In the process of oil and gas development and production, when the flow rate in the wellbore is large, the materials underground will be eroded, causing the operation to be unable to proceed smoothly and reducing the efficiency of oil and gas production. Therefore, optimizing the anti-erosion coating under high-speed flow conditions in wellbore is a very interesting thing. It can greatly improve operational efficiency. In this paper, laser cladding was used to prepare the new coating used in the PDC drill bit. Then, the effects of tungsten carbide and multi-layer graphene on the microstructure and properties of the tungsten carbide coating were studied. The research results indicate that, for new coatings, 60% tungsten carbide and 0.3% graphene are the optimal ratios. After adding WC, the hardness has significantly improved. However, when the WC content further increases more than 30%, the increase in hardness is relatively small. In addition, when the content of graphene is more than 0.3%, the branched structure became thicker, and not only the segregation of Cr, Si and W became very obvious again, but also the segregation of Fe occurred at the Ni enrichment site. The research results contribute to improving oil and gas production and operational efficiency under high-speed fluid flow conditions in the wellbore.

The calculation of effective doses is crucial in many medical and radiation fields, in order to ensure safety and compliance with regulatory limits. Traditionally, Monte Carlo codes using detailed human body computational phantoms have been used for such calculations. Monte Carlo dose calculations can be time-consuming and require expertise in different processes when building the computational phantom and dose calculations. This study employs various machine learning (ML) algorithms to predict the organ doses and effective dose conversion coefficients (DCCs) for different anthropomorphic phantoms. A comprehensive data set comprising neutron energy bins, organ labels, masses, and densities is compiled from Monte Carlo studies, and is used to train and evaluate the supervised ML models. This study includes a broad range of phantoms, including those from the International Commission of Radiation Protection (ICRP-110, ICRP-116 phantom), the Visible-Human Project (VIP-man phantom), and the Medical Internal Radiation Dose Committee (MIRD-Phantom), with row data prepared using numerical data and organ categorical labeled data. Extreme gradient boosting (XGB), gradient boosting (GB), and the random forest-based Extra Trees regressor are employed to assess the performance of the ML models against published ICRP neutron DCC values using the mean square error, mean absolute error, and R² metrics. The results demonstrate that the ML predictions significantly vary in lower energy ranges and vary less in higher neutron energy ranges, while showing good agreement with ICRP values at mid-range energies. Moreover, the categorical data models align closely with the reference doses, suggesting the potential of ML in predicting effective doses for custom phantoms based on regional populations, such as the Saudi voxel-based model. This study paves the way for efficient dose prediction using ML, particularly in scenarios requiring rapid results without extensive computational resources or expertise. The findings also indicate potential improvements in data representation and the inclusion of larger data sets to refine model accuracy and prevent overfitting. Thus, ML methods can serve as valuable techniques for the continued development of personalized dosimetry.

This paper reveals some properties of the cumulative entropy of consecutive k-out-of-n:F system's lifetime. First, we introduce a method for calculating the cumulative entropy of their lifetime and explore its preservation properties using established stochastic orders. Ad- ditionally, we obtain useful bounds that can used in situations where the distribution function of the system's component lifetimes are complicated or systems have large components. To support practical applications, we present two nonparametric estimators for the cumulative entropy of these systems. The efficiency and performance of these estimators are illustrated with simulated datasets and further validated with real data sets.

Deep learning image reconstruction (DLIR) algorithms employs convolutional neural networks (CNNs) for CT image reconstruction to produce CT images with a very low noise level, even at low radiation dose. The aim of this study was to assess whether the DLIR algorithm reduces the CT effective dose (ED) and im-proves CT image quality in comparison with filtered back projection (FBP) and iterative reconstruction (IR) algorithms in intensive care unit (ICU) patients. We identified all consecutive patients referred to the ICU of a single hospital who underwent at least two consecutive chest and/or abdominal contrast-enhanced CT scans within a time period of 30 days using DLIR and subsequently FBP or IR algorithm (Advanced Mod-eled Iterative Reconstruction model-based algorithm [ADMIRE], or Adaptive Iterative Dose Reduction 3D [AIDR 3D]) for CT image reconstruction. The radiation ED, noise level, and signal-to-noise ratio (SNR) were compared between the different CT scanners. The non-parametric Wilcoxon test was used for statistical comparison. Statistical significance was set at p < 0.05. A total of 83 patients (mean age, 59 ± 15 years [standard deviation]; 56 men) were included. DLIR vs FBP reduced ED (18.45 ± 13.16 mSv vs 22.06 ± 9.55 mSv, P < 0.05), while DLIR vs FBP and vs ADMIRE and AIDR 3D IR algorithms reduced image noise (8.45 ± 3.24 vs 14.85 ± 2.73 vs 14.77 ± 32.77 and 11.17 ± 32.77\, P < 0.05) and increased SNR (11.53 ± 9.28 vs 3.99 ± 1.23 vs 5.84 ± 2.74 and 3.58 ± 2.74, P < 0.05). CT scanners employing DLIR reduced radiation ED and im-proved SNR compared to CT scanners using FBP, whereas CT scanners using DLIR improved SNR com-pared to CT scanners using FBP or IR algorithms in ICU patients.

We investigate some information properties of consecutive k-out-of-n:G systems in light of fractional generalized cumulative residual entropy. We firstly derive a formula to compute fractional generalized cumulative residual entropy related to the system's lifetime and explore its preservation properties in terms of established stochastic orders. Additionally, we obtain useful bounds. To aid practical applications, we propose two non parametric estimators for the fractional generalized cumulative residual entropy in these systems. The efficiency and performance of these estimators are illustrated using simulated and real datasets.

This study aims to evaluate the patient’s dose exposure from Computed Tomography Pulmonary Angiography (CTPA) examination and to estimates the cancer risk induced from the examinations based on the patient’s size. One hundred patients were recruited, and data information was collected retrospectively. A multi-detector (MDCT) (Philips Brilliance 128, USA) scanner were utilized for the CTPA examination, and dose data were obtained from the system. The effective diameter of each subjects’ image was measured for the Size-specific dose estimates (SSDEs). All subjects divided into Group 1 (19 – 25 cm), Group 2 (25-28 cm) and Group 3 (28-38 cm), where the association between gender were analysed. Effective dose (E), SSDE, organ dose and cancer risk of each group were evaluated and compared statistically using independent t-test and one-way ANOVA. The range of mean CTDI_vol, DLP and E values were (6.44 – 17.42 mGy), (239 – 631 mGy), (5.19 – 13.90 mSv), respectively. In respective with the patient’s effective diameter, the mean SSDE value for Group 1, Group 2 and Group 3 were 9.93 ± 3.89 mGy, 13.70 ± 9.04 mGy and 22.29 ± 7.35 mGy. The organ dose and cancer risk attained for breast, lung and liver were 17.05 ± 10.40 mGy (194 per one million procedure), 17.55 ± 10.86 mGy (192 per one million procedure) and 15.04 ± 9.75 mGy (53 per one million procedure), respectively. Lung and breast with more massive patient’s effective diameter received the highest dose exposure which increases the probability of the cancer risk. CTDI_vol was found to be underestimated, and SSDE provides more accurate in describing the radiation dose and cancer risk. Body effective diameter found to be significant on the estimation except for gender. Therefore, it is essential to apply optimised protocols in order to reduce patient’s exposure during CTPA examination.

In this work, we introduce a generalized measure of cumulative residual entropy and study its properties. We show that several existing measures of entropy such as cumulative residual entropy, weighted cumulative residual entropy and cumulative residual Tsallis entropy, are all special cases of the generalized cumulative residual entropy. We also propose a measure of generalized cumulative entropy, which includes cumulative entropy, weighted cumulative entropy and cumulative Tsallis entropy as special cases. We discuss generating function approach using which we derive different entropy measures. Finally, using the newly introduced entropy measures, we establish some relationships between entropy and extropy measures.

Turmeric starch (TS) has gained significant attention due to its potential health benefits, this study intended to investigate the dose-dependent effects of TS on colonic fermentation in rats. Four experimental diets containing different levels of TS (5%, 10%, and 20% w/w) were formulated and fed to male Fischer 344 rats for two weeks and compared with rats fed 0% TS diet (TS0). The results showed that increasing doses of TS resulted in reduced body weight gain and lower visceral tissue weights compared to the TS0 group. These effects may be attributed to the high content of resistant starch in TS, which contributed to lower caloric intake. Colonic fermentation analysis revealed that higher doses of TS resulted in increased short chain fatty acids (SCFA) production, specifically increased cecal acetate content and decreased cecal pH dose-dependently. Notably, beneficial bacteria from the family Oscillospiraceae, genus Lachnospiraceae NK4A136 group, and Ruminococcus spp. were enriched in the TS-fed groups, further supporting its beneficial effects on gut microbiota and SCFA production. Furthermore, these results suggest that TS may have beneficial effects on colonic fermentation in rats.

In this study, the friction factor of turbulent pipe flow for dried rice malt extract solutions is reduced experimentally to that of a Newtonian fluid. The friction factor is measured for four types of solutions at different culture times and concentrations. The results indicate that the experimental data points of the test solutions diverge from the maximum drag reduction asymptote at and above Re√f ≅ 200 and align parallel to those of Newtonian fluids. This drag reduction phenomenon differs from that of artificial high molecular polymer solutions. It is classified as a Type B drag reduction phenomenon of biopolymer solutions and fine solid particle suspensions. The order of drag reduction corresponds approximately to that of 5–50 ppm xanthan-gum solutions reported previously. Furthermore, the velocity profile in a turbulent pipe flow was predicted using a semi-theoretical equation, in which the friction factors were determined using the difference between the experimental results of the tested solutions and Newtonian fluids. The results indicate a more considerable thickening of the viscous sublayer in the turbulent pipe flow of the test solutions than that of Newtonian fluids.

Objective: We report a case of acute pancytopenia and liver injury after concomitant administration of low-dose methotrexate (MTX), and high-dose esomeprazole and metamizole. Case summary: A 71-year-old patient with chronic systemic idiopathic erosive arthritis was admitted after a pelvic ring fracture. After hospital admission, she received MTX in addition to esomeprazole and metamizole. Subsequent laboratory tests revealed pancytopenia and elevated liver enzymes. The follow-up clinical examinations were unremarkable, with the exception of sub-febrile temperatures. Further investigations did not detect a definitive etiology. Due to the suspicion of methotrexate-induced hematotoxicity and hepatotoxicity, antagonizing therapy with calcium folinate was administered, after which the blood counts and liver parameters normalized. Discussion: Due to the administration of high-dose metamizole immediately before the administration of low-dose MTX, the pre-existing hematotoxic pharmacodynamic effect of MTX was acutely enhanced by that of metamizole, although folic acid was administered preemptively. In addition, the concomitant administration of high-dose esomeprazole and normal dose torasemide resulted in a pharmacokinetic interaction with MTX by decreasing its renal secretion and elimination, further enhancing the concentration-dependent hematotoxic and hepatotoxic side effects of MTX. Conclusions: The relatively high demand for analgesics in patients with chronic rheumatic diseases already being treated with MTX and proton pump inhibitors necessitates that clinicians consider drug-drug interactions as potential causes of adverse drug reactions after the administration of metamizole or nonsteroidal anti-inflammatory drugs. In this category of patients, it is strongly recommended to switch to analgesics of other classes.

Since the exploitation of mineral resources results in the release of radionuclides, and consuming radionuclides affects public health in the short and long term. A case study of the environmental radiation impact from coal mining and germanium processing was carried out in southwest China. The coal mines contain germanium and uranium and have been exploited for more than 40 years. The farmlands around the site of coal mining and germanium processing have been contaminated by the solid waste and mine water in some extend since then. Samples of crops have been collected from contaminated farmlands in research area. The research area covers a radius of 5 km, in which there are 2 coal mines located. 210Pb and 210Po have been analyzed as the key radionuclides during monitoring program. The average activity concentrations of 210Pb and 210Po in the crops were 1.38 and 1.32 Bq/kg in cereals, 4.07 and 2.19 Bq/kg in leafy vegetables and 1.63 and 1.32 Bq/kg in root vegetables. The annual effective doses due to the ingestion of 210Pb and 210Po in consumed crops have been estimated for adult residents living in research area. The average annual effective dose was 0.336mSv/a, while the minimum was 0.171 mSv/a and the maximum was 0.948 mSv/a. The results show that crops grown on contaminated farmland contained an enhanced level of radioactivity concentration. Ingestion doses of local residents in research area were significantly higher than the China average level of 0.112 mSv/a, and the world average level of 0.042 mSv/a through 210Pb and 210Po in crops intake respectively.

This study uses machine learning to identify key factors influencing the cost-effectiveness of over-the-counter (OTC) medications. By developing a novel cost-effectiveness rating (CER) from user ratings and prices, we analyzed data from Amazon. The findings indicate that FSA/HSA eligibility, symptom treatment range, safety warnings, special effects, active ingredients, and packaging size significantly impact cost-effectiveness across cold, allergy, digestion, and pain relief medications. Medications eligible for FSA or HSA funds, treating a broader range of symptoms, and having smaller packaging are perceived as more cost-effective. Cold medicines with safety warnings were found to be cost-effective due to their lower average price and effective ingredients like phenylephrine and acetaminophen. Allergy medications with kid-friendly features showed higher cost-effectiveness, and ingredients like calcium, famotidine, and magnesium boosted the cost-effectiveness of digestion medicines. These insights help consumers make informed purchasing decisions and assist manufacturers and retailers in enhancing product competitiveness. Overall, this research supports better decision-making in the pharmaceutical industry by highlighting factors that drive cost-effective medication purchases.

Adenomyosis, a benign gynecological condition characterized by the infiltration of endometrial tissue into the myometrium, poses significant challenges to women's reproductive health. Recently, the landscape of adenomyosis diagnosis transformed significantly, thanks to advancements in imaging technologies such as transvaginal ultrasound and magnetic resonance imaging. This lead to a noticeable shift in the demographic profile of patients diagnosed with adenomyosis, including younger women of reproductive age who frequently present with a diverse array of symptoms. Approximately 20% of women are affected by adenomyosis. Adenomyosis manifests with various subtypes, distinct epidemiological profiles, symptomatology, and treatment responses, necessitating tailored approaches for optimal management. Despite its clinical significance, adenomyosis remains understudied, resulting in a significant disparity in research and literature compared to other gynecological conditions. The severity of adenomyosis is compounded when coexisting with endometriosis, particularly deep infiltrating endometriosis (DIE), leading to exacerbated fertility issues and severe symptomatology. The wide range of symptoms, including adverse pregnancy outcomes such as pre-eclampsia, highlights its wider impact and emphasizes the need for increased awareness of the condition. Furthermore, Adenomyosis is frequently associated with treatment failure in endometriosis, contributing to dienogest resistance, elevated discontinuation rates, and persistent pain post endometriosis surgery. Additionally, the lack of specific treatments tailored to adenomyosis poses a considerable challenge in clinical management.

We describe a recently developed approach to quantify welfare loss in animals, the Cumulative Pain metric. It combines the two most relevant dimensions of negative affective experiences: intensity and duration. The metric enables estimating the time individuals spend in negative affective states of a physical or psychological nature (operationally referred to simply as ‘pain’) of different intensities as the result of one or more challenges (e.g., diseases, injuries, deprivations). A new notation protocol (the Pain-Track) is used in which the duration of the experience is represented along the horizontal axis and intensity is represented by four categories in the vertical axis. Pain experiences are partitioned into temporal segments, where hypotheses for the experienced duration and intensity are proposed based on existing welfare indicators (e.g., neurophysiological, behavioral, anatomical, evolutionary). This structure forces transparency about assumptions and uncertainties, highlights knowledge gaps, and enables estimates to be continuously adjusted. Because the Cumulative Pain metric is based on parameters with a broadly common biological meaning, it provides the much needed interoperability among assessments of animal welfare. It enables comparing the impact of practices and living conditions, policies and interventions, and the calculation of welfare footprints of animal-sourced products using a universal measurement unit.

The current treatment for cervico-facial cancer involves radio and/or chemotherapy. Unfortunately, cancer therapies can lead to local and systemic complications such as mucositis, which is the most common dose-dependent complication in the oral cavity and gastrointestinal tract. Mucositis can cause a considerably reduced quality of life in cancer patients already suffering from physical and psychological exhaustion. However, melatonin, whose role in the treatment of mucositis has recently been investigated, offers an effective alternative therapy in the prevention and/or management of radio and/or chemotherapy-induced mucositis. This review focuses on the pathobiology and management of mucositis in order to improve the quality of cancer patients’ lives.

X-ray Fluorescence Computed Tomography (XFCT) is an emerging non-invasive imaging technique providing molecular-level data, gaining attention for high-resolution imaging. However, increased sensitivity with benchtop X-ray sources raises radiation exposure. Artificial Intelligence (AI), particularly deep learning (DL), has revolutionized medical imaging by delivering high-quality images in the presence of noise. In XFCT, traditional methods rely on complex algorithms for noise reduction, but AI holds promise in addressing high-dose concerns. We present an optimized SCUNet model for noise reduction in low-concentration XRF images. Compared to higher-dose images, our method’s effectiveness is evaluated. While various denoising techniques exist for X-ray and CT, few address to XFCT. The DL model is trained and assessed using the augmented data, focusing on background noise reduction. Image quality is measured using PSNR and SSIM, comparing outcomes with 100% X-ray dose images. Results show the proposed algorithm achieves high-quality images from low-dose and low-contrast agents, with a maximum PSNR of 39.05 and SSIM of 0.86. The model outperforms BM3D, NLM, DnCNN, and SCUNet in both visual inspection and quantitative analysis, particularly in high-noise scenarios. This indicates the potential of AI, specifically the SCUNet model, in significantly improving XFCT imaging by mitigating the trade-off between sensitivity and radiation exposure.

Partial Differential Equations (PDEs) constitute a fundamental framework for modeling various physical phenomena across diverse fields such as physics, engineering, and finance. Solving PDEs accurately and efficiently remains a significant challenge, particularly when dealing with complex systems or high-dimensional data. In this paper, we present a novel approach based on deep learning techniques to investigate the effective factors in solving PDEs. Our methodology leverages the expressive power of deep neural networks to learn and represent the underlying relationships between input parameters and the solutions of PDEs. By incorporating domain knowledge into the network architecture and training process, our approach aims to provide insights into the key factors influencing the solution of PDEs. We demonstrate the effectiveness of our method through numerical experiments on various PDEs, showcasing its capability to identify important features and improve predictive accuracy. Our findings suggest that deep learning techniques offer a promising avenue for understanding and analyzing the complex dynamics inherent in PDEs, paving the way for enhanced computational methods in scientific and engineering applications.

This study is based on the clamor of fish farmers for a cheaper fish feed alternative to current commercial feeds. At present, 70-80% of aquaculture costs come from feed cost, keeping farmers' income below their expectation. This study aimed to find alternative feeds or supplementary feeds that can perform similarly to the existing commercial feeds thereby reducing farmer expense and cutting down their cost of production and increasing their profitability. To do that, various indigenous raw materials were selected based on an earlier study which could result in a better feed alternative. The formulations for the study included four grow-out treatments mainly: control (commercial feed), taro+control (powdered Colocasia esculenta+commercial fish feed), bloodmeal (formulated fish feed based on bloodmeal), banana stem+control (chopped banana stem+commercial fish feed). A total of 12,000 fingerlings initially weighing 16 g (TL=10 cm) individually were assigned randomly to the four treatments (3000 in each cage measuring 6 x 6 m). Week zero was used for acclimation period, and fingerlings were fed with commercial fish feed. Then the first week used the treatment diets which were adjusted based on average body weight and sampled weekly (ABW=23g; TL=11 cm). The result of the study first showed significant differences between treatments on their fourth week in terms of the diet treatments (MS=0.103, df=3, F=4.12, P=0.0076) with the control and the taro+control showing no difference in terms of weight and length (TC vs CF; P=0.4524). But during the fifth week, the bloodmeal treatment showed increased weight and length for fish sampled (MS=0.109, df=3, F=4.10, P=0.0076) and provided similar weight and length as those from the taro+control and the control (TC vs CF; P=0.3721 and BM vs CF; P=0.0587). During the succeeding weeks, there were no significant differences between feed treatments from 6th weeks onwards, whether with weight [MS=0.130, df=3, F=1.14, P=0.333] or total length of the treatments [MS=0.008, df=3, F=0.40, P=0.75]. The FCR ratio showed taro (1.81) as lowest, followed by blood meal (2.09), and control (2.24) and then banana stem (2.84). In terms of weight gain, fish from the bloodmeal treatment gained the highest (236.97 g), followed by control (223.33 g), then taro (217.67 g) and banana stem (196.99 g). As a result, we find that the tested treatments such as bloodmeal formulated feed, taro+commercial feed, and banana stem+commercial feed can serve as an alternative to purely commercial fish feeds. Cost-benefit analysis showed that a better gross profit margin of 42% and cost-benefit ratio of 1.37 was observed in taro+commercial feed diet.

Computed tomography (CT) is a widely employed imaging modality with diverse clinical applications in pediatric and adult populations, offering numerous advantages. Despite several alternatives to imaging modalities with ionising radiation, CT scans have demonstrated persistent global popularity, contributing to a substantial amount of effective radiation doses for patients. This exposure results in hazards, including stochastic effects that amplify the radiation-induced cancer risk proportionally to the radiation dose received. CT-related radiation comprises a substantial portion of cumulative effective doses within diagnostic radiology, specifically impacting younger patient cohorts undergoing repeated investigations for chronic diseases over time. Scientific literature over recent decades has explored various methods to mitigate radiation doses during medical imaging. One notable strategy involves implementing low-dose and ultralow-dose CT protocols, maintaining diagnostic efficacy in acute and non-acute medical and surgical conditions. Utilising innovative image reconstruction algorithms, such as iterative reconstruction and emerging deep-learning algorithms based on artificial intelligence, plays a pivotal role in achieving an approximately 80% reduction in patient radiation compared to standard doses. This review article discusses the significance of low-dose protocols across a spectrum of acute and chronic medical conditions affecting different body systems.

A dioxomolybdenum catalyst [(MoO2Cl2-O-MoO2Cl2)(L)] (1) (with L (1S,2S)-N,N´-bis(2-pyridinecarboxamide)-1,2-cyclohexane) was prepared and used as catalyst for the desulfurization of a multicomponent model fuel containing the most refractory sulfur compounds in real fuels. This complex showed to have a high efficiency to oxidize the aromatic benzothiophene derivative compounds present in fuels, mainly using a biphasic 1:1 model fuel/MeOH system. This process conciliates catalytic oxidative and extractive desulfurization, occurring the oxidation of the sulfur compounds in the polar organic solvent. The oxidative catalytic performance of (1) showed to be influenced by the presence of water in the system. Using 50% aq. H2O2 it was possible to reuse the catalyst and the extraction solvent MeOH during ten consecutive cycles without loss of desulfurization efficiency.

Our hypothesis that controlled ozone applications interfere into the redox balance of the biological organism (first published in 1998 with a preclinical trial on protecting the liver from CCl4 intoxication), has been verified over the last 2 decades in reactive oxygen species (ROS)-induced mitochondrial pathologies, such as rheumatoid arthritis, osteoarthritis, aging processes, diabetes-2 and in prevention of intoxications. Low-dose ozone acts as a redox bioregulator: The restoration of the disturbed redox balance is comprehensible in a number of preclinical and clinical studies by a remarkable increase of the antioxidant repair markers, here mainly shown as glutathione increase and a reduction in oxidative stress markers, mainly malondialdehyde. The mechanism of action is shown, relevant data are displayed, evaluated and comprehensively discussed: The repair side of the equilibrium increases by 21% up to 140% compared to the non-ozone treated groups and depending on the indication; the stress markers are simultaneously reduced, the redox system regains its balance.

Observe the synergistic effect and dose-effect relationship of Trimethoprim (TMP) on bactericidal activity with Flos Lonicerae in vitro. Microamount chessboard dilution method was conducted to determine the minimal inhibitory concentration (MIC) of Trimethoprim, Flos Lonicerae, as well as the combination of Trimethoprim and Flos Lonicerae separately against Staphylococcus aureus, Escherichia coli in vitro and Salmonella. The pour plate count method was used to determine the combined bactericidal activity of Flos Lonicerae combined with Different concentrations TMP. The results showed that the MIC values of the combination of Flos Lonicerae with TMP was much less than the MIC values of the independent use of Flos Lonicerae or TMP, The FIC values of the combination of Flos Lonicerae with TMP were between 0.5 and 1, there was additive effect between them. The bactericidal rates were fitted with least square method, the 95% confidence intervals of the optimal blending quantity about the combination of Flos Lonicerae with TMP on the test organisms were 231μg·mL^-1-249μg·mL^-1, 237μg·mL^-1-259μg·mL^-1, and 235 -259μg·mL^-1

BackgroundLiving donor liver transplantation offers comparable long-term results to cadaveric donor transplantation. This study analyzes the selection process of living liver donors at a Western transplant center that utilizes both donation forms. MethodsThis retrospective analysis examined potential living donors, collecting medical data and reasons for refusal, and divided patients by indication and urgency for transplantation. ResultsFrom January 2013 to December 2023, 594 potential living donors were assessed at Jena University Hospital. Of these, 124 living donor transplants were performed. During outpatient evaluation, 357 potential donors were excluded. Subsequently, 238 individuals underwent inpatient assessment, with 100 more being excluded. Main reasons for donor refusal included medical or psychological issues (n=160), disease progression in recipients (n=90), and recipient refusal or donor withdrawal (n=54). The evaluation process showed a trend towards considering more distant relatives and acquaintances as donor candidates with increasing severity of the recipient's disease.

Histone changes that are adjustable and transmitted without altering the DNA sequence are part of epigenetic control. In many disorders, most famously malignancy, abnormal genetic information is seen as a result of mismanagement of typical epigenetic mechanisms. A paradigm change in the diagnosis and treatment of cancer has been brought about by recent discoveries about the processes of epigenetic modifications, chromatin remodeling, and noncoding RNAs implicated in the changed expression patterns of tumor cells. There is a significant increase in the search for drugs that could alter the epigenetic environment altered by tumor cells and benefit from their therapeutic potential. Phytochemicals with a high concentration of naturally produced phenol molecules known as flavonoids can regulate genomic processes. Understanding the precise epigenetic alterations brought on by flavonoid-mediated mechanisms is necessary to develop combination therapy techniques and genomic therapies for cancer. This article aims to thoroughly examine the epigenetic modifications of flavonoids, including their anticancer properties.

Background: External beam radiation therapy requires a sophisticated and laborious planning procedure. To improve the efficiency and quality of the planning procedure, machine learning predictions of the dose distributions have been introduced to speed up the planning procedure and to serve as quality assurance. The most recent dose prediction models are based on deep learning U-Nets that give good approximations of the dose in 3D almost instantly. It is our purpose to train a 3D dose prediction for glioblastoma VMAT treatment and test its robustness and sensitivity for the purpose of quality assurance of automatic contouring. Methods: From a cohort of 125 glioblastoma (GBM) patients, VMAT plans were created according to a clinical protocol. The initial model was trained on a concatenated 3D U-Net. A total of 60 cases were used for training, 15 for validation and 20 for testing. The prediction model was tested for sensitivity to dose changes according to realistic contour variations. Additionally, the model was tested for robustness by exposing it to a worst-case test set containing out-of-distribution cases.Results: The initially trained prediction model had a dose score of 0.94 Gy and a mean DVH score for all structures of 1.95 Gy. In terms of sensitivity, the model was able to predict the dose changes that occurred due to the contour variations with a mean error of 1.38 Gy.Conclusions: We obtained a 3D VMAT dose prediction model for GBM with limited data, providing good sensitivity to realistic contour variations. We tested and improved the model's robustness, by targeted updating the training set, making it a useful technique for dose awareness in the contouring evaluation and quality assurance.

Neuroinflammation, defined as inflammatory reactions mediated by cytokines, chemokines, reactive oxygen species, and secondary messengers in the central nervous system (CNS) including the brain and spinal cord is the basis of many neurological disorders. Recently, erythropoietin (EPO) has been considered and studied as a modulator of neuroinflammation. On this article minireview of pathophysiology of neuroinflammation and the neuroprotective effects of EPO is discussed and a case of subacute huge subdural hematoma with double mydriasis operated urgently, treated with low daily dose (vs high dose once or twice a month in the literature) of EPO and recovered fully and discharged home with good consciousness is reported. In addition, the probable unfavorable outcome of erythropoietin administration in patients with neuroinflammation in COVID-19 is considered.

Background: The two-stage technique combining the Endoscopic Retrograde CholangioPancreatography (ERCP) with common bile duct (CBD) clearance carried out before the laparoscopic cholecystectomy represents the most common approach for CBD stones. Over time, different techniques have been proposed to manage cholecysto- choledocholithiasis (CCL) advantageously in one stage. Among these, the laparoendoscopic rendez-vous (LERV) addresses the CCL issue with a laparoscopic cholecystectomy with insertion of a guide wire performed at initial stage of the procedure, followed by the clearance of the bile duct carried out by the endoscopists. The goal of this study was to evaluate the efficacy and safeness of LERV procedure recording results and complications, also making a comparison between our results and current literature. Methods: We reviewed our experience of all consecutive patients with cholecysto-choledocholithiasis managed with LERV between January 2018 and December 2023. LERV success rate, operative time, length of hospital stay, stone recurrence, incidence of endoscopic and surgical complications were analysed. Results: A total of 120 patients underwent LERV in our facilities. We reported a 97% LERV success rate, 1.6% conversion-to-open rate, a median intraoperative time of 122 (range 95-220) min. The median hospital stay was 4 (range 2-38) days. An overall morbidity of 15% was reported (18/120): 15 Clavien-Dindo type 1/2, 2 type 3a and one type 3b. In two cases a re-operation during the hospital stay was necessary. At a median follow-up of 14 months (3-59) five patients experienced stone recurrence requiring redo-ERCP in two cases. Conclusion: LERV offers the significant advantage of a single stage procedure and hospitalisation along with a lower risk of post-ERCP pancreatitis, failed CBD cannulation and complications. Our experience confirms safety and effectiveness of the technique for CCL management.

In this paper, we investigate the cumulative historical entropy of the lifetime of an n-component coherent system under the assumption that all system components have failed at time t. Using the system signature, we can calculate the cumulative historical entropy of the system’s lifespan, which is an important aspect in determining a system’s predictability. This research produces a number of significant results, including expressions, bounds, and ordering aspects for this measure. In addition, we offer a method for finding a preferred system based on cumulative Kullback-Leibler discriminating information that is closely related to the parallel system. These findings provide important insights into the predictability and dependability of coherent systems, emphasizing the importance of this field.

The steel damper column is an energy-dissipating member that is suitable for reinforced concrete (RC) buildings, and those used for multistory housing in particular. However, the effectiveness of steel damper columns may be affected by the behavior of surrounding members, and this effect can be severe in the case of seismic sequences. This article investigates the nonlinear response of building models having an RC moment-resisting frame (MRF) with and without steel damper columns under seismic sequences. The applicability of the concept of the momentary energy input to the prediction of the peak response of RC MRFs with damper columns under seismic sequences is also investigated. The main findings of the study are summarized as follows. (1) The peak response of RC MRFs with damper columns subjected to sequential accelerations is similar to the peak response obtained considering only the mainshock, whereas the cumulative strain energy of RC MRFs accumulates more for sequential accelerations. (2) The steel damper column is effective in reducing the peak and cumulative responses of RC MRFs in the case of sequential seismic input. (3) The relation of the hysteretic dissipated energy during a half cycle of the structural response and the peak displacement of the first modal response can be properly evaluated using the simple model proposed in this study.

Vitamin A, or retinol, is one of the most effective anti-ageing molecules, but it presents issues with photo-sensitivity and irritation. Retinol-like alternatives are emerging, but have so far been less effective. Here, we present a Silibum marianum extract (SME) as a retinol-like ingredient providing both safety and efficacy. SME was compared to the reference compound, retinol, and to the main alternative, bakuchiol. In ex vivo tests, skin explants from a 58-year-old donor were treated with pure retinol (0.1%), bakuchiol (0.2%) or SME (0.8%). After 5 days, collagen and hyaluronic acid levels were analysed. A placebo-controlled study involving 57 volunteers (ages 45-73 years) was also conducted, with products applied twice-daily for 56 days. Results were measured by AEVA-HE and VISA. Levels of collagen III were significantly increased by SME, by 23% and 16% compared to bakuchiol and retinol, respectively. Compared to bakuchiol, SME treatment increased hyaluronic acid production by 36%. In clinical tests, SME had a significantly stronger anti-wrinkle effect than bakuchiol – reducing the number of wrinkles on the forehead by 21%, and their circumference by 17% – producing effects similar to retinol, and better than bakuchiol. In the self-assessment, 43% of volunteers reported discomfort while using retinol, as compared to 0% for the SME formulation. By enhancing levels of collagen III – the youth collagen – and hyaluronic acid in the skin, SME paves the way for the maturation of collagen I fibrils and skin plumping. With its stronger efficacy compared to bakuchiol and enhanced safety profile compared to retinol, SME may be the next-generation of natural alternatives to retinoids.

Dye/salt separation has gained increasing attention in recent years, prompting the quest for cost-effective and environmentally-friendly raw materials for synthesis high performance nanofiltration (NF) membrane for effective dye/salt separation. Herein, a high-performance loose structured NF membrane was fabricated by via a simple vacuum filtration method using a green nanomaterial, 2,2,6,6-tetramethylpiperidine-1-oxide radical (TEMPO)-oxidized cellulose nanofiber (TOCNF), by sequentially filtrating larger-size and finer-size TOCNFs on a microporous substrate, followed by cross-linked with trimesoyl chloride. The resultant TCM membrane possesses a separating layer composed entirely of pure TOCNF, eliminating the need for other polymer or nanomaterials additives. TCM membranes exhibits high performance and effective dye/salt selectivity. Scanning Electron Microscope (SEM) analysis shows that the TCM membrane with Fine-TOCNF layer has a tight layered structure. Further characterizations via Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) confirm the presence of functional groups and chemical bonds of the crosslinked membrane. Notably, the optimized TCM-5 membrane exhibits a rejection rate of over 99% for various dyes (Congo red, orange yellow) and 14.2% for NaCl, showcasing a potential candidate for efficient dye wastewater treatment.

Cannabidiol (CBD), a non-psychotropic main component of the Cannabis plant, is approved as a drug in the European Union (EU) under the name “Epidyolex”. However, the approval process as a food ingredient under the Novel Food Regulation was paused by the European Food Safety Authority (EFSA) due to a lack of safety data. Nevertheless, there is a growing, unregulated market in which CBD is advertised with various health claims and different dosage instructions. Of particular concern is its toxic effect on the liver and possible reproductive toxicity in humans. Studies suitable for calculating a benchmark dose were identified from the available data. Animal studies yielded a Benchmark Dose Lower Confidence Limit (BMDL) of 43 mg/kg bw/day, which translates into a safe human dose of approximately 15 mg/day. Only a Lowest Observed Adverse Effect Level (LOAEL) of 4.3 mg/kg bw/day could be identified from the human data. This updated risk assessment confirmed the Health-based Guidance Value (HBGV) of 10 mg/day based on human LOAEL. Despite existing data gaps, preliminary regulation appears advisable as the current form of the gray CBD market is unacceptable from the standpoint of consumer safety and protection.

Background/Objectives: Encouraging results reported of Platelet-Rich Plasma (PRP) treatment for knee osteoarthritis (KOA). The present retrospective study reports the efficacy and safety of a high dose of neutrophile and red blood cell-depleted PRP to treat 212 patients with KOA. Methods: 212 consecutive patients diagnosed with Kellgren-Lawrence (KL) grading 1-3 KOA chronic knee pain for at least 1 year were treated with 3 injections at 15-day intervals with a high dose of neutrophil-depleted PRP (4 billion platelets). Clinical outcomes were retrospectively recorded as a percentage of responders at 3,6, and 12-month follow-up, following the OMERACT-OARSI criteria. Pain through VAS score and WOMAC score have also been recorded. Results: 4ml of PRP containing 4X109 platelets were obtained by single spin centrifugation and injected intra-articular into each patient with no pre-activation. The overall responder rate of patients responding to OMERACT-OARSI criteria at 3,6,12 months was 68.9%, 72,7% and 70,6%. There was a significant improvement in VAS and WOMAC scores at 3-, 6- and 12-month follow-up compared to the pre-treatment value (p&lt; 0.01). The lowest VAS score was observed at 6 months overall and in all three-grade KL groups. KL2 groups showed the best results regarding pain reduction and WOMAC score at 6 months (p&lt; 0.01). Conclusions: a high dose of neutrophil-depleted PRP is an effective treatment for KL1-3 KOA. It provides symptomatic relief, can potentially reduce disease progression, and has sustained effects for up to 12 months.

System-of-systems (SoS) evolution is a complex and unpredictable process. Although various principles to facilitate collaborative SoS evolution have been proposed, there is a lack of experimental data validating their effectiveness. To address these issues, we present an Agent-Based Model (ABM) for SoS evolution in the Internet of Vehicles (IoV) , serving as a quantitative analysis tool for SoS research. By integrating multiple complex and rational behaviors of individuals, we aim to simulate real-world scenarios as accurately as possible. To simulate the SoS evolution process, our model employs multiple agents with autonomous interactions and incorporates external environmental variables. Furthermore, we propose three evaluation metrics: evolutionary time, degree of variation, and evolutionary cost, to assess the performance of SoS evolution. Our study demonstrates that enhanced information transparency significantly improves the evolutionary performance of distributed SoS. Conversely, the adoption of uniform standards only brings limited performance enhancement to distributed SoSs. Although our proposed model has limitations, it stands out from other approaches that utilize Agent-Based Modeling to analyze SoS theories. Our model focuses on realistic problem contexts and simulates realistic interaction behaviors. This study enhances the comprehension of SoS evolution processes and provides valuable insights for the formulation of effective evolutionary strategies.

Objectives: To analyze cumulative incidence and mortality by COVID-19 in the different types of nursing homes, in the first and second wave.Methods: Data source: Transparency portal of the Generalitat de Catalunya, official COVID-19 register of all Catalan nursing homes (from March to December 10, 2020). Variables: Affectation of disease and mortality by COVID-19 in geriatric centers in Catalonia, stratified by size of center and type of management. Univariate, bivariate and multivariate linear regression analysis, IBM^TMSPSS^® v.20.Results:N = 1,057 residences (63,682 beds, average = 60.48). 52% have <50 beds, 42.8% between 50-150 beds, and 5%> 150 beds. COVID-19: Cumulative incidence: 21,370 (confirmed + suspicious); mortality: 5,010 (confirmed + suspicious).233 residences did not register COVID-19 patients (22%) and 636 did not register COVID-19 deaths (60.2%).According to the type of supplier, the lowest incidence of COVID-19 was in non-accredited (36.2% without cases), then concerted / collaborators (19.3%) and own of the Generalitat de Catalunya (7.9 %, p = 0.000). The centers with the fewest deaths were the non-accredited (78% without deaths), followed by contracted / collaborators (56.8%) and those of the Generalitat de Catalunya (41.3%, p = 0.000).Depending on the size, no COVID-19 patients were registered: 168 centers <50 beds (30.5%); 64 of the 50-150 beds (14.2%); and 1 of the> 150 beds (1.9%) (p = 0.000). 395 of the <50 beds did not register deaths due to COVID-19 (71.8%), 232 of the 50-150 beds (51.3%), and 9 of the> 150 beds (17%) (p = 0.000).Discussion:Of the 1,057 centers analyzed, 22% did not register cases and in 60% there were no deaths from COVID-19.Residences without concert / collaboration with the Generalitat and with fewer beds showed a lower cumulative incidence and mortality due to COVID-19 during the first wave.

The deep neural network - BERT model (Bidirectional Encoder Representations from Transformers) and the stocks cumulative abnormal return is used in this article to analyze the sentiment of financial texts. The proposed approach, unlike those used so far, does not require the creation of dictionaries, takes into account the broad context of words and their meaning in financial texts, eliminates the problem of ambiguity of words in various contexts, does not require manual labelling of data and is free from the subjective assessment of the researcher. The sentiment of financial texts in the meaning presented in this paper is directly related to the market reaction to the information contained in these texts. For texts belonging to one of the two classes (positive or negative) with the highest probability the BERT model gives the results of predictions with a precision level of 62.38% for the positive class and 55% for the negative class. The results at this level can be used in event study, market efficiency research, investment strategy development or support of investment analysts using fundamental analysis.

Sepsis is a major health problem and accounts for 20 per cent of deaths worldwide. It is the most expensive condition treated in United States hospitals at $27 billion per year or about $20,000 per patient. Treatment consisting largely of fluid resuscitation and antibiotics has only marginal impact. Mortality is about 27 per cent for hospitalized patients and about 42 per cent for patients in intensive care.There are two phases of sepsis – a hyper inflammatory phase and a subsequent hypo inflammatory phase.During the hyper inflammatory phase the metabolic rate increases associated with an increase in body temperature and a rapid escalation of immune system functioning including increased numbers of leucocytes and migration of those leucocytes to infected and damaged tissues and an increased supply and consumption of glucose to fuel this immune system.During the subsequent hypo inflammatory phase the metabolic rate declines and this is associated with a decrease in body temperature and a generalized decrease in the physiological activity of many organs including the immune system akin to hibernation. The activated immune system has priority for the available glucose over most other organs and physiological functions during such potentially life threatening circumstances. Thus adenosine triphosphate (ATP) production by mitochondria (the source of energy at the cellular level for the organism as a whole) also has a lower priority for the available glucose relative to the activated immune system. If glucose availability is threatened then mitochondrial production of ATP is partially or substantially suppressed in favor of glycolysis because glycolysis can rapidly produce large quantities of ATP that are necessary for immune cell function in infected, anaerobic, ischemic, or damaged tissues.However, glycolysis is only a temporary fix as it cannot produce the quantities of ATP necessary on an ongoing basis for the normal functioning of the healthy animal. Mitochondrial production of ATP must be recommenced for full recovery.It appears that the partial or substantial suppression of mitochondrial production of ATP by activation of the immune response becomes relatively fixated in some patients leading to a substantial ATP deficit. This is the fundamental issue of sepsis.This paper reviews the metabolism of glucose and insulin during sepsis and concludes that high dose insulin with mild hyper glycaemia in conjunction with the intravenous administration of thiamine, an inhibitor of the pyruvate dehydrogenase kinase enzymes, to re-establish physiological ATP production by mitochondria, administered early in the hypo metabolic (hypo inflammatory) phase of sepsis should significantly improve survival.

Celecoxib as adjuvant therapy has been shown in a small randomized trial for Covid-19 to prevent clinical deterioration and rapidly improve thoracic computerized axial tomography (CT-chest)¹. Multiple descriptive trials of high dose famotidine (both inpatient and outpatient) have demonstrated clinical response^2,3,4. We describe the rapid clinical responses after increasing the celecoxib dosage to 400mg bid with high dose famotidine 80mg qid in both a critical inpatient who on baseline required 40 liters per minute high flow nasal insufflation and an outpatient who declined admission but had critical Covid-19 biomarkers.

Background and Objectives: The complications seen after lower impacted third molar surgery affect the quality of life of the patients. The aim of the study was to investigate the efficacy of a single preoperative dose of deflazacort on pain, swelling and trismus following impacted lower third molar surgery. Materials and Methods: This randomised, prospective, double-blind, split-mouth clinical study included 30 healthy individuals with bilaterally impacted lower third molars that was removed for orthodontic purposes between September 2017 and September 2018. Group 1 was given a placebo (single dose vitamin C tablet) and group 2 was given a single 30 mg dose of deflazacort 1 hour prior to the surgery. Pain was evaluated using the visual analog scale for 1 week postoperatively. Edema (in mm) and trismus (in mm) were evaluated preoperatively and on postoperative days 2 and 7. The Mann-Whitney U test was applied for group analysis. p values < 0.05 were considered statistically significant. Results: When postoperative pain scores were evaluated, a significant difference was found between the groups only at the 6th and 12th hours (p0.05). Even high trismus values were recorded on the 2nd day, it was observed that the trismus resolved on the 7th day. There were no significant differences in trismus between the groups at any time point (p>0.05). Evaluation of swelling showed that there was no statistically significant difference between the study and control groups at any time point (p>0.05). No side effect was detected in both the study and the control groups. Conclusions: This was the first split-mouth study evaluating the anti-inflammatory effect of deflazacort after lower impacted third molar surgery. A single dose of 30 mg deflazacort was shown to be effective in reducing pain at 6 and 12 hours postoperatively.

There is an observed general low performance of Ethiopian Sport Governing Bodies (SGBs) in service delivery. Evidence shows that the trend can be corrected with proper understanding and insight into the process of organisational and management factors of these SGBs. This study aimed to investigate the contribution of organisational and management factors on effective sport service delivery in SGBs. For this study, a cross-sectional research design was employed. Purposive sampling was used to choose 350 samples. Pearson Product Moment Correlation Coefficient and multiple regression were used to analyse the data at the 0.05 significant level. The findings confirmed that organisational and management factor variables had a significant positive relationship with sport service delivery (organisational structure (r=0.515), organisational capabilities (r=0.701), communication (r=0.549), management practice (r=0.571), materials &amp; resources (r=0.527) and stakeholders satisfaction (r=0.742). In addition, Management factors were found to be significant contributors for predicting effective sport service delivery (F(3, 329)= 165.868, R2= 0.612). Furthermore, organisational factors had a joint significant contribution to effective sport service delivery (F(3, 329) = 148.743, R2= 0.576). In addition, organisational and management factor variables jointly best predicted effective sport service delivery in Ethiopian SGBs (F(6, 326) =130.81, R2= 0.707). Therefore, this study suggests organisational and management factor variables can be used to predict effective sport service delivery.

The movement of liquid droplets on the energy gradient surface has attracted extensive attention. Inspired by biological features in nature, such as the periodic spindle-shaped nodes in spider silks and conical-like barbs of cacti, the structure-property-function relationship of multifunctional gradient surfaces. In this study, a series of specific patterns are fabricated by 3D printing technology, followed by modification via the atmospheric pressure plasma treatment and liquid phase chemical deposition, resulting in enhancing the ability of water droplets of 5μL to travel 18.47mm on a horizontal plane and 22.75mm against gravity up to 20° tilting angle. Additionally, analysis techniques have been employed including contact angle analyzer, ESCA and laser confocal microscope to evaluate the sample performance. This work could further be applied to many applications related to microfluidic devices, drug delivery and water/fog collection.

This mini-review explores the comparative efficacy, safety, and clinical outcomes of high-dose proton pump inhibitor (PPI) intravenous infusion versus oral acid pump inhibitor therapy following endoscopic treatment for bleeding peptic ulcers. Recent evidence suggests that intravenous PPIs can significantly reduce the rebleeding rates within the critical first 72 hours post-intervention, with a noted rebleeding rate of 6% compared to 14% in patients receiving oral Vonoprazan (VPZ) therapy. Additionally, the rapid onset of action associated with intravenous administration leads to faster stabilization of vital signs and a reduced need for subsequent blood transfusions. Safety profiles for both intravenous and oral VPZ were favourable, with minimal adverse effects, the most common being transient headaches.However, the findings from our single-centre study with a moderate sample size prompt consideration of more extensive, multicentre trials to enhance the generalizability of the results. Current limitations include potential biases, short-term focus, missing data issues, and a need for long-term outcome data, necessitating further research. Future studies should also explore the cost-effectiveness of intravenous versus oral VPZ and the impact on patient quality of life and long-term mortality rates.This review underscores the importance of tailored PPI therapy in managing bleeding peptic ulcers post-endoscopy. It suggests a potentially pivotal role for intravenous PPIs in high-risk patient groups, advocating for a shift towards more aggressive and immediate care protocols in specific clinical settings.

Objectives: COVID-19, a respiratory disease caused by SARS-COV2 and transmitted from person-to-person through viral droplets remains a global pandemic. There is a need to understand the transmission modes, populations at risk, and how to mitigate the spread and case fatality in the United States (US) and globally. The current study aimed to assess the global COVID-19 transmission and case fatality, examine similar parameters by countries and determine evidence-based practice in extreme epidemiology response in epidemic curve flattening and case fatality reduction. Methods: A cross-sectional ecologic design was used to assess the preexisting data on confirmed COVID-19 cases and mortality in March 2020 from the CDC, WHO, Worldodomter, and STATISTA. A rapid assessment between March 23^rd and 31^st, 2020, was utilized for the extreme epidemiology response. The case fatality, termed fatality proportion, was examined using mortality in relation to confirmed cases involving the world, United States of America (USA), United Kingdom (UK), Italy, France, Spain, China, Germany, India and South Korea. Results: The COVID-19 is a global pandemic, with the US as the epicenter for transmission, representing 20.9% of all confirmed cases worldwide, while Italy is the epicenter for case fatality, 30.6% of mortality as at 03/31/ 2020. The fatality proportion (FP) in Italy was 11.4%, Spain (8.8%), France (6.8%) and UK (6.4%). Despite the increased number of confirmed cases, the lowest FP was observed in Germany (0.96%) and South Korea (1.66%). There is increasing linear tends in transmission in the US, R²=0.97 as well as positive daily percentage change, ranging from 1.27% to 20.5%. Conclusions: The USA remains the epicenter for COVID-19 transmission, while Italy is the epicenter for case fatality. The observed relatively low case fatality in Germany and South Korea is due to an “extreme epidemiology” response through the application of Wuhan, China’s early data on COVID-19 transmission control measures and optimized patient care. These data are suggestive of relaxing the clinical guidelines in the United States in COVID-19 testing, application of contact tracing and testing, case isolation and most importantly enhancing resources for case management and social and physical distancing globally, hence epidemic curve flattening and case fatality reduction.

The use of chemical pesticides in agriculture contributes to soil, water and air pollution, biodiversity loss and can harm non-target species. The European Commission has already established a Harmonized Risk Indicator to quantify the progress in reducing the risks linked to pesticides. Therefore, there is an increasing need to promote biopesticides or so-called low-risk pesticides (LRP). Extract from Melaleuca alternifolia – tea tree oil (TTO) is known for its antiseptic, antimicrobial, antiviral, antifungal, and anti-inflammatory properties. Tea tree oil has been extensively studied in pest management as well as in the pharmaceutical and cosmetic industry and there are already products based on its active substances on the market. This review focuses on the overall evaluation of tea tree oil in terms of effectiveness and safety as a biopesticide for the first time. The collected data can be an added value for further evaluation of tea tree oil in terms of the authorization extension as a fungicide in 2026.

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

Background: Leishmaniasis is a significant global public health issue that is caused by parasites from Leishmania genus. With limited treatment options and rising drug resistance, there is a pressing need for new therapeutic approaches. Molecular chaperones, particularly Hsp90, play a crucial role in parasite biology and are emerging as promising targets for drug development. Objective: This study evaluates the efficacy of 17-DMAG in treating BALB/c mice from cutane-ous leishmaniasis through in vitro and in vivo approaches. Materials and Methods: We assessed 17-DMAG cytotoxic effect on bone marrow-derived mac-rophages (BMMΦ) and its effects against L. braziliensis promastigotes and intracellular amastigotes. Additionally, we tested the compound's efficacy in BALB/c mice infected with L. braziliensis via intraperitoneal administration to evaluate the reduction of lesion size and de-crease of parasite load in the ears and lymph nodes of infected animals. Results: 17-DMAG showed selective toxicity [selective index=432) towards Leishmania amastigotes, causing minimal damage to host cells. The treatment significantly reduced lesion sizes in mice and results in parasite clearance from ears and lymph nodes. It also diminished in-flammatory responses and reduced the release of pro-inflammatory cytokines (IL-6, IFN-g, TNF) and the regulatory cytokine, IL-10, underscoring its dual leishmanicidal and anti-inflammatory properties. Conclusion: Our findings confirm the potential of 17-DMAG as a viable treatment for cutaneous leishmaniasis and support further research into its mechanisms and potential applications against other infectious diseases.

Evidence suggests that COVID-19 infection can cause lasting health consequences. Multidiscipli-nary rehabilitation services have been recommended to reduce the sequalae. However, the effec-tiveness of physical exercise interventions remains insufficiently documented. The aim of this study was to develop and implement a specific and well tolerated protocol-based, intervention to reduce muscle weakness in older adults impacted by COVID-19. Forty six older adults random-ized into Intervention and Control Groups. Isometric and isokinetic strength assessments were conducted for selected muscle groups using JBA Staniak® torquemeter and Biodex System 3 dy-namometer. Functional abilities were evaluated with the Time Up and Go test and Chair Stand Tests. Men in intervention group demonstrated a significant improvement in static conditions for knee flexors (KF), trunk extensors (TE) and trunk flexors (TF) and in dynamic conditions for knee extensors (KE). Women in intervention group showed significant improvement in static condition for EF, KF, TE and TF and in dynamic for a KE and for a KF. The interaction GROUP x TESTING SESSION was significant for Chair test (s) and Chair test (n). Our results demonstrate the effec-tiveness of a well-tolerated, protocol-based approach that can be used to diminish long lasting functional deficits in post-covid survivors.

In this study, the degradation characteristics of radio-frequency (RF) low-noise amplifier (LNA) based on silicon-germanium (SiGe) heterojunction bipolar transistors (HBTs) due to total ionizing dose (TID) are investigated. The small-signal equivalent model of a SiGe HBT is utilized to analyze circuit-level performance including the input and the output matching and noise figure (NF). As a target circuit, an LNA with a cascode common-emitter stage with emitter degeneration is studied and the equation of each performance parameter is derived. The RF LNA fabricated using commercial 350 nm SiGe technology was exposed to X-ray irradiation with the total dose up to 3 Mrad (SiO2). The experimental results exhibit that modeled device parameters estimate the degraded circuit performance. In addition, the relative impact of each parameter on the circuit metrics is revealed, which is expected from the derived design equations. The key device parameters for modeling TID-induced circuit degradations include the base resistance, the transconductance, and the base-to-emitter capacitance.

A medium scale household in South Africa consumes about 1000 kWh on average, and ae household spend about 3000 ZAR per month on energy supply using grid electricity. Grid electricity. South Africa’s energy is supplied by a huge governmental organization. Statistical analyses indicate that projected increase of the cost of grid electricity in South Africa is about 30% per annum for the next five years. Our research show that Photo-Voltaic (PV) technology can offer a viable alternative, provided a large initial capital outlay can be made. The technology is user-friendly and easy to operate. It is calculated that the cost of electricity, capitalized over 20 years, considering an 80 % supply of needs and assuming 20 sunny days per month, is about 2.80 ZAR. The study also shows that utilizing a hybrid combination of renewable energies, such as combining PV supply with solar thermal energy absorbers, and converting thermal energy to electricity, as energy supply systems, could reduce the current cost of electricity per household in South Africa to about half of national grid supply prize, R1,50 per kWhr. The study also shows that water provides as a most viable medium to store energy, instead of using expensive battery technology to perform such functions.

A steel damper column is an energy-dissipating member that is suitable for reinforced concrete (RC) buildings and multistory housing. To assess the seismic performance of buildings with steel damper columns, the peak displacement of the whole building and the energy dissipation demand of the dampers must be evaluated. This article proposes an energy-based prediction procedure for the peak and cumulative response of an RC frame building with steel damper columns. The proposed procedure considers two energy-related seismic intensity parameters, namely the maximum momentary input energy and the total input energy. The peak displacement is predicted considering the energy balance during a half cycle of the structural response, using the maximum momentary input energy. The energy dissipation demand of the dampers is then predicted considering the energy balance during a whole response cycle using the total input energy. The local responses (e.g., peak drift, maximum plastic rotation of beams, maximum shear strain, and energy dissipation demand of dampers) are predicted using pushover analysis. Numerical analysis results for 8- and 16-story RC buildings show that the proposed prediction method achieves satisfactory accuracy.

Exposure to traffic-related air pollution is linked with acute alterations in blood pressure (BP). We examined the cumulative short-term effect of black carbon (BC) exposure on systolic (SBP) and diastolic (DBP) BP and assessed effect modification by participant characteristics. SBP and DBP were repeatedly measured on 152 traffic enforcers. Using a linear mixed-effects model with random intercepts, quadratic (QCDL) and cubic (CCDL) constrained distributed lag models were fitted to estimate the cumulative effect of BC concentration on SBP and DBP during the 10-hours (daily exposure) and 7-days (weekly exposure) before the BP measurement. Ambient BC was related to increased BP with QCDL models. An interquartile range change in BC cumulative during the 7-days before the BP measurement was associated with increased BP [1.2% change in mean SBP, 95% confidence interval (CI), 0.1 to 2.3; and 0.5% change in mean DBP, 95% CI, –0.8 to 1.7]. Moreover, the association between the 10-hours cumulative BC exposure and SBP was stronger for females (4.0% change, 95% CI: 2.1–5.9) versus males, and for obese (2.9% change, 95% CI: 1.0–4.8) vs. non-obese traffic enforcers. Short-term cumulative exposure to ambient traffic-related BC could bring about cardiovascular diseases through mechanisms involving increased BP.

Recently, there has been growing interest in alternative measures of uncertainty, including cumulative residual entropy. In this paper, we consider a mixed system consisting of n components, assuming that all components are operational at time t. We use the system signature to calculate the cumulative residual entropy of the mixed system’s remaining lifetime. This measure is a useful criterion for assessing the predictability of a system’s lifetime. We study several results related to the cumulative residual entropy of mixed systems, including expressions, limits, and order properties. These results shed light on the behavior of the measure and provide insights into the predictability of mixed systems. In addition, we propose a criterion for selecting a preferred system based on the relative residual cumulative entropy. This criterion is closely related to the parallel system and provides a practical way to choose the best system configuration. Overall, the present study of cumulative residual entropy and the proposed selection criterion provide valuable insights into the predictability of mixed systems and can be applied in various fields.

Biological invasions are a human-induced environmental disturbance that can cause major changes in ecosystem structure and functioning. Located in the northeastern Mediterranean basin, the Aegean Sea is a hotspot of biological invasions. Although the presence of alien species in the Aegean has been studied and monitored, no assessment has been conducted on their cumulative impacts on native biodiversity. To address this gap and identify the most highly impacted areas and habitats and the most impactful invasive species in the Aegean, we applied the CIMPAL index, a framework developed for mapping the cumulative impacts of invasive species. Coastal habitats showed stronger impacts than the open sea. The highest CIMPAL scores were four times more frequent in the South than in the North Aegean. Shallow (0-60 m) hard substrate was the most heavily impacted habitat type, followed by soft substrates and seagrass meadows. We identified Caulerpa cylindracea, Lophocladia lallemandii, Siganus spp. and Womersleyella setacea as the most im-pactful species across their range of occurrence in the Aegean but, ranking varied depending on the habitat and impact indicator applied. Our assessment can support marine managers in prioritizing decisions and actions to control biological invasions and mitigate their impacts in the Aegean Sea.

Background: The coronavirus disease-19 (COVID-19) has spread globally with more than 80,000 people infected, and nearly 3000 patients died. Currently, we are in an urgent need for effective treatment strategy to control the clinical deterioration of COVID-19 patients. Methods: The clinical data of 10 COVID-19 patients receiving short-term moderate-dose corticosteroid (160mg/d) plus immunoglobulin (20g/d) were studied in the North Yard of The First Hospital of Changsha, Hunan from January 17^th to February 27^th, 2020. Epidemiological, clinical, laboratory, radiological findings were analyzed. Results: After treatment with combination of low-dose corticosteroid (40-80mg/d) and immunoglobulin (10g/d), patients’ lymphocyte count (0.88±0.34 vs 0.59±0.18, P<0.05), oxygenation index including SPO₂ (94.90±2.51 vs 90.50±5.91, P<0.05) and PaO₂/FiO₂ (321.36±136.91 vs 129.30±64.97, P<0.05) were significantly lower than pre-treatment, and CT showed that the pulmonary lesion deteriorated in all patients. While after treatment of short-term moderate-dose corticosteroid plus immunoglobulin, patients’ APACHE Ⅱ score (9.10±6.15 vs 5.50±9.01, P<0.05), body temperature (37.59±1.16 vs 36.46±0.25, P<0.05), lymphocyte count (0.59±0.18 vs 1.36±0.51, P<0.05), Lactate dehydrogenase (419.24±251.31 vs 257.40±177.88, P<0.05), and C-reactive protein (49.94±26.21 vs 14.58±15.25, P<0.05) significantly improved compared with post-treatment with low-dose therapy. In addition, oxygenation index including SPO₂ (90.50±5.91 vs 97.50±1.18, P<0.05), PaO₂ (60.47±14.53 vs 99.07±34.31, P<0.05), and PaO₂/FiO₂ (129.30±64.97 vs 340.86±146.72, P<0.05) significant improved. Furthermore, CT showed that pulmonary lesions obviously improved in 7 patients. After systematic therapy, 4 out of 10 COVID-19 patients recovered and discharged. Conclusions: Short-term moderate-dose corticosteroid plus immunoglobulin is effective for reversing the continued deterioration of COVID-19 patients who failed to respond to the low-dose therapy. Funding: This work was supported by the Innovative Major Emergency Project Funding against the New Coronavirus Pneumonia in Hunan Province (Dr. Ji-Yang Liu, number 2020SK3014; Dr. Yuan-Lin Xie, number 2020SK3013).

This study was to identify clinical cancer biomarkers for recurrent gastric cancer survivors using artificial intel-ligence. From a hospital-based cancer registry database in Taiwan, the datasets of the incidence of recurrence and clinical risk features were included in 2476 gastric cancer survivors. We benchmarked Random forest with MLP, C4.5, AdaBoost, and Bagging algorithms on metrics and leveraged synthetic minority oversampling technique (SMOTE) for imbalanced dataset issues, cost-sensitive learning for risk assessment, and SHapley Additive ex-Planations (SHAP) for feature importance analysis in this study. Our proposed Random forest outperformed the other models with an accuracy of 87.9%, a recall rate of 90.5%, an accuracy rate of 86% and F1 of 88.2% on re-current category by a 10-fold cross-validation in a balanced dataset. We identified clinical features of recurrent gastric cancer, which are the top five features, stage, number of regional lymph node involvement, Helicobacter pylori, BMI(body mass index), and gender, which significantly affect the prediction model's output, are worth paying attention to in the following causal effect analysis. Using an artificial intelligence model, the risk factors for recurrent gastric cancer could be identified and cost-effectively ranked according to their feature importance. In addition, they should be crucial clinical features to provide physicians with the knowledge to screen high-risk patients in gastric cancer survivors as well.

The effects on Raychaudhuri's equation of an intrinsically discrete or particle nature of spacetime are investigated, through consideration of null congruences emerging from, or converging to, a generic point of spacetime, i.e. in geometric circumstances somehow prototypical of singularity issues. This is done from an effective point of view, meaning through a (continuous) description of spacetime modified to embody the existence of an intrinsic discreteness on the small scale, adding to previous results for non-null congruences. Various expressions for the effective rate of change of expansion are derived. They in particular provide finite values for the limiting effective expansion and its rate of variation when approaching the focal point; this on top of resulting non vanishing the limiting cross-sectional area itself of the congruence.

In mountain-gorge areas, the rock creep is the critical process for high rock slopes failure. During long-term rock creep, slopes might encounter earthquakes and form further creep after earthquakes. This complex mechanical response process can easily lead to the slope failure. Based on a high rock slope in the Nujiang River Basin, this paper analyzes deformation characteristics and dynamic response characteristics by using FLAC3D software, considering combined effects of multiple earthquakes and long-term creep. Results show that when the amplitude increases, the shear strength of the slope decreases and the risk of instability increases under combined actions of creep and earthquakes. Earthquakes promote the development of creep and induce the accumulation of damage on the slope surface and in the slope. The delayed effect becomes more pronounced as the slope height increases. We need to consider deformation differences of the slope further. The ground motion response on the slope surface is stronger than those in the slope, with the peak occurring at the top of the slope. Earthquakes have a greater impact on the middle and top of the slope surface, where cumulative damage and crack development begin. Reinforcement should be considered in these two places. Vertical earthquake has a great effect on the dynamic response. The phenomenon of slope resonance leads to a larger MPGA in the vertical direction than in the horizontal direction. Nonlinear and damping characteristics of the slope and the frequency of seismic waves cause the MPGA to decrease with the increase of amplitudes. This study could promote the development of high rock slope failure mechanism and provide references for the prevention of landslides in the Nujiang River Basin.

We model the COVID-19 coronavirus epidemic in China. We use early reported case data to predict the cumulative number of reported cases to a final size. The key features of our model are the timing of implementation of major public policies restricting social movement, the identification and isolation of unreported cases, and the impact of asymptomatic infectious cases.

Barium monofluoride (BaF) is a polar molecule of interest to measurements of the electron electric dipole moment [1, 2]. For this purpose efforts are under way to investigate this molecule embedded within cryogenic matrices, e.g., in solid Ne [3]. For a theoretical understanding of the electronic structure of such an embedded molecule the need arises for efficient methods which are accurate, but also can handle a number of atoms which surround the molecule. The calculation for gas-phase BaF can be reduced to involve only outer electrons by representing the inner core of Ba with a pseudopotential [4] while carrying out a non-relativistic calculation with an appropriate basis set [5]. In this work we demonstrate to which extent this can be achieved using coupled-cluster methods to deal with electron correlation. As a test case the SrF(X 2Σ+ → B 2Σ+) transition is investigated and excellent accuracy is obtained with the EOM-CC3 method. For the BaF(X 2Σ+ → A′ 2∆, X 2Σ+ → A 2Π, X 2Σ+ → B 2Σ+) transitions various coupled-cluster approaches are compared with very good agreement for EOM-CC3 with experimentally derived spectroscopic parameters except for the excitation to the A′ 2∆ state for which the excitation energy is overestimated by 200 cm−1.

We conducted a study to determine if antenatally collected maternal urine cotinine (a me- 13 tabolite of nicotine) measurements can be used to assess the neonatal impact of nicotine exposure 14 during pregnancy. This was a prospective longitudinal cohort of mother-infant dyads. Only term 15 singleton pregnancies were included. The primary outcome measure was the correlation between 16 maternal urine cotinine and infant birth weight. We analysed data from 238 mother-neonates' dy- 17 ads. Urine cotinine was detected in 50.4 % (120/238) women from the whole cohort, but only 16% 18 (38/238) self-reported as smokers (chi-square 39.7, p<0.0001), and these women had significantly 19 smaller babies (p=0.010). There was a significant negative correlation between maternal urine co- 20 tinine and birth weight (Spearman's coefficient = -0.0226, p=0.013). Female babies born to women 21 with nicotine in the urine were significantly smaller (p= 0.001). The number of women exposed to 22 nicotine during late pregnancy (measured in urine) was markedly higher than self-reported and 23 National smoking percentages, suggesting an urgent need for improvement of medical record re- 24 porting on smoking habits to better assess neonatal outcomes.

Purpose: Novel coronavirus disease (COVID-19) is the current global concern. Radiotherapy (RT), commonly employed in cancer management, has been considered one of the potential treatments for COVID-19 pneumonia. Here, we present the final report of the pilot trial evaluating the efficacy and safety of low-dose whole-lung irradiation (LD-WLI) in patients with COVID-19 pneumonia. Methods and Materials: We enrolled patients with moderate COVID-19 pneumonia who were older than 60 years. Participants were treated with LD-WLI in a single fraction of 0.5 or 1.0Gy along with the national protocol of COVID-19. The primary endpoints were improvement of SpO₂, the number of hospital/ICU stay days, and the number of intubations after RT and the secondary endpoints were alterations of the c-reactive peptide, interleukin-6, ferritin, procalcitonin, and D-dimer. The response rate (RR) was defined as a rise in SpO₂ upon RT with rising or constant trend in the next two days, and clinical recovery (CR) included patients who were discharged from the hospital or acquired SpO₂ ≥93% on room air. Results: Between 21 May 2020 and 2 July 2020, ten patients were enrolled. The median age was 75 years, 80% were male, and 80% had comorbidities. The first five patients received a single 0.5Gy-WLI, and others received 1.0Gy. Patients were followed for 2-14 days (median 5.5 days). Following one day, nine patients experienced an improvement in SpO₂. Five patients were discharged (median 6^th day, range 2^nd-14^th day), and four patients died (median 7^th day, range 3^rd-10^th day). Overall, the RR and CR were 60.0% and 55.5%, respectively. The RR and CR rates of 0.5- and 1.0Gy group were 80% vs 40% and 75% vs 40%, respectively. No acute radiation-induced toxicity was recorded. Conclusions: LD-WLI with a single 0.5Gy fraction seems to be a more appropriate dose to warrant further evaluation in a large-scale, randomized trial.

Zero-dose children, or children who have not received any routine vaccination, are a priority population for global health policy makers as these children are at high risk of mortality from vaccine-preventable illnesses. We conducted a narrative review to identify potential interventions, both within and outside of the health sector, to reach zero-dose children. We reviewed peer-reviewed and grey literature and identified 59 relevant resources. Additionally, we interviewed six key informants to enhance synthesis of our findings. Data were organized into three priority settings: (1) urban slums, (2) remote or rural communities, and (3) conflict settings. We found that zero-dose children in the three-priority settings face differing barriers to vaccina-tion and, therefore, require context-specific interventions, such as leveraging slum health commit-tees for urban slums or integrating with existing humanitarian response services for conflict set-tings. Three predominant themes emerged for grouping the various interventions: (1) community engagement, (2) health systems strengthening and integration, and (3) technological innovations. The barriers to reaching zero-dose children are multifaceted and nuanced to each setting, there-fore, no one intervention is enough. Technological interventions especially must be coupled with community engagement and health systems strengthening efforts. Evaluations of the suggested interventions are needed to guide scale up, as the evidence-base around these interventions is rel-atively small.

In ore regions impacted by mining and metal smelting emissions, distinguishing between geogenic anoma-lies and anthropogenic contamination poses a significant challenge. In a study from two areas with different mining histories in the Ore Mountains, Czech Republic, we demonstrate that targeted sampling of topsoils and subsoils respecting local geology and correct soil data treatment respecting soil textural variability effects are indispensable to correctly construct and interpret geochemical maps and identify anthropogenic contam-ination by As, Cu, Pb, and Zn. The list of analysed elements must include both potentially toxic and lithogenic elements, otherwise natural controls of soil composition cannot be deciphered. By using empirical cumulative distribution functions, we found that local backgrounds for As/Fe and Pb/Ti are significantly naturally ele-vated (5.7 to 9.8 times and 2.1 to 2.7 times higher, respectively) compared to the global averages. We con-structed geochemical maps with topsoil minus subsoil concentrations to show the main directions of spreading anthropogenic contamination. The anthropogenic diffuse contamination contribution was calcu-lated (1.12·10-4 and 1.42·10-4 for As/Fe and 16.5·10-4 and 16.2·10-4 for Pb/Ti, respectively), which corresponds to topsoil enrichment by ca. 15 and 14 mg kg-1 for As and ca. 35 and 42 mg kg-1 for Pb in the two study areas. Our study thus provided the first published quantitative estimates of geogenic and anthropogenic contribution to this well-known montane area. The obtained estimates were comparable to the results obtained previously from the local peat archives. The approach we used is efficient in deciphering natural and anthropogenic controls of PTEs in geochemically complicated areas.

Rice cultivation serves as a significant anthropogenic source of methane (CH4), a primary greenhouse gas, and nitrous oxide (N2O), a secondary greenhouse gas. Although N2O emissions remain relatively small compared to CH4 emissions, they are remarkably affected by nitrogen-fertilized soil conditions during rice cultivation. To date, investigations are very limited concerning N2O emissions from rice cultivation in relation to environmental factors such as temperature, rainfall, and soil properties. In this case study, we investigated the characteristics of N2O emissions in the central region of South Korea, where a single rice cropping cycle occurs annually over a span of three years, from May 2020 to May 2023. We investigated the impact of variations in temperature and soil moisture on N2O emissions during rice cultivation. In this context, we attempted to discover the complex dynamics of N2O emissions by comparing longer fallow periods with the rice cultivation periods and extended non-dry periods with irrigated periods. We observed that extremely high N₂O flux events encountered during the fallow period appeared to have a substantial impact on the yearly cumulative N₂O emissions, surpassing the impact of cumulative N₂O emissions during the rice cultivation period. We found that high N₂O flux events arose not only from artificial nitrogen inputs but also due to temperature and soil moisture variations influenced by weather conditions. We concluded that assessing N₂O emissions solely based on the rice cultivation period would underestimate annual emissions. To prevent underestimation of N₂O emissions, continual gas collection throughout a year covering both rice cultivation and fallow phases is required in align with monitoring of varying temperature and soil moisture conditions. Based on our findings, we recommend that at least a three whole year evaluation period is needed to ensure estimation accuracy of N₂O emissions under varying nitrogen fertilization rates. Also, the findings from this study would help prepare a further revision or refinement of N2O emission factor from rice cultivation in the national greenhouse gas inventories defined by the inter-governmental panel on climate change (IPCC).

Nonparametric assessments of police technical and scale efficiency is challenging because of the stochastic nature of criminal behavior and because of the subjective dependence on multiple decision criteria, which can lead to a more or less efficiency prospect depending on the regulation, necessity, or organizational objective. There is a trade-off between efficiency and effectiveness in many police performance assessments, i.e., efficient departments (producing more clear-ups with a given resource) are crime-specialized or cannot reproduce those good results effectively on more severe or complex occurrences. This study proposes a combined methodology for carrying out efficiency and effectiveness analysis of Police departments. A conditional non-parametric approach, which allows to include crime as an external factor in the analysis, is combined with a non-compensatory ranking based on the PROMETHEE II methodology for the approach illustrated on the multidimensional efficiency and effectiveness comparison of 145 Pernambuco (Brazil)'s police departments. The application results offer compelling perspectives for public administrations concerning the strategic prioritization of units for rewards or interventions.

This study investigates the interpretability of machine learning (ML) models applied to cumulative damage prediction during a sequence of earthquakes, emphasizing the use of techniques such as SHapley Additive exPlanations (SHAP), Partial Dependence Plots (PDPs), Local Interpretable Model-agnostic Explanations (LIME), Accumulated Local Effects (ALE), Permutation and Impurity-based technique. The research explores the cumulative damage during seismic sequences, aiming to identify critical predictors and assess their influence on the cumulative damage. Moreover, the predictors contribution in respect with the range of final damage is evaluated. Nonlinear time history analyses are applied to extract the seismic response of an eight-story Reinforced Concrete (RC) frame. The regression problem’s input variables are divided into two distinct physical classes: pre-existing damage from the initial seismic event and seismic parameters representing the intensity of the subsequent earthquake, expressed by Park and Ang damage index (DIPA) and Intensity Measures (IMs), respectively. The study offers a comprehensive review of cutting-edge ML methods, hyperparameter tuning, and ML method comparisons. A LightGBM model emerges as the most efficient, among 15 different ML methods examined, with critical predictors for final damage being the initial damage caused by the first shock and the IMs of the subsequent shock: IFVF and SIH. The importance of these predictors is supported by feature importance analysis and local/global explanation methods, enhancing the interpretability and practical utility of the developed model.

Vitamin D deficiency and insufficiency are highly prevalent in CKD affecting over 80% of hemodialysis (HD) patients and require therapeutic intervention. Nephrological societies suggest the administration of cholecalciferol according to the guidelines for the general population. The aim of the observational study was to evaluate the efficacy and safety of the therapy with a high dose of cholecalciferol in HD patients with 25(OH)D deficiency and insufficiency to reach the target serum 25(OH)D level &gt; 30 ng/mL. 22 patients (16 M), with an average age of 72.5 ± 13.03 years and 25(OH)D concentration of 13.05 (9.00–17.90) ng/mL were administered cholecalciferol at a therapeutic dose of 70,000 IU/week (20,000 IU + 20,000 IU + 30,000 IU, immediately after each dialysis session). All patients achieved the target value &gt;30 ng/mL, with a mean time of 2.86 ± 1.87 weeks. In the first week, the target level of 25(OH)D (100%) was reached by 2 patients (9.09%), in the second week – by 15 patients (68.18%), in the fourth week – by 18 patients (81.18%) and in the ninth week by all 22 patients (100%). A significant increase in 1,25(OH)2D levels was observed during the study, however, only 2 patients (9.09%) achieved a concentration of 1,25(OH)2D above 25 ng/mL – the lower limit of the reference range. The intact PTH concentrations remained unchanged during the observation period. No episodes of hypercalcemia, and one new episode of hyperphosphatemia were observed. In conclusion, our study showed that the administration of a high therapeutic dose of cholecalciferol allowed for a quick, effective, and safe leveling of 25(OH)D concentration in HD patients.

We aimed to directly compare the cost-effectiveness of the NELSON and NLST screening protocols, two trials influencing lung cancer screening implementation internationally. A decision-analytic model analyzing the cost-effectiveness of the NELSON protocols was manipulated to reflect the protocols of the NLST, while maintaining features specific to the Hungarian healthcare setting. In the NELSON protocol, there are three possible outcomes to the initial round of screening: positive, negative, or indeterminate, indicating an uncertain degree of suspicion for lung cancer. This pro-tocol differs from the NLST protocol, in which the only possible screening outcomes are positive or negative, with no indeterminate option. The NLST pathway for smokers aged 55-74 resulted in a 43 € increase in total average lifetime costs compared to the Hungarian screening pathway and re-sulted in a lifetime gain of 0.006 QALYs. The incremental costs and QALYs yield an ICER of 7875 €/QALY. Our results demonstrate that assigning any suspicious LDCT screen as a positive result (NLST protocol) rather than indeterminate (NELSON protocol) can yield a slight QALY gain that is worth the additional use of resources according to Hungary’s willingness to pay threshold. Our study provides insight on the cost-effectiveness, advantages, and disadvantages of various LDCT screening protocols for lung cancer and can assist other countries as they implement their screening programs.

Vaccine hesitancy has emerged as a significant barrier to achieving herd immunity and protecting populations from preventable diseases. Despite the proven effectiveness and safety of vaccines, many individuals remain hesitant or refuse to vaccinate themselves or their children. This review aims to identify the factors contributing to vaccine hesitancy, including misinformation, lack of trust in authorities, cultural beliefs, and access barriers. We also discuss the impact of vaccine hesitancy on public health, including outbreaks of vaccine-preventable diseases and erosion of trust in public health authorities. Furthermore, we present evidence-based communication strategies for addressing vaccine hesitancy, including building trust, providing accurate information, addressing myths and misconceptions, engaging with local influencers, and utilizing social media and digital platforms. By understanding the factors contributing to vaccine hesitancy and implementing effective communication strategies, healthcare providers, public health officials, and community leaders can work towards promoting widespread vaccine acceptance and protecting public health.

By using geodesic equations to obtain a gravitational potential generated from a point-like source, we end up in the concept of a nearly Newtonian gravity to analyse effective potentials of quasi-circular orbits. By means of an approximate solution from an axially static and symmetric Weyl metric, we study an effective gravitational potential to obtain its related rotation curves, orbital planes and orbits. Moreover, using as initial condition a Plummer sphere, some prospects on star cluster disruption are also discussed in this framework.

Medical waste management is crucial issues for keeping our life safe and safety. Without effective measures for waste management, we cannot keep ourselves safe from different types of contagious diseases; viruses, bacteria. Knowledge sharing assists healthcare staff in identifying and mitigating hazards on appropriate handling, segregation and disposal medical waste. The aim of the study is to identify a multifaceted analysis of knowledge sharing, training, communication and attitudes for effective medical waste management. This study selected 153 medical workers randomly, including nurses, lab technologists, and cleaners, from hospitals, diagnostic centers, and clinics in the northern part of Bangladesh. The study design of this research is mixed-methods. This research adopts a survey and interview as a research strategy. The samples are collected randomly. SPSS software packages, MS Excel Office, and PLS-SEM are used to analyze data. Most of the respondents always share their knowledge face-to-face according to the findings. The result also shows that there are positive relationship between sources of knowledge (p: 0.046), awareness and knowledge (p: 0.049), attitudes of waste management (p: 0.025) and effective medical waste management. However, there are no relationships between communication and collaboration (p: 0.943), the practice of waste management (p: 0.155), supervision and staff monitoring (p: 0.527), training and education (p: 0.656) and effective medical waste management. Its focus on the northern part of Bangladesh introduces regional specificity, potentially limiting the applicability of results to other regions. The knowledge-sharing practices for waste management among medical staff are examined within this research, along with the relationship between attitude, awareness, and knowledge, staff supervision and monitoring, practice, training, and education and effective medical waste management that have not been studied before home and abroad. This analysis highlights the critical need for an integrated approach to medical waste management, emphasizing the importance of continuous education, open communication, and cultivating a culture that prioritizes environmental sustainability. The insights from this study offer practical recommendations for healthcare institutions to improve their medical waste management practices, ultimately leading to enhanced health outcomes and better environmental protection.

ABSTRACT Objectives: Typical Diagnostic Reference Levels (DRL) in terms of Computed Tomography Dose Index (CTDI) and patient dose in terms of Effective Dose (ED ) and Size Specific Dose Estimate (SSDE) were estimated in Computed Tomography (CT) guided biopsy procedures. Materials and Methods: A total of 226 CT biopsy procedures - Iliac bone, liver, lung, mediastinum and para-aortic tissue - were retrospectively analyzed and Typical DRL extracted based on ICRP 135 instructions. Results: For helical mode acquisitions, DRLs in terms of CTDIvol were 9.7 mGy for Iliac bone, 8.9 mGy for liver, 8.8 mGy for lung, 7.9 mGy for mediastinal mass and 9 mGy for para-aortic lymph nodes biopsy procedures. For biopsy acquisitions, DRL values were 7.3 mGy, 7.7 mGy, 5.6 mGy, 5.6 mGy and 7.4 mGy respectively. Also, SSDE median values ranged from 7.6 mGy to 10 mGy for biopsy acquisitions and 11,3 mGy to 12,6 mGy for helical acquisitions, as well as the median values for effective dose ranged from 1.6 mSv to 5,7 mSv for biopsy scans and 3.9 to 9.3 mSv for helical scans. Conclusions: The use of DLR as an optimization tool for CT-guided biopsy procedures revealed that helical scans across the entire anatomical region greatly affect radiation dose compared to biopsy acquisitions.

This commentary is focused on radioactive contaminations in the Urals, where the consequences were more severe in the long term than those after the Chernobyl accident. The difference is that the latter was a technogenic catastrophe, but the former - a radioactive contamination tolerated since 70 years with several accidents in between. In earlier publications of Russian researchers no cancer frequency elevation was reported after exposures below 0.5 Sv or generally in the populations exposed to low doses. Later on, the same scientists started to claim similar relative risks for cancer and other diseases among exposed people in the Urals and in atomic bomb survivors from Hiroshima and Nagasaki. Apparently, an unofficial directive has been behind this ideological shift noticed around the year 2005. Trimming of statistics has been not unusual in the former Soviet Union. Potential motives included fostering radiophobia, stirring anti-nuclear protests in other countries and strangulation of nuclear energy aimed at the boosting of fossil fuel prices. Recent publications claiming cardiovascular risks after low-dose low-rate exposures and recommending more stringent standards of radiological protection are discussed here in some detail. Such recommendations for dose rates compatible with the natural radiation background are obviously nonsensical.

To date, radiation adaptation response has been reported as a low-dose related phenomenon and has been associated with radiation hormesis. Well-known cancers are caused by non-radiation active reactants, in addition to radiation. A model of suppression for radiation-specific cancers was previously reported, but the model did not target radiation-nonspecific cancers. In this paper, we describe kinetic models of radiation-induced suppressors for general radiation non-specific cancers, estimating the dose that induces the maximum hormesis effect while satisfying the condition that the risk is approximately proportional to dose above 100 mSv. It was found that the radiation hormesis effect is maximal at about 20 mSv when the rate constant for generation is the same as the rate constant for decomposition. When the two rate constants are different, the dose at which the radiation hormesis effect is maximized depends on both rate constants, but the dose increases as the two rate constants approach each other, reaching a maximum of about 20 mSv. This conclusion may lead to the discovery of unknown cancer suppressors at low doses and the development of cancer suppression methods in the future.

Recent technological advancements in conservation genetics and genomics have resulted in diverse tools for aiding conservation of species. The precision and resolution of high throughput sequencing technologies provide valuable insights to aid conservation decisions, but these technologies are often financially unfeasible or unavailable in resource constrained countries. Inter-Simple Sequence Repeat (ISSR) markers, when combined with sensitive automated detection systems, provide a simple, cheap means to investigate genetic diversity and discriminate closely related species. Here we apply this technology to assess genetic diversity and taxonomic delimitation in the Encephalartos eugene-maraisii species complex, a highly threatened, taxonomically dubious group of cycads in South Africa. Our analyses support taxonomic singularity of E. dyerianus, E. dolomiticus and E. eugene-maraisii. Relationships between E. nubimontanus and E. cupidus remain uncertain. E. middelburgensis samples showed no clustering but had poor amplification success. This study demonstrates the suitability of automated ISSR fingerprinting as a method for plant conservation studies, especially in resource-constrained countries, and we make recommendations as to how this methodology can be effectively implemented.

Patients with lean NAFLD make up an increasing subset of liver diseases. The association between lean NAFLD and feutin-A, which serves as a hepatokine and adipokine, has never been examined. Our study aimed to explore the association of serum fetuin-A among lean and nonlean patients. The study comprised 606 adults from the community, stratified into lean or nonlean (BMI </≥ 24 kg/m2) and NAFLD or non-NAFLD (scoring of ultrasonographic fatty liver indicator, US-FLI ≥ 2/<2). Multivariate logistic regression analyses were performed to estimate the odds ratio of having NAFLD among the tertiles of fetuin-A after adjustment. The least square means were computed by general linear models to estimate marginal means of the serum fetuin-A concentrations in relation to the NAFLD groups. The OR of having NAFLD for the highest versus the lowest tertile of fetuin-A was 2.62 (95% CI: 1.72-3.98; P for trend<0.001). Stratifying by BMI, the OR of having lean NAFLD for the highest versus the lowest tertile of fetuin-A was 2.09 (95% CI: 1.09-3.98; P for trend 0.026), while nonlean NAFLD had no significant association with the fetuin-A gradient after adjustments. Fetuin-A was positively associated with lean NAFLD after adjusting for central obesity and insulin resistance.

Distributed tracing is a cutting-edge technology for monitoring, managing, and troubleshooting native cloud applications. It offers a more comprehensive and continuous observability, surpassing traditional logging methods, and is indispensable for navigating modern complex software architectures. However, the sheer volume of generated traces is staggering in distributed applications, and direct storage and utilization of every trace are impractical due to associated operational costs. This entails a sampling strategy to select which traces warrant storage and analysis. Historically, sampling methods have included a rate-based approach, often relying heavily on a manual configuration. There is a need for a more intelligent approach, and we propose a hierarchical sampling methodology to address multiple requirements concurrently. Initial rate-based sampling mitigates the overwhelming volume of traces, as no further analysis can be performed on this level. In the next stage, more nuanced analysis is facilitated based on the previous foundation, incorporating information regarding trace properties and ensuring the preservation of vital process details even under extreme conditions. This comprehensive approach not only aids in the visualization and conceptualization of applications but also enables more targeted analysis in later stages. As we delve deeper into the sampling hierarchy, the technique becomes tailored to specific purposes, such as simplifying application troubleshooting. In this context, the sampling strategy prioritizes the retention of erroneous traces from dominant processes, thus facilitating the identification and resolution of underlying issues. The focus of this paper is to reveal the impact of the sampling on troubleshooting efficiency. Leveraging intelligent and explainable artificial intelligence solutions enables the detection of malfunctioning microservices and provides transparent insights into root causes. We advocate for using rule-induction systems, which offer explainability and efficacy in decision-making processes. By integrating advanced sampling techniques with machine learning-driven intelligence, we empower organizations to navigate the complexities of large-scale distributed cloud environments effectively.

We report the negative effective mass metamaterials based on the electro-mechanical coupling exploiting plasma oscillations of a free electron gas. The negative mass appears as a result of vibration of a metallic particle with a frequency of ω which is close the frequency of the plasma oscillations of the electron gas m_2 relatively to the ionic lattice m_1. The plasma oscillations are represented with the elastic spring k_2=ω_p^2 m_2, where ω_p is the plasma frequency. Thus, the metallic particle vibrated with the external frequency ω is described by the effective mass m_eff=m_1+(m_2 ω_p^2)/(ω_p^2-ω^2 ) , which is negative when the frequency ω approaches ω_p from above. The idea is exemplified with two conducting metals, namely Au and Li.

We use oblate coordinates to study its resulting orbit equations. Their related solutions of Einstein's vacuum equations can be written as a linear combination of Legendre polynomials of positive denite integers $l$. Starting from solutions of the zeroth order $l=0$ in a nearly newtonian regime, we obtain a non-trivial formula favoring both retrograde and advanced solutions for the apsidal precession depending on parameters related to the metric coecients, particularly applied to the apsidal precessions of Mercury and asteroids (Icarus and 2 Pallas). As a realization of the equivalence problem in general Relativity, a comparison is made with the resulting perihelion shift produced by Weyl cylindric coordinates and the Schwarzschild solution analyzing how different geometries of space-time influence on solutions in astrophysical phenomena.

Abstract Background: Temporomandibular disorders (TMD) are a range of clinical problems related to the temporomandibular joint (TMJ), chewing muscles, and surrounding facial structures. Functional magnetic resonance studies suggest that these disorders affect over 5% of the population. The relationship between dental occlusion and TMD has been a topic of debate in dentistry; some researchers suggest using lateral cephalograms and cephalometric data to identify which morphological profiles and types of malocclusion are most likely to cause TMD. The aim of this study is to identify the morphological profiles and associated skeletal malocclusions that have the greatest influence on the development of TMD. This will be accomplished through the analysis of cephalometric data obtained from cephalograms and condylar section images of patients from the Orthognathodontics Department of Chieti, who underwent low-dose cbct during their initial visit. Matherial and methods: This study, conducted at the Orthognathodontics Department of Gabriele D’Annunzio University in Chieti, examined a group of 67 patients (both males and females) presenting with signs of temporomandibular joint disorders (TMD). The inclusion criteria for the study were first-time TMD diagnosis, age 18 and above, and accessible medical records, wide field of view cone beam low dosage, and photographs. Patients with a history of tumor, trauma, surgical interventions in the jaw and facial area, fractures, and other craniofacial anomalies were excluded from the study. The aim of the study is to further understand the morphological profiles and associated skeletal malocclusions that contribute to TMD. Results: male patients: sagittal profile: 56% exhibited a skeletal Class II profile due to mandibular retrognathia. Vertical Profile: 73% were brachyfacial with a hypodivergent pattern. Dental Relationships: Increased overjet and a tendency towards deep bite were observed. 23% exhibited deep bite, 20% were normodivergent, and 8% were dolichofacial. The soft tissue profile tended towards flatness. Condyle Position: in Class II hypodivergent males, the condyle was non-concentric and positioned more posteriorly. In mesiodivergent males, the condyle was concentric, while in hyperdivergent males, it was slightly anterior. Female Patients: Sagittal Profile: 79% had a skeletal Class II profile with mandibular retrognathia. Vertical Profile: 47% were hypodivergent with reduced anterior facial height (105°). Dental Relationships: 17% exhibited deep bite, and 48% of those with a Class II profile had increased overjet. 43% were mesofacial, and 10% were dolichofacial. Condyle Position: In Class II hypodivergent and normodivergent females, the condyle was non-concentric and positioned more posteriorly. In hyperdivergent females, the condyle was positioned more anteriorly and higher in the fossa. Conclusion: The study highlighted significant differences in cephalometric parameters and condyle positions between male and female patients with TMD. A posteriorly positioned condyle was associated with a flattened condylar head, particularly in Class II hypodivergent profiles. These findings underscore the importance of individualized diagnostic and treatment approaches based on detailed cephalometric and condylar assessments. Further research is needed to explore the implications of these variations for TMD management and outcomes.

Background: The transversus abdominis plane (TAP) block has gained increasing importance as a very effective pain relief in for caesarean section. This study aimed to compare bupivacaine (Group B), bupivacaine with dexmedetomidine (Group BD) and bupivacaine with dexamethasone (Group BDx) applied in ultrasound-guided TAP block in the treatment of CS postoperative pain. Material and Method: American Society of Anesthesiologists I and II pregnant women who underwent cesarean section were included in the study. Forty patients were admitted in each group. All patients were applied TAP block with ultrasound guidance by administering the medications of the group in which they were included. Results: Body mass index (BMI) and operation duration were higher in Group B (p*=0.01 and 0.004, respectively). Instant tramadol requirement and amount were higher in Group B at some of follow up times. Patient satisfaction scale were better in Group BD and Group BDx. Conclusion: TAP block significantly reduces pain after cesarean section, prolongs the time to first analgesic request, and reduces the need for additional opioid analgesics. The addition of adjuvant to the TAP block usually improves the postoperative clinical condition. However, some special conditions such as body mass index (BMI) may negatively affect the clinical situation. Comprehensive, standardized, randomized controlled studies are needed to compare results under different conditions.

Cumulative exposure to multiple early life stressors are expected to affect behavioral development causing increased susceptibility towards neuropsychiatric disorders. The present study was designed to mimic such conditions in rat model to study behavioral impairments during adolescence and adulthood. Female Wistar rats (n=32; 140-150 gm) were switched to low protein (LP; 8% protein) or Control (20% protein) diet, 15 days prior to conception and then diet regime was maintained throughout the experimental period. Pups born to Control and LP dams were intraperitoneally injected with deltamethrin (DLT-pyrethroid insecticide; 0.7mg/kg body weight; PND 1 to 7) or lipopolysaccharide (LPS-bacterial endotoxin; 0.3mg/kg body weight; PND 3 and 5) or DLT+LPS, on designated days forming 8 experimental groups (Control, LP, Control+LPS, LP+LPS, Control+DLT, LP+DLT, Control+DLT+LPS and LP+DLT+LPS). Neurobehavioral assessments were performed in F1 rats (1, 3, 6 months) by Open field, Elevated plus maze, Light and Dark box, and Rotarod tests. LP rats were found to be more susceptible to either singular or cumulative exposure as compared to their age matched control counterparts, showing significantly severe behavioural abnormalities, as hyperactivity, attention deficits, impulsiveness and low anxiety, the hallmark symptoms of neuropsychiatric disorders like schizophrenia and ADHD, suggesting thereby that early life multi-hit exposure may predispose individuals to developmental disorders.

Supplier collaboration and partnership in procurement are essential elements for enhancing organizational efficiency, innovation, and resilience in today's globalized markets. This qualitative study investigates the dynamics of effective supplier relationships, focusing on trust, communication, innovation, quality, cost savings, and resilience as critical factors. Data were gathered through semi-structured interviews, case studies, and document analysis across diverse industries, highlighting insights from procurement professionals and supplier representatives. Key findings underscore the foundational role of trust and communication in fostering successful collaborations. Establishing transparent, ongoing communication channels facilitates mutual understanding, reduces conflicts, and enhances overall satisfaction. Collaborative innovation emerged as pivotal, enabling organizations to pool resources and expertise for product development and process improvement. Quality and reliability were identified as significant outcomes of close partnerships, particularly in industries with stringent standards such as aerospace and healthcare. Furthermore, the study reveals substantial cost savings and efficiency gains through collaborative efforts in process optimization and waste reduction. Effective risk management practices within these partnerships enhance supply chain resilience, enabling organizations to anticipate and mitigate disruptions proactively. Despite these benefits, challenges such as cultural differences, technological integration, and regulatory compliance require strategic mitigation strategies. In conclusion, organizations can optimize supplier collaborations by prioritizing trust-building, fostering a culture of innovation, and investing in robust relationship management practices. This approach not only enhances operational performance but also positions organizations to navigate market uncertainties and achieve sustainable growth in a competitive landscape.

The global trend towards increased demand for organic food, greener environments, and the integration of biological control agents into pest management strategies has greatly enhanced the need for biological pesticides (biopesticides). Biopesticides are generally environmentally friendly and are made from micro-organisms or other natural substances. Despite their great potential, relatively few have been registered and commercialised in Nigeria compared to other African countries such as South Africa and Kenya. Biological active agents are so diverse such that ap-plying the same safety standards or environmental conditions to all of them is almost impossible. A review of risk assessment processes and comparative assessments of Nigeria's biopesticide regulations with other developing African countries and developed regions was conducted. Prolonged field testing, lack of bridged risk assessments and technical checklists have been identified as key factors hampering the timely development and commercialisation of biopesti-cides in Nigeria. Recommendations on necessary changes to the existing Nigeria biopesticide regulations have been made. Risk assessment matrices for microbial and biochemical biopesti-cides and a scientific/technical checklist have also been developed. Harmonisation and data ex-change among other countries in the region will also enhance the advancement of scientific and technical knowledge for sustainable regulation and cross-border trade.

Mosquitoes carrying endosymbiotic bacteria called Wolbachia are being released in mosquito and arbovirus control programs around the world. Open field releases of Wolbachia-infected male mosquitoes have achieved over 95% population suppression, while the replacement of populations with Wolbachia-infected females is self-sustaining and can greatly reduce local dengue transmission. Despite many successful interventions, significant questions and challenges lie ahead. Wolbachia, viruses and their mosquito hosts can evolve, leading to uncertainty around the long-term effectiveness of a given Wolbachia strain, while few ecological impacts of Wolbachia releases have been explored. Wolbachia strains are diverse and the choice of strain to release should be made carefully, taking environmental conditions and the release objective into account. Mosquito quality control, thoughtful community awareness programs and long-term monitoring of populations are essential for all types of Wolbachia intervention. Releases of Wolbachia-infected mosquitoes show great promise, but existing control measures remain an important way to reduce the burden of mosquito-borne disease.

We review past and present results on the non-local form-factors of the effective action of semiclassical gravity in two and four dimensions computed by means of a covariant expansion of the heat kernel up to the second order in the curvatures. We discuss the importance of these form-factors in the construction of mass-dependent beta functions for the Newton's constant and the other gravitational couplings.

Cardiovascular diseases (CVD) are the leading cause of morbidity and mortality worldwide, including in Croatia. Since most patients have multiple disorders and diseases caused largely by the same risk factors, and as it is essential to approach each patient as a person with all disorders, today we are talking about a new paradigm - cardio-renal-metabolic (CKM) syndrome and cardio-renal-metabolic health, which necessarily includes brain health. Elevated systolic blood pressure, LDL cholesterol, smoking, obesity, diabetes, impaired renal function or chronic kidney disease, which all stem from insufficient physical activity, unhealthy diet with excessive intake of table salt, and air pollution, are the leading causes of overall morbidity and mortality from CKM diseases, especially mortality from CVD. Experts from various fields key to CKM health have written this document with the aim of integrating it as part of the national plan for the prevention of chronic non-communicable diseases with a focus on CVD, which should become mandatory and be based on the existing guidelines of professional societies.

Porphyromonas gingivalis is the major pathogenic bacteria found in the subgingival plaque of patients with periodontitis, leading to neuroinflammation. The bacteria destroy periodontal tissue through its virulence factors which are retained in the bacteria’s outer membrane vesicles (OMV). The purpose of this study was to determine the real time effect of intraperitoneal in-jection of P. gingivalis OMV on the production and expression of inflammatory markers as well as histopathological changes in the central nervous system (CNS) of adult zebrafish. Fol-lowing the LD50 (21 µg of OMV), the zebrafish were injected intraperitoneally with 18 µg of OMV and control group with normal saline at 7 different time points. Brains of experimental zebrafish were dissected at desired time points for colorimetric assays, ELISA and histology. This study discovered that nitric oxide and PGE2 were significantly increased at 45 minutes while IL-1β and IL-6 were expressed at subsequent 12- and 24-hours. respectively. Histopatho-logical changes such as blood coagulation, astrocytosis, oedema, spongiosis, and necrosis were also observed between 6- and 24-hours. The two apoptotic enzymes, caspases 3 and 9 were not expressed at any time point. In summary, the OMV induced neuroinflammatory responses and histopathological changes in adult zebrafish were time point dependent

Hyper-radiosensitivity (HRS) is the increased sensitivity to low doses of ionizing radiation observed in most cell lines. We previously demonstrated that HRS is permanently abolished in cells irradiated at a low dose rate (LDR), in a mechanism dependent on transforming growth factor β3 (TGF-β3). In this study, we aimed to elucidate the activation and receptor binding of TGF-β3 in this mechanism. T-47D cells were pre-treated with inhibitors of potential receptors and activators of TGF-β3, along with addition of small extracellular vesicles (sEVs) from LDR primed cells, before their radiosensitivity was assessed by the clonogenic assay. The protein content of sEVs from LDR primed cells was analyzed with mass spectrometry. Our results show that sEVs contain TGF-β3 regardless of priming status, but only sEVs from LDR primed cells remove HRS in reporter cells. Inhibition of the matrix metalloproteinase (MMP) family prevents removal of HRS, suggesting an MMP-dependent activation of TGF-β3 in the LDR primed cells. We demonstrate a functional interaction between TGF-β3 and activin receptor like kinase 1 (ALK1), by showing that TGF-β3 removes HRS through ALK1 binding, independent of ALK5 and TGF-βRII. These results are an important contribution to a more comprehensive understanding of the mechanism behind TGF-β3 mediated removal of HRS.

Simple summary This reassessment of the findings from our Phase I/II study seeks to evaluate the effectiveness of SBRT for treating local intermediate-high risk prostate cancer in the absence of androgen-deprivation therapy due to patient’s refusal, with a median follow-up of 6.5 years. Our primary focus is on analysing the treated areas compared to recurrence patterns in the seven patients who experienced local relapse. Additionally, we provide updated data on late toxicities of grade 2 or higher, both genitourinary and gastrointestinal. Abstract Objectives: We investigated spatial patterns between primary and recurrent tumor sites and assessed long-term toxicity after dose escalation stereotactic body radiation therapy (SBRT) to the dominant intraprostatic nodule (DIN). Materials and methods: In 33 patients with intermediate-high risk prostate cancer (PCa), doses up to 50 Gy were administered to the DIN. Recurrence sites were determined and compared to the original tumor development sites through multiparametric MRI and 68Ga-labelled prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (68Ga-PSMA-PET/CT) images. Overlap rates, categorized as 75% or higher for full overlap, and 25-74% for partial overlap, were assessed. Long-term toxicity is reported. Results: All patients completed treatment, with only one receiving concomitant androgen deprivation therapy (ADT). Recurrences were diagnosed after a median of 33 months (range: 17-76 months), affecting 13 out of 33 patients (39.4%). Intraprostatic recurrences occurred in 7 patients (21%), with ≥ 75% overlap in two, a partial overlap in another two, and no overlap in the remaining three patient. Notably, 5 patients with intra-prostatic recurrences had synchronous bone and/or lymph node metastases, while six patients had isolated bone or lymph node metastasis without intraprostatic recurrences. Extended follow-up revealed grade 2 or higher late GU and GI toxicity in 18% (n=6) and 6% (n=2) of the patients. Conclusions: Among patients with intermediate-high risk PCa undergoing focal dose-escalated SBRT without ADT, DIN recurrences were infrequent. When present, these recurrences were typically located at the original site or adjacent to the initial tumor. Conversely, relapses beyond the DIN and in extra-prostatic (metastatic) sites were prevalent, underscoring the significance of systemic ADT in managing this patient population. Advances in knowledge: focal dose escalated prostate SBRT prevented recurrences in the dominant nodule, however extra-prostatic recurrence sites were frequent.

Objectives. Optimal treatment strategy for ischemic stroke in patients presenting with tandem occlusions the internal carotid artery remains controversial. Several studies have demonstrated better clinical outcomes after eptifibatide, which is a short half-life antiplatelet agent. This retrospective analysis was focused at safety and efficacy of administration of low-dose eptifibatide in stroke patients with tandem lesions. Methods. We evaluated results of endovascular treatment in 148 stroke patients with tandem lesions. Patients in whom balloon angioplasty alone resulted in satisfactory cerebral flow did not receive eptifibatide (33 patients); others received this drug together with stent implantation (115 patients). Eptifibatide was given in as intravenous bolus 180 g/kg, and then in modified low dose of 1 g/kg/min for 24 hours. Results. There were no statistically significant differences between both groups regarding 30-day mortality, frequency of thrombotic events and hemorrhagic complications. Analysis of clinical status at 30-day follow-up revealed that administration of eptifibatide was associated with statistically significant better outcome: a higher rate of either no neurological symptoms or only mild symptoms (4 NIHSS points maximally). Conclusions. Administration of eptifibatide in stroke patients presenting with tandem lesions is relatively safe. Moreover, treatment with this drug can improve clinical outcomes in these challenging patients.

We compared the functional and morphologic effects in the loading dose between patients with treatment-naïve neovascular age-related macular degeneration treated with either intravitreal aflibercept (IVA) or intravitreal faricimab (IVF) injection in clinical settings. This retrospective study included 30 eyes from 28 patients who started IVA treatment between June and September 2022 and 30 eyes from 29 patients who started IVF treatment between October 2022 and March 2023. The mean best corrected visual acuity (BCVA) significantly improved from pre-treatment after loading dose in the IVA group (from 0.46 ± 0.46 to 0.36 ± 0.37, p=0.0047) and not in the IVF group (from 0.46 ± 0.41 to 0.44 ± 0.45, p=0.60). The mean central retinal thickness (CRT) significantly improved in both groups. The proportion of eyes with residual exudative change was greater in the IVF group than in the IVA group at 2 months after the first treatment. (p=0.026) We further analyzed the patients who obtained complete resolution of exudative changes after the loading dose. The IVA group had a significant improvement in BCVA, whereas the IVF group did not p=0.0047 and 0.20, respectively) Although IVA and IVF significantly improved the CRT, the BCVA improved significantly in IVA group and not in IVF group.

Ecdysterone is a phytosteroid widely discussed for its various pharmacological, growth-promoting and anabolic effects mediated by activation of estrogen receptor beta (ERbeta). Performance-enhancement in sports was demonstrated recently, and ecdysterone was consequently included in the Monitoring Program to detect potential patterns of misuse in sport. Only few studies on the pharmacokinetics of ecdysterone in humans have been reported so far. In this study, post-administration urines in twelve volunteers (single dose of 50 mg of ecdysterone) were analyzed using dilute-and-inject liquid chromatography-tandem mass spectrometry. Identification and quantitation of ecdysterone and of two metabolites, 14-deoxy ecdysterone and 14-deoxy poststerone was achieved. Ecdysterone was the most abundant analyte present in post-administration urines, detected for more than 2 days with a maximum concentration (Cmax) in the 2.8-8.5 h urines (Cmax = 4.4-30.0 µg/mL). The metabolites 14-deoxy ecdysterone and 14-deoxy poststerone were detected later reaching the maximum concentrations at 8.5-39.5 h (Cmax = 0.1-6.0 µg/mL) and 23.3-41.3 h (Cmax = 0.1-1.5 µg/mL), respectively. Cumulative urinary excretion yielded average values of 18%, 2.3% and 1.5% for ecdysterone, 14-deoxy ecdysterone and 14-deoxy poststerone, respectively. Ecdysterone and 14-deoxy ecdysterone were excreted following first order kinetics with half-lives calculated with three hours, while pharmacokinetics of 14-deoxy poststerone needs further evaluation.

While there is a coordinated effort around reaching zero dose children and closing existing equity gaps in immunization delivery, it’s important that there is agreement and clarity around how ‘zero dose status’ is defined and what is gained and lost by using different indicators for zero dose status. There are two popular approaches used in research, program design, and advocacy to define zero dose status: one uses a single vaccine to serve as a proxy for zero dose status, while another uses a subset of vaccines to identify children who have missed all routine vaccines. We provide a global analysis utilizing the most recent publicly available DHS and MICS data to compare the number, proportion, and profile of children 12 to 23 months who are ‘penta-zero dose’ (have not received the pentavalent vaccine), ‘truly’ zero dose (have not received the BCG, polio, pentavalent, and measles vaccines), and ‘misclassified’ zero dose children (those who are penta-zero dose but have received at least one other vaccine). Our analysis includes 194,829 observations from 82 low- and middle-income countries. Globally, 14.2% of children are penta-zero dose and 7.5% are truly zero dose, suggesting that 46.5% of penta-zero dose children have had at least one contact with the immunization system. While there are similarities in the profile of children that are penta-zero dose and truly zero dose, there are key differences between the proportion of key characteristics among truly zero dose and misclassified zero dose children, including access to maternal and child health services. By understanding the extent of connection zero dose children may have with the health and immunization system and contrasting it with how much the use of a more feasible definition of zero dose may underestimate the level of vulnerability in the zero dose population, we provide insights that can help immunization programs design strategies that better target the most disadvantaged populations. If the vulnerability profiles of the truly zero dose children are qualitatively different from that of the penta zero dose children, then failing to distinguish the truly zero dose populations, and how to optimally reach them, may lead to the development of misguided or inefficient strategies for vaccinating the most disadvantaged population of children.

Abstract: rainfall is the main driver of soil erosion. With the daily rainfall, riverine flow discharge and sediment load in the upper Lianjiang River watershed from 1990 to 2020, extreme rainfall events were defined by the 95th percentile method and minimum event interval time (MIT), change trends and mutations of yearly rainfall, riverine flow discharge and sediment load were identified using the Mann-Kendall test, then the optimum lag response time and antecedent rainfall were investigated with the multiple linear regression. The results showed that (1) the sediment changed significantly and abruptly in 1995 due to the expansion of the garden land. (2) Compared with ordinary rainfall, extreme rainfall events explained more variations of riverine flow and sediment with a higher degree, and had a more significant effect on the lag time of runoff and sediment. (3) Garden land expansion in extreme rainfall scenarios resulted in longer lag times for runoff and sediment and decreased demand for antecedent rainfall with more pre-event time. Therefore, taking the rainfall event as a breakthrough, analyzing the antecedent rainfall and the lag response of riverine flow discharge and sediment load is conducive to revealing the response mechanism of riverine flow discharge and sediment load and improving the simulation accuracy of riverine flow and sediment under extreme rainfall condition, thus help for the soil erosion control under extreme rainfall.

Environmental estrogen pollution and estrogen effects on the female reproduction system are well-recognized scientifically. Among the estrogens, 17 β-estradiol is a priority in environmental estrogen pollution, and it is also a major contributor to estrogen which regulates the female reproduction system. 17 β-estradiol is carcinogen and has a tumor promotion effect relating to breast cancer, lung cancer and others. It also affects the psychological well-being such as depression, fatigue and others. Thus, a simple method of detection of 17 β-estradiol will be important for both environmental estrogen pollution and women’s health care. This study demonstrates a simple-use, cost effective 17 β-estradiol biosensor system which can be used for both environment and women’s health care applications. The bio-recognition mechanism is based on the influence of the redox couple, K₃Fe (CN) ₆/K₄Fe (CN) ₆ by the interaction between 17 β-estradiol antigen and its α-receptor (ER- α; α-estrogen antibody). The transduction mechanism is an electrochemical analytical technique, differential pulse voltammetry (DPV). The levels of 17 β-estradiol antigen studied was between 2.25 pg/mL to 2,250 pg/mL, Phosphate buffered saline (PBS), tap water from the Cleveland regional water district, and simulate urine were used as the test media covering the potential application areas for 17 β-estradiol detection. An interference study by testosterone which has a similar chemical structure and molecular weight as those of 17 β-estradiol was carried out, and this 17 β-estradiol biosensor showed excellent specificity without any interference by similar chemicals.

This study investigates effective strategies for second language education in primary schools, analyzing the efficacy of immersive and interactive methods, digital literacy tools, and mixed-method approaches. The findings reveal significant improvements in language proficiency and student engagement through these methodologies, with immersive and interactive strategies showing substantial benefits in oral proficiency and engagement, digital tools enhancing accessibility and engagement, and mixed-method approaches yielding the highest overall effectiveness. The study underscores the importance of a balanced, flexible approach to language education, integrating traditional and modern methods to cater to diverse learner needs. These strategies not only advance linguistic skills but also contribute to the broader cognitive and emotional development of young learners, emphasizing the critical role of effective language education in preparing students for a globalized world.

Fractals and multifractals are well-known trademarks of nonlinear dynamics and classical chaos. The goal of this work is to tentatively uncover the unforeseen path from multifractals and selfsimilarity to the framework of effective field theory (EFT). An intriguing finding is that the partition function of multifractal geometry includes a signature analogous to that of gravitational interaction. Our results also suggest that multifractal geometry may offer insights into the non-renormalizable interactions presumed to develop beyond the Standard Model scale.

Why animals sleep is an outstanding open question. Information about the toxic byproducts of aerobic cellular respiration along with the analysis of patterns in animal size, sleep needs, dietary-type, metabolism, number of heart beats, transportation-network design, and transportation energetics/dynamics suggest that the function of sleep is to maximize the time an animal has to perform its life functions given the finite and constant number of lifetime heart beats it has. Sleep slows down metabolism, and the heart rate, thereby decreasing the load of toxic reactive oxygen species in the cell and extending the cell’s lifetime/proper-functioning. I argue that this is used to maximize the time an animal spends in its ‘effective environment’, which is defined as the period in the light cycle (day or night) where the essential life-functions of that animal (like finding resources, finding sex, hunting) are better achieved. Larger, slow-metabolizing animals need less sleep because their large-bodily-networks and slow metabolisms keep their heart rates relatively low, resulting in a lower rate of oxidative damage, and more relative time in the ‘effective environment’ to get their essential life-functions accomplished.

In this paper we have discussed the importance of human resource management in project management. As a concept human resource management emerged in 1980 [9]. It is very important to utilize resources effectively in any organization. Like triple constrains (cost, quality, scope) human resources are also considered as one of the most important factor for the success of any project. Management of human resources involve hiring experienced workers, giving appropriate training, acknowledgement about the significance of the project and the effective use of techniques and tools in order to get the project done productively with in time and budget. It becomes the responsibility of the project manager to effectively manage human resources as it is more challenging than managing other technical resources. In this paper we have also discussed the challenges that an organization faced during the management of the resources and use of some strategic human practices in order to overcome these challenges.