independent studies. Besides being used as a method to correlate circadian features of human biology with other factors – ranging from health issues to geographical factors – the MCTQ gave rise to quantifying old wisdoms, like “teenagers are late” and has produced new concepts, like social jetlag. Some like the MCTQ’s simplicity and some view it critically; it is time to have a self-critical view on the MCTQ, to address some misunderstandings and give some definitions about MCTQ-derived chronotype and the concept of social jetlag.

Background As a major virus outbreak in the 21st century, the Coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented hazards to mental health globally. Health care workers, patients with COVID-19 are experiencing post-traumatic stress disorders, anxiety, depression, and insomnia. Methods: A cross-sectional study using a questionnaire consisted of four parts: sociodemographic, current and previous health status, measures in a social isolation, and the Arabic version of Depression, Anxiety and Stress Scale (DASS-21). Results: We had 110 patients who completed the data. 89 (80.9%) of patients recovered from COVID-19. They ranged from 18-84 with a mean of 37.6 years (SD = 9.8 years). We had 33.6% of patients re-ported moderate to extremely severe depression compared to 18.2% with mild reported symptoms. The anxiety severity showed that (35.4%) out of patients had moderate to extremely severe anxiety, compared to (6.4%) who had mild anxiety. While stress severity showed that (22.7%) had moderate to extremely severe stress compared to (13.6%) who had mild stress. Conclusion: COVID-19 has caused a significant increase in the prevalence of mental health illness in the general population. Large systematic reviews are required to set the general overall of impact of this pandemic on mental health.

The ongoing pandemic of the 2019 novel coronavirus disease (COVID-19) raises a global health crisis, which has resulted in 75,778 confirmed cases with 2130 deaths in China and beyond. Atypical symptom renders it challenging to earlier recognize the 2019-nCoV carrier with the potential ability of equivalent transmission. Therefore, it is needed to gain full spectrum of COVID-19. Here we report clustered COVID-19 cases of person-to-person transmission. The symptoms of typical pneumonia are shared by the two familial members, namely son (Patient 1) and father (Patient 2). Unexpectedly, an influenza-like illness (ILI) is also caused in Patient 3 having close contact with Patient 1 at personal dinner party. Combined with clinical and epidemiological study, chest computed tomography (CT) and molecular diagnosis demonstrate that all the three cases tested positive for COVID-19 with distinct symptoms by human-to-human transmission. To the best of knowledge, it closes in part (if not all), a missing gap of clinical repertoires of COVID-19 outbreaks and underlines the possibility that neglection of cryptic/asymptomatic/mild cold-like syndromes gives biased screen in the earlier stage of COVID-19 cases.

This article presents a critical review of the current and future state of “business architecture” within the enterprise architecture frameworks. The review is conducted in the following four stages. In the first stage of analysis, the research and publication questions are established. In the second stage, the search for information is designed and implemented using the Prisma methodology, and once the selection criteria were applied, 75 article-type documents were selected from Scopus, WoS, and Dimensions databases. In the third stage, the information analysis is conducted, and then it is synthesized. Finally, in fourth stage, the discussion is elaborated. This research contributes in understanding the current and future trends of business architecture in Industry 4.0. Considering the challenges of the changing market, the results show the need to implement architectures and dynamic business models, including their artifacts, in a globalized context immersed in new technologies.

California and most other coastlines around the world are being impacted by both long-term sea-level rise and short-term extreme events. Because of California’s long and intensively developed coastline, it is an important area for evaluating responses to these challenges. The predominant historic approach to coastal erosion in California and globally has been the construction of hard coastal armoring such as seawalls and rock revetments. The concept of living shorelines – defined as using natural elements like plants, sand or rocks to stabilize the coastline – has been widely proposed as a soft or green response to coastal erosion and flooding. These approaches have very limited application in high-energy environments, however, such as California’s 1,100-mile-long outer coast and are not realistic solutions for protection from wave attack at high tides or long-term sea-level rise. Each of the state’s coastal communities need to identify their most vulnerable areas, develop adaptation plans, and plan eventual relocation strategies in response to an accelerating sea-level rise.

In recent years, Neural networks are increasingly deployed in various fields to learn complex patterns and make accurate predictions. However, designing an effective neural network model is a challenging task that requires careful consideration of various factors, including architecture, optimization method, and regularization technique. This paper aims to comprehensively overview the state-of-the-art artificial neural network (ANN) generation and highlight key challenges and opportunities in machine learning applications. It provides a critical analysis of current neural network model design methodologies, focusing on the strengths and weaknesses of different approaches. Also, it explores the use of different learning approaches, including convolutional neural networks (CNN), deep neural networks (DNN), and recurrent neural networks (RNN) in image recognition, natural language processing, and time series analysis. Besides, it discusses the benefits of choosing the ideal values for the different components of ANN, such as the number of Input/output layers, hidden layers number, activation function type, epochs number, and model type selection, which help improve the model performance and generalization. Furthermore, it identifies some common pitfalls and limitations of existing design methodologies, such as overfitting, lack of interpretability, and computational complexity. Finally, it proposes some directions for future research, such as developing more efficient and interpretable neural network architectures, improving the scalability of training algorithms, and exploring the potential of new paradigms, such as Spiking Neural Networks, quantum neural networks, and neuromorphic computing.

Systematics plays the most crucial role in biodiversity conservation which is at stake due to anthropogenic activities and environmental degradations. The ever-increasing decline of classical taxonomic expertise drives the need to develop molecular marker-based tools for quick, efficient, and reliable detection of organisms, to assess their ecological impacts for deepening our understanding of systematic and evolutionary relationships between organisms which is central to biology. The pace of alpha taxonomy has quickened by its integration with an increasingly fashionable and novel concept called DNA barcoding which utilizes a short genetic marker or barcode to categorize species for enhanced biodiversity assessment. As a supplementary but not complete alternative of systematics research, DNA barcoding, however, not error-free, brings precision in identification by solving existing problems of classical taxonomy and phylogenetics, irrespective of the growth stage of organisms, particularly for known taxa rather than unknown ones. Mitochondrial gene Cytochrome C Oxidase 1 (COI) serves as a universal animal barcode but there is no such universal barcode for plants and developing a suitable one is more challenging. With the recent advancement of Next Generation Sequencing (NGS), DNA metabarcoding technology is advancing rapidly. Still, ambiguity and error prevail with the correct identification of species due to some problems. After extensive analysis of the existing DNA barcoding papers, this review discusses commonly used DNA barcodes in plants and animals, their roles, advantages, limitations to solve existing problems of conservation biology and add the author’s views and recommendations.

Pinus patula is one of the most planted wood conifer species worldwide; however, no foliar nutrient standards exist for this species up to date. The objective of the present study was to generate and verify two sets of foliar nutrient standards for nearly ten-year-old P. patula trees: critical nutrient concentrations and DRIS norms. Nutrients studied were N, P, K, Ca, Mg, Fe, Cu, Zn, Mn, and B. The reference standards were verified experimentally by installing two fertilization trials; one of them located in Huayacocotla, state of Veracruz and the other one in Aquixtla, state of Puebla, Mexico. Nutrient status of each fertilization trial was correctly predicted by critical nutrient values and DRIS as well. Both standards were able to detect the secondary growth-limiting nutrient deficiency in the Huayacocotla trial, where the primary limitation for growth was scarcity of solar radiation within tree crowns. The limiting nutrient in both experimental trials was K.

During the COVID-19 pandemic, the circulation of non–SARS-CoV-2 respiratory viruses changed throughout the world. This study aimed to analyze the effect of respiratory syncytial virus (RSV), metapneumovirus (MPV), rhinovirus (RV), and parainfluenza (PIV)-3 single infection, dual co-infection, and viral load on cytokine and chemokine expression in 300 Mexican patients with ARIs negative for SARS-CoV-2. Molecular detection and viral load were performed by RT-qPCR. Cytokine and chemokine expression was determined in samples positive for single RSV, MPV, RV, or PIV-3 infection, and in the most frequent dual co-infections, by a cytokine panel using a magnetic-bead-based multiplex immunoassay. Of the patients positive for viral infection, 91.7% had a single infection and 8.3% had dual co-infections. In this study, RSV was the respiratory virus with the highest prevalence, and the most common dual co-infection was RV+RSV. On the other hand, RV infections had the highest viral loads compared to the other viruses detected. FGF basic, MIP-1α IL-8, IP-10, MCP-1, IFN-γ, and RANTES showed differential expression between single infections and dual co-infections compared to healthy patients. We report, for the first time, the circulation of non-SARS-CoV-2 viruses in the south of Mexico and the cytokine and chemokine profiles associated with these viruses.

We reviewed the association between seasonal influenza vaccination and the risk of SARS-CoV-2 infection or complicated illness or poor outcome (e.g. severe disease, need for hospitalization or ventilatory support, or death) among COVID-19 patients. None of the studies that were reviewed (n=12) found a significant increase in the risk of infection or in the illness severity or lethality, while some reported significantly inverse associations. Our findings support measures aimed at raising influenza vaccination coverage in the coming months.

With increasing awareness amongst physicians and improved radiological imaging techniques, the peritoneal cavity is increasingly recognized as an important metastatic site in various malignancies. Prognosis of these patients is usually poor as traditional treatment including surgical resection or systemic treatment is relatively ineffective. Intraperitoneal delivery of chemotherapeutic agents is thought to be an attractive alternative as this results in high tumor tissue concentrations with limited systemic exposure. The addition of hyperthermia aims to potentiate the anti-tumor effects of chemotherapy, resulting in the concept of heated intraperitoneal chemotherapy (HIPEC) for the treatment of peritoneal metastases as it was developed about 3 decades ago. With increasing experience, HIPEC has become a safe and accepted treatment offered in many centers around the world. However, standardization of the technique has been poor and results from clinical trials have been equivocal. As a result, the true value of HIPEC in the treatment of peritoneal metastases remains a matter of debate. The current review aims to provide a critical overview of the theoretical concept and preclinical and clinical study results, to outline areas of persisting uncertainty, and to propose a framework to better define the role of HIPEC in the treatment of peritoneal malignancies.

A significant percentage of children suffer from neurodevelopmental aberrations, which have long-term effects on both individuals and society. Since the developmental timelines of different brain regions vary, the type, severity and timing of harmful exposures are crucial for understanding the specific pathological processes and consequences involved. During development, the cerebellum is one of the first brain structures to begin to differentiate, but one of the last to achieve maturity. This relatively long period underscores its vulnerability to detrimental environmental exposures throughout gestation. Moreover, as the postnatal functionality of the cerebellum is multifaceted, enveloping sensorimotor, cognitive, and emotional domains, prenatal disruptions in cerebellar development can result in a variety of neurological and mental health disorders. Here, we review major intrauterine insults that affect cerebellar development in both humans and rodents, ranging from abuse of toxic chemical agents such as alcohol and nicotine, to stress and sleep, malnutrition as well as infections. Understanding these pathological mechanisms in the context of the different stages of cerebellar development in humans and rodents may help us to identify critical and vulnerable periods and thereby to prevent the risk of associated prenatal and early postnatal damage that can lead to lifelong neurological and cognitive disabilities.

(1) Background; limited research exists which considers master plots expressed by individuals with Stroke. The literature so far has focused on identified pre-established illness narrative types; (2). Methods: A narrative method was selected and a purposive sample of individuals with Stroke are identified. A categorical-form analysis was undertaken; (3) Results: A narrative master plot named overcoming the monster is identified and explored for its components and located temporally for each participant; (4) Conclusions: Health care professionals need to understand the importance of understanding the master plot overcoming the monster. This research supports the need for health care professionals to recognise and support narratives by listening in a non-directive way.

We discuss the neutron skins of 48Ca and 208Pb. We review and critically examine modern predictions and empirical constraints, with special attention to the dierent interpretations of the ndings from the PREX-II experiment and the recently reported value of the neutron skin in 48Ca extracted from the CREX experiment. We argue that, in the spirit of the ab initio philosophy, the path to understanding the behavior of dense neutron-rich matter must not circumvent fundamental nuclear forces. Based only on that argument, a thick neutron skin in 208Pb is highly unlikely.

Preserving and restoring biodiversity is becoming a great challenge as we face a world where planetary boundaries will likely be crossed over the following decades. Such challenge needs to consider multiple scales of complexity, both in space and time. A common thread in most cases is the presence of nonlinear phenomena generating shifts among alternative states. These breaking points imply a new perception of risk and different management strategies. A broad range of phenomena affect the preservation of healthy communities and constrain the ways to deal with conservation, from local features associated with habitat loss or facilitation to mesoscale or global network-level ecological complexity and the role played by extreme events. How are these scales connected? How can the emergent properties associated with ecosystem dynamics be exploited? Here a synthesis of ideas is presented, with a complex systems view of the different scales involved, the emergent phenomena separating them, and the universal properties that allow defining simple models on each scale.

HIV/AIDS and COVID-19 discourses are often compared; however, theorizing them together in terms of political efficacy and possibility is more novel. The collective of academics, activists, artists, and others–What Would an HIV Doula Do? (WWHIVDD) which for years has responded to the HIV/AIDS pandemic, has turned their attention to experiences of living with COVID-19. Through a qualitative analysis of two texts–a zine and a guide for authors writing about these pandemics–that specifically address experiences of/with COVID-19 by WWHIVDD, we examine how HIV/AIDS and COVID-19 discourses can productively be considered as chronic illness/COVID discourses that have the potential for more fruitful collective/political action and scholarly theorization of people living with pandemics.

People with severe mental illness (SMI) are often in poor physical health, resulting in higher mortality and reduced life expectancy compared to the general population. Although eating habits are one of the main predictors of physical health, few studies assess the nutritional status and eating behaviour of people with SMI. The aim of this study was to examine the nutritional status and risk of malnutrition in people with SMI and in need of intensive psychiatric treatment. The cross-sectional study included 65 inpatients and 67 outpatients with psychotic or depressive disorders from the Psychiatric Hospital of the University of Zurich. Patients’ assessments at admission included anthropometric measurements, such as weight and height, and interview data including severity of symptoms and functioning (SCL-K-9, PHQ-D, CGI, m-GAF), personal and medical data, nutrition risk screening tools (adapted NRS, MNA-SF) and laboratory values. The results showed that 32% of the inpatients (body mass index [BMI] = 25.3) and 34% of the outpatients (BMI = 27.9) were at risk of malnutrition, which was associated with higher levels of psychiatric symptoms and lower levels of functioning. These results indicate that a substantial proportion of psychiatric patients seem to be at risk of malnutrition, despite most being overweight, and hence they might benefit from nutritional support during their psychiatric treatment. Moreover, nutritional risk screening tools specifically developed for the mental healthcare setting are needed.

There is now evidence that, based on cytokine profiles, bipolar disorder (BD) is accompanied by simultaneous activation of the immune-inflammatory response system (IRS) and the compensatory immune-regulatory system (CIRS), and that both components may be associated with the staging of illness. Nevertheless, no BD studies have evaluated the IRS/CIRS ratio using CD (cluster of differentiation) molecules expressed by peripheral blood activated T effector (Teff) and T regulatory (Treg) subpopulations. This study examined T cell subsets both before and after ex vivo anti CD3/CD28 stimulation using flow cytometric immunophenotyping in 25 euthymic BD patients and 21 healthy controls as well as human cytomegalovirus (HCMV)-specific IgG antibodies. BD is associated with a significantly lowered frequency of baseline (unstimulated) CD3+CD8+CD71+ and CD4+CD25+FOXP3 and increased CD4+CD25+FOXP3+CD152+ frequencies and with lowered stimulated frequencies of CD3+CD8+CD71+, CD4+CD25+FOXP3+CD152+ and CD4+CD25+FOXP3+GARP cells and, consequently, by an increased stimulated Teff/Treg ratio. Moreover, the number of manic, but not hypomanic or depressive episodes, is significantly and negatively associated with the stimulated proportions of CD3+CD4+CD154+, and CD69+ and CD71+ expression on CD4+ and CD8+ cells, while duration of illness (≥ 10 years) is accompanied by a depleted frequency of stimulated CD152+ Treg, and CD154+ and CD71+ CD4+ T cells. BD and anti-human cytomegalovirus (HCMV) IgG levels significantly interact to decrease the expression of CD4+CD25+FOXP+GARP T phenotypes. In conclusion, BD is characterized by deficits in immune-regulatory functions while the staging of illness is characterized by additional impairments is Teff and Treg activation. HCMV seropositivity may contribute to an immune-risk phenotype associated with BD.

The umbrella concept for the current efforts to digitize construction is known as Construction 4.0. One of its key concepts is cyber-physical systems. The construction industry is not only creating increasingly valuable digital assets (in addition to physical ones) but also the buildings and built infrastructures are increasingly monitored and controlled using digital technology. Both make construction a vulnerable target of cyber-attacks. While the damage to digital assets, such as designs and cost calculations, may result in economic damage, attacks on digitally-controlled physical assets may damage the well-being of occupants and, in worst-case scenarios, even damage (or death) to the users. The problem is amplified by the emerging cyber-physical nature of the systems, where the human checks may be left out. We propose that construction learns from the work done in the context of critical infrastructures (CI). First, a lot of CI is construction-related, and the process of designing and building it must be secured accordingly. Second, while most assets may not be critical in the CI sense, they are critical to the operations of a business and the lives of citizens. In the end, we recommend some steps so that well-established processes of critical infrastructure protection trickle down to make Construction 4.0 and the built environment more cyber-secure. With that in mind, we describe the possible inclusion of Construction 4.0 considerations into existing critical infrastructure protection (CIP) frameworks with minimum frictions. We also propose some suggestions regarding possible future courses of action to improve the increasingly vulnerable cyber-security environment of the built environment across all life cycle phases - design, construction, operation, maintenance, and end of life.

This study evaluated the impact of didactic videos and service user testimonial videos on mental illness stigma among medical students. Two randomized controlled trials were conducted in Nepal. Study 1 examined stigma reduction for depression. Study 2 examined depression and psychosis. Participants were Nepali medical students (Study 1:n=94, Study 2:¬n=213) randomized to three conditions: a didactic video based on the mental health Gap Action Programme (mhGAP), a service user video about living with mental illness, or a control condition with no videos. In Study 1, videos only addressed depression. In Study 2, videos addressed depression and psychosis. In Study 1, both didactic and service user videos reduced stigma compared to the control (F2,91=6.37, p=0.003). In Study 2 (depression and psychosis), there were no differences among the three arms (F2,210=2.07, p=0.13). When comparing Study 1 and 2, there was greater stigma reduction in the service user video arm with only depression versus service user videos with depression and psychosis (t(31)=-3.04, p=0.005). In summary, didactic and service user videos were associated with decreased stigma when content addressed only depression. However, no stigma reduction was seen when including depression and psychosis. This calls for different strategies based on types of mental illnesses. ClinicalTrials.gov identifier: NCT03231761

Over the last decade, the prevalence of health issues has increased by approximately 29.1%, putting a substantial strain on healthcare services. This has accelerated the integration of machine learning in healthcare, particularly following the COVID-19 pandemic. The utilization of machine learning in healthcare has grown significantly, however many present approaches are unsuitable for real-world implementation due to high memory footprints and lack of interpretability. We introduce DeClEx, a pipeline designed to address these issues. DeClEx ensures that data mirrors real-world settings by incorporating gaussian noise and blur and employing autoencoders to learn intermediate feature representations. Subsequently, our convolutional neural network, paired with spatial attention, provides comparable accuracy to state of the art pre-trained models while achieving threefold improvement in training speed. Furthermore, we provide interpretable results using explainable AI techniques. We integrate denoising and deblurring, classification and explainability in a single pipeline called DeClEx.

The present study reports a critical review of NIO's business model, considering the evolving landscape of the electric vehicle market and servicing. The objective of this study is to develop a comprehensive framework that facilitates the identification of key elements characterizing a company's business model and highlights ongoing transformations, crucial for adaptation and survival in a rapidly changing environmental context. Focusing on the case study of NIO, a relatively young Chinese original equipment manufacturer (OEM) specializing in high-tech electric cars, the research delves into the challenging scenario of the Chinese electric vehicle market, which has recently faced a bubble in 2023. The market proliferation, supply chain disruptions, and price wars triggered by Tesla have resulted in a survival struggle for numerous automotive startups, leaving larger companies with increasing market shares. Despite facing adversities, NIO managed to secure a promising segment, catering to premium-range battery electric vehicles (BEVs), establishing a competitive advantage through differentiation. By pursuing ambitious investments, the company aims to create economies of scope and achieve cost leadership, venturing into new market sectors and vertically integrating the production chain. Given NIO's agility in adapting to market conditions, aggressive entry into new segments, and a strategic vision for the future, it serves as an excellent candidate for testing and validating the proposed framework. The research sheds light on NIO's trajectory and offers insights into its potential for sustained growth in the dynamic electric vehicle market.

This research paper aims to critically review the state of spiritual journalism in India. Spiritual journalism is a niche form of journalism that focuses on exploring and reporting on spiritual and religious topics, practices, and perspectives. In India, a country with a rich spiritual heritage and diverse religious traditions, spiritual journalism plays a significant role in shaping public discourse and understanding of spirituality. This paper examines the strengths and weaknesses of spiritual journalism in India, exploring its impact on society, its challenges, and the ethical considerations associated with its practice. By providing a critical analysis of the current state of spiritual journalism in India, this paper aims to shed light on its role, relevance, and potential for improvement.

The complex systems that require safety are the Safety Critical Systems. Maintaining these systems is a big challenge. Now a days, safety is a very critical requirement for the latest systems. Safety critical systems must be safe. Different approaches to ensure quality and safety in safety critical systems has been discussed in this paper. A comparison is also conducted between these various approaches. Safety critical systems must remain more influential in future.

Dogs are considered property under UK law, while current discourses of pet ownership place canine companions as part of an extended family. This means sentences for those who steal dogs are not reflective of a dogs’ sentience and agency, rather reflecting the same charges for those who steal a laptop or wallet. This is particularly problematic as dog theft is currently on the rise in England and Wales and led to public calls to change the law. Recognizing that a more robust analysis of dog theft crime statistics is required, we gathered dog theft data for 2015, 2016 and 2017 from 37 of 44 police forces through FOI requests. This paper uses this data to examine how dog theft crime statistics are constructed; assesses the strengths and weaknesses of this data; and categorizes, maps and measures dog theft changes temporally per police force in England and Wales. Our findings reveal there has been an increase in dog theft crimes, 1,294 in 2015, 1,525 in 2016 (+17.85%), and 1,678 in 2017 (+10.03%); and a decrease in court charges related to dog theft crimes, 62 (4.7%) in 2015, 48 (3.14%) in 2016, 37 (2.2%) in 2017. There were police force inconsistencies in recording dog theft crime which meant some data was unusable or could not be accessed or analysed. There is a need for a qualitative study to understand dog theft crime in different areas, and standardised approach to recording the theft of a dog by all forces across England and Wales.

Due to the upward trend in the globalization of sustainability issues and the intense competitive environment, it is evident that higher education institutions need new strategic approaches to succeed. To this end, the inquiry for this paper has been made into the debate about student relationship management. Going through the literature indicates that institutions have mainly perceived the concept as a technological initiative for solving the problems in individual domains, accompanied by uncoordinated efforts. Thus, the aims of this study are to theoretically present critical success factors of this strategic approach and to empirically examine the recognized factors. To do so, confirmatory factor analysis that is a quantitative analytic method was performed. The results and analyses revealed that there has been a significant correlation between the four critical success factors including knowledge management, student relationship management technology, student orientation, and employees’ involvement. It was also found that these factors are significantly correlated with the construct of student relationship management success. The findings have consequently highlighted that in addition to the technological tool, the role of knowledge management, employees’ involvement, and student orientation appeared to be particularly important for the implementation of the application.

Abstract: Supplementation of infant formula with ingredients potentially able to manage, in a way positive for the host, the gut microbiota of infants, is nowadays widely used by infant food producers. The impact of this class of compounds, named prebiotics, on gut microbiota composition, was initially measured on the enrichment of Bifidobacterium and Lactobacillus spp., but the use of culture-independent analytical techniques has allowed to establish that a larger number of intestinal microorganisms are affected by the ingestion of prebiotics. However, despite a relevant number of scientific publications, actually there is no consensus on the amount of prebiotics to be administered daily, the potentially different actions exerted by prebiotics which differ in biochemical structures, as well as the impact of different percentages of the same prebiotics when used in mixtures and/or combination. This paper is aimed to critically review the available data on the use of prebiotics in infant formula, with special attention paid to identify a link between, the dosage used, the mixture composition and the observed outcomes, keeping in mind the influences in nutrition quality and growth influence.

Nuclear bodies (NBs) are dynamic structures present in eukaryotic cell nuclei. They are not bounded by membranes and are often considered biomolecular condensates, defined structurally and functionally by the localisation of core components. Nuclear architecture can be reorganised during normal cellular processes such as the cell cycle as well as in response to cellular stress. Many plant and animal viruses target their proteins to NBs, in some cases triggering their structural disruption and redistribution. Although not all such interactions have been well characterised, subversion of NBs and their functions may form a key part of the life cycle of eukaryotic viruses that require the nucleus for their replication. This review will focus on Cajal bodies (CBs) and the viruses that target them. Since CBs are dynamic structures, other NBs (principally nucleoli and promyelocytic leukaemia, PML, bodies), whose components interact with CBs, will also be considered. As well as providing important insights into key virus: host cell interactions, studies on Cajal and associated NBs may identify novel cellular targets for development of anti-viral compounds.

The relationship between religion and politics is a constant in the history of humanity. In the specific case of Western culture, it is possible to trace an archeology of the political as an effect of theological-political devices (essentially Christian-inspired). If we add to this the evolution of politics, in modern times, towards biopolitics, then the relationship focuses on very concrete topics. This is the case of the immunological process – from a personal, social, and philosophical perspective – thoroughly analyzed by Italian philosopher Roberto Esposito. In the context of his philosophical immunology, the place of religion is mainly archaeological and is interpreted critically. This article also aims to critically analyze his position, proposing a reading close to his thought but which is, at the same time, somewhat different.

Low-cost RGB-D cameras are increasingly used in several research fields including human-machine interaction, safety, robotics, biomedical engineering and even Reverse Engineering applications. Among the plethora of commercial devices, the Intel RealSense cameras proved to be among the best suitable devices, providing a good compromise between cost, ease of use, compactness and precision. Released on the market in January 2018, the new Intel model RealSense D415 has a wide acquisition range (i.e. ~160-10000 mm) and a narrow field of view to capture objects in rapid motion. Given the unexplored potential of this new device, especially when used as a 3D scanner, the present work aims to characterize and to provide metrological considerations on the RealSense D415. In particular, tests are carried out to assess the device performances in the near range (i.e. 100-1000 mm). Characterization is performed by integrating the guidelines of the existing standard (i.e. the German VDI/VDE 2634 part 2 normative) with a number of literature-based strategies. Performance analysis is finally compared against latest close-range sensors, thus providing a useful guidance for researchers and practitioners aiming to use RGB-D cameras in Reverse Engineering applications.

Human genetic studies have long been vastly Eurocentric, raising a key question about the generalizability of these study findings to other populations. Because humans originated in Africa, these populations retain more genetic diversity, and yet individuals of African descent have been tremendously underrepresented in genetic studies. The diversity in Africa affords ample opportunities to improve fine-mapping resolution for associated loci, discover novel genetic associations with phenotypes, build more generalizable genetic risk prediction models, and better understand the genetic architecture of complex traits and diseases subject to varying environmental pressures. Thus, it is both ethically and scientifically imperative that geneticists globally surmount challenges that have limited progress in African genetic studies to date while meaningfully including African investigators, as greater inclusivity and enhanced research capacity affords enormous opportunities to accelerate genomic discoveries that translate more effectively to all populations. We review the advantages and challenges of studying the genetic architecture of complex traits and diseases in Africa. For example, with greater genetic diversity comes greater ancestral heterogeneity; this higher level of understudied diversity can yield novel genetic findings, but some methods that assume homogeneous population structure and work well in European populations may work less well in the presence of greater diversity and heterogeneity in African populations. Consequently, we advocate for methodological development that will accelerate studies important for all populations, especially those currently underrepresented in genetics.

Critical realism emerged from the philosophical writings of Roy Bhaskar, and has evolved into a philosophy of social science research using the model of “dialectical critical realism” (DCR) which begins with the researcher’s assumptions that the structures being researched have a real, ontological grounding which is independent of the researcher. This approach has proved fruitful in British and European social science research, but has had less influence in North America. We outline DCR’s four level model for understanding society and its changing social structures through “the pulse of freedom”. DCR has been used by Marxists, Muslims, Catholics and secular scholars who engage fruitfully in morphogenic dialogues leading to a critical realist understanding of society and social research, which transcends positivist and social constructionist models. Examples of DCR’s application in the fields of childhood research, child abuse, education, and research on organisations are outlined to illustrate the working of this new research paradigm. We are enthusiastic in our advocacy of DCR as a model of qualitative research, and for constructing models of positive social change, and are particularly impressed by the substantive and theoretical expositions of DCR by Priscilla Anderson, Matthew Wilkinson and Margaret Archer, whose work we document and review.

Type 2 diabetes mellitus (T2DM) is an endocrine illness associate with various changes in the immune system and adaptor protein levels. Cytokine dependent hematopoietic cell linker (CLNK) is an adapter protein that regulates immune receptor signaling and acts as a regulator of the receptor signaling of T-cells and natural killer T-cell. The role of CLNK in T2DM is not studied previously. In the present study, serum CLNK level was measured and correlated with some sociodemographic and insulin resistance (IR) parameters. This is achieved by performing measurement of CLNK and insulin parameters (glucose, insulin, and HbA1c in addition to the calculation of the functions of IR (HOMA2IR), insulin sensitivity (HOMA%S), and beta-cell function (HOMA%B)) in 60 T2DM patients and 30 controls. The results indicated a significant increase (p=0.025) in serum CLNK in patients group in comparison with the controls. Multivariate generalized linear model (GLM) analysis revealed no significant effect of age, BMI, and sex on the CLNK level. The results of tests for between-subjects showed that the CLNK affects diagnosis significantly (F=7.445, p=0.008, partial η² =0.081) and its effect is approximately the same as the effect of insulin (F=8.107, p=0.006, partial η² =0.087). The correlation study showed a highly significant positive correlation between CLNK and the duration of disease (rho=0.420, p<0.001). It can be concluded that the increase CLNK in T2DM revealing the role of the adaptor proteins level in the nature of disease. Elevation of CLNK level may be used as a predictor for diabetes complications, which needs more investigations.

Respiratory viral infections (RVI) are common reasons for healthcare consultations. The inpatient management of RVI consumes significant resources. From 2009-2014, we assessed the costs of RVI management in 4776 hospitalized chil-dren aged 0-18 years participating in a quality improvement program, where all ILI patients underwent virologic testing at the National Reference Centre followed by de-tailed recording of their clinical course. The direct (medical or non-medical) and indirect costs of inpatient management outside the ICU (“non-ICU”) versus management requiring ICU-care (“ICU”) added up to 2,767.14€ (non-ICU) vs. 29,941.71€ (ICU) for Influenza, 2,713.14€ (non-ICU) vs. 16,951.06€ (ICU) for RSV infections, and 2,767.33€ (non-ICU) vs. 14,394.02€ (ICU) for human rhinovirus (hRV) infections, respectively. Non-ICU inpatient costs were similar for all 8 RVI studied: Influenza, RSV, hRV, ade-novirus (hAdV), metapneumovirus (hMPV), parainfluenzavirus (hPIV), bocavirus (hBoV) and seasonal coronavirus (hCoV) infections. ICU-costs for Influenza however, ex-ceeded all other RVI. At the time of the study, Influenza was the only RVI with antivi-ral treatment options available for children, but only 9.8% of Influenza patients (non-ICU) and 1.5% of ICU-patients with Influenza received antivirals; only 2.9% were vac-cinated. Future studies should investigate the economic impact of treatment and pre-vention of Influenza-, COVID-19-, and RSV post vaccine introduction.

Background: Social skills deficits are present in 43.3% of major depressed patients and significantly impact health-related quality of life. However, studies concerning social deficits as state-dependent markers of depression are limited. Objective: To delineate the effects of severity of depression, personality characteristics, family support satisfaction and self-esteem on social skills in clinical depression. Methods: We recruited 150 patients with major depressive disorder or persistent depressive disorder and assessed 1) Beck Depression Inventory-II (BDI-II), 2) Social Skill Inventory (SSI), 3) Family Adaptation, Partnership, Growth, Affection, Resolve (APGAR) Questionnaire 4) Rosenberg Self-Esteem Scale (RSES) and 5) Maudsley Personal Inventory (MPI). Results: Social skills deficits were significantly associated with female gender, age < 40 years, depression severity, introvert / neurotic personality, and lowered family support satisfaction and self-esteem. A large part of the variance (47.2%) in social skills deficits was predicted by satisfaction of family support, introvert personality, and low self-esteem. Exploratory Factor Analysis showed that a bifactorial model best fitted the data with a) a general factor loading highly on BDI-II, SSI emotional and social, APGAR, RSES, MPI_introvert and MPI_neurotic scores, and b) a single-group factor loading on both SSI, RSES, and MPI introvert scores. Conclusion: In clinical depression, social skills deficits covary with increasing severity of depression and thus constitute a state marker of depression, and independently from severity of depression covary with introvert personality features. As such, remission of social skills deficits may emerge as a novel objective for the treatment of depression and prevention of new episodes.

Throughout its history Western science has tended to treat complexity as a problem to be avoided or solved. A philosophy of simplification achieved significant improvements in human life and prevails as a model for achieving societal good. However, misplaced efforts to control complexity worsen our sustainability challenges. Effective responses to modern day dilemmas such as floods and climate change require ways of thinking that are more congruent with the complexity of the world. Further, governmental programs to reduce flood risk depend on the support of an informed and engaged public. It has proven difficult to communicate risk in ways that align scientific and technical expertise based on an objective worldview, with communal and individual under-standings of risk based on subjective experiences and perspectives. I introduce Paul Cilliers’ philosophy of critical complexity as the basis of a new conceptual framework that values and balances complexity and simplicity. This paper shows how objective strategies that rely on analytic and probabilistic thinking can be integrated with subjective approaches that draw on the experiential and possibilistic. An example depicts how the problematic framing of the “100-year flood” can be replaced by a model of the data that covers a range of possibilities within an experiential time frame. Cilliers’ work opens an ethical dimension in which we make more intentional choices and acknowledge our limitations. Complexability – understanding how to live with complexity rather than aiming to simplify it – is a vital component of sustainability communication and education.

Polymyalgia rheumatica (PMR) is an inflammatory disease common in people aged 50 years and older. This condition is characterized by the presence of pain and stiffness involving mainly the shoulder and pelvic girdle. Besides the frequent association with giant cell arteritis (GCA), several conditions may mimic PMR or present with PMR features. Since the diagnosis is basically clinical, an adequate diagnosis of this condition is usually required. Positron emission tomography-computed tomography (PET-CT) has proved to be a useful tool for the diagnosis of PMR. The use of 18F-FDG-PET imaging appears promising as it provides detailed information on inflammatory activity that may not be evident with traditional methods. However, since PET-CT is not strictly necessary for the diagnosis of PMR, clinicians should consider several situations in which this imaging technique can be used in patients with suspected PMR.

Innovation and technology are important tools of minerals sector efficiency and productivity im-provement. The uptake of technologies has proven important levelrs to improve the productivity of mining sector. This paper provides a comprehensive analysis of mine-level productivity by using a global data of copper, gold, and platinum from 1991-2020. Various drivers of proioductivity have been analysed to draw policy insights. Empirical findings reveal significant disparities in technical efficiency and productivity across mines and regions. A further decomposition of TFP into its different components suggest that the adoption of innovative practices and investment in technology adoption could improve the overall productivity of these commodities. The findings also suggest that an appropriate input mix and optimal scale of production could boost platinum mining productivity. Regional disparities in productivity in different commodities (e.g., South Africa vs. Zimbabwe) give policymakers with insights into how to support production scale and productivity through appropriate input mixtures.

The interband transitions of urania (UO2) are validated independently through cathode luminescence of UO2. A picture emerges consistent with density functional theory. While theory is generally consistent with experiment, it is evident that the choice of functional can significantly alter the band gap and some details of the band structure, in particular at the conduction band minimum. Strictly ab initio predictions of the optical properties of the actinide compounds, based on density functional theory alone continues to be somewhat elusive.

The article obtains large deviation asymptotic for sub-critical communication networks modelled as signal-interference-noise-ratio(SINR) random networks. To achieve this, we define the empirical power measure and the empirical connectivity measure, as well as prove joint large deviation principles(LDPs) for the two empirical measures on two different scales. Using the joint LDPs, we prove an Asymptotic equipartition property(AEP) for wireless telecommunication Networks modelled as the subcritical SINR random networks. Further, we prove a Local Large deviation principle(LLDP) for the sub-critical SINR random network. From the LLDPs, we prove the large deviation principle, and a classical McMillan Theorem for the stochastic SINR model processes. Note that, the LDPs for the empirical measures of this stochastic SINR random network model were derived on spaces of measures equipped with the $\tau-$ topology, and the LLDPs were deduced in the space of SINR model process without any topological limitations. We motivate the study by describing a possible anomaly detection test for SINR random networks.

The notion of Critical Point Theory has extensive application in the filed of Partial Differential Equations, one of which is studying the existence and commenting on the uniqueness and multiplicity (in case when the solution is not unique) of weak solutions to Elliptic PDEs under certain boundary conditions.\par This article provides a brief survey about specific concepts like : differentiation on Banach Spaces, maxima and minima and its applications to PDEs. Furthermore, we've discussed the notion of defining a weak topology on Banach Spaces, before introducing the Variational Principle and its applications.\par The epilogue of the article primarily deals with results which studies the existence of weak solutions to Dirichlet Boundary Value Problems under specific conditions. The most notable aspect of this article is the proof of \textit{Rabinowitz's Saddle Point Theorem} using the method of \textit{Brouwer Degree}. Readers who are highly motivated in pursuing research in any of the topics relevent to the contents of this paper will surely find the \texttt{References} section to be extremely resourceful.

Critical distance concerns precise digital levelling, which has inaccurate results at a certain sighting distance. The influence of critical distance on a measured height difference has been confirmed by calibrating certain digital levels and their appropriate code devices on a vertical comparator under laboratory conditions. The paper describes the research based on experimental measurements done to find the influence of critical distance on height differences obtained by precise digital levels of Leica NA3003 and DNA03. The processing of the measurement results consisted of de-fining a random error on a station by using parameter estimation of an error model to specify a partial error on a station dependent on sighting distance and then the processing phase continues with the finding the relation between sighting distance and dispersion of height differences ac-quired by digital levelling under terrain conditions. The theoretical part involves the development of levelling accuracy theories that vary over time by view on random and systematic error propagation. The numerical and graphical solution of the experimental measurements involves ordering the height differences into sighting groups according to the sighting distances and the computed standard deviations, which represent a measure of height differences dispersion. The suspicious sighting groups are highlighted in the table and compared with theoretical data pro-vided by authors of calibrating the same digital levels

Sulfolane, a highly water-soluble industrial solvent, has raised environmental concerns due to its persistence once released into the environment. To assess the extent of contamination effectively, reliable analytical methods are essential. In this review, we delve into the published literature on sulfolane analytical procedures. Existing guidelines for sampling from environmental matrices provide a solid foundation for sul-folane analysis. Notably, there is little variation in the choice of determination method, with GC-MS or GC-FID being favored across studies. However, substantial variability emerges in sample prep-aration methods. Many procedures rely on large quantities of environmentally hazardous solvents, such as dichloromethane, during extraction. Nevertheless, by incorporating extraction enhancement techniques proposed in various studies, it is possible to develop more eco-friendly extraction processes. Overall, this field calls for further re-search to devise efficient and environmentally sustainable analytical methods for sulfolane analysis. Through this review, insights into the challenges at hand and potential solutions can be gained, offering a foundation for the development of novel sulfolane analysis methods applicable to a range of environmental matrices.

Parasitic capacitance represents the main error source in measurement systems based on electrical impedance spectroscopy. The capacitive nature of electrodes’ impedance in tetrapolar configuration can give origin to phase errors when electrodes are coupled to parasitic capacitances. Nevertheless, reactive charges in tissue excitation systems are susceptible to instability. Based on such a scenario, mitigating capacitive effects associated with the electrode is a requirement in order to reduce errors in the measurement system. A literature review about the main compensation techniques for parasitic capacitance was carried out. The selected studies were categorized into three groups: (i) compensation in electronic instrumentation; (ii) compensation in measurement processing, and (iii) compensation by negative impedance converters. The three analyzed methods emerged as effective against fixed capacitance. No method seemed capable of mitigating the effects of electrodes’ capacitance, that changes in the frequency spectrum. The analysis has revealed the need for a method to compensate varying capacitances, since electrodes’ impedance is unknown.

Despite their Nobel prize-winning empirical confirmation, the interpretation of the Bell inequality remains controversial. By carefully analyzing Bell's work on nonlocality, we show how the correct appreciation of Bell's rationale calls for reformulating a widespread argument on quantum nonlocality, yielding a more consistent formulation of the problem. We delve into a formal proof of quantum mechanics' violation of local causality strikingly overlooked in favor of less appropriate arguments. For completeness, we also mention a few alternatives that may rationally justify considering quantum mechanics as a local theory.

Deep reinforcement learning (DRL) has achieved significant results in many Machine Learning (ML) benchmarks. In this short survey we provide an overview of DRL applied to trading on financial markets, including a short meta-analysis using Google Scholar, with an emphasis on using hierarchy for dividing the problem space as well as using model-based RL to learn a world model of the trading environment which can be used for prediction. In addition, multiple risk measures are defined and discussed, which not only provide a way of quantifying the performance of various algorithms, but they can also act as (dense) reward-shaping mechanisms for the agent. We discuss in detail the various state representations used for financial markets, which we consider critical for the success and efficiency of such DRL agents. The market in focus for this survey is the cryptocurrency market.

A critical review of recent work on fuel lubricant interactions is undertaken. The work focusses on liquid fuels used in diesel and gasoline vehicles. The amount of fuel that contaminates the lubricant depends on driving conditions, engine design, fuel type and lubricant type. When fuel contaminates a lubricant, the viscosity of the lubricant will change (it will usually decrease), the sump oil level may increase, there may be a tendency for more sludge formation, there may be an impact on friction and wear, and low speed pre-ignition could occur. The increased use of biofuels (particularly biodiesel) may require a reduction in oil drain intervals, and fuel borne additives could contaminate the lubricant. The move to active regeneration of particulate filters by delayed fuel post-injection and the move to hybrid electric vehicles, and vehicles equipped with stop-start systems will lead to increased fuel dilution. This will be of more concern in diesel engines, since significant fuel dilution could still persist at sump oil temperatures in the range 100-150C (whereas in gasoline engines the more volatile gasoline fuel will have substantially evaporated at these temperatures). It is anticipated that more research into fuel lubricant interactions, particularly for diesel engines, will be needed in the near future.

Background. Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous systemic syn-drome that often coexists with multiple comorbidities. In high-complex COPD patients the role of the Cumulative Illness Rating Scale (CIRS) as a risk predictor of COPD exacerbation is not known. Objective. To determine the effectiveness of the CIRS score in detecting the association of comorbidities and disease severity with the risk of acute exacerbations in COPD patients. Methods. 105 adults with COPD were included in this prospective study. All participants at baseline had at least 2 moderate exacerbations or 1 leading to hospitalization. The primary outcome was a composite of moderate or severe COPD exacerbation during 12-months follow-up. Results. CIRS indices (CIRS total score, Severity Index and Comorbidity Index) showed a positive correlation with mMRC, CAT and a negative correlation with FEV1, FVC, FEV1/FVC. The three CIRS indices were able to predict the 12-month rate of moderate or severe exacerbation (CIRS-Total Score: Hazard Ratio (HR) = 1.12 (95% CI: 1.08-1.21); CIRS-Severity Index: HR = 1.21 (95% CI: 1.12-1-31); CIRS-Comorbidity Index = 1.58 (95% CI: 1.33-1.89)). Conclusions. Among patients with COPD, comorbidity number and severity, assessed by the CIRS score, influence the risk in moderate to severe exacerbations. The CIRS score also correlates with the severity of respiratory symptoms and lung function

Identification of drug targets and biochemical investigations on mechanisms of action is a are major issues in modern drug development. The present article reviews the classical “one drug” – “one target” paradigm. Novel methods for target deconvolution and for investigation of resistant strains based on protein mass spectrometry have shown that multiple gene products and adapta-tion mechanisms are involved in responses of pathogens to xenobiotics. This review is focused on protozoan pathogens. The conclusions can, however, be extended to chemotherapies against other pathogens or cancer. For this review we have searched Pubmed (pubmed.ncbi.nlm.nih.gov) and Web of Science (webofscience.com) using the key words listed below (status May 2024)

The digital transformation of critical infrastructures, such as energy or water distribution systems, is essential for their smart management. Faster issue identification and smoother services enable better adaptation to consumers' evolving demands. However, these large-scale infrastructures are often outdated. Their digital transformation is crucial to enable them supporting societies. This process must be carefully planned, providing guidance that ensures that the data they rely on is dependable and that the system remains fully operational during the transition. This paper presents a formal model that supports reliable data acquisition in legacy critical infrastructures, facilitating their evolution towards a data-driven smart system. Our model provides the foundation for a flexible transformation process while generating dependable data for system management. We demonstrate the model's applicability in a use case within the water distribution domain and discuss its benefits.

Hydrogen plays an important role in the implementation of Australia’s Net-Zero Strategy. It competes with lithium-ion rechargeable batteries in the electrification of Australian land transportation sector, and can provide an alternative energy storage medium for the greening of the country’s electrical grid system. This paper reviews the role hydrogen plays in the current government’s Net-Zero strategy, and investigates the potential role of other bioenergy sources. It is found that hydrogen and batteries play essentially complementary roles in reducing transport emissions, and that the former energy source is more suited to the operation of long-distance commercial service vehicles than batteries. It is suggested that bioenergy fuels such as biomethane, second generation biofuels and HVO can provide suitable bridging alternatives in the event that Australia’s EV strategy is unable to meet the 2030 target.

Food and drinks can be contaminated with pollutants such as lead and strontium and this poses a serious danger to human health. For this reason, a number of effective sensors have been developed for the rapid and highly selective detection of such contaminants. TBA, a well-known aptamer developed to selectively target and thereby inhibit the protein of clinical interest -thrombin, is receiving increasing attention for sensing applications, particularly for the sensing of different cations. Indeed, TBA, in the presence of these cations, folds into the stable G-quadruplex structure. Furthermore, different cations produce small but significant changes in this structure that result in changes in the electrical responses that TBA can produce. In this article we produce an overview of the expected data regarding the use of TBA in the detection of lead and strontium, calculating the expected electrical response using different measurement techniques. Finally, we conclude that the TBA should perform better as a detector of strontium rather than lead.