We introduce NodeFlow, a flexible framework for probabilistic regression on tabular data that combines Neural Oblivious Decision Ensemble (NODE) and Conditional Continuous Normalizing Flows (CNF). It offers improved modeling capabilities for arbitrary probabilistic distributions, addressing the limitations of traditional parametric approaches. In NodeFlow, the NODE captures complex relationships in tabular data through a tree-like structure, while the conditional CNF utilizes the NODE’s output space as a conditioning factor. The training process of NodeFlow employs standard gradient-based learning, facilitating end-to-end optimization of the NODEs and CNF-based density estimation. This approach ensures outstanding performance, ease of implementation, and scalability, making NodeFlow an appealing choice for practitioners and researchers. Comprehensive assessments on benchmark datasets underscore NodeFlow’s efficacy, revealing its achievement of state-of-the-art outcomes in multivariate probabilistic regression setup and its strong performance in univariate regression tasks. Furthermore, ablation studies are conducted to justify the design choices of NodeFlow. In conclusion, NodeFlow’s end-to-end training process and strong performance make it a compelling solution for practitioners and researchers. Additionally, it opens new avenues for research and application in the field of probabilistic regression on tabular data.

Fire is a serious security threat that can lead to casualties, property damage, and environmental damage. However, despite the availability of object detection algorithms, challenges persist in detecting fires and smoke. These challenges include slow convergence speed, poor performance in detecting small targets, and high computational cost limiting deployments. In this paper, Fire smoke and human detection based on ConvNeXt and Mixed encoder (FCM-DETR), an end-to-end object detection algorithm based on Deformable DETR, is proposed. Firstly, we introduce ConvNeXt to take the place of Resnet, which greatly reduces the amount of computation and improves the ability to extract irregular flame features. Secondly, to effectively process multi-scale features, the original encoder is decoupled into two modules. Then Mixed encoder, an innovative encoder structure, is proposed, resulting in excellent performance of multi-scale fire and smoke features fusion. What can’t be overlooked is that the encoder block is compatible with any DETR-based models. Finally, the convergence speed is accelerated and the mean of average precision is improved by applying a novel loss function called Powerful IoU v2. The experimental results indicate that our model achieves the best detection accuracy compared to other models, with mAP reaching 66.7%, mAPs and Accuracyfire achieving impressive 50.2% and 98.05%, respectively.

End-to-end learned image compression codecs have notably emerged in recent years. These codecs have demonstrated superiority over conventional methods, showcasing remarkable flexibility and adaptability across diverse data domains while supporting new distortion losses. Despite challenges such as computational complexity, learned image compression methods inherently align with learning-based data processing and analytic pipelines due to their well-suited internal representations. The concept of Video Coding for Machines has garnered significant attention from both academic researchers and industry practitioners. This concept reflects the growing need to integrate data compression with computer vision applications. In light of these developments, we present a comprehensive survey and review of lossy image compression methods. Additionally, we provide a concise overview of two prominent international standards, MPEG Video Coding for Machines and JPEG AI. These standards are designed to bridge the gap between data compression and computer vision, catering to practical industry use cases.

Advanced glycation end products (AGEs) play a significant role in the aging processes, further regarding as a hallmark of aging. Despite the importance, a lack of monitoring tools has hampered the study of relationship between AGEs and aging. Here, we firstly report a novel AGEs-selective probe, AGO. AGO presented its ability to detect AGEs more sensitively than a conventional approach of measuring autofluorescence from AGEs. In addition, we confirmed that AGO can detect AGEs depending on kinetics, reflecting by a preference to ribose-derived AGEs. Finally, AGO revealed its competence to visualize glycation products in glycation mimicking model, made by collagen framework. We believe that this study will enrich molecular toolboxes to understand physiological processes of AGEs during aging processes.

Background: Microscopic examination of acid-fast stained sputum smears for detecting mycobacterial acid-fast bacilli (AFB) remains the most economical and readily available method for laboratory diagnosis of tuberculosis (TB). However, this conventional approach has limitations, including low sensitivity and labor-intensive procedures. Methods: An automated microscopy system incorporating artificial intelligence (AI) and machine learning for AFB identification was evaluated. The study was conducted at an Infectious Disease Hospital in Jiangsu Province, China, utilizing an intelligent microscope system (TB-Scan, Wellgen Medical, Kaohsiung). A total of 1,000 sputum smears were included in the analysis, with the system capturing digital microscopic images and employing an image recognition model to automatically identify and classify AFB. Referee technicians provided the gold standard for discrepant results. Results: The automated system demonstrated an overall accuracy of 95.00% (950/1,000), sensitivity of 91.24% (177/194), and specificity of 95.91% (773/806). Notably, the system identified 21 smears as positive that were previously reported as negative, with referee technicians confirming 17 of these as true positive and retracting the test results accordingly. Recalculating the performance, the accuracy increased to 96.70% (967/1,000), sensitivity to 91.94% (194/211), and specificity to 97.97% (773/789), with a false negative rate of 8.06% (17/211) and a false positive rate of 2.03% (16/789). Conclusions: The incorporation of AI and machine learning into an automated microscopy system demonstrated the potential to enhance the sensitivity and efficiency of AFB detection in sputum smears compared to conventional manual microscopy. This approach holds promise for widespread application in TB diagnostics and potentially other fields requiring labor-intensive microscopic examination.

Objective: To analyze prevalence of tuberculosis among the people who presented PIMS with complaints of fever, cough, difficulty in breathing during COVID pandemic.Study Design: Retrospective/ Cross-sectional study.Place and Duration: Department of Radiology, Pakistan Institute of Medical Sciences, Islamabad. 2020-2023. Methods: Total 17121 patients who presented PIMS during COVID pandemic with complaints of high grade fever, cough, difficulty in breathing ,were included in this study. Following the acquisition, the HRCT scans were conducted by a skilled and experienced technician and researcher, utilizing GE Healthcare equipment for HRCT Chest procedures. The scans covered the lung apices to the bases and were executed with maximal inspiration, employing a CT scanner from Toshiba Aquilion. Frequency of TB among all cases was recorded. SPSS 21.0 was used to analyze all data.Results: This study incorporated a total of 17,121 patients, comprising 9,961 (58.1%) males and 7,160 (41.8%) females. The mean age of the enrolled cases was 49.11±7.67 years, demonstrating consistency with the findings of a prior study [33]. This study also examined the prevalence of Tuberculosis in different years based on imaging findings of HRCT chest as follows: in 2020, 582 cases out of 2,450, equivalent to 23.7%; in 2021, 2,377 cases out of 9,584, equivalent to 24.8%; in 2022, 1,099 cases out of 3,913, equivalent to 28.1% and in 2023, 295 cases out of 1,174, equivalent to 25.1%. The average prevalence of TB cases from 2020 to 2023 was determined to be 4,353 cases out of 17,121, which is equal to 25.42%.Conclusion: As per the National Tuberculosis Program (NTP) in Pakistan, the prevalence rate of tuberculosis stands at 340 cases per 100,000 population, equivalent to 0.34%. However, our study reveals an exceptionally high frequency of TB cases. Specifically, the prevalence of Tuberculosis in 2020 was 23.7% (582 out of 2,450), in 2021 it was 24.8% (2,377 out of 9,584), in 2022 it surged to 28.1% (1,099 out of 3,913), and in 2023 it was 25.1% (295 out of 1,174). The average prevalence of TB cases over the period from 2020 to 2023 was calculated at 25.4% (4,353 out of 17,121). Consequently, our findings suggest the presence of a substantial tuberculosis burden in Pakistan, equating to a TB Tsunami in Pakistan.

Few prior works study self-driving cars by deep learning with IoT collaboration. SDC-Net, which is an end-to-end multitask self-driving car camera cocoon IoT-based system, is one of the research that tackles this direction. However, by design SDC-Net is not able to identify the accident locations, it only classifies if it is a crash scene or not. In this work, we introduce an enhanced design for the SDC-Net system by 1) replacing the classification network with a detection one, 2) adapting our benchmark dataset labels built on the CARLA simulator to include the vehicles bounding boxes while keeping the same training, validation, and testing samples, 3) modifying the shared information via IoT to include the accident location. We keep the same path planning and automatic emergency braking network, the digital automation platform, and the input representations to formulate the comparative study. SDC-Net++ system is proposed to 1) output the relevant control actions, especially in case of accidents: accelerate, decelerate, maneuver, and brake, and 2) share the most critical information to the connected vehicles via IoT, especially the accident locations. A comparative study is also conducted between SDC-Net and SDC-Net++ with the same input representations: front camera only, panorama and bird-eye views, and with single-task networks: crash avoidance only, and multitask networks. Multitask network with a BEV input representation outperforms the nearest representation in precision, recall, f1-score, and accuracy by more than 15.134%, 12.046%, 13.593%, and 5%, respectively. SDC-Net++ multitask network with BEV outperforms SDC-Net multitask with BEV in precision, recall, f1-score, accuracy, and average MSE by more than 2.201%, 2.8%, 2.505%, 2%, and 18.677% respectively.

Two novel core-shell composites SiO2@PMDA-Si-Tb, SiO2@PMDA-Si-Tb-phen with SiO2 as the core and terbium organic complex as the shell, were successfully synthesized. The terbium ion was coordinated with organic ligand forming terbium organic complex in the shell layer. The bi-functional organosilane ((HOOC)2C6H2(CONH(CH2)3Si(OCH2CH3)3)2 (abbreviated as PMDA-Si) was used as the first ligand and phen as the second ligand. Furthermore, the silica-modified SiO2@PMDA-Si-Tb@SiO2, SiO2@PMDA-Si-Tb-phen@SiO2 core-shell-shell composites were also synthesized by sol–gel chemical route. An amorphous silica shell was coated around the SiO2@PMDA-Si-Tb and SiO2@PMDA-Si-Tb-phen core-shell composites. The core-shell and core-shell-shell composites both exhibited excellent luminescence in solid state. The luminescence of core-shell-shell composites was stronger than that of core-shell composites. Meanwhile, an improved luminescence stability property for the core-shell-shell composites was found in the aqueous solution. The core-shell-shell composites exhibited bright luminescence, high stability, long lifetime, and good solubility, which may present potential applications in the field of bio-medical.

Tuberculosis (TB) is an infectious disease declared a global emergency by the World Health Organization and continues as one of the world’s top ten causes of death. TB diagnosis is more critical in developing countries where demanded infrastructure for detection, and treatment complicates the efforts against the disease. These aspects related to limited resources are significant, especially in areas away from the main cities, with few mechanisms to make a timely diagnosis that contributes to successfully addressing the possible patients. Artificial intelligence has begun to be essential in providing additional strategies in the diagnosis processes for health professionals’ support. This paper uses natural language processing (NLP) and machine learning (ML) techniques to create models that can supply TB diagnosis when the needed infrastructure is unavailable. Two different sources were explored: text extracted from electronic medical records (EMR) and patient clinical data (CD). Four proposals using five different machine learning models were implemented. The first two models employed ML and each data source independently. Then, two additional approaches developed a data fusion from both sources. This strategy’s employment was analyzed with physicians according to their pertinence in the process and understanding of the EMR. Finally, the results of the data fusion were compared to each source, obtaining better performance at using only the CD, where an area under the ROC curve of 69.9±2.3% was obtained. However, the advantage of analyzing physician’s reports is the availability of this information contrasted to clinical-specific data, which can be more useful in places far from the main cities without enough basic structure for its obtaining.

Introduction: Tuberculosis (TB) is one of the most prevalent respiratory diseases in the world. In 2020 there were at least 9.9 million new infections, with 1.5 million deaths. Approximately 10% of people infected with Mycobacterium tuberculosis (LTBI) develop the disease during the first 2 to 5 years after infection. Currently in South America, the diagnosis of LTBI continues to be per-formed through the Mantoux tuberculin skin test (TST). Objective: The objective of our study was to compare the sensitivity of a new immunofluorescence IGRA test against a widely available IGRA kit on the market. Material and method: Close contact to infectious patients with TB, or HIV patients or immunocompromised for another cause were recruited. Two interferon gamma release assay (IGRA) diagnostic kits were used and compared with TST. Results: 76 patients were recruited. 93.42% were Chilean nationality, 98.68% of the patients did not have immunosuppres-sion. The sensitivity of the new technique was 88.89% and specificity 92.50% in the study popula-tion compared to the IGRA previously used. In the subgroup older than 36 years, the sensitivity was 95.65% and the specificity 89.47%. Conclusion: IGRA techniques are a new resource in clini-cal laboratories to be able to make an accurate diagnosis in LTBI in the region of the Americas. In our population, the greatest benefit of this new IGRA would be observed in people over 36 years of age, where the sensitivity of the technique was like that of the currently available test.

COVID-19, caused by SARS-CoV-2, was first identified in China in 2019. The exact origin of the disease remains uncertain, with theories suggesting it may have emerged from animals or accidentally leaked from a research laboratory. If the hypothesis that COVID-19 originated from a research laboratory is accurate, it is crucial to investigate potential pathways for pathogens to escape from biocontainment research animal facilities (BRAFs). We examine key biosafety issues associated with BRAFs, including inadequate decontamination procedures for water and experimental samples, handling high biosafety level pathogens in lower level laboratories, risks of animal bites and sharps injuries, contamination of bedding and enrichment materials, and improper management and transportation of biohazard samples. Additionally, we discuss the role of veterinarians in African research animal facilities and the challenges they encounter in maintaining biocontainment standards. We emphasize the importance of routine monitoring of effluent water to detect possible disease outbreaks. We recommend a thorough investigation of the COVID-19 pandemic to identify potential sources of pathogen release from BRAFs, which could serve as hotspots for future disease outbreaks. Findings from such investigations will inform the development of policies aimed at safeguarding human populations from future pandemics and preventing BRAFs from becoming sources of infectious disease outbreaks.

Existing methods for 3D human pose estimation mainly divide the task into two stages. The first stage identifies the 2D coordinates of the human joints in the input image, namely the 2D human joint coordinates. The second stage uses the results from the first stage as input to recover the depth information of human joints from the 2D human joint coordinates to achieve 3D human pose estimation. However, the recognition accuracy of the two-stage method relies heavily on the results of the first stage and includes too many redundant processing steps, which reduces the inference efficiency of the network. To address these issues, we propose the EDD, a fully End-to-end 3D human pose estimation method based on transformer architecture with Dual Decoders. By learning multiple human poses, the model can directly infer all 3D human poses in the image using a pose decoder, and then further optimize the recognition result using a joint decoder based on the kinematic relations between joints. With the attention mechanism, this method can adaptively focus on the most relevant features to the target joint, effectively overcoming the feature misalignment problem in the human pose estimation task and greatly improving the model performance. Any complex post-processing step, such as non-maximum suppression, is eliminated, further improving the efficiency of the model. The results show that the method achieves an accuracy of 87.4% on the MuPoTS-3D dataset, significantly improving the accuracy of end-to-end 3D human pose estimation methods.

First described in 1760 by the anatomist Morgagni, CoA is a congenital heart defect characterized by narrowing the aorta, typically distal to the left subclavian artery. It accounts for approximately 5-8% of all congenital heart diseases, with an incidence estimated at 4 per 10,000 live births. In 1944, the Swedish surgeon Clarence Crafoord achieved the first successful surgical CoA repair by performing an aortic end-to-end anastomosis on two patients aged 12 and 27 years old. Presently, the most prevalent techniques for surgical repair, particularly in infants and neonates with isolated coarctation, involve resection with end-to-end anastomosis (EEA) and the modified Crafoord technique (extended resection with end-to-end anastomosis (EEEA)). Subclavian flap aortoplasty (SCAP) is an alternative surgical option for CoA repair in patients under two years of age. In cases where the stenosis extends beyond resection and end-to-end anastomosis feasibility, patch aortoplasty (PP) employing a prosthetic patch can augment the stenotic region, especially for older patients. Despite advances in pediatric cardiology and cardiac surgery, recoarctation remains a significant concern after surgical or interventional repair. This comprehensive review aims to provide a thorough analysis of coarctation management, covering the pioneering techniques introduced by Crafoord using head-to-tail anastomosis and now extending to the contemporary era marked by percutaneous interventions as well as the recoarctation rate associated with each type.

We present TOLGAN that generates traditional oriental landscape (TOL) image from a map that specifies the locations and shapes of the elements composing TOL. Users can create a TOL map by using a user interface or a segmentation scheme from a photograph. We design the generator of TOLGAN as a series of decoding layers where the map is applied between the layers. The generated TOL image is further enhanced through an AdaIN architecture. The discriminator of TOLGAN processes a generated image and its groundtruth TOL artwork image. TOLGAN is trained through a dataset composed of paired TOL artwork images and their TOL maps. We present a tool through which users can produce a TOL map by specifying and organizing the elements of TOL artworks. TOLGAN successfully generates a series of TOL images from the TOL map. We evaluate our approach using a quantitative way by estimating FID and ArtFID scores and a qualitative way by executing two user studies. Through these studies, we prove the excellence of our approach by comparing our results with those from several important existing works.

In Holter monitoring, the precise detection of standard heartbeats and Ventricular Premature Contractions (PVCs) is paramount for accurate cardiac rhythm assessment. This study introduces a novel application of the 1D U-Net neural network architecture aimed at enhancing PVC detection in Holter recordings. Training data comprised the Icentia11k, INCART DB, and our custom dataset. The model’s efficacy was subsequently validated against traditional Holter analysis methodologies across multiple databases, including AHA DB, MIT 11 DB, NST, and another custom dataset encompassing challenging real-world examples. The results underscored the 1D U-Net model’s prowess in QRS complex detection, achieving near-perfect balanced accuracy scores across all databases. PVC detection exhibited variability, with balanced accuracy scores ranging from 0.909 to 0.986. Despite some databases, like the AHA DB, showcasing lower sensitivity metrics, their robust balanced accuracy accentuates the model’s equitable performance in discerning both false positives and negatives. In conclusion, while the 1D U-Net architecture is a formidable tool for QRS detection, there’s a clear avenue for further refinement in its PVC detection capability, given the inherent complexities and noise challenges in real-world PVC occurrences.

Autonomous driving vehicles rely on sensors for the robust perception of surroundings. Such vehicles are equipped with multiple perceptive sensors with a high level of redundancy to ensure safety and reliability in any driving condition. However, multi-sensor, such as camera, LiDAR and radar, systems bring up the requirements related to sensor calibration and synchronization, which are the fundamental blocks of any autonomous system. On the other hand, sensor fusion and integration have become important aspects of autonomous driving research and directly determine the efficiency and accuracy of advanced functions such as object detection and path planning. Classical model-based estimation and data-driven models are two mainstream approaches to achieving such integration. Most recent research is shifting to the latter, showing high robustness in real-world applications but requiring large quantities of data to be collected, synchronized, and properly categorized. To generalize the implementation of the multi-sensor perceptive system, we introduce an end-to-end generic sensor dataset collection framework that includes both hardware deploying solutions and sensor fusion algorithms. The framework prototype integrates a diverse set of sensors, such as cameras, LiDAR, and radar. Furthermore, we present a universal toolbox to calibrate and synchronize three types of sensors based on their characteristics. The framework also includes the fusion algorithms, which utilize the merits of three sensors , namely, camera, LiDAR and radar, and fuse their sensory information in a manner that is helpful for object detection and tracking research. The generality of this framework makes it applicable in any robotic or autonomous applications, also suitable for quick and large-scale practical deployment.

While thunderstorms can pose severe risks to property and life, forecasting remains challenging, even at short lead times, as these often arise in meta-stable atmospheric conditions. In this paper, we examine the question of how well we could perform short-term (up to 180min) forecasts using exclusively multi-spectral satellite images and past lighting events as data. We employ representation learning based on deep convolutional neural networks in an “end-to-end” fashion. Here, a crucial problem is handling the imbalance of the positive and negative classes appropriately in order to be able to obtain predictive results (which is not addressed by many previous machine-learning-based approaches). The resulting network outperforms previous methods based on physically-based features and optical flow methods (similar to operational prediction models) and generalizes across different years. A closer examination of the classifier performance over time and under masking of input data indicates that the learned model actually draws most information from structures in the visible spectrum, with infrared imaging sustaining some classification performance during the night.

It is time-consuming for acquiring complete data by fully phase encoding in two orthogonal directions along with one frequency encoding direction. Undersampling in the 3D k-space is promising in accelerating such 3D MRI process. Though 3D undersampling can be conducted according to predefined probability density, the density based method is not optimal. Because of the large amount of 3D data and computational cost, it is challenging to perform data-driven and learning-based 3D undersampling and subsequent 3D reconstruction. To tackle this challenge, this paper proposes a deep neural network called EEUR-Net, realized by optimizing specific undersampling patterns for the fully-sampled 3D k-space data. Innovatively, our undersampling algorithm employs an end-to-end deep learning approach to optimize phase encoding patterns and uses a 3D U-Net for image reconstruction of undersampled data. Through end-to-end training, we obtain an optimized 3D undersampling pattern, which significantly enhances the quality of the reconstructed image under the same acceleration factor. A series of experiments on a knee MRI dataset demonstrated that, in comparison to standard random uniform, radial, Poisson and equispaced Cartesian undersampling schemes, our end-to-end learned undersampling pattern considerably improves the reconstruction quality of undersampled MRI images.

Owing to the expansion of non-face-to-face activities, security issues in video conferencing systems are becoming more critical. In this paper, we focus on the end-to-end encryption (E2EE) function among security services of video conferencing systems. First, the E2EE-related protocols of Zoom and Secure Frame (SFrame), which are representative video conferencing systems, are thoroughly investigated, and the two systems are compared and analyzed overall. Next, the E2EE protocol in the Government Public Key Infrastructure (GPKI)-based video conferencing system, in which the user authentication mechanism is fundamentally different from those used in private sector systems, such as Zoom or SFrame, will be considered. In particular, among E2EE-related protocols, we propose a detailed mechanism in which the post-quantum cryptography (PQC) key encapsulation mechanism (KEM) is applied to the user key exchange process. As the session key is not disclosed to the central server even in futuristic quantum computers, the mechanism to which the PQC KEM method proposed in this study is applied satisfies the E2EE security requirements and can be applied to domestic GPKI-based systems. It is expected to contribute in strengthening the safety of the next-generation video conferencing system.

Radio Frequency Interference (RFI) detection and characterization play a critical role to in ensuring the security of all wireless communication networks. Advances in Machine Learning (ML) have led to the deployment of many robust techniques dealing with various types of RFI. To sidestep an unavoidable complicated feature extraction step in ML, this paper proposes an efficient end-to-end method using the latest advances in deep learning to extract the appropriate features of the RFI signal. Moreover, this study utilizes the benefits of transfer learning to determine both the type of received RFI signals and their modulation types. To this end, the scalogram of the received signals is used as the input of the pre-trained convolutional neural networks (CNN), followed by a fully-connected classifier. This study considers a digital video stream as the signal of interest (SoI), transmitted in a real-time satellite-to-ground communication using DVB-S2 standards. To create the RFI dataset, the SoI is combined with three well-known jammers namely, continuous-wave interference (CWI), multi- continuous-wave interference (MCWI), and chirp interference (CI). This study investigated four well-known pre-trained CNN architectures, namely, AlexNet, VGG-16, GoogleNet, and ResNet-18, for the feature extraction to recognize the visual RFI patterns directly from pixel images with minimal preprocessing. Moreover, the robustness of the proposed classifiers is evaluated by the data generated at different signal to noise ratios (SNR).

Einstein’s publication of the Special Theory of Relativity in 1905 gave birth to the space-time model as a fundamental arena of the universe. Time has become 4th dimension of space and theoretically one could move backward and forward in time. Hypothetical time travel has been a hot topic of scientific discussion since Kurt Gödel published his article about closed time-like curves (CTC) in 1949. He was aware that his CTC model confirms that there is no physical time. Physicists understood his model as a theoretical frame for time travel. Recent research confirmed that universal space is time-invariant. Motion happens only in space and time is the duration of motion. Nobody can travel in time because time has no physical existence. Time as duration is an emergent physical quantity entering existence in the process of measurement of the duration of material change with clocks. The universal space is utterly timeless. There is no physical time in the universe.

Speech recognition, also known as automatic speech recognition (ASR), is a technology that enables software to transcribe spoken language into text. However, existing Amharic ASR methods require multiple separate blocks, such as language, acoustic, and pronunciation models with dictionaries, which can be time-consuming and influence performance. This study proposes an approach that replaces much of the speech pipeline with a single recurrent neural network (RNN) architecture. Our proposed architecture is based on a hybrid approach that combines a convolutional neural network (CNN) with a recurrent neural network (RNN) and a connectionist temporal classification (CTC) loss function. We conducted several experiments with noisy audio data that contain 20,000 valid sentences. The model was evaluated using the word error rate (WER) metric, achieving impressive results of 7% WER on noisy data. This approach has significant implications for the field of speech recognition, as it reduces the human effort required to create dictionaries and improves the efficiency and accuracy of ASR systems, making them more practical for real-world applications.

This paper addresses the analysis for the nonlinear vibration response of a rectangular tube with a flexible end and non-rigid acoustic boundaries. This is a further work of the linear structural acoustic problem in a well-known acoustic book. In fact, the acoustic boundaries of an enclosed space sometimes are non-rigid and the structural vibration responses are nonlinear. These two points are the focuses of this paper. The multi-level residue harmonic balance method is applied to this nonlinear structural acoustic problem. The results obtained from the multi-level residue harmonic balance method and numerical method are generally in good agreement. The effects of excitation magnitude, tube length, and phase shift parameter etc. are examined.

At the end of the dry season in early March to early April each year, extensive agricultural biomass waste burnings occur throughout insular mainland Southeast Asia. During this biomass burnings period, smoke aerosols blanket the whole regions and were transported and dispersed by predominant westerly and south westerly winds to southern China, Taiwan and as far southern Japan and the Philippines. The extensive and intense burnings coincided with some wildfires in the forests due to high temperature making the region one of the global hot spots of biomass fires. In this study, we focus on the effect of pollutants emitted from biomass burnings in March 2019 at the height of the burnings period to the exposed population and their health impact. The Weather Research Forecast- Chemistry (WRF-Chem) model was used to predict the PM2.5 concentration over the simulating domain and health impacts are then assessed on the exposed population in the four countries of Southeast Asia, namely Thailand, Laos, Cambodia and Vietnam. Using the health impact based on log-linear concentration response function and Integrated Exposure Response (IER), the results show that at the peak period of the burnings from 13 to 20 March 2019, Thailand experienced the highest impact, with an estimated 2170 premature deaths. Laos, Vietnam, and Cambodia followed, with estimated mortalities of 277, 565, and 314 deaths respectively. However, when considering the impact per head of population, Laos exhibited the highest impact, followed by Thailand, Cambodia, and Vietnam. The results highlight the significant health impact and associated economic cost of agricultural waste burnings in Southeast Asia at the end of the dry season. And hence policy makers should take these into account to design measures to reduce the negative impact of widespread burnings on exposed population in the region.

Autonomous driving navigation relies on diverse approaches, each with advantages and limitations depending on various factors. For HD maps, modular systems excel, while end-to-end methods dominate mapless scenarios. However, few leverage the strengths of both. This paper innovates by proposing a hybrid architecture that seamlessly integrates modular perception and control modules with data-driven path planning. This innovative design leverages the strengths of both approaches, enabling a clear understanding and debugging of individual components while simultaneously harnessing the learning power of end-to-end approaches. Our proposed architecture achieved 1st and 2nd place in the 2023 CARLA Autonomous Driving Challenge’s SENSORS and MAP tracks, respectively. These results demonstrate the architecture’s effectiveness in both map-based and mapless navigation.

The detection performance of small objects in remote sensing images has not been satisfactory compared to large objects, especially in low-resolution and noisy images. A generative adversarial network (GAN)-based model called enhanced super-resolution GAN (ESRGAN) showed remarkable image enhancement performance, but reconstructed images usually miss high-frequency edge information. Therefore, object detection performance showed degradation for small objects on recovered noisy and low-resolution remote sensing images. Inspired by the success of edge enhanced GAN (EEGAN) and ESRGAN, we applied a new edge-enhanced super-resolution GAN (EESRGAN) to improve the quality of remote sensing images and used different detector networks in an end-to-end manner where detector loss was backpropagated into the EESRGAN to improve the detection performance. We proposed an architecture with three components: ESRGAN, EEN, and Detection network. We used residual-in-residual dense blocks (RRDB) for both the ESRGAN and EEN, and for the detector network, we used a faster region-based convolutional network (FRCNN) (two-stage detector) and a single-shot multibox detector (SSD) (one stage detector). Extensive experiments on a public (car overhead with context) dataset and another self-assembled (oil and gas storage tank) satellite dataset showed superior performance of our method compared to the standalone state-of-the-art object detectors.

Advanced glycation end-products (AGEs) form through non-enzymatic glycation of various proteins. Optic nerve degeneration is a frequent complication of diabetes, and retinal AGEs accumulation is strongly linked to diabetic retinopathy development. Type 2 diabetes mellitus (T2DM) is a major risk factor for Alzheimer's disease (AD), with patients often exhibiting optic axon degeneration in the nerve fiber layer. Notably, a gap exists in our understanding of how AGEs contribute to neuronal degeneration in the optic nerve within the context of both diabetes and AD. Our previous work demonstrated that glyceraldehyde (GA)-derived toxic advanced glycation end-products (TAGE) disrupt neurite outgrowth through TAGE-β-tubulin aggregation and tau phosphorylation in neural cultures. In this study, we further illustrated GA-induced suppression of optic nerve axonal elongation via abnormal β-tubulin aggregation in mouse retinas. Elucidating this optic nerve degeneration mechanism holds promise for bridging the knowledge gap regarding vision loss associated with DM and AD.

Speech recognition, or automatic speech recognition (ASR), is a technology designed to convert spoken language into text using software. However, conventional ASR methods involve several distinct components, including language, acoustic, and pronunciation models with dictionaries. This modular approach can be time-consuming and may influence performance. In this study, we propose a method that streamlines the speech recognition process by incorporating a unified recurrent neural network (RNN) architecture. Our architecture integrates a convolutional neural network (CNN) with an RNN and employs a connectionist temporal classification (CTC) loss function. Key experiments were carried out using a dataset comprising 576,656 valid sentences, using erosion techniques. Evaluation of the model performance, measured by the word error rate (WER) metric, demonstrated remarkable results, achieving a WER of 2%. This approach has significant implications for the realm of speech recognition, as it alleviates the need for labor-intensive dictionary creation, enhancing the efficiency and accuracy of ASR systems, and making them more applicable to real-world scenarios. For future enhancements, we recommend the inclusion of dialectal and spontaneous data in the dataset to broaden the model's adaptability. Additionally, fine-tuning the model for specific tasks can optimize its performance for targeted objectives or domains, further enhancing its effectiveness in those areas.

Wheat is used for making many food products due to its diverse quality profile found among different wheat classes. Since laboratory analysis of these end-use quality traits is costly and time-consuming, genetic dissection of the traits is preferential. This study used a genome-wide association study (GWAS) of 10 end-use quality traits, including kernel protein, flour protein, flour yield, softness equivalence, solvent’s retention capacity, cookie diameter, and top-grain, in soft red winter wheat (SRWW) adapted to US southeast. The GWAS study included 266 SRWW genotypes that were evaluated in two locations over two years (2020-2022). A total of 27,466 single nucleotide markers were used and a total of 80 significant marker-trait associations were identified. There were 13 major effect quantitative trait loci (QTLs) explaining > 10% phenotypic variance out of which 12 were considered as novel. Five of the major effect QTLs were found to be stably expressed across multiple datasets, and four showed associations with multiple traits. Candidate genes were identified for eight of the major-effect QTLs including genes associated with starch biosynthesis and nutritional homeostasis in plants. These findings increase genetic comprehension of these end-use quality traits and could potentially be used for improving the quality of SRWW.

Tuberculosis (TB) caused by Mycobacterium tuberculosis remains a predominant cause of mortality, especially in low- and middle-income nations. Recently antimicrobial peptides were discovered that at low concentrations could stimulate the growth of M. tuberculosis (hormetic response). In this study, such a peptide was used to investigate the effects on the time to positivity (TTP). A systematic substitution analysis of peptide 14D was synthesized using Spot synthesis technology, resulting in 171 novel peptides. Our findings revealed a spectrum of interactions, with some peptides accelerating M. tuberculosis growth, potentially aiding in faster diagnostics, while others exhibited inhibitory effects. Notably, peptide NH2-wkivfiwrr-CONH2 significantly reduced the TTP by 25 hours compared to the wild-type peptide 14D, highlighting its potential in improving TB diagnostics by culture. Several peptides demonstrated potent antimycobacterial activity, with a minimum inhibitory concentration (MIC) of 20 µg/mL against H37Rv and a multidrug-resistant M. tuberculosis strain. Additionally, a reduction in the formation of cord-like structures was observed, which is indicative of reduced virulence and transmission potential. This study underscores the multifaceted roles of antimicrobial peptides in TB management, from enhancing diagnostic efficiency to offering therapeutic avenues against M. tuberculosis.

TB and HIV continue to increase and constitute major public health concerns worldwide, mainly in resource-limited countries, showing that we are not going to end HIV if we do not also end TB. Herein, we investigated the risk factors related to HIV infection among TB patients in Luanda, the capital city of Angola. This was a retrospective cohort study conducted on the medical records of 117 TB patients from January to September 2016. Overall, the HIV/TB co-infection rate was 12%. The mean age of coinfected patients was 37.7±10.1 years. No statistically significant relationship was observed between sociodemographic or clinical features with HIV/TB co-infection (p>0.05). TB patients aged 30 years or older (OR: 4.13, p=0.072), female (OR: 1.08, p=0.898), residing in urbanized areas (OR: 1.90, p=0.578), with a history of treatment abandonment (OR: 3.74, p=0.083), with polyresistance (OR: 1.62, p=0.603), and MDR-TB (OR: 2.00, p=0.454), were more likely to have HIV/TB co-infection, while latent TB infection (OR: 0.63, p=0.559) and treatment-susceptible TB patients (OR: 0.56, p=0.616), presented a lower chance of HIV/TB coinfection. Our finding showed a slightly high HIV/TB coinfected rate, which suggests that the dual HIV/TB epidemic keeps evolving and poses a huge concern to the public health in Angola. Further studies on features related to HIV/TB coinfection and its impact on disease progression and clinical outcome in adults from high-risk Angolan communities, should be carried out to intensify and strengthen collaborative activities between national TB and HIV programs in Angola.

Imperfection sensitivity of large amplitude vibration of curved single-walled carbon nanotubes (SWCNTs) is considered in this study. The SWCNT is modeled as a Timoshenko nano-beam and its curved shape is included as an initial geometric imperfection term in the displacement field. Geometric nonlinearities of von Kármán type and nonlocal elasticity theory of Eringen are employed to derive governing equations of motion of nano-beam. Spatial discretization of governing equations and associated boundary conditions is performed using differential quadrature (DQ) method and the corresponding nonlinear eigenvalue problem is iteratively solved. Effects of value and location of the geometric imperfection, and the nonlocal small-scale parameter on the nonlinear frequency ratio and imperfection sensitivity of a curved SWCNT for various boundary conditions are investigated. The results show that the geometric imperfection plays a significant role in the nonlinear vibration characteristics of curved SWCNTs.

The goal of the investigation is to increase coverage, which is ensure better transmission around IoT services using IRS within a two-tier 6G system comprising of one micro cell tier running beneath a macro cellular tier. As a result, the study tested and compared the reliability of traditional connectivity with IRS-enhanced connectivity in terms of upstream end-to-end latency using computer-based measuring methods. The study concluded that the implementation of IRS greatly improves coverage, which means transmission effectiveness, for 6G services.

In the leading/trailing edge’s adaptive machining of the near-net-shaped blade, a small portion of the theoretical part is retained for securing aerodynamic performance by manual work. However, this procedure is time-consuming and depends on the human experience. In this paper, we defined retained theoretical leading/trailing edge as the reconstruction area. To accelerate the reconstruction process, an anchor-free neural network model based on Transformer was proposed, named LETR (Leading/trailing Edge Transformer). LETR extracts image features from an aspect of mixed frequency and channel domain. We also integrated LETR with the newest meta-Acon activation function. We tested our model on the self-made dataset LDEG2021 on a single GPU and got an mAP of 91.9\%, which surpassed our baseline model, Deformable DETR by 1.1\%. Furthermore, we modified LETR’s convolution layer and named the new model after GLETR (Ghost Leading/trailing Edge Transformer) as a lightweight model for real-time detection. It is proved that GLETR has fewer weight parameters and converges faster than LETR with an acceptable decrease in mAP (0.1\%) by test results.

Steel fibre reinforced concrete (SFRC) consists of short hooked steel fibres randomly distributed and oriented within the cementitious matrix. The contribution of fibre in bridging cracks to provide the stress transfer required relies upon the orientation of the fibre in the concrete. Bridging fibre aligned with a crack are less effective than those inclined to it. Therefore, understanding the pull-out behaviour of misaligned fibre is a key factor to quantify and optimize the design of SFRC in the structural applications. In the laboratory a single oriented fibre embedded in a solid cylinder of concrete is subjected to a pull-out test where the axis of a tensile force is aligned with the axis of the cylinder. Based upon the observed behaviour this paper presents a new analytical bounding approach to capture the pull-out response of misaligned hooked-end steel fibre embedded in a concrete matrix. The analysis is based upon a transversely isotropic condition assumed for the plasticity that occurs in the cold drawn fibre. The model accounts for the influence of fibre diameter and the combined strengths of the steel and concrete. The model predictions have also been compared with other experimental results published in the literature. The results showed that the model can predict pull-out loads reasonably for different fibre orientations between bounds of failure derived from the strengths of the two constituents. A critical orientation is observed at maximum strength. Therein, an understanding of the pull-out behaviour of misaligned, hooked-end fibres is necessary to optimize the strength of concrete from this method of reinforcement.

Transforaminal lumbar interbody fusion (TLIF) is a commonly used technique for treating lumbar degenerative diseases. In this study, we developed a fully computer-supported pipeline to predict both the cage height and the degree of lumbar lordosis subtraction from the pelvic incidence (PI-LL) after TLIF surgery, utilizing preoperative X-ray images. The automated pipeline comprised two primary stages. First, a deep learning model was employed to extract essential features from X-ray images. Subsequently, five machine learning algorithms were trained to identify the optimal models to predict interbody cage height and postoperative PI-LL. LASSO regression and support vector regression demonstrated superior performance in predicting interbody cage height and postoperative PI-LL, respectively. For cage height prediction, the root mean square error (RMSE) was calculated as 1.01, and the model achieved the highest accuracy at a height of 12 mm, with exact prediction achieved in 54.43% (43/79) of cases. In most of the remaining cases, the prediction error of the model was within 1 mm. Additionally, the model demonstrated satisfactory performance in predicting PI-LL, with an RMSE of 5.19 and an accuracy of 0.81 for PI-LL stratification. In conclusion, our results indicate that machine learning models can reliably predict interbody cage height and postoperative PI-LL.

This paper presents a novel approach for indoor acoustic source localization using microphone arrays and based on a Convolutional Neural Network (CNN). The proposed solution is, to the best of our knowledge, the first published work in which the CNN is designed to directly estimate the three dimensional position of an acoustic source, using the raw audio signal as the input information avoiding the use of hand crafted audio features. Given the limited amount of available localization data, we propose in this paper a training strategy based on two steps. We first train our network using semi-synthetic data, generated from close talk speech recordings, and where we simulate the time delays and distortion suffered in the signal that propagates from the source to the array of microphones. We then fine tune this network using a small amount of real data. Our experimental results show that this strategy is able to produce networks that significantly improve existing localization methods based on SRP-PHAT strategies. In addition, our experiments show that our CNN method exhibits better resistance against varying gender of the speaker and different window sizes compared with the other methods.

Background Increasingly, healthcare organizations are using technology for the efficient management of data. The aim of this study was to compare the data quality of digital records with the quality of the corresponding paper-based records by using data quality assessment framework. Methodology We conducted a desk review of paper-based and digital records over the study duration from April 2016 to July 2016 at six enrolled TB clinics. We input all data fields of the patient treatment (TB01) card into a spreadsheet-based template to undertake a field-to-field comparison of the shared fields between TB01 and digital data. Findings A total of 117 TB01 cards were prepared at six enrolled sites, whereas just 50% of the records (n=59; 59 out of 117 TB01 cards) were digitized. There were 1,239 comparable data fields, out of which 65% (n=803) were correctly matched between paper based and digital records. However, 35% of the data fields (n=436) had anomalies, either in paper-based records or in digital records. 1.9 data quality issues were calculated per digital patient record, whereas it was 2.1 issues per record for paper-based record. Based on the analysis of valid data quality issues, it was found that there were more data quality issues in paper-based records (n=123) than in digital records (n=110). Conclusion There were fewer data quality issues in digital records as compared to the corresponding paper-based records. Greater use of mobile data capture and continued use of the data quality assessment framework can deliver more meaningful information for decision making.

We report world record high data transmission over standard optical fiber from a single optical source. We achieve a line rate of 44.2 Terabits per second (Tb/s) employing only the C-band at 1550nm, resulting in a spectral efficiency of 10.4 bits/s/Hz. We use a new and powerful class of micro-comb called soliton crystals that exhibit robust operation and stable generation as well as a high intrinsic efficiency that, together with an extremely low spacing of 48.9 GHz enables a very high coherent data modulation format of 64 QAM. We achieve error free transmission across 75 km of standard optical fiber in the lab and over a field trial with a metropolitan optical fiber network. This work demonstrates the ability of optical micro-combs to exceed other approaches in performance for the most demanding practical optical communications applications.

In this work, an analog front-end (AFE) circuit for Electrocardiogram (ECG) detection system has been designed, implemented, and investigated in an industry-standard Cadence simulation framework using advanced technology node of 45 nm. The AFE consists of an instrumentation amplifier, a Butterworth band-pass filter (with fifth-order low-pass and second-order high-pass sections), and a second-order notch filter- all are based on two-stage, Miller-compensated operational transconductance amplifiers (OTA). The OTAs have been designed employing the $g_m/I_D$ methodology. Both the pre-layout and post-layout simulation were carried out. The layout consumes an area of 0.0058 mm$^2$ without the resistors and capacitors. Analysis of various simulation results were carried out for the proposed AFE. The circuit demonstrates a post-layout bandwidth of 239 Hz with a variable gain between 44 to 58 dB, a notch depth of -56.4 dB at 50.1 Hz, a total harmonic distortion (THD) of -59.65 dB (less than 1\%), an input referred noise spectral density of $

This paper reviews the ethical issues involved and argues that each of the usual policies for handling conscientious refusals faces serious challenges. Healthcare providers who refuse to provide medical services should be expected to explain their reasons, make prompt referrals, and bear some of the resulting costs or burdens.

Tuberculosis (TB) remains a major public health threat globally, especially in sub-Saharan Africa. Both human and Mycobacterium tuberculosis (MTBC) genetic variation affect TB outcomes, but few studies have examined if and how the two genomes interact to affect disease. We hypothesize that long-term coexistence between human genomes and MTBC lineages modulate disease to affect its severity. We examined this hypothesis in our TB household contact study in Kampala, Uganda, in which we identified 3 MTBC lineages of which one, L4.6-Uganda, is clearly derived and hence recent. We quantified TB severity using the Bandim TBscore and examined the interaction between MTBC lineage and human single nucleotide polymorphisms (SNPs) genome-wide, in two independent cohorts of TB cases (N=149 and N=127). We found a significant interaction between a SNP in PPIAP2 and the Uganda lineage (combined p=4x10-8). PPIAP2 is a pseudogene that is highly expressed in immune cells. Pathway and eQTL analyses indicated potential roles between coevolving SNPs and cellular replication and metabolism as well as platelet aggregation and coagulation. This finding provides further evidence that host-pathogen interactions affect clinical presentation differently than host and pathogen genetic variation independently, and that human-MTBC coevolution is likely to explain patterns of disease severity.

Background: This study addresses the burgeoning impact of Large Language Models (LLMs) such as ChatGPT on the integrity of online examinations and seeks to demonstrate latent and advanced LLM reasoning capabilities. The research devises an iterative self-reflective strategy for invoking critical thinking and higher-order reasoning in LLMs based on multimodal exam questions using visuals and text. Methods: The proposed strategy was demonstrated and evaluated on real exam questions by subject experts and the performance of ChatGPT (GPT-4) with vision was estimated on an additional dataset of 600 text descriptions of multimodal exam questions, focusing on its response to complex, visual, and textual prompts. Results: The results indicate that latent multi-hop reasoning capabilities can be invoked using the proposed self-reflective strategy, which can effectively steer ChatGPT towards correct answers by integrating critical thinking from each modality into the final response. Meanwhile, ChatGPT demonstrated considerable proficiency in being able to answer multimodal exam questions across 12 subjects. Conclusions: This work challenges findings from recent studies which claim that existing LLMs are unable to reason on complex multimodal tasks, and therefore this study underscores the need for enhanced online exam security measures like proctoring software, that can mitigate the potential misuse of AI technologies in educational settings.

In the evolving landscape of pharmaceutical manufacturing, a comprehensive continuous production process is being crafted for small-scale active pharmaceutical ingredient production. This study focuses on continuous crystallization with separate nucleation and crystal growth units, as well as continuous downstream processing, encompassing filtration, washing, and drying until the formation of free-flowing particles. We introduce a novel continuous nucleator designed based on solubility data and produced via 3D printing, enabling a fast and precise small-scale manufacturing of a nucleator meeting the requirements for nucleation and for the further growth processes. The nucleator was evaluated with regard to its suitability for continuous long-term operation across various coupled crystallizers. As a practical application example it is connected to a slug flow crystallizer to enable high-quality continuous crystallization. Additionally, the full integration of downstream processes using the continuous vacuum screw filter to achieve free-flowing product particles is realized. Even under non-optimized process conditions, with the help of in-situ generation of nuclei free-flowing product particles were successfully obtained. This is particularly useful during drug development when no material is available for seed addition and quickly obtain product for further characterization.

This study evaluated the effectiveness of an electronic system for managing drug-sensitive pulmonary tuberculosis patients in the Kyrgyz Republic. This was a cohort study using programmatic data. The study included patients registered on the paper-based system in 2019 and the electronic system between June 2021 and May 2022. Data was taken from 302 individuals from the electronic system for completeness and concordance in comparison with the paper-based system. The study showed that for most variables the completeness and concordance was 85.3%-93.0% and was lowest for non-mandatory fields such as medication side effects (26.8% vs 13.6%). No significant difference was observed in time taken from symptom onset to diagnosis and treatment initiation between the two systems. However, the electronic system had a significantly higher percentage of patients who initiated treatment on the same day of diagnosis (80.3% vs. 57.1%). The proportion with successful outcomes was similar in both groups, but the electronic system had a significantly lower proportion of patients with outcomes that were not evaluated or recorded (4.8% vs. 14.3%, p < 0.001). The study highlights the potential advantages of implementing an electronic TB register system for improving records. We advocate for similar studies in other regions in Kyrgyz Republic.

Pit lakes can represent significant liabilities at mine closure. However, pit lakes also present opportunities to provide significant regional benefit and address residual closure risks of both their own and overall project closure, and even offset the environmental costs of mining by creating new end uses. Unfortunately, many pit lakes have continued to be abandoned without repurposing for an end use. We reviewed published pit lake repurposing case studies of abandoned mine pit lakes. We found beneficial end use type and outcome varied dependent upon climate and commodity; but equally important social and political dynamics that manifest as mining company commitments or regulatory requirements. Many end uses have been realized: passive and active recreation, nature conservation, fishery and aquaculture, drinking and industrial water storage, greenhouse carbon fixation, flood protection and waterway remediation, disposal of mine and other waste, mine water treatment and containment, and education and research. Common attributes and reasons that led to successful repurposing of abandoned pit lakes as beneficial end uses are discussed. Recommendations are given for all stages of mine closure planning to prevent pit lake abandonment and to achieve successful pit lake closure with beneficial end uses.

Acacia dealbata Link, named Mimosa in Portugal, is an invasive hardwood species with potential for construction use, but research is limited. The available stock of small-diameter juvenile wood (sjw) logs can help reduce this gap, but tangential cracking at log ends challenges fastener connections. This study evaluated different treatments to control and reduce end-face cracking in sjw logs during air drying, an economical and environmentally friendly procedure. Extreme two-thirds of sixteen Mimosa logs were subjected to two treatments: one with longitudinal kerfs 15 mm deep along the length (2 and 3 kerfs) and the other with a hollow in the centre up to half the length (16 mm and 30 mm diameters). Over 219 days of air drying and compared with the central part, kerfing treatments significantly reduced outer wood tangential cracking (p < 0.001), with the 3-kerf also reducing crack numbers (p < 0.05) but increasing significantly cracks near the pith (p < 0.01). The 30 mm central hollow significantly reduced central perforation cracking (p < 0.05). Results suggest that a combined treatment approach could help mitigate cracking, enhancing the suitability of wild Mimosa logs for construction use.

Background : The quantification of electromyographic activity using surface electrodes is inval-uable for understanding gait disorders in patients with central nervous system lesions. We propose to evaluate a commercially available low-cost system compared to a reference system in partic-ipants with stroke-related movement disorders in functional situations. Methods : Three hemiparetic participants performed three functional tasks: two treadmill walks at different speeds and a sit-to-stand test. The vastus lateralis and gastrocnemius medialis muscles were equipped with two EMG sensors. The comparison between the two EMG systems was based on 883 identified cycles. Spearman’s correlation coefficients (SC), linear correlation coefficients (LCC), and cross-correlation coefficients (CCC) were calculated. Results : The main results indicate good to very good similarity of the EMG signals collected from the two tested sEMG systems. In the comfortable walking condition, an SC of 0.894±0.091 and an LCC of 0.909±0.094 were noted. In the fast walking condition, an SC of 0.918±0.064 and an LCC of 0.935±0.056 were observed. For the 1-minute sit-to-stand test an SC of 0.880±0.058 and an LCC of 0.881±0.065 were noted. Conclusions : This study demonstrates good to very good similarity between the two sEMG systems, enabling the analysis of muscle activity during functional tasks.

IgA nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. IgAN causes end-stage kidney disease (ESKD) in 20–40% of all cases. The activation of the complement system by pathological circulating IgAs, which is often associated with low serum C3 levels (LowC3), seems to play a crucial role. Previous studies have shown an association between histological evidence of TMA, which is the result of alternative complement activation, and poor outcome. However, it is not known to what extent the decrease in serum C3 levels reflects ongoing TMA injury. Our study aimed at assessing the association of LowC3 and ESKD and whether this association reflects ongoing TMA. We enrolled all patients with biopsy-proven IgAN and followed-up patients until last visit, ESKD or death. Of the 56 patients included in the study, 12 (21%) presented low serum C3 (LowC3) at the time of renal biopsy. TMA was significantly more frequent in the LowC3 group [7/12 (58%) vs 9/44 (20%), p=0.02]. After adjusting for potential confounders, LowC3 was strongly associated with an increased hazard of ESKD (hazard ratio [HR]: 5.84 [95%CI: 1.69,20.15; P=0.005). The association was not affected by adjusting for TMA. The estimated overall proportion of the relation between C3 and ESKD mediated by TMA was low and not statistically significant. Our study provides evidence that C3 hypocomplementemia is associated with an increased risk of ESKD with mechanisms that are largely independent from TMA.

Patients with end stage liver disease (ESLD) undergoing liver transplantation are prone to thromboses both while on the waiting list or in the perioperative period. This hypercoagulability is associated with significant endothelial dysfunction (ED) due to nitric oxide dysregulation. ED in combination with increased thrombin generation are the main factors responsible for this hypercoagulability. Sepsis itself can significantly change the coagulation profile, but in combination with ESLD, sepsis, and septic shock is responsible for very complex changes in the patients coagulation making both assessment and management of coagulation in patients with ESLD very challenging. Viscoelastic testing (VET) is a preferred method of coagulation management in patients with cirrhosis because, as with standard laboratory testing, VET can assess the entire coagulation system including the interaction between both pro- and anticoagulants and platelets.

The cyclic universe theory is a model of cosmic evolution according to which the universe undergoes endless cycles of expansion and cooling, each beginning with a big bang and ending in a big crunch. In this paper, the researcher finds a unique property of Space-time, this particular and marvelous nature of space shows us that space can shrink, expand, and stretch. This property of space is caused the size of the Universe changing over time: growing or shrinking. The observed accelerated expansion, which relates the stretching of Shrunk space for the new theory, is derived. This model is based on three underlying notions: First, the Big Bang was not the beginning of Space-time, but rather at the very beginning fraction of a second there was an infinite force of infinite Shrunk space in the cosmic singularity, that force gave rise to the big bang and caused the rapidly growing of space-time, and all other forms of energy are transformed into matter and radiation and a new period of expansion and cooling begins. Second, there was a previous phase leading up to it, with multiple cycles of contraction and expansion that repeat indefinitely. Third, the two principal long-range forces are the gravitational force and the repulsive force generated by shrunk space. They are the two most fundamental quantities in the universe that govern cosmic evolution. They may provide the clockwork mechanism that operates our eternal cyclic universe. The space will not continue to expand forever, no need however, for dark energy and dark matter. This model of Space-time and its unique properties enables us to describe a sequence of events from the Big Bang to the Big Crunch.

This paper presents the validation of the End Point Rate (EPR) tool for QGIS (EPR4Q), a tool built-in QGIS Graphical Modeler to calculate the shoreline change by End Point Rate method. The EPR4Q tries to fill the gap of user-friendly and free open-source tool for shoreline analysis in Geographic Information System environment, since the most used software - Digital Shoreline Analysis System (DSAS) - although is a free extension, is suited for commercial software. Besides, the best free open-source option to calculate EPR called Analyzing Moving Boundaries Using R (AMBUR), since it is a robust and powerful tool, the complexity and heavy processes can restrict the accessibility and simple usage. The validation methodology consists of applying the EPR4Q, DSAS, and AMBUR on different examples of shorelines found in nature, extracted from the U.S. Geological Survey Open-File. The obtained results of each tool were compared with Pearson correlation coefficient. The validation results indicate that the EPR4Q tool created acquired high correlation values with DSAS and AMBUR, reaching a coefficient of 0.98 to 1.00 on linear, extensive, and non-extensive shorelines, guarantying that the EPR4Q tool is ready to be freely used by the academic, scientific, engineering, and coastal managers communities worldwide.

The production of recombinant enzymes, mainly used for obtaining pure and functional target molecules, holds significant importance in modern biotechnology. This study aimed to produce recombinant α-amylases (Amy3500 and Amy1974), derived from B. amyloliquefaciens MDC1974 and B. subtilis MDC3500 respectively, using the pBE-S shuttle vector, and to characterize them. Both α-amylase genes were molecularly cloned into the E. coli/B. subtilis pBE-S shuttle vector, both with (Amy1974sig and Amy3500sig) and without their own signal peptides (Amy1974 and Amy3500), along with a signal peptide originating from the plasmid, and tested in flask fermentations. For recombinant Amy3500, the amylase variants resulted in similar levels of volumetric activity (700-750 U/mL). In contrast, the expression of Amy1974 nearly doubled compared to Amy1974sig with double signal peptides, reaching 2000 U/mL. The SDS-PAGE estimated the molecular weight of Amy1974 α-amylase to be 54.6 kDa, which was in accordance with the theoretical molecular mass calculations. However, the estimated molecular weight of Amy3500 amylase was significantly reduced when exiting the producer cells. Ca2+ had no significant activating effect on the activities of Amy1974 amylase and Amy3500 amylase, likely due to its tight binding to the protein scaffold. Both enzymes exhibited broad activity peaks between 45-70°C, with a maximum at 65°C. The Amy1974 and Amy3500 α-amylases demonstrated broad pH optima and pH-dependent thermostability, with optimum pH values at 6.5 and 5.8, and thermal stability peaks at pH 7.6 and 5.9, respectively. Both α-amylases displayed high relative activity against various starches, including corn amylopectin and potato amylose, while showing comparatively lower activity towards cyclodextrins. The Amy1974 amylase converts starch to dextrins of varying lengths, whereas Amy3500 almost entirely converts starch into glucose.

Acetyleugenol is a phytochemical compound with broad effect against infectious diseases and tumors. Here, we extracted, characterized and elucidated the structure of acetyeugenol, for the first time, from the leaves of Acacia nilotica (L.)―a well-known medicinal plant. The broad antibacterial potential of acetyleugenol was first confirmed against seven bacterial pathogenic isolates with best activity against Proteus sp., Salmonella typhi, Staphylococcu aureus, and Streptococcus pneumonia, which showed similar or better zone of inhibition to that of the control amoxicillin. To further investigate its effect against Mycobacterium tuberculosis, acetyleugenol and its indole and phenyl analogs were subjected to molecular docking experiments against two potential tuberculosis drug targets―MtPknE and MtPknB Ser/Thr protein kinases. The results reveal that all of the analogs have improved docking scores comparing to the acetyleugenol. The indole analogs EUG-1 and EUG-3 were more effective with better docking scores for MtPknE with –11.08 and –10.05 kcal/mol, respectively. Similar results were obtained for the MtPknB. In contrast, only the EUG-2 phenyl analog has given rise to similar docking scores for both targets. This opens the door for further comprehensive studies on these acetyleugenol analogs with in vitro and in vivo experiments to validate and get more insights into their mechanisms of action.

Randomized clinical trials represent the gold standard in therapeutic research. Nevertheless, observational cohorts of patients treated for multidrug-resistant (MDR) or rifampin-resistant (RR) tuberculosis (TB) also play an important role in generating evidence to guide MDR/RR TB Generally, summary exposure classifications (e.g., ‘ever versus never’, ‘exposed at baseline’) have been used to characterize drug exposure, in the absence of detailed longitudinal data on MDR-TB regimen These summary classifications, along with an absence of data on covariates that change throughout the course of treatment, constrain researchers’ ability to answer the most relevant questions while accounting for known This paper highlights the importance of regimen changes in improving inference from observational studies of longer MDR-TB treatment regimens and offers an overview of the data and analytic strategies required to do

Human tuberculosis (TB) is caused mainly by Mycobacterium tuberculosis (MTB) and M. africanum (MAF) remains a major global health threat. The varying response of different host to contact with the TB bacteria, indicates the importance of host genetics in susceptibility to TB disease. We explored the association among selected human/host genomic variants and disease caused by the two causative pathogens in Ghana through a case control study. MTBC isolates (323) recovered from pulmonary TB patients recruited between 2016 and 2018 were genotyped using spoligotyping. A selection of 29 SNPs from MTB-related genes with high frequency among African populations were genotyped using a TaqMan® SNP Genotyping Assay and iPLEX Gold Sequenom Mass Genotyping Array. Associations between MTBC lineages and host variables were assessed using univariate and multivariate logistic regression. The prevalence of MTB and Maf among the participants were 79% and 21% respectively. Association analysis between the controls and MAF showed that rs2695342 variant on the SIC11A1 gene have the propensity to confer susceptibility to MAF infections (P = 0.093, OR = 8.35, 95% CI = 0.70 – 99.24) whilst the rs17048476 (P = 0.088, OR = 1.57, 95% CI = 0.93 – 2.63) and rs1482868 (P = 0.095, OR = 0.60, 95% CI = 0.33 – 1.09) were observed to be only suggestive. Our findings implicate SLC11A1 as a potential susceptibility gene of substantial interest for TB caused by MAF which is an important pathogen in West Africa and highlight the need for in-depth host pathogen studies in West Africa.

Dielectric elastomer actuators (DEAs) offer robust, high energy density solutions for soft robotics. The proposed end effector consists of three spring roll configuration DEAs, each acting as a robotic finger, using a 3M VHB-F9473PC adhesive membrane. The lateral force, bending angle and response time of the actuator are measured experimentally and compared with the predictions of an analytical model. The cylindrical actuator measures 70 mm in length and 15 mm in diameter and achieved a lateral force of 30 mN, a bending angle of 6.8 ° and a response time of ≈ 1 s. Spring roll configuration DEAs are shown to reduce the effects of viscoelasticity seen in the membrane, making the actuator more controllable at higher voltages. The dielectric constant of the membrane is shown to be a limiting factor of actuation, with a decrease in dielectric constant resulting in larger actuation. The end effector successfully gripped numerous light objects for extended periods, showing the applicability of spring roll DEAs for soft end effectors.

The value of QuantiFERON in the diagnosis of tuberculosis and in the monitoring of the response to anti-tuberculosis treatment is unclear. The aims of this study were to evaluate the accuracy of the QuantiFERON-TB Gold In-Tube (QFT-GIT) test in the diagnosis of tuberculosis and in the monitoring of the response to anti-tuberculosis treatment in patients with active pulmonary tuberculosis (PTB). Between January 2013 and December 2015, 128 cases with active PTB and 128 controls with no mycobacterial infection, matched by age (within 3 years) and by the week that they visited Tainan Chest Hospital, were enrolled in the study. Serial testing by QFT-GIT at baseline and after 2 and 6 months of treatment was performed. At these time points, a comparison of the performance of QFT-GIT with that of sputum culture status among study subjects was conducted. Compared to baseline, 116 (87.2%) cases showed a decreased response, whereas 17 (12.8%) showed persistent or stronger interferon-gamma (IFN-γ) responses at 2 months. Their IFN-γ responses declined significantly from baseline to 2 months (median, 6.32 vs. 4.12; P < 0.005). The sensitivity values of the QFT-GIT test for the detection of pulmonary tuberculosis at cut-off points of 0.35 IU/ml, 0.20 IU/ml, and 0.10 IU/ml were 74.4%, 78.2%, and 80.5%, respectively. The specificity values at cut-off points of 0.35 IU/ml, 0.20 IU/ml, and 0.10 IU/ml were 66.2%, 63.9%, and 57.1%, respectively. Our results support the QFT-GIT assay as a potential tool for diagnosing tuberculosis and for monitoring the efficacy of anti-tuberculosis treatment.

Indole is a versatile pharmacophore widely distributed in bioactive natural products. This privileged scaffold has been found in a variety of molecules isolated from marine organisms such as algae and sponges. Among these, indole alkaloids represent one of the biggest, most promising family of compounds, having shown a wide range of pharmacological properties, including anti-inflammatory, antiviral and anticancer activities. The aim of this review is to show the current scenario of marine indole alkaloid derivatives, covering not only the most common chemical structures, but also new synthetic routes developed during the last years as well as promising therapeutic applications.

This paper discusses a MEMS switch that can be fabricated using low temperature (<100^oC) deposition and patterning techniques suitable for the back-end-of-the-line integration with CMOS. The resulting cross-bar switches can be used for electrostatic discharge protection, FPGA implementation, chip security assessment and lock-down, and circuit block power management. We discuss platinum and iron switch with turn-on voltages of ~ 1.8 V. In the case of the iron switches, we also show that they can be magnetized to have “memory” and stay on when turned on. Platinum switch cycling of up to 1000 times did not show any changes in their turn-on voltage and their contact resistance was unchanged. The 10-100 nm switch airgaps were formed using low temperature sputtered sacrificial polysilicon and XeF₂ etching. XeF₂ does not attack any of the metals used in CMOS enabling fabrication of cross-bar switches with any of these metals. Once activated, it takes ∿ 6 to mechanically turn on the switch that can be decreased to ~1 ns by optimizing the device structure. Interestingly, the nm-scale gaps can be used as spark gap as a fast plasma switch to discharge first followed by the activation of the MEMS switch.

To elucidate mesenchymal stromal cells (MSC)-tumor intricate and ambiguous interactions, the reliable cell labeling and tracking techniques are imperative. Traditional methods of cell labelling have limitations mostly relevant to need for genetic modification what demands the exploration for alternative strategies. Here, we propose using fluorescent photoconvertible microcapsules containing Rhodamine B (RhB) to study mMSC migration in brain tumors. These 3 μm sized microcapsules are readily internalised by cells and undergo photoconversion under 561 nm laser exposure with fluorescence blue shift on demand. Optimal photoconversion was achieved with a laser irradiation duration of 0.4 ms, which provide a maximal brightness of photoconverted label without an excessive laser exposure on cells. Capsules modified with polyallylamine hydrochloride demonstrated the best potential for intracellular uptake without significantly affecting cell viability, motility, or proliferation. The optimal ratio of 20 capsules per mMSC was determined for labeling. Moreover, migration of individual mMSCs within 2D and 3D glioblastoma cell (EPNT-5) colonies over 2 days and in vivo tumor settings over 7 days was tracked. Our study unveils a robust platform for investigating MSC-tumor dynamics, offering insights into therapeutic strategies. Photoconvertible microcapsules could also become an indispensable tool for studying complex fundamental processes of cell-cell interactions for a wide range of problems in biology and medicine.

Tuberculosis (TB) remains a significant public health challenge in Nigeria, with high rates of transmission and low case detection rates. This paper presents the challenges of TB screening and the existing gaps in Contact Investigation (CI). This descriptive qualitative study was conducted in 8 local government areas with high TB burdens in Oyo and Osun States, Nigeria. Twenty-four focus group discussions and 27 key informant interviews were conducted among TB patients, household TB contacts, and government TB staff, among others. Respondents' ages ranged from 17-85 years with a mean of 42.08±14.9 years, and (4.0%) had a postgraduate degree. The unwillingness of the majority of TB contacts who tested negative for TB to be placed on TB preventive therapy because of the belief that only a sick person should take drugs and hostility from the TB contacts to the contact tracers during the house-to-house screening of presumptive TB cases due to community stigma associated with TB were some of the existing gaps reported in TB contact investigations. The findings emphasize the importance of tailored approaches in TB prevention and control, addressing challenges in testing and contact investigations; this necessitates investments in community engagement strategies to enhance the cooperation of TB contacts.

Background: Ventilator-associated pneumonia (VAP) is among the most common healthcare-associated infections in Pediatric Intensive Care Units (PICUs). Because of the lack of a gold-standard diagnostic test, early diagnosis of VAP is challenging. We investigated whether bronchial biomarkers interleukin-4 (IL-4), plasminogen activator inhibitor-1 (PAI-1) and soluble receptor for advanced glycation end products (RAGE) could contribute in early VAP diagnosis through their fluctuation in time in critically ill pediatric patients. Methods: Bronchial secretions were collected from PICU patients with VAP on days 1 and 6. PAI-1, RAGE and IL-4 levels were measured by ELISA. Protein concentrations between high and low VAP suspicion patients were compared using unpaired Student’s t or Mann–Whitney U tests. Results: Twenty PICU patients, with median age 7.75yrs (range 0.5-15.3), mechanically ventilated for ≥48hrs with increased oxygenation requirements and VAP clinical/laboratory signs were enrolled. They were divided in VAP high-suspicion (n=12) or low-suspicion (n=8) groups based on Clinical Pulmonary Infection Score (cutoff:6). ΡΑΙ-1 και RAGE levels did not differ between high- or low-VAP suspicion groups the 1st or 6th days (p-value&gt;0.05). IL-4 was not detected in bronchial secretions. Conclusion: Bronchial concentrations of IL-4, PAI-1 and RAGE in critically ill children are not correlated with high- or low-VAP suspicion.

Objective: The private healthcare providers (PHCP) are believed to improve access to healthcare services in Public-Private Mix (PPM) projects, as they are considered first point of contact for healthcare. The purpose of this study was to know the satisfaction level of TB patients. Design: A questionnaire-based, cross-sectional study was carried out during November and December 2017 for 572 under-treatment patients registered with PHCPs in the PPM project. Lot quality assurance sampling technique was used to randomly select 19 districts from sample frame of 75 districts. In each selected district, data collector retrieved TB register of 8 months (Jan – Aug 2017) and systematically selected patients by fixed periodic interval. SPSS (version 24.0) was used to analyze the data. Results: Study included 53% (n=301) of males and 47% (n=271) of females, with mean age of 38 years (SD, ±18). Almost half of the participants were illiterate (51%, n=289) and 64% (n=365) were non-earning members of the family. In practice, most of the participants visit private providers (71%, n=407), including private hospital/clinic (44%) and traditional practitioners (27%; n=153). 55% of participants visited the current doctor because of clinic’s proximity to residence. 82% of the participants (n=469) were satisfied with the TB care services and 85% (n=488) said that they would recommend this clinic to others. Conclusion: PHCPs are preferred providers for individuals, which is consistent with findings of other studies. Though they are satisfied with TB care and services, interventions should be introduced to reduce the financial burden on the patient. Partnering PHCP is a way forward to ensure universal health coverage, health system strengthening and better health outcomes of the population.

To study the coupling mechanism and dynamic response of the end-face movable gear trans-mission system under complex excitation, a specific configuration of end-meshing movable gear reduction mechanism was used to achieve predetermined rigid thrust transmission and mis-matched gear meshing functions, which solved the inherent defects of traditional harmonic gear mechanism thin-wall flexible wheel easy to be damaged by fatigue. Considering the phenomenon of elastic deformation of live teeth accompanied by significant changes in meshing characteristics in the transmission process of end-meshing harmonic reducer, the influence of dynamic meshing parameters, live tooth deformation, time-varying stiffness of tooth meshing, and time-varying backlash on nonlinear dynamic performance was explored, as well as the mechanism of mul-ti-parameter coupling on transmission performance. The nonlinear dynamics model of the end-meshing harmonic reducer is established to solve the chattering prediction problem. Finally, a comprehensive test bed for the transmission system of harmonic reducer with meshing type with adjustable characteristic end was built to verify the correctness of the theoretical model and provide the theoretical and technical basis for exploring the optimal parameter selection of pas-sive vibration suppression problem.

The standard model of cosmology assumes that our Universe began 14 Gyrs (billion years) ago with a hot Big Bang expansion out of nothing. It can explain a vast range of different astrophysical data from a handful of free cosmological parameters. However successful this model is, we have no direct evidence or fundamental understanding of some key assumptions: low entropy start, Inflation, Dark Matter and Dark Energy. Here we present a simpler and more physical explanation for the same observations that do not require such assumptions or new laws of Physics. It is based on the evidence that we live inside a Black Hole (BH) of mass $ M \simeq 5 \times 10^{22} M_{\odot}$, which we observed as cosmic acceleration. How did the Big Bang end up inside such a BH? We propose that 25 Gyrs ago, a very low density dust cloud collapsed and form such BH. As there was no pressure support, the collapse continued inside until it reached neutron energy densities (GeV). Causal regions of solar mass size rebound by neutron degeneracy, like a supernovae, producing the Big Bang expansion and compact dark matter remnants. During collapse, perturbations exit the horizon to re-enter during expansion, given rise to the observed universe. We review the evidence for such BH Universe.

Background. Wnt-pathway proteins play a vital role in kidney development and defects in the Wnt-pathway are associated with kidney disorders. However, the knowledge on the role of Wnt/β-catenin pathway proteins in end-stage renal disease (ESRD) is limited.Aim of the study. To delineate the association of ESRD and Wnt-proteins including the agonistR-spondin 1, the transducer β-catenin and the antagonists Dickkopf-related protein 1 (DKK1) and sclerostin.Methods. Serum Wnt-pathway proteins levels were measured by ELISA, while other biochemicals were measured spectrophotometrically in 60 ESRD patients and 30 normal controls.Results. DKK1 and sclerostin were significantly higher in ESRD than in controls, and β-catenin and the catenin + R-Sponin-1 / DKK1 + sclerostin ratio, reflecting the ratio of agonist and transducer on antagonists (AT/ANTA), were significantly lower in ESRD. Logistic regression analysis showed that ESRD was significantly predicted by increased levels of DDK1 and sclerostin and lowered β-catenin (p<0.001). eGFR was significantly associated with DKK1 and sclerostin (inversely), β-catenin (positively) and the AT/ANTA ratio (r=0.468, p<0.001). DKK1 levels were significantly and positively correlated with urea, creatinine, and copper. DKK1 and sclerostin were inversely associated with hemoglobin and packet cell volume. Catenin was significantly negatively associated with copper, urea and creatinine.Conclusion. Wnt/β-catenin pathway proteins show significant alterations in ESRD, indicating significantly increased levels of antagonists and, therefore, attenuated Wnt/β-catenin pathway activity. The latter is associated with lowered eGFR and increased serum copper levels. Wnt/β-catenin pathway proteins are possible drug targets to treat ESRD or its consequences.

Parallel manipulators with multiple end-effectors bring us interesting advantages over conventional parallel manipulators such as improved manipulability, workspace and avoidance of singularities. In this work the kinematics of a five-bar planar parallel manipulator equipped with two end-effectors is approached by means of the theory of screws. As an intermediate step the displacement analysis of the robot is also investigated. The input-output equations of velocity and acceleration are systematically obtained by resorting to reciprocal-screw theory. In that regard the Klein form of the Lie algebra se(3) of the Euclidean group SE(3) plays a central role. In order to exemplify the method of kinematic analysis, a case study is included. Furthermore, the numerical results obtained by means of the theory of screws are confirmed with the aid of special software like ADAMS.^TM

Background: Although Tuberculosis (TB) is one of the oldest diseases known to mankind, many practitioners are still unaware of various aspects of management of TB including drug resistant TB. To be able to make an impact on the disease burden we need to understand the knowledge, attitude and practices (KAP) of practitioners, both in government and private sector, towards TB case management. Methodology: A random cross-sectional survey of 99 respondents to assess the KAP towards TB case management using a digital semi-structured questionnaire which was pre-tested and administered to allopathic practitioners from across States in North and Central India. Results: 77% responders were government doctors and 23% were private practitioners. Chest physicians accounted for 61% of the responders. 26% of government and 78% of private doctors relied on sources which are difficult to validate for their knowledge on drug resistant TB management. There were large variations seen in knowledge on modes of transmission, standard precautions, extent of drug resistant TB, diagnostics as well as treatment regimen for drug resistant TB. Conclusion: The knowledge of both sector doctors especially amongst private practitioners with respect to the awareness of extent, diagnosis, and treatment and infection control measures for drug resistant TB is suboptimal which translates to poor diagnostic, therapeutic and infection control choices amongst private practitioners. If India has to achieve the targets for TB Elimination by 2025, serious work needs to be done to upgrade the knowledge of the private sector doctors on drug resistant tuberculosis. The Ministry of Health and Family Welfare, GoI needs to have regular educational programs for the private practitioners coupled with awareness campaigns and frequent surveys to assess the knowledge, attitude and practices being followed in the private sector for TB management including drug resistant TB.

This is the second of a series of two papers comparing the end of life issues in human and veterinary medicine. We outline the main differences between human and animal patients such as patient communication, finance and ‘conflicts of interest’ between animal, owner and veterinarian. We discuss striking similarities between human and veterinary issues such as assessing quality of life and the primary role of the attending veterinarian or doctor being the welfare and care of the patient. This paper takes the form of an ethical argument in favour of allowing euthanasia in human medicine, by providing insights into end of life issues for humans from an independent veterinary perspective. Veterinary surgeons are well trained in the ethics of euthanasia and put it to good use in the best interest of their animal patients. Doctors in the UK are limited and unwilling to put forward a case for the option of euthanasia for those patients who face a slow and agonizing death. With advances in medical science being able to significantly prolong the dying process, autonomy for the patient demands a review of the law regarding patient choice in the UK.

LuBO3 crystallizes in the calcite type (CaCO3) structure and is a widely applied inorganic host for luminescent materials and scintillators. Even though many scientific works have been published concerning the optical properties of rare earth doped LuBO3, so far, no study of the emission spectra as function of the excitation energy of such orthoborates has been conducted. Therefore, this work deals with the photoluminescence of RE doped LuBO3 with RE = Ce3+, Eu3+, Gd3+, or Tb3+, while an emphasize is laid on the energy dependence of these four luminescent compounds.

Background: World Health Organization (WHO) estimates that there were 558000 new cases with resistance to Rifampicin, of which 82% had multidrug-resistant tuberculosis (MDR-TB). Objectives: We aimed to identify the prevalence of MDR-TB in River Nile state, Sudan, and the risk factors contributing to its occurrence. Methods: This was a descriptive cross-sectional hospital-based study involved 200 specimens taken from patients suspected of having MDR-TB tested using an automated GeneXpert assay. Results: Results of GeneXpert assay showed that the presence of Mycobacterium tuberculosis in 81 (40.5%), and out of 81 positive test results there were 13 (16%) had MDR-TB. Additionally, 7 cases of MDR-TB were previously treated which represented about (53%) of MDR patients, the remaining 6 MDR-TB patients were new cases and represented (47%) of MDR-TB patients. Moreover, there were 4 MDR-TB patients who had a history of contact with MDR-TB patients. Conclusion: Prevalence of MDR-TB in River Nile State, Sudan was 16%, which is greater than WHO estimation for Sudan (10.1%). The results revealed that the main risk factor to develop MDR-TB was a history of contact with MDR-TB, so adherence to treatment and social awareness about the spread of MDR-TB are crucial preventive measures.

The purpose of this study was to identify the factors that affect the mortality among adult HIV/TB co-infected patients and to see the nutritional difference among mortality in residence level. Retrospective cohort studies of 417 patients which fulfill our criteria were included. Multilevel logistic regression models were used. MLwiN and SPSS software are used to estimate the parameter. The variance of the random factor in the empty model was significant which indicates that there were residential differences in TB-HIV co-infected mortality and it shows multilevel analysis was an appropriate approach for further analysis. The prevalence of HIV/TB co-infected patients' death was 12.9% in study time. Functional status, age of patients, WHO clinical stages, nutritional status, CD4 counts, regimen, and BMI were found to be significant determinants of HIV/TB co-infected mortality. In our study, patients with the bedridden category of functional status, the fourth stages of WHO clinical stages (stage IV), patients with higher age, patients whose treatments were second-line regimen and low CD4 cell counts were more at risk of death. The study also revealed that; poor nutritional status increased the risk of mortality among HIV/TB co-infected patients and it varies among the residence of the patients (rural area were more at risk).

After UV excitation, gas phase thymine returns to ground state in 5 to 7 ps, showing multiple time constants. There is no consensus on the assignment of these processes, with a dispute between models claiming that thymine is trapped either in the first (S1) or in the second (S2) excited states. In the present study, nonadiabatic dynamics simulation of thymine is performed on the basis of ADC(2) surfaces, to understand the role of dynamic electron correlation on the deactivation pathways. The results show that trapping in S2 is strongly reduced in comparison to previous simulations considering only non-dynamic electron correlation on CASSCF surfaces. The reason for the difference is traced back to the energetic cost for formation of a CO p bond in S2.

Active front-end (AFE) rectifiers have been becoming widely employed in power systems to achieve unity power factor and harmonic mitigations. The typical modeling approaches applied for AFE rectifiers in the literature mostly relied on two baselines named the detailed model and the time average model. The former approach deals with the switching element model (SEM) leads to significant harmonics in currents with distorted waveforms. The latter approach uses the average-value model (AVM) to overcome the currents’ harmonics as well as provide fast responses. However, even the AVM baseline has contained problems during the starting stage (lack of control signals) and over the dead-time periods which causes serious issues in the implementation process. This paper presents an improved dynamic AVM for AFE rectifiers by precisely considering the issues mentioned above along with the practical starting procedure and desirable initialization. The studied AFE rectifier is developed using the voltage-oriented control (VOC) technique based on the different modeling methodologies including SEM, Conventional AVM, and the proposed AVM. The performance of all models is analyzed and compared using simulation results with MATLAB/Simulink R2023a Function blocks for all the algorithm parts and SimScape elements for the electrical circuit model. The simulation results illustrate that the performance of the proposed AVM approach can closely resemble the behavior of the SEM baseline with low harmonic distortion.

Background: Once a widely used analgesic in the United States (US), meperidine offered an alternative to other opioids as a pain reliever. However, within the last two decades, meperidine has gone from a drug to be utilized only when patients exhibit atypical reactions to opioids (e.g., morphine and hydromorphone) to being taken off the World Health Organization List of Essential Medications and receiving strong recommendations for the overall avoidance. The aim of this study was to identify changes in meperidine distribution in the US and regional disparities as reported to the Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (DEA ARCOS) and Medicaid. Methods: Data related to the meperidine distribution was obtained through ARCOS (2001 –2021) and Medicaid public use files (2016 –2021). Heat maps were used to visualize regional disparities in distribution by state. States outside a 95% confidence interval were statistically significant. Results: Meperidine distribution between 2001 and 2021 decreased by 97.4% (R=.-97, P &lt; .0001). There was a 34-fold state-level difference in meperidine distribution between Arkansas (16.8 mg/10 persons) and Connecticut (0.5 mg/ 10 persons) in 2020. Meperidine distribution in 2020 was elevated in Arkansas, Mississippi, and Alabama. In 2021, Meperidine distribution was highest in Arkansas ( 1.67 /10 persons) and lowest in Connecticut (0.08 /10 persons). Total prescriptions of meperidine as reported by Medicaid decreased by 73.8% (R= -0.67, P = 0.045) between 2016 and 2021. Conclusion: We observed a decrease in the overall distribution of meperidine in the past two decades with similar recent declines in prescribing to Medicaid enrollees. The shortage of some parenteral formulations is an important contributor to these declines. This data may reflect plans to phase out the use of this opioid, especially in the many situations where preferred opioids are available.

Health information and communication are key elements that allow patients and family members to make decisions about end-of-life process and guarantee a death with dignity. Objective: To understand carers’ experiences regarding health information and communication during the illness and death of family members. Methods: This qualitative study was conducted in Andalusia based on the paradigm of hermeneutic phenomenology. Participants were carers who had accompanied a family member at the end of life for over 2 months and less than 2 years. Five nominal groups and 5 discussion groups were established, and 41 in-depth interviews with 123 participants were conducted. Atlas.ti 7.0 software was used to analyse the discourses. Results: Four dimensions of the dying process emerged: differences in carers’ perceptions of information and communication, a conspiracy of silence, consequences of the absence or presence of information, and the need for a culture change. Conclusions: Poor management of health information and communication at the end of life suffering and discomfort patients and their families. The culture of denying and avoiding death is still present today. A change in education about death would better enable health professionals to care for patients at the end of life.

This paper presents a study of the 2D roughness profiles on a flat surface generated on a steel work piece, by ball nose end milling, with linear equidistant tool paths (pick-intervals). The milled surface exploration with a surface roughness tester (on pick and feed directions) produces usually 2D roughness profiles having periodical evolutions. These evolutions can be seen as time-dependent signals, describable as a sum of sinusoidal components (the wavelength of each component being regarded as a period). In order to detect a well approximated description of these components, two appropriate signal processing techniques are used in this work: first technique provides a direct mathematical (analytical) description and is based on computer aided curve (signal) fitting (more accurate), the second technique (providing an indirect and incomplete description) is based on the spectrum generated by fast Fourier transform (less accurate). This study can be seen as a way for a better understanding the interaction between the tool and the work piece or to achieve a mathematical description of the machined surface microgeometry in terms of roughness (e. g. its description being a collection of closely spaced 2D roughness profiles).

This study innovatively assesses the Mun River flow components in Thailand, integrating Artificial Neural Networks (ANN) and Isotopic (18O) End-Member Mixing Analysis (IEMMA). It quantifies the contributions of the Upper Mun River (UMR) and Chi River (CR) to the overall flow, revealing a discrepancy in their estimated contributions. ANN predicts the UMR and CR contribute approximately 70.1% and 29.5% respectively, while IEMMA indicates a more pronounced disparity with 84% from UMR and 16% from CR. This divergence highlights the distinct perspectives of ANN, focusing on hydrological data patterns, and IEMMA, emphasizing isotopic signatures. Despite discrepancies, both methods validate UMR as a significant contributor to the overall flow, highlighting their utility in hydrological research. The findings underscore the complexity of river systems and advocate for an integrated approach of river flow analysis for a comprehensive understanding, crucial for effective water resource management and planning.

Background. There is limited evidence on the relationship between chronic kidney disease (CKD) and frailty in older people in Vietnam. This study aimed to examine the prevalence of frailty and its impact on mortality in older patients with end-stage renal disease. Method. This is a prospective, observational study at two large Dialysis Centres in Vietnam from November 2020 to June 2021. Consecutive older patients diagnosed with end-stage renal disease and on dialysis were recruited. Participants’ frailty status was defined by the Clinical Frailty Scale (CFS). The study outcome was all-cause mortality at 6th month. Results. A total of 175 participants were recruited (mean age 72.4 years, 58.9% female). Using the cut-point of CFS ≥4, 87.4% of the participants were frail. Mortality at 6th month was 14.9%, 31.9% in participants with CFS ≥7, 12.8% in participants with CFS=6, 7.5% in participants with CFS from 4 to 5, and 4.5% in participants with CFS ≤3 (p=0.001). Cox regression analysis showed that compared to the non-frail participants, the probability of death over 6 months was nearly 2-fold higher in the mildly frail, 3-fold higher in the moderately frail, and 9-fold higher in the severely frail participants. Conclusion. This study demonstrated a very high prevalence of frailty in older patients with end-stage renal disease and dialysis and the significant impact of frailty severity on mortality. Healthcare providers should consider incorporating frailty screening into routine care for older patients with end-stage renal disease and dialysis.

Falls, especially those left unattended, are fatal for the elderly. Several efforts have been made to use the Internet of Things and Machine Learning algorithms to detect falls. All such systems have issues such as (a) sensor placement on the torso and thigh which will be uncomfortable for the elderly. (b) Predictions made on the cloud- the result of the prediction is then sent back to the end device to raise an alert. This is prone to network connectivity and latency issues. We have built an end/device that is wrist-worn and has multiple Inertial Measurement Unit sensors and a heart sensor. We have developed three novel ensemble algorithms (a)Stack(A) (b) Variable weighted Ensemble Voting algorithm-B(VWE(B)), and (c) Variable weighted Ensemble Voting algorithm-C (VWE(C)). Since the ensemble algorithm is run on the end-device built around Qualcomm Snapdragons 820c, we do both feature extraction and selection to reduce data dimensionality. We have used multiple methods such as (a) Identifying features that have maximum impact (b) Principal Component Analysis (PCA) (c) Shapley’s values (d) Cross-Correlation combined with relliefF. We got an accuracy of 97% and specificity of 99%. In this paper, we present the analysis of the system with and without pruning.

Non-homologous end-joining (NHEJ) is a DNA repair pathway required to detect, process, and ligate DNA double-stranded breaks (DSBs) throughout the cell cycle. The NHEJ pathway is necessary for V(D)J recombination in developing B and T lymphocytes. During NHEJ, Ku70 and Ku80 form a heterodimer that recognizes DSBs and promotes recruitment and function of downstream factors PAXX, MRI, DNA-PKcs, Artemis, XLF, XRCC4, and LIG4. Mutations in several known NHEJ genes result in severe combined immunodeficiency (SCID). Inactivation of Mri, Paxx or Xlf in mice results in normal or mild phenotype, while combined inactivation of Xlf/Mri, Xlf/Paxx, or Xlf/Dna-pkcs leads to late embryonic lethality. Here, we describe three new mouse models. We demonstrate that deletion of Trp53 rescues embryonic lethality in mice with combined deficiencies of Xlf and Mri. Furthermore, Xlf^-/-Mri^-/-Trp53^+/- and Xlf^-/-Paxx^-/-Trp53^+/- mice possess reduced body weight, severely reduced mature lymphocyte counts, and accumulation of progenitor B cells. We also report that combined inactivation of Mri/Paxx results in live-born mice with modest phenotype, and combined inactivation of Mri/Dna-pkcs results in embryonic lethality. Therefore, we conclude that XLF is functionally redundant with MRI and PAXX during lymphocyte development in vivo. Moreover, Mri genetically interacts with Dna-pkcs and Paxx.

Not a lot is known about either death or the dying process. Politicians and many in the medical profession in the UK tend to shy away from interfering with it by not allowing euthanasia as an end of life option for the patient. This is the first paper in a series of two, comparing the situation in human medicine and veterinary medicine, in which euthanasia is well practiced for relieving suffering at the end of an animal’s life. This first part takes the form of a literature review including best practice around end of life care, its deficiencies and the need for assisted dying. Veterinary surgeons are well trained in the ethics of euthanasia and put it to good use in the best interest of their animal patients. In countries which have legalized physician assisted suicide for the terminally ill reporting indicates that it works well, without increases in involuntary euthanasia and most importantly without intimidation of the vulnerable. However, there is still an ever increasing tendency to overuse sedation and opioids at the end of life, which merits further investigation. With advances in medical science able to significantly prolong the dying process, patient autonomy demands a review of the law in the UK.

This paper presents the formative assessment to implement mobile portable chest X-ray (PDX) machines for Tuberculosis (TB) contact tracing in Oyo and Osun States, Nigeria. This descriptive qualitative study was carried out in 8 Local Government Areas, and 24 FGDs and 33 KIIs were conducted using a 4-stage sampling technique to select participants. Validated transcribed notes were entered and analysed using Nvivo. The respondents' ages ranged from 17-85 years, with a mean age of 42.08±14.9 years, and 4.0% had a postgraduate degree. The majority of the government officials stated that deploying the PDX machine intervention at the community level is the best means as it offers a level of convenience to the community members in the sense that there will be limited disruption to their daily activities as well as zero concerns about the cost of transportation to the health facility. The portable X-ray machine intervention should be implemented at the community level for contact tracing to allow more TB contacts living with the index patient to be screened. However, the PDX machine can also be set up in a special location, and the TB contacts can be invited for the screening.

Background: Women in rural districts of Pakistan face numerous barriers to healthcare, rendering gender-responsive health programming important, including for Tuberculosis (TB). This study was conducted to assess the general understanding of TB and of access to healthcare for women, as a first step towards implementation of a gender responsive TB programme in TandoAllayar, a rural district of Pakistan. Methods: A total of 36 participants were interviewed. The focus group discussion guide comprised of questions on: (1) family/household dynamics (2) community norms (3) healthcare system (4) women’s access to healthcare (5) TB Awareness;, and (6) women’s access to TB Care. Results: Limited autonomy in household financial decision-making, disapproval of unassisted travel, long travel time, lack of prioritization of spending on women’s health and inadequate presence of female health providers, were identified as barriers to access of healthcare for women, higher in younger women. Facilitators to access of TB care included a reported lack of TB-related stigma, moderate knowledge about TB disease, and broad understanding of tuberculosis as a curable disease. Other suggested facilitators include health facilities closer to the villages and the availability of higher quality services. Conclusion: Significant barriers are faced by women in access to TB care in rural districts of Pakistan. Programme implementers in high burden countries, should shift towards improved gender-responsive TB programming.

The purpose of this study is to investigate the impact of the voltage drop of a three-phase voltage source inverter in driving brushless motors. This study also proposes an enhanced Field Oriented Control scheme that accounts for the inverter voltage drop enabling efficient drive at very low motor-speeds. Experimental results are provided to verify the theoretical study and the proposed control scheme.

Vaccine development against SARS-CoV-2 has been highly successful in slowing down the COVID-19 pandemic. A wide spectrum of approaches including vaccines based on whole viruses, protein subunits and peptides, viral vectors, and nucleic acids have been developed in parallel. For all types of COVID-19 vaccines, good safety and efficacy have been obtained in both preclinical animal studies and in clinical trials in humans. Moreover, emergency use authorization has been granted for all types of COVID-19 vaccines. Although high safety has been demonstrated, rare cases of severe adverse events have been detected after global mass vaccinations. Emerging SARS-CoV-2 variants possessing enhanced infectivity have affected vaccine protection efficacy requiring re-design and re-engineering of novel COVID-19 vaccine candidates. Furthermore, insight into preparedness against emerging SARS-CoV-2 variants and other future viral infections is given.

Abstract: Like other plants, every PV power plant will one day reach the end of its service life. Calculations show that 20,400 tons of PV waste will be generated worldwide by 2030 and 60.2 million tons by 2050, not including the mass of the support structure. Such large amounts of waste pose a potential threat to the environment and people if not properly managed. The paper analysed the options for dealing with PV waste, namely reuse, recycling and landfilling. For recycling as the best option in terms of environmental protection and circular economy, an overview of recycling technologies and the percentage of achievable recycling for the materials contained in each PV system component is given. In addition, the current situation of legislation and recycling of PV modules in Europe was examined with special reference to the Balkan countries. There are a small number of factories for recycling PV modules in Europe, but none in the Balkan countries. The main reason for this is the small amount of PV waste in these countries and consequently the economic unprofitability. For this reason, PV modules (after dismantling the aluminum frame and cables) are mostly disposed of as non-hazardous waste in landfills in these countries. Finally, the main barriers to faster implementation of PV module reuse and recycling are listed, along with guidelines for their removal. The cost of recycling Si modules is about ten times higher than the cost of disposal. To change this ratio in favor of recycling, cheaper recycling methods need to be developed and taxes on landfill disposal need to be increased.

Objective: In India, yearly, estimated one million TB cases are missing from notification, mostly from private sector. The large number of patients in private sector has raised concerns for suboptimal quality of care. This study was conducted to find out the treatment adherence status among the private TB patients and factors associated with poor adherence.Data Source: Secondary project data, obtained through adherence monitoring house visit by NGO workers. Data collected by reviewing different records available with the patients & data was entered into the CommCare HQ, an open-source mobile platform designed for data collection.Methods: Descriptive observational study.Results: Default rate among private patients was 5%. Commonest reasons stated for being a defaulter were ‘Medicine is not good’ (30%), ‘Travel’ (28.6%), ‘Cost of treatment’ (21.8%) and ‘Side effects’ (11.6%). Despite best of efforts only 36.9% defaulter could be retrieved. Higher default rate was associated with 15-59 years age, males, earning member of the family, addiction, DR-TB, continuation phase of treatment, previous history of TB, presence of symptoms and inability to walk.Conclusion: Privately treated TB patients are vulnerable to non-adherence. Once defaulted, it is difficult to retrieve them. Economically productive age group is at higher risk of being defaulter. Strict adherence monitoring for private TB patients and extensive advocacy communication & social mobilization program in the community, workplaces and institutions is a need of hour.

Biotechnological potential of Thermoanaerobacter strain AK15 to produce ethanol and valuable alcohols from carbohydrates and amino acids were evaluated in present study. The strain is highly ethanologenic, producing a maximum of 1.57 mol ethanol per mol of glucose degraded at high liquid-gas phase ratios. The strain degrades most of the sugars tested as well as starch and pretreated hydrolysates of biopolymers (Whatman paper, newspaper, Timothy grass, Rhubarb leaves, and several macroalgae species) to ethanol mainly. The strains degraded serine and threonine when used as a single substrate, producing mainly acetate and ethanol as end products, and the branched-chain amino acids (leucine, isoleucine, valine) when cultivated in the presence of thiosulfate. The main end products from branched-chain amino acids were a mixture of their corresponding branched-chain fatty acids and alcohols. Finally, the strain was also shown to use butyrate as an electron sink during glucose degradation resulting in the reduced product butanol in addition to end products produced from glucose. Thus, strain AK15 is a promising candidate for ethanol and fine chemical production from a range of lignocellulosic and algal biomass.

The recycling of wastes to obtain value-added products is a great challenge in the sustainable economy. In our studies, a mixed precursor containing aluminium scrap from end – of – life vehicles and TiO2 Degussa P25 was used to prepare TiO2 modified Al photocatalyst through solid state reaction. Al scrap and TiO2 Degussa P25 in the ration of n(Ti) / n(Al) = x (x = 0.0 - 2.5%), and acetylacetonate and Tween 80 was mixed under magnetic stirring and sintered using a con-ventional furnance at 550°C. DTA – TG – DTG, X – ray diffraction, Fourier – transform infrared, UV – Vis and photoluminescence spectroscopies were assed to investigate the thermal, structural, optical properties and photocatalytic activity. The effect of aluminium concentration on the characteristics of TiO2 Degussa P25 depending on the above instruments are studied. XRD revealed that the materials have crystal structure of anatase TiO2, rutile TiO2 and aluminium. The opto-electronic properties show that Al addition shifted the absorption spectra toward the visible range. The photocatalytic performance of Al – TiO2 composites was quantified by the degradation of Allura Red solution under a visible condition. The highest photocatalytic activity (79.99%) was achieved for the sample containing 0.5% Al and a higher concentration of Al particles shields the active centres of the semiconductor, thus reducing its photocatalytic activity. Aluminium scrap from end-of-life vehicles can be a source of raw material to be considered in semiconductor production. The spin-trapping technique evidenced that •O2- was the main species generated responsible for the Allura Red degradation.

Traditional end-effector robots for arm rehabilitation are usually attached a­t the hand, primarily focusing on coordinated multi-joint training. Therapy at an individual joint level of the arm for severely impaired stroke survivors is not always possible with existing end-effector robots. The Arm Rehabilitation Robot (AREBO)—an end-effector robot—was designed to provide both single and multi-joint assisted training while retaining the advantages of traditional end-effector robots, such as ease of use and cost-effectiveness (compared to exoskeletons). This work presents the design, optimization, and characterization of AREBO for training single-joint movements of the arm. The AREBO has three actuated and three unactuated degrees of freedom, allowing it to apply forces in any arbitrary direction at its endpoint and self-align to arbitrary orientations within its workspace. The AREBO’s link lengths were optimized to maximize its workspace and manipulability. The AREBO provides single-joint training in both unassisted and adaptive weight support modes using a human arm model to estimate the human arm's kinematics and dynamics without using additional sensors. The characterization of the robot’s controller and the algorithm for estimating the human arm parameters were performed using a two degrees of freedom mechatronic model of the human shoulder joint. The results demonstrate that: (a) the movements of the human arm can be estimated using a model of the human arm and robot’s kinematics, (b) the AREBO has similar transparency to that of existing arm therapy robots in the literature, and (c) the adaptive weight support mode control can adapt to different levels of impairment in the arm. This work demonstrates how an appropriately designed end-effector robot can be used for single-joint training, which can be easily extended to multi-joint training. Future work will focus on the evaluation of the system on patients with any neurological condition requiring arm training.

This note applies the Logistic model approximation to determine the suitable start and end dates for the observed epidemic curves in the total number of cases for different countries. The Logistic model is presented and explicit relations for the beginning and end dates are obtained together with the total epidemic duration. Using data from Brazil, Germany, Italy, and South Korea, the extreme dates are calculated. Since the epidemic onset time is found, a fair comparison of the epidemic curve for these countries is obtained. The result does not depend on the poor statistics available in the early phase of the epidemic when the initial number of infectives is unknown. In fact, the total duration depends only on the characteristic time parameter of the LM model.

Non-homologous end-joining (NHEJ) is a major DNA repair pathway in mammalian cells that recognizes, processes and fixes DNA damages throughout the cell cycle, and is specifically important for homeostasis of post-mitotic neurons and developing lymphocytes. Neuronal apoptosis increases in the mice lacking NHEJ factors Ku70 and Ku80. Inactivation of other NHEJ genes, either Xrcc4 or Lig4, leads to massive neuronal apoptosis in the central nervous system (CNS) that correlates with embryonic lethality in mice. Inactivation of either Paxx, Mri or Dna-pkcs NHEJ gene results in normal CNS development due to compensatory effects of Xlf. Combined inactivation of Xlf/Paxx, Xlf/Mri and Xlf/Dna-pkcs, however, results in late embryonic lethality and high levels of apoptosis in CNS. To determine the impact of NHEJ factors on early stages of neurodevelopment, we isolated neural stem and progenitor cells from mouse embryos and investigated proliferation, self-renewal and differentiation capacity of these cells lacking either Xlf, Paxx, Dna-pkcs, Xlf/Paxx or Xlf/Dna-pkcs. We found that XLF, DNA-PKcs and PAXX maintain the neural stem and progenitor cell populations and neurodevelopment in mammals, which is particularly evident in the double knockout models.

Background: Active case finding for TB was implemented in selected sixty high TB burden wards of Kolkata, India. Community volunteers called TOUCH agents (TAs) identified and referred presumptive TB patients (PTBPs) to health facilities for TB diagnosis and treatment. We aimed to describe the ‘care cascade’ of PTBPs identified during July to December, 2018 and to explore the reasons for attrition as perceived by TAs and PTBPs. Methods: An explanatory mixed methods study with quantitative phase of cohort study using routinely collected data followed by descriptive qualitative study with in-depth interviews was conducted. Results: Of the 3, 86,242 individuals enumerated, 1132 (0.3%) PTBPs were identified. Only 713 (63.0%) PTBPs visited referred facility for TB diagnosis. TB was diagnosed in 177 (24.8%) and the number needed to screen for one TB was 2,183 individuals. The potential reasons for low yield were stigma and apprehension about TB, distrust about TA, wage loss for attending health facilities and substance abuse among PTBPs. Conclusion: The yield of ACF was suboptimal with low PTBP identification rate and high attrition rate. Interviewing each individual for symptoms of TB and supporting PTBPs for diagnosis through sputum collection and transport can be adopted to improve the yield.

Background Lower respiratory tract infections (LRTIs), particularly pneumonia, are a leading cause of morbidity and mortality among children worldwide, especially in low-resource settings. The World Health Organization (WHO) Integrated Management of Childhood Illness (IMCI) guidelines currently recommend antibiotic treatment for all case of with pneumonia based on clinical signs along, which can lead to over-prescription of antibiotics and contribute to antimicrobial resistance (AMR). Point of care Lung Ultrasound (LUS) has emerged as a promising diagnostic tool in this context and has demonstrated potential in distinguishing between bacterial and viral pneumonia, thus enabling more targeted antibiotic use. This study aims to explore whether integrating LUS into the IMCI-based management of clinical pneumonia will better identify those who would benefit from antibiotic treatment, reducing antibiotic overuse without compromising health outcomes. Methods An open label randomized controlled trial will enrol 3500 children aged 60 days to 12 years presenting with IMCI-defined pneumonia. Participants will be enrolled in Senegal, Tanzania, and South Africa. Participants will be randomly assigned in a ratio of 1:1, stratified by site and age group (<5years, 5-12years) to either an intervention group, where LUS will guide antibiotic prescriptions utilising a predefined interpretation framework, or a control group receiving routine IMCI-based care. The co-primary outcomes of this study are the reduction in antibiotic use on the day of enrolment (Day 1) and rate of clinical failure by Day 8, using an acceptable clinical difference of 1.5x as a non-inferiority margin (delta of 2.5%). Secondary outcomes will include adverse drug reactions, cure rates, hospital admissions including in-patient duration, and cost-effectiveness. Data will be collected at baseline (Day 1), Day 8, and Day 29 post-enrolment. Discussion This study seeks to provide evidence on the clinical and public health benefits of using LUS to improve the diagnosis and management of paediatric pneumonia in low-resource settings. If this intervention proves effective it could contribute significantly toward reducing unnecessary antibiotic prescriptions, thereby addressing AMR. The potential for LUS to be integrated into routine clinical practice could revolutionize pneumonia management, especially in areas with limited access to advanced diagnostic tools. Trial Registration This trial will be registered on ClinicalTrials.gov and The South African National Clinical Trials Register (SANCTR) prior to participant enrolment.

Introduction: Advanced glycation end-products (AGEs) may play a relevant role as inducers in the chronic inflammatory pathway present in immune-mediated diseases, such as systemic lupus erythematosus (SLE). AGEs concentrations have been associated, with discrepant results to date, with some parameters such as disease activity or accrual damage, suggesting their potential usefulness as biomarkers of the disease. Objectives: To confirm differences in AGEs levels measured by cutaneous autofluorescence between SLE patients and healthy controls (HC) and study their correlation with various disease parameters. Methods: Cross-sectional study, where AGEs levels were measured by skin autofluorescence, and SLE patients’ data were compared with those of sex- and age-matched HC in a 1:3 proportion through a multiple linear regression model. Correlations of AGEs levels with demographic and clinical data were analyzed through ANOVA tests. Both analyses were adjusted for confounders. Results: AGEs levels in SLE patients were significantly higher than in HC (p<0.001). We found statistically significant positive correlation with SLE disease activity index (SLEDAI) and damage index (SDI), physician and patient global assessment, C-reactive protein, leukocyturia, complement C4, IL6 and oral ulcers. We also found a negative statistically significant correlation with current positivity of anti-nuclear and anti-Ro60 antibodies. Conclusions: AGEs seem to have a role in LES pathophysiology, becoming a new management and prognosis biomarker in this disease. The association with specific antibodies and disease manifestations may indicate a specific clinical phenotype related to higher AGEs levels.

Shaped surfaces are increasingly used in the field of mould making for casting or injection moulding, where future products include shapes with different curvatures. These are surfaces that form convex curves, concave curves, or a combination thereof. Given these machined surfaces, it is important to know the impact of the finishing strategies on these surfaces. This paper deals with the comparison of finishing milling strategies in the production of shaped surfaces and the analysis of different methods for the evaluation of surface topography, surface roughness and the evaluation of deviations. The material used for the experiments was AlCu4Mg aluminium alloy, and Constant Z, Spiral and Spiral circle strategies were chosen for the finishing strategies. The evaluation of surface topography and surface roughness was carried out at three different sample heights with respect to the tool contact with the machined surface. The results showed changes in the toolpaths due to the variation of the effective diameter of the tool cutter to the machined surface as well as the choice of strategy. To produce specimens with corresponding shapes in terms of topography, the Constant Z strategy was the most suitable, in which uniform toolpaths were obtained over the whole height of the sample.

In the context of modern healthcare, the concept of patient-centered care (PCC) has emerged as a crucial aspect, prompting the need for innovative frameworks to empower patients and enhance healthcare outcomes. This paper introduces the Patient-Oriented Medical Ontology Conceptual Framework (POMOCF), a powerful framework aimed at giving patients control over their personal and healthcare information. It prioritizes patient independence by allowing for direct control of electronic health records (EHRs) and facilitates the gathering of information through document upload or scanning. In the POMOCF front-end framework, we propose to maintain scalability, along with robust authorization, authentication, and secure data protocols, all of which are detailed within the framework. This approach enhances data accuracy and security, improving data management efficiency. As part of our ongoing development, we are planning to implement an innovative inference system that will automatically analyze and extract relevant details from the uploaded authorized document, provide real-time updates, and maintain data accuracy. This approach further strengthens data accuracy and prevents unauthorized modifications, thereby making the data management process more efficient. POMOCF leverages medical ontology principles to ensure standardized clinical concepts and improved semantic interoperability. Our integration plans involve integrating genotypic data for personalized medicine initiatives and strengthening the front-end infrastructure. By linking front-end interfaces with advanced technological solutions, we aim to provide effective healthcare delivery, promoting personalized care and enhancing patient outcomes.

The edible portion of Cannabis sativa L. are the seeds. The seeds are generally used for the production of hemp oil, appreciated for the high percentage of α-linolenic acid. The waste obtained after seeds oil extraction, reduced in fine powder, is the subject of this study. Since hemp seeds are considered to be a source of many valuable bioactive compounds, the addition of hemp seed flour to durum wheat for making fortified bread could have an effect on the health of consumers. The aim of this study was to use variable percentages of hemp seed flour for the production of bread, and to determine the fortification impact on chemicals, texture, organoleptic characteristics, crumb color, changes in crumb texture, total polyphenols, free radical scavenging activity and amino acids contents. The rheological and chemical qualities of bread samples, obtained by using a durum wheat cultivar Ciclope fortified with defatted hemp seeds flours, were evaluated. The solid residue left after the extraction of the oil from seeds (generally thrown away as waste or added to feed) was shredded and sieved at 0.530 mm (Hemp 1) or 0.236 mm (Hemp 2). Samples of fortified breads were obtained by substitution of variable percentages of durum wheat flour with the two hemp flours (5%, 7.5%, and 10%). Fortified bread’s total phenolic content was in a range of 0.73±0.017 and 1.73±0.029 mg GAE/g and an-ti-radical scavenging activity was included in the range from 1.17±0.099 and 3.18±0.071mmol TEAC/100g, according to the increasing fortification. Comparison between bread made with Ciclope semolina and hemp flour fortified breads, showed a large increase in amino acid content in fortified samples ones. In particular, bread fortified with 10% Hemp 2 flour highlights a greater content of glutamic acid, tyrosine, proline and essential amino acids such as leucine and isoleucine, compared to the other samples with same percentage of substitution. The amount of hemp seed flour influenced the color of the crumb by increasing the yellow index from 18.24 (100% Ciclope) to 21.33 (bread with Hemp 2 flour at 5%).