Primary biliary cholangitis (PBC) is a cholestatic liver disease characterized by immune-mediated injury to small bile ducts. Although PBC is an autoimmune disease, the results of traditional immunosuppressive therapy are disappointing. Nearly 40% of PBC patients do not respond to the first-line drug UDCA. Without appropriate intervention, PBC patients would eventually progress to liver cirrhosis and even death. There is an urgent need to develop new therapies. The gut-liver axis emphasizes the interconnection between the gut and the liver, and there is increasing evidence that gut microbiota and bile acids play an important role in cholestatic diseases. Dysbiosis of gut microbiota, imbalance of bile acids, and immune-mediated bile duct injury constitute the triad of pathophysiology in PBC. Understanding the gut microbiota-bile acid network and corresponding immune functions in PBC provides a new perspective for its treatment strategies. Therefore, we summarize the latest advancements in research of gut microbiota and bile acids in PBC and, for the first time, explore the potential of immune factors related to them as novel immunotherapy targets. This article discusses potential therapeutic approaches focusing on regulating gut microbiota, maintaining bile acid homeostasis, their interactions, and related immune factors.

Chronic pancreatitis is a progressive fibroinflammatory disorder with no currently satisfactory treatment. Emerging evidence suggests an association between gut microbial dysbiosis and chronic pancreatitis. Although direct causative evidence is lacking, it is hypothesized that the gut microbiota may play a pivotal role in modulating pancreatic function via the gut-pancreas axis. Thus, modulating the gut microbiota through the administration of probiotics or prebiotics may alleviate pancreatic disorders. In this review, we first propose the potential mechanisms by which specific probiotics or prebiotics may ameliorate chronic pancreatitis, including the alleviation of small intestinal bacterial overgrowth (SIBO), facilitation of short-chain fatty acids (SCFAs) production, activation of the glucagon-like peptide 1 receptors (GLP-1Rs) in the pancreas. Since there are currently no probiotics or prebiotics used for the treatment of chronic pancreatitis, we have discussed research in other disease models that use probiotics or prebiotics to modulate pancreatic endocrine and exocrine functions and prevent pancreatic fibrosis. This provides indirect evidence for their potential application in the treatment of chronic pancreatitis. We anticipate that this research will stimulate further investigation into the gut-pancreas axis and the potential therapeutic value of probiotics and prebiotics in chronic pancreatitis.

We developed an ovarian cancer-targeted drug delivery system based on a follicle-stimulating hormone receptor (FSHR) peptide. The lipophilic chemotherapeutic drug SN38 and the photosensitizer IR820 were loaded into the phospholipid bilayer of liposomes. Near-infrared laser irradiation stimulated the generation of reactive oxygen species, causing short-term reactive molecular species and spatial-temporal restricted photodamage to the biological targets. The reactive molecular species and spatial-temporal restricted photodamage enhanced the release and uptake of chemotherapy drugs and increased the sensitivity to chemotherapy drugs in ovarian cancer cells. FSH liposomes loaded with SN38 and IR820 (SN38/IR820-Lipo@FSH) were prepared using thin-film hydration-sonication. FSH peptide binding was analyzed using 1H NMR spectrum and Maldi-Tof. The average size and zeta potential of SN38/IR820-Lipo@FSH were 105.1 ± 1.15 nm (PDI: 0.204 ± 0.03) and −27.8 ± 0.42 mV, respectively. SN38/IR820-Lipo@FSH exhibited good drug-loading properties and the in vitro release was slow. FSH significantly increased the uptake of liposomes, inhibited cell proliferation, and induced apoptosis in A2780 cells. Moreover, SN38/IR820-Lipo@FSH exhibited good tumor-targeting ability and anti-ovarian cancer activity in vivo. The SN38/IR820-Lipo@FSH exhibited specific targeting to A2780 ovarian cancer cells. The combination of chemotherapy and photodynamic treatment based on an FSH peptide-targeted delivery system may be an effective approach to treating ovarian cancer.

Despite significant advancements in Artificial Intelligence (AI) and Large Language Models (LLMs), detecting and mitigating bias remains a critical challenge, particularly within social media platforms like X (formerly Twitter) and in addressing cyberbullying present on them. This research investigates the effectiveness of leading LLMs in generating synthetic biased and cyberbullying data and evaluates the proficiency of Transformer AI models in detecting bias and cyberbullying within both authentic and synthetic contexts. The study involves semantic analysis and feature engineering on a dataset of over 48,000 sentences related to cyberbullying collected from Twitter (before it became X). Leveraging state-of-the-art LLMs such as ChatGPT-4o, Pi AI, Claude 3 Opus, and Gemini-1.5, synthetic biased, cyberbullying, and neutral data were generated to deepen the understanding of bias in human-generated data. AI models including DeBERTa, Longformer, BigBird, HateBERT, MobileBERT, DistilBERT, BERT, RoBERTa, ELECTRA, and XLNet were initially trained to classify Twitter cyberbullying data and subsequently fine-tuned, optimized, and quantized for multilabel classification (detecting both biases and cyberbullying). The study's outcomes include a prototype of a hybrid application that combines a Bias Data Detector and a Bias Data Generator, validated through extensive testing.

Objectives: In recent years, ear endoscopy has gradually become an important tool in ear surgery. This study further explored its application in ear surgery, to establish a surgical approach for semicircular canal obstruction (SOC) via the ear canal to control vertigo in Meniere's disease. Methods: With the approval of the ethics committee, recruitment started in June 2019. ​Four patients with Meniere's disease who had been treated conservatively for more than six months received SCO via an external ear canal approach under otoendoscopy and were followed for two years after surgery to assess the safety and efficacy of the procedure. Results The control of vertigo after the operation was satisfactory (100%), and the frequency and degree of vertigo were significantly improved. Tinnitus improved in 1 case (25%) and did not progress in the other 3 cases. Hearing loss did not progress in all patients. Postoperative walking instability occurred in 1 patient (25%), and there were no obvious complications. All patients reported significant improvements in their quality of life. Conclusions: SCO via the external auditory canal approach is safe, effective, easy to accept, and an alternative to conservative treatment of Meniere's disease with no actual hearing for more than 6 months.

Cytomegalovirus infection contributes to 10-30% congenital hearing loss in children. Vertebrate peripheral auditory organs include the outer, middle and inner ear. Their development is regulated by multiple signaling pathways. However, most ear diseases due to viral infections are due to congenital infections and reactivation, and affect healthy adults to a lesser extent. This may be due to the fact that viral infections affect signaling pathways that are important for the development of peripheral hearing organs. Therefore, an in-depth understanding of the relationship between viral infections and the signaling pathways involved in the development of peripheral hearing organs is important for the prevention and treatment of ear diseases. In this review, we summaries the effects of viruses on signaling pathways and signaling molecules in development of peripheral auditory organ, with a focus on Human cytomegalovirus as an example.

Gastrointestinal bleeding (GIB) after heart transplantation (HT) remains a significant clinical issue. The study aimed to explore its incidence, trends, outcomes and clinical predictors of GIB in HT patients. Adult patients who underwent HT between 2015 and 2021 at Union Hospital were recruited and divided into two groups based on the presence or absence of postoperative GIB. Primary outcomes were evaluated by follow-up. Independent predictors of GIB after HT were identified by logistic regression analysis. A nomogram prediction model was constructed according to these independent variables, and the accuracy of the model was assessed using the receiver operating characteristic (ROC) curve and the calibration curve. Among 461 patients, 40 (8.7%) developed GIB post-HT. HT patients with postoperative GIB exhibited higher in-hospital, 30-day, 90-day and 1-year mortality (all P < 0.05). Multivariate analysis identified age, preoperative warfarin, postoperative continuous renal replacement therapy and postoperative nasogastric tube as independent risk factors for GIB following HT. The nomogram prediction model was performed using the 4 variables. The area under the curve (AUC) of this model was 0.852(95% CI: 0.787-0.917, P < 0.001) and the calibration curve was close to the ideal diagonal line. GIB following HT is associated with a poor clinical prognosis. The constructed nomogram, incorporating its independent risk factors, demonstrated a favorable predictive value for GIB.

In the era of Artificial Intelligence (AI), comprehending and responding to non-verbal communication is increasingly vital. This research extends AI's reach in bridging communication gaps, notably benefiting American Sign Language (ASL) and Taiwan Sign Language (TSL) communities. It focuses on employing various AI models, especially the Hierarchical Vision Transformer with Shifted Windows (Swin), for recognizing diverse sign language datasets. The study assesses Swin architecture's adaptability to different sign languages, aiming to create a universal platform for Unvoiced communities. Utilizing deep learning and transformer technologies, hybrid application prototypes have been developed for ASL-to-English translations and vice versa, with plans to expand this to multiple sign languages. The Swin models, trained on varied dataset sizes, show considerable accuracy, indicating their flexibility and effectiveness. This research underscores major advancements in sign language recognition and underlines a commitment to inclusive communication in the digital era. Future work will focus on enhancing these models and broadening their scope to include more sign languages, integrating multimodality and Large Language Models (LLMs), thereby fostering global inclusivity.

Polyploid seed production is complicated, and costly work, produce a fewer number of seeds/fruits as compared to diploid seeds. Here we investigated the interactive effect of a new grafting technique of polyploid watermelon scion onto rootstock on plants' survival rate. In this study, three different branches, apical meristem (AM), branch with 1 node (1N), and 2 nodes (2N) from di, tri, and tetraploid watermelon plants, were used as scion and grafted onto squash rootstock. The results showed highly significant differences between polypoid watermelon when 1N was used as a scion. Tetraploid showed maximum survival rates, higher contents of hormones, carbohydrates, and antioxidants activities, compared to diploid. Here, we also performed applied sucrose exogenously, on the rootstocks seedlings before grafting to enhance survival rates. Significant survival rates were observed in the case of 2% sucrose application in all polyploids when 1N was used as a scion. RTq-PCR results confirm that the expression of genes linked to compatibility is consistent with the carbohydrates, hormonal and antioxidants activities. This study provides an alternative and economical approach to produce more tetraploid and triploid plants for breeding and seed production by using branches as scions, furthermore, provides more understanding of graft compatibility.

This review explores the nuanced decision-making surrounding postoperative radiotherapy for diffuse low-grade glioma (DLGG) patients, emphasizing the need for personalized treatment to balance the benefits of tumor control with the risks of long-term side effects. Radiotherapy is a cornerstone of DLGG treatment, offering significant improvements in progression-free survival, but its potential for cognitive decline and vascular lesions necessitates careful consideration of individual patient factors. The review delves into the complexities of radiotherapy timing, revealing that while early radiotherapy enhances progression-free survival, it does not significantly impact overall survival and may lead to earlier onset of cognitive decline. Conversely, delayed radiotherapy may mitigate cognitive decline but may result in shorter progression-free survival and the onset of neurological symptoms. The review advocates for a patient-centered approach, emphasizing the importance of weighing individual risks and benefits, and highlights the potential of artificial intelligence in predicting cognitive decline and the need to revisit previous research findings in light of the 2021 WHO (World Health Organization) classification update, underscoring the evolving nature of DLGG treatment and the ongoing quest for optimal therapeutic strategies.

Several types of guided bone regeneration materials are available with various properties and clinical indications. Among them, dentin-derived matrix from extracted teeth is an excellent alternative to traditional graft materials, such as allografts and xenografts. Different clinical preparation protocols exist: block form versus powder form, demineralized versus non-demineralized form. Out of these methods, demineralization protocols for dentin-derived matrix from extracted teeth have been noted for a wide range of successful clinical outcomes. The purpose of this animal study was to find out the most effective method of demineralizing dentin-derived matrix to result in the highest regenerative ability in the bone graft material in rabbit calvaria. The study conducted a comparative histomorphometric analysis of four groups in distinguished matrix conditions: a control group without graft placement, a non-demineralized dentin-derived matrix graft placement group, a 15-minute demineralized dentin-derived matrix graft placement group, and a 30-minute demineralized dentin-derived matrix graft placement group. Regenerative processes were evaluated three times at 2, 4, and 8 weeks post-graft placement. These groups of rabbits were evaluated randomly in a blinded setting to prevent bias. Among the four groups compared, the group with a 15-minute demineralized dentin-derived matrix graft showed the most efficient bone regeneration in the histomorphometric analysis. Based on this animal study, it was apparent that a 15-minute demineralization of dentin-derived matrix is the preferred preparation protocol to maximize the regenerative potential in the matrix.

Current VAT rules for cross-border e-commerce companies in the EU are not sustainable, because they are extremely complex and often opaque, due to the lack of tax harmonization. The aim of the research is to explore, using a qualitative method, what kind of harmonization would make the current legislation more uniform, simpler, more transparent, and easier to understand, without conflicting with the rules of any Member State. To this end, the aspects of the new platform regulation introduced on 1 July 2021 and its potential for expansion are assessed through information from possible sales models. The research suggests that the rules on platforms do not cover all possible sales models, which in our view imposes an unnecessary extra administrative burden on some businesses and makes their tax activities less transparent. In the light of the results of the research, we propose that the current EU platform regulation should be extended to cover B2B, B2C transactions and services. As a result of this suggested harmonization, a simpler, more transparent, uniform and sustainable tax system would contribute to the whitening of the economy, generating additional tax revenue for Member States.

Objective: To report time-loss match injuries in Portugal’s “Divisão de Honra” (Portuguese First Tier) 2022/23 season focusing on injury incidence, injury burden, anatomical region and type of injury. Methods: A cohort prospective observational study was conducted. Data was collected through an online form sent for every team medical department categorizing player position, injury type, location and severity. Injury incidence and burden were calculated per 1000-player-match-hours. Results: The overall injury incidence was 54.4 injuries per 1000 player-match-hours (CI95% 30.3-96.2). Forwards had a higher incidence comparing to backs. Lower limbs were the most affected location (52% of the injuries). Sprain/ligaments injuries were the most common type of injury followed by muscle injuries. Discussion: The injury incidence was higher than what is reported in amateur competitions and lower than professional ones. Injury severity was similar to other studies. Our study suggests a lower injury burden compared to other semi-professional and elite leagues. Further research with broader participation and training injury data is needed.

Hypoxia is a hallmark of solid tumors, including hepatocellular carcinoma (HCC). Hypoxia has proved to be involved in multiple tumor biological processes and associated with malignant progression and resistance to therapy. Transarterial chemoembolization (TACE) is a well-established locoregional therapy for patients with unresectable HCC. However, TACE-induced hypoxia regulates tumor angiogenesis, energy metabolism, epithelial-mesenchymal transition (EMT), and immune processes through hypoxia-inducible factor 1 (HIF-1), which may have adverse effects on the therapeutic efficacy of TACE. Hypoxia has emerged as a promising target for combination with TACE in treatment of HCC. This review summarizes impact of hypoxia on HCC tumor biology, adverse effects of TACE-induced hypoxia on its therapeutic efficacy, highlighting the therapeutic potential of hypoxia-targeted therapy in combination with TACE for HCC.

Such rapidly changing external conditions as the COVID-19 pandemic and the war in Ukraine, being pure crisis phenomena, not only determine the geopolitical and geoeconomic situation on the global markets, but also cause structural changes in individual countries. Under these conditions, the level of food self-sufficiency becomes particularly important, as it is one of the factors determining the food security of any country. The aim of the research is to assess Ukraine's food self-sufficiency compared to the European Union and Poland. The self-sufficiency ratio (SSR) index was used to assess food self-sufficiency. This is the ratio of the volume of production of the most important products of plant and animal origin to the volume of domestic consumption. Domestic consumption was defined as the volume of domestic production increased by the volume of imports, reduced by the volume of exports and also included changes in domestic stock levels. The surveyed time frame is 2019–2021. The analyzed data were taken from the State Statistics Service of Ukraine, FAOSTAT, USDA and Statistics Poland. A comparative analysis of self-sufficiency for the main agri-food sectors of Ukraine, the EU, and Poland showed significant differences. Taking into account the production potential and food self-sufficiency indicators of Ukraine, Ukraine's possible accession to the EU can be expected to have a major impact on the EU's supply and demand situation, as it may pose a threat to many EU agri-food sectors.

We consider a multitude of topics in mathematics where unification constructions play an important role: the Yang–Baxter equation and its modified version, Euler’s formula for dual numbers, means and their inequalities, topics in differential geometry, etc. It is interesting to observe that the idea of unification (unity and union) is also present in poetry. Moreover, Euler’s identity is a source of inspiration for the post-modern poets.

Viral co-infections, where a host is infected by multiple viruses simultaneously, are common in the human population. Human viral co-infections can lead to complex interactions between viruses and the host immune system, affecting the clinical outcome and posing challenges for treatment. Understanding the types, mechanisms, impacts, and identification methods of human viral co-infections is crucial for the prevention and control of viral diseases. In this review, we first introduce the significance of studying human viral co-infections and summarize the current research progress and gaps in this field. We then classify human viral co-infections into four types based on the pathogenic properties and species of the viruses involved. Next, we discuss the molecular mechanisms of viral co-infections, focusing on virus-virus interactions, host immune responses, and clinical manifestations. We also summarize the experimental and computational methods for identifying viral co-infections, emphasizing the latest advances in high-throughput sequencing and bioinformatics approaches. Finally, we highlight the challenges and future directions in human viral co-infection research, aiming to provide new insights and strategies for the prevention, control, diagnosis, and treatment of viral diseases. This review provides a comprehensive overview of the current knowledge and future perspectives on human viral co-infections, and underscores the need for interdisciplinary collaborations to address this complex and important topic.

Commonly macrophages are categorized into M1 and M2 subsets. M1 macrophages are defined as inflammatory cells and may contribute to tissue injury, while, M2 macrophages play a central role in tissue remodeling and control of immune responses. It seems that the existence of these cells in graft location is effective for control of inflammation and improvement of transplantation consequences. Although the relative contribution of M2 cells in organ transplantation is not clear, the accumulation of these cells in acute and chronic injury models of transplantation was shown. In some cases, the depletion of M2 cells leads to the amelioration of disease; however in other causes, skewing the response in M2 cells leads to an augmentation of graft fibrosis and worsening of graft condition. In spite of these findings, the benefits of such strategies and their implications in human disease are not clearly understood. The purpose of this mini-review is to highlight the role of alternatively activated M2-type macrophages in the improvement or reduction of the kidney transplantation outcome.

Bone is a dynamic tissue with the capacity of repair and regeneration in specific conditions. Nevertheless, due to the increased incidence of bone disorders, the need of bone grafts has been growing over the past decades and the development of an ideal bone graft with optimal properties remains a clinical challenge. This review addresses the bone properties (morphology, composition and their repair and regeneration capacity) and puts the main focus on the potential strategies for developing bone repair and regeneration materials. It describes the requirements for designing a suitable scaffold material, types of materials (polymers, ceramics and composites) and techniques to obtain the porous structures (additive manufacturing techniques/robocasting or derived from marine skeletons) for bone tissue engineering applications. The main objective of this review is to gather the knowledge on the materials and methods for the production of scaffolds for bone tissue engineering and highlighting the potential of natural porous structures such as marine skeletons as promising alternative bone graft substitute materials without any further mineralogical changes, or after partial or total transformation into calcium phosphate. The suitability of the marine-derived porous bone graft substitutes for the intended applications will be also discussed.

Objectives: We aim to evaluate technical and clinical outcomes with E-nside stent-graft for thoraco-abdominal aortic aneurysm (TAAA) and pararenal abdominal aortic aneurysm (PAAA) endovascular treatment at our University Hospital Center. Methods: Retrospective analysis of patients electively treated by inner branched EVAR (iBEVAR) between 05/2021 and 03/2023. Demographics, procedural and clinical data were analyzed. Technical success and clinical outcomes, such as access-site related complications were reported. Perioperative and early mortality rate, freedom from aortic reintervention, Target vessels (TVs) patency and endoleak rate were evaluated during the follow-up. Technical aspects (external iliac artery diameter, iliac tortuosity, extent of aortic coverage) were retrospectively analyzed. Results: Twenty-two patients included (age 75.9±5.5; 72.7% male). Aneurism extent was Craw-ford I=4 (18.2%), III=8 (36.4%), IV=5 (22.7%), V=1 (4.5%) and PAAA=4 (18.2%). Mean aortic di-ameter was 63.5±9.9mm. The technical success 95.5% (assisted primary success 100%). The clini-cal success 86.4%. Perioperative and early freedom from all-cause mortality rate 90.9% and 90%, respectively. No case of inter-stage aortic-related mortality reported, as no permanent/temporary spinal cord ischemia (SCI). Seventy-eight out of 81 patent TVs were incorporated through a bridging stent (96.3%). TV success 95.1%. Mean external iliac artery (EIA) diameter 7.5±1.1mm. Twelve patients (six women, 100%) were considered outside the instructions for use (IFU) due to narrow iliac arteries. One access-site related complication reported. Conclusions: Our experience confirms that E-nside has promising technical and clinical success rates, as low reintervention rate, but requires a great sacrifice of healthy aorta and adequate iliac arteries that still represent a limitation, especially among women. Mid- to long-term studies and prospective registries are mandatory to evaluate long-term efficacy and safety, as a comparison between E-nside and other alternative off-the-shelf solution.

Surface modification of polypropylene (PP) films is achieved using gamma-irradiation-induced grafting to proffer with antimicrobial activity. The copolymer was obtained through a versatile two-step route; pristine PP is exposed to gamma rays and grafted using methyl methacrylate (MMA), then N-vinylimidazole (NVI) is grafted onto the copolymer PP-g-MMA by simultaneous irradiation. The characterization included Fourier-Transform Infrared Spectroscopy (FTIR), Scanning Electron Microscope (SEM), Thermogravimetric Analysis (TGA), X-ray Photoelectron Spectroscopy (XPS), and physicochemical analysis of swelling and contact angle. The copolymer (PP-g-MMA)-g-NVI was loaded with vancomycin, and the drug released was quantified by UV-vis spectrophotometry at different pH. The surface of (PP-g-MMA)-g-NVI exhibited pH-responsiveness and moderate hydrophilicity, suitable properties for controlled drug release.

Candidate vaccines against African swine fever virus (ASFV) based on naturally attenuated or genetically modified viruses have the potential to generate protective immune responses, although there is no consensus on what defines a protective immune response against ASFV. Studies, espe-cially in sensible host species, focused on unravelling protective mechanisms will contribute to the development of safer and more effective vaccines. The present study provides a detailed analysis of phenotypic and functional data on cellular responses induced by intradermal immunization and subsequent boosting of domestic pigs with the naturally attenuated field strain Lv17/WB/Rie1, as well as the mechanisms underlying protection against intramuscular challenge with the virulent genotype II Armenia/07 strain. The transient mild to moderate increase of IL-8 and IL-10 in serum observed after immunization might be directly correlated with survival. Protection was also associated with a robust ASFV-specific polyfunctional memory T cell response, where CD4CD8 and CD8 T cells were identified as the main cellular sources of virus-specific IFNγ and TNFα. In parallel to cytokine response, these T-cell subsets also showed specific cytotoxic activity as evidenced by the increased expression of the CD107a degranulation marker. Along with virus-specific multifunctional CD4CD8 and CD8 T responses, the increased levels of antigen experienced cytotoxic CD4 T cells observed after challenge in immunized pigs might also contribute to control virulent infection by killing mechanisms targeting infected antigen-presenting cells. Future studies should elucidate whether the memory T-cell responses evidenced in the present study persist and provide long-term protection against further ASFV infections.

This study aims to find countries that differ in their development of the agricultural sector in terms of environmental care and to examine the relationship between renewable and non-renewable energy consumption and agricultural sector production in European Union countries. The classification of countries was conducted using the principal component method and biplot. Panel data for the period 2000-2022 and a VAR model, an impulse response function (IRF) and causality tests were used for the study. The results indicate two distinct groups of countries that significantly differ in adopting green agricultural practices. Only seven EU countries stand out for sustainable agriculture with low pesticide use, a significant share of organic farms and high use of renewable energy in agriculture. Energy consumption affects agricultural production differently in the two groups of countries studied: in countries with sustainable agriculture, an increase in renewable energy consumption translates into a positive increase in agricultural production. On the other hand, an increase in non-renewable energy consumption shows a dampening effect on agricultural production growth, especially in countries with less sustainable agriculture. The study results highlight the need to promote renewable energy development in agriculture and raise awareness about the adverse environmental effects of intensive agriculture while emphasising the positive impact of organic agriculture on agricultural production.

The aim of this study was to evaluate the use of a flexible synthetic polymer bone graft to provide implant stability in the absence of implant stability during implant placement in a dense cortical bone model. Sockets were prepared on polyurethane blocks according to the standard implant socket drilling protocol in the control group, both oversizing and deepening in group 2, and oversizing only in group 3. In groups 2 and 3, flexible synthetic polymer bone grafts were placed in the sockets prior to implant placement. The implants were placed at bone level in all groups. The highest torque value obtained was recorded as the insertion torque. 75 implant sites in 3 groups were included in the study. The torque values of the implants in the control group were significantly higher than those of the implants with the oversized and deepened sockets and the oversized-only sockets (p&lt;0.05; p&lt;0.01).The torque values of the implants with the oversized and deepened sockets were significantly higher than those of the implants with the oversized-only sockets (p&lt;0.01). In this study, flexible synthetic polymer bone graft was shown to be effective in achieving implant stability in the management of implants with loss of primary stability.

Objective: Interstitial fibrosis / tubular atrophy (IFTA) is a common, irreversible, and progressive form of chronic kidney allograft injury, and it is considered a critical predictor of kidney allograft outcomes. The extent of IFTA is estimated through a graft biopsy, while a non-invasive test is lacking. The aim of this study was to evaluate the feasibility and accuracy of an MRI radiomic-based machine learning (ML) algorithm in estimating the degree of IFTA in a cohort of transplanted patients. Approach: Patients who underwent MRI and renal biopsy within a 6-month interval from 1/1/2012 to 1/3/2021 were included. Stable MRI sequences were selected, and renal parenchyma, renal cortex and medulla were segmented. After image filtering and pre-processing, we computed radiomic features which were subsequently selected through a LASSO algorithm for their highest correlation with the outcome and lowest intercorrelation. Selected features and relevant patients’ clinical data were used to produce ML-algorithms using 70% of the study cases for feature selection, model training and validation with a 10-fold cross-validation, and 30% for model testing. Performances were evaluated using AUC with 95% confidence interval. Main results: 70 coupled tests (63 patients, 35.4% females, mean age 52.2 years) have been included and subdivided into a wider cohort of 50 for training and a smaller cohort of 20 for testing. For IFTA ≥ 25%, AUCs in test cohort were 0.60, 0.59, and 0.54 for radiomic features only, clinical variables only, and combined radiomic-clinical model, respectively. For IFTA ≥ 50%, AUCs in training cohort were 0.89, 0.84, 0.96, and in test cohort were 0.82, 0.83, and 0.86, for radiomic features only, clinical variables only, and combined radiomic-clinical model, respectively. Significance: An ML-based MRI radiomic algorithm showed promising discrimination capacity for IFTA>50%, especially when combined with clinical variables. These results need to be confirmed in larger cohorts.

Acute and chronic graft versus host disease (a/cGVHD) are major complications of allogeneic stem cell transplantation and a frequent cause of non relapse-mortality. The treatment of a/cGVHD consists of steroid administration at full dose. In the case of aGVHD, around 60 % of patients with grade III/IV fails to respond (steroid-resistant, SR), requiring a second line therapy. Extracorporeal photopheresis (ECP) represents a good option for second line treatment, leading to multiorgan response in several patients. Here, we have evaluated the performances of a cytofluorimetric quality control of the first ECP procedure in 29 patients with severe SR aGVHD who underwent ECP. The quality control represents a check control of in vitro cell apoptosis/death induction in collected and irradiated CD3+ cells by ECP. Our analysis shows that in more than 70 % quality controls a relevant apoptotosis/death of CD3+ cells was observed after cell irradiation, as compared to non-irradiated controls. Albeit observed in a small patients’ series, the occurrence of relevant in vitro effect after ECP relates to less procedures and/or to a better survival on ECP. Age, disease, gender, aGVHD grade and time from transplant to the first ECP had not impact on ECP efficacy in this patients’ series.

Background: Transit-time flow measurement (TTFM) is frequently used to evaluate intraoperative quality control during coronary artery bypass grafting (CABG). Although TTFM has the ability to assess graft failure intraoperatively, the perioperative factors affecting TTFM during CABG surgery remain poorly understood. Methods: Patients who underwent CABG surgery at a single institution between July 2016 and May 2018 were prospectively evaluated. Patients’ demographic characteristics, previous medical history, Euroscore, the results of preoperative blood tests, and intraoperative data were recorded. TTFM and blood viscosity were measured hemodynamically, and mean flow (mL/min) and pulsatility index (PI) were recorded. Arterial blood gas was analyzed immediately after anastomosis of the left internal mammary artery (LIMA) to the left descending artery (LAD) and before sternal closure. Factors associated with TTFM were assessed by multiple linear regression analysis. Results: Of the 62 patients who underwent CABG surgery during the study period, 57 were evaluated, including 49 who underwent off-pump and eight who underwent on-pump surgery. Blood viscosity was not significantly associated with TTFM (p > 0.05). However, TTFM was significantly associated with body mass index (BMI), systolic blood pressure, and cardiac index (p < 0.05 each). Conclusions: Blood viscosity was not significantly associated with intraoperative graft flow. Blood flow of graft vessels, however, was significantly associated with BMI, systolic blood pressure, and cardiac index.

Background: Since the onset of widespread COVID-19 vaccination campaigns, there have been concerns about serious cardiovascular adverse events, including myocarditis, myocardial infarction, and venous thromboembolisms, all of which can lead to cardiopulmonary arrest. This study aimed to estimate excess cardiopulmonary arrest mortality in King County, WA, and investigate any association with COVID-19 vaccination rates. Methods: Data was obtained from the annual King County, WA, EMS reports, the U.S. Census Bureau, and The Tennessean COVID-19 Vaccine Tracker. An exploratory data analysis was performed. Excess deaths were calculated using the 2015-2020 cardiopulmonary arrest mortality trend line. The relationship between excess cardiopulmonary arrest mortality and vaccination rates was analyzed using polynomial regression analysis. A quadratic regression model was used to generate expected population growth trends. The excess mortality model for King County was used to calculate yearly estimates for excess cardiopulmonary arrest fatalities in the USA. Results: Approximately 98% of the King County population received at least one dose of a COVID-19 vaccine by 2023. Our analysis revealed a 25.7% increase in total cardiopulmonary arrests and a 25.4% increase in cardiopulmonary arrest mortality from 2020 to 2023 in King County, WA. Excess cardiopulmonary arrest deaths were estimated to have increased by 1,236% from 2020 to 2023, rising from 11 excess deaths (95% CI: -12, 34) in 2020 to 147 excess deaths (95% CI: 123, 170) in 2023. A quadratic increase in excess cardiopulmonary arrest mortality was observed with higher COVID-19 vaccination rates. The general population of King County sharply declined by 0.94% (21,300) in 2021, deviating from the expected population size. Applying our model from these data to the entire United States yielded 49,240 excess fatal cardiopulmonary arrests from 2021-2023. Conclusions: We identified a very strong ecological and temporal association between excess cardiopulmonary arrest mortality and the COVID-19 vaccination campaign, which resulted in high vaccination rates. The biological plausibility of death from acute cardiac and pulmonary causes after COVID-19 vaccination has been previously demonstrated and is concerning given these real-world observations. Urgent further research is needed to determine if similar trends are observed in other regions with attention to risk mitigation for incident events and improved survival with resuscitation.

The partial information decomposition (PID) framework is concerned with decomposing the information that a set of (two or more) random variables (the sources) has about another variable (the target) into three types of information: unique, redundant, and synergistic. Classical information theory alone does not provide a unique way to decompose information in this manner and additional assumptions have to be made. One often overlooked way to do this decomposition is using a so-called measure of union information – which quantifies the information that is present in at least one of the sources – from which a synergy measure stems. In this paper, we introduce a new measure of union information based on adopting a communication channel perspective, compare it with existing measures, and study some of its properties. We also include a comprehensive critical review of characterizations of union information and synergy measures that have been proposed in the literature.

Digitalisation provides access to an integrated network of information that can benefit society, and business. Building digital network and society using digital means can create something unique opportunities to strategically address sustainable development challenges for the United Nations Targets (SDG) to ensure higher productivity, education and to equality oriented society. This point of view describes the potential of digitalisation for society and business of the future. The authors revise the links between digitalisation and sustainability in the European Union countries. The methodology for the research is suggested in the paper and linear regression method is applied. The results showed tiers with five SDG, focusing on society and business, and all these tiers are fixed in the constructed equations for each SDG. The suggested solution is statistically valid and proves the novelty of research. Among digitalisation indicators, only mobile-cellular subscriptions and fixed-broadband sub-basket prices in part have no effect on researched sustainable development indicators.

By using a two-stage physiologically based extraction test (PBET) and (W-PBET), the authors of this paper have estimated the bioaccessibility of metals (Pb and Fe) and their compounds in the GI tract of waterfowl and mammals. It has been shown that the metals (Pb and Fe) have low bioaccessibility; combined with the short time of shot exposition at the GI tract, this eliminates the risk of toxic effects in the case of shot ingestion by waterfowl. It has also been discovered that there is a significant difference in the bioaccessibility of metals and their compounds. A model was proposed and tested to predict the toxic effects of lead on biological objects depending on the threshold mass of consumption. This model takes into account data on the bioavailability of lead and regulatory values indicating dangerous concentrations of lead.

Modification the biodegradable matrix was carried by graft-copolymerization polylactide with methacrylic acid of various concentrations. Ultraviolet irradiation with different exposure times to the samples was chosen as the initiator of copolymerization. In the experiment the effect of ultraviolet light on polylactide and graft copolymerization was investigated: the resulting samples were studied by viscosimetry, gravimetry, FTIR, static cation- exchange capacity analysis . The conditions for obtaining grafted copolymers and the dependence of the characteristics on the reaction conditions are established.

The different cell subsets of the immune system express vitamin D receptor (VDR). Through VDR, vitamin D exerts different functions which influences on immune responses, as previously shown in different preclinical models. Based on this background, retrospective studies have explored the impact of vitamin D levels on the outcome of patients undergoing allogeneic hematopoietic stem cell transplantation, showing that vitamin D deficiency is related to an increased risk of complications, especially graft-versus-host disease. These results have been confirmed in a prospective cohorts trial, although further studies are required to confirm this data. In addition, the role of vitamin D on the treatment of hematologic malignancies has also been explored. Considering this dual effect both on the immune system as well as on tumor cells in patients with hematologic malignancies, vitamin D might be useful in this setting both to decrease graft-versus-host disease and relapse rates.

Sharing activity is getting higher attention due to increasing popularity in recent years. In the paper, the authors investigated the main elements affecting the sharing activity. (1) Literature review: The theoretical part starts from the revision of definitions of sharing activity; description of the links between sharing and sustainable development, policy recommendations and relevant regulation in the field; later on, the study emphasises the key elements important for sharing. Finally, the authors investigated how the Covid-19 pandemic affected sharing activity; (2) Methods: During empirical research, the authors revised the list of 37 variables. The study uses data for each of the 27 EU countries from 2011 to 2020. The authors investigated correlation between macroeconomics variables to determine key variables for the regression model; (3) Results: The authors constructed a dynamic regression model that can be applied to predict the number of participants visiting sharing platforms in the European Union (EU); (4) Conclusions: The study shows that seeking to forecast the number of visits to sharing platforms it is necessary to use values of main macroeconomic variables such as consumer price index, productivity index, total unemployment rate, the number of users and households connected to the Internet, etc.

Purpose: To compare the efficacy and safety of graft-free short tunnel small flap (STSF) technique with that of scleral patch graft (SPG) in Ahmed glaucoma valve (AGV) implantation. Design: Randomized clinical trial. Participants: Eighty-eyes of eighty patients with medically uncontrolled glaucoma including 41 in STSF and 39 eyes in SPG. Methods: Patients were enrolled and assigned randomly to STSF or SPG. Main Outcome Measures: tube exposure, Intraocular pressure (IOP), number of glaucoma medications, best corrected visual acuity (BCVA), surgical complications, and success rate ( defined as intraocular pressure (IOP) >5 mmHg, ≤21 mmHg, and IOP reduction ≥20% from baseline at two consecutive visits after three months, no reoperation for glaucoma). Results: only one case in SPG developed tube exposure at 1-year follow-up. The cumulative probability of success during the first year of follow-up was 70% in the STSF and 65% in SPG (P = 0.36). IOP decreased significantly from 29.6 ± 8.6 mmHg at baseline to 16.4 ± 3.6 mmHg at the final follow-up in STSF (p = 0.001). The corresponding numbers for SPG were 30.9 ± 11.2 and 15.8 ± 4.7, respectively (p = 0.001). The final IOP was comparable between both groups (p = 0.65). Mean ± standard deviation of the number of glaucoma medications was 1.8 ± 0.9 in STSF and 1.6 ± 0.9 in SPG at final follow-up (P = 0.32). Postoperative complications developed in 8 patients (19%) in STSF and 9 patients (23%) in SPG (P = 0.81). Conclusions: STSF and SPG techniques had comparable complication rate at one-year follow-up. Both techniques were comparable in terms of success rate, postoperative IOP, and glaucoma medications.

This study aims to provide empirical evidence on whether using renewable and non-renewable energy, CO₂ emissions and the resulting changes in temperature and precipitation can alter cereal yields in European Union countries. To this end, a panel data set covering 1992-2021 has been used to analyse the impact of climate change and economic factors on cereal production in European Union countries. The study employed various analytical techniques to understand better the relationship between climate change, energy consumption, and economic growth. These included using annual average temperature and rainfall to measure climate change and energy consumption and economic growth to analyse the economic aspects. To achieve the objective, feasible generalised least squares (FGLS) models with robust standard errors and bootstrap and a quantile regression (QR) model with marginal analysis were employed. The Westerlund cointegration test confirmed the presence of cointegration between cereal production and climate variables, economic growth, and energy consumption. The results indicate that increases in temperature and precipitation may contribute to increased cereal production in European Union countries. In contrast, energy consumption, including renewable energy and CO₂ emissions, may have a nonlinear effect on cereal production. Quantile regression analysis suggests climate change may impact crop yields most in countries with low and moderate cereal production per hectare. Increased CO₂ emissions may increase yields in the initial period, but excessive CO₂ may negatively impact cereal production in the long term. It would be advisable for countries with low and moderate crop productivity to consider implementing technological advances and combating global warming by modernising cultivation methods and making greater use of renewable energy sources.

Patients from regions without stem cell transplant (SCT) facilities often seek treatment abroad and return home for post-transplant care. While extensive data exists on GVHD and its risk factors, the prevalence of GVHD in international SCT patients returning to countries without transplant facilities, where multiple factors compromise post-transplant care, is not well documented. We screened 149 transplant recipients and analyzed data from 91 who received transplants abroad and were followed at our center from January 2019 to December 2022. This observational study used data from electronic medical records (EMR) and employed descriptive statistics, inferential tests, and relative risk calculations with forest plots to analyze GVHD prevalence and key risk factors. Of the recipients, 31.8% were residents from nine countries living in the UAE, and 67.2% were UAE citizens. Adults comprised 48.3% of the recipients, and 51.7% were pediatric. Hematological malignancies were the most common indication (49%), primarily in adults. Siblings were the majority of donors (52.6%), followed by related donors (23.09%), and unrelated donors (8.9%). Most (69.2%) received HLA-identical transplants followed by 21.9% who received haploidentical. Among adults, 62.2% developed GVHD, compared to 26% of pediatric patients. Recipients with related HLA-identical donors had a 50% GVHD prevalence, while those with unrelated identical donors had 71%. The overall GVHD prevalence was 50% among the 87.9% who received allogeneic SCTs. Despite favorable factors, GVHD prevalence remains high. Larger multicenter studies are needed to identify and assess the impact of contributing factors.

In an era where dietary habits significantly impact health, technological interventions can offer personalized and accessible food choices. This paper introduces Chef Dalle, a recipe recommen-dation system that leverages multimodal human-computer interaction (HCI) techniques to pro-vide personalized cooking guidance. The application integrates voice-to-text conversion via Whisper, ingredient image recognition through GPT-Vision, and employs TF-IDF vectorization alongside cosine similarity for personalized recipe recommendations. These methods enable users to interact with the system using voice, text, or images, accommodating various dietary re-strictions and preferences. Furthermore, the utilization of DALL-E 3 for generating recipe images enhances user engagement. User feedback mechanisms allow for the refinement of future rec-ommendations, demonstrating the system's adaptability. Chef Dalle showcases potential appli-cations ranging from home kitchens to grocery stores and restaurant menu customization, ad-dresses accessibility, promoting healthier eating habits. This paper underscores the significance of multimodal HCI in enhancing culinary experiences, setting a precedent for future developments in the field.

As the EU is moving towards a low carbon economy and seeks to further develop its renewable energy policy, this paper quantitatively investigates the impact of plausible energy market reforms from the perspective of bio-renewables. Employing a state-of-the-art biobased variant of a computable general equilibrium model, this study assesses the perceived medium-term benefits, risks and trade-offs which arise from an advanced biofuels plan, two exploratory scenarios of a more 'sustainable' conventional biofuels plan and a 'no-mandate' scenario. Consistent with more recent studies, none of the scenarios considered present significant challenges to EU food-security or agricultural land usage. An illustrative advanced biofuels plan simulation requires non-trivial public support to implement whilst a degree of competition for biomass with (high-value) advanced biomass material industries is observed. On the other hand, it significantly alleviates land use pressures, whilst lignocellulose biomass prices are not expected to increase to unsustainable levels. Clearly, these observations are subject to assumptions on technological change, sustainable biomass limits, expected trends in fossil fuel prices and EU access to third-country trade. With these same caveats in mind, the switch to increased bioethanol production does not result in significant market tensions in biomass markets.

The Anterior Cruciate Ligament (ACL) is a crucial stabilizing ligament in the knee, essential for maintaining knee joint stability and proper biomechanical function. ACL rupture is one of the most common injuries, especially prevalent among athletes participating in high-demand sports that involve pivoting, cutting, and jumping. Such injuries not only lead to immediate functional impairment but also predispose individuals to long-term consequences, including osteoarthritis if left untreated. ACL reconstruction using a graft, whether autograft or allograft, has become the gold standard treatment method aimed at restoring knee stability and function. However, the postoperative healing process of the graft within the bone tunnel presents significant challenges due to its complexity. This healing involves a coordinated sequence of molecular and cellular events, including inflammation, proliferation, and remodeling phases. These phases are governed by a myriad of molecular signals, growth factors, and cellular interactions that ultimately determine the success of the graft integration and the restoration of ligamentous function. The review article "Molecular Biology of ACL Graft Healing: Early Mechanical Loading Perspective" delves deeply into these intricate biological processes. It provides a comprehensive analysis of the underlying molecular mechanisms that facilitate graft healing. Furthermore, it emphasizes the critical role of early mechanical loading in this context. Mechanical loading, when applied appropriately, has been shown to positively influence graft healing by enhancing cellular responses, collagen fiber alignment, and overall biomechanical properties of the graft. By exploring the impact of early mechanical loading, the review sheds light on how mechanical stimuli can be optimized to improve clinical outcomes. This understanding is vital for developing effective rehabilitation protocols that promote faster and more robust graft healing. The article offers valuable insights for clinicians and researchers, aiming to bridge the gap between molecular biology and practical rehabilitation strategies in ACL reconstruction. Overall, this review underscores the importance of an integrated approach that considers both the biological and mechanical aspects of ACL graft healing. Such an approach holds promise for advancing patient care and improving the success rates of ACL reconstruction surgeries.

In this paper we present an application of the dynamic tracking games framework to a monetary union. We use a small stylized nonlinear three-country macroeconomic model of a monetary union to analyse the interactions between fiscal (governments) and monetary (common central bank) policy makers, assuming different objective functions of these decision makers. Using the OPTGAME algorithm we calculate solutions for several games: a noncooperative solution where each government and the central bank play against each other (a feedback Nash Equilibrium solution), a fully cooperative solution with all players following a joint course of action (a Pareto optimal solution), and three solutions where various coalitions (subsets of the players) play against coalitions of the other players in a noncooperative way. It turns out that the fully cooperative solution yields the best results, the noncooperative solution fares worst, and the coalition games lie in between, with a broad coalition of the fiscally more responsible countries and the central bank against the less thrifty country coming closest to the Pareto optimum.

Regional organisations (ROs) are important in that they can enable states in their regions to pros-per and develop for improvement. Interest here lies in the European Union (EU) and the Associa-tion of South East Asian Nations (ASEAN). Their political development involves complex process-es for collective actions involving ingroup member RO states. To explore development, we firstly examine the rise of both the EU and ASEAN. The literature gives some attention to the behaviour-alist political approach to explain developmental differences using social organisation theory, often in terms of the Gemeinschaft-Gesellschaft paradigm of Tönnies. However, here we adopt a social psychology approach that distinguishes between operative structure (which directly determines behaviour), and substructure (housing normative personality deemed to be responsible for behav-ioural imperatives). This enables a relationship to be made between the Tönnies paradigm and the Collectivism-Individualism paradigm of Triandis. The theoretical approach adopted involves a complex adaptive systems model deriving from metacybernetics, and this also delivers Mindset Agency Theory as a qualitative methodology. Consistent with the general view, it is shown that the EU is more or less a coherent rational organisation, while ASEAN is more idealistic delivering pragmatic paradox. In particular, ASEAN is frequently descried as an organisation with contra-dictions, and for this reason its pathologies are explored in some detail

The purpose of this paper was to examine the differences in using agricultural entrepreneurship support and in how it relates to characteristics such as the agrarian structure, socioeconomic de-velopment level and land use across the Polish territory. The analyses were carried out at district (poviat) level which is an intermediate administrative unit. The study found that the decisions on co-financing the measures dedicated to non-agricultural economic activity heavily depend on the agrarian structure. The highest levels of activity were witnessed in districts where the agrar-ian structure is particularly fragmented.

The study investigates the impact of globalization, renewable energy consumption and economic growth on CO2 emissions in 26 European Union (EU) countries for the period 1990-2020. The second-generation panel unit root tests are applied, the Westerlund cointegration test is used, and panel Fully Modified Least Squares (FMOLS) and Dynamic Ordinary Least Squares (DOLS) techniques are employed to estimate the long-term relationship between variables. The causality relationship among variables under investigation is identified by the heterogeneous Dumitrescu-Hurlin causality test. It is found that globalization and renewable energy consumption contributed to the carbon emissions mitigation, while economic growth induced their increase. The results are robust when control variables (i.e., financial development, foreign direct investment and urbanization) are added in the model. Foreign direct investment and urbanization are contributors to carbon emissions increase whereas financial development induce their decrease. The effect of variables under consideration on carbon emissions is differentiated by the economic development and institutional quality level. Unidirectional causalities relationships were identified from globalization to carbon emissions and from carbon emissions to foreign direct investment and bidirectional relationships between economic growth, renewable energy consumption, financial development and carbon emissions. Policy implications of the findings are also discussed.

Mesenchymal Stromal Cells (MSCs) are multipotent, non-hematopoietic progenitor cells with a wide range of immune conditioning and regenerative potential which qualify them as potential component of cell based therapy for various autoimmune / chronic inflammatory ailments. Their immunomodulatory properties include the secretion of immunosuppressive cytokines, the ability to suppress T-cell activation and differentiation, and the induction of regulatory T-cells. In view of this and our interest, we here discuss the significance of MSC for the management of Graft-versus-Host Disease (aGVHD), one of the autoimmune manifestation in human.. In pre-clinical models, MSCs have been shown to reduce the severity of aGVHD symptoms, including skin and gut damage, which are the most common and debilitating manifestations of this disease. While initial clinical studies of MSCs in aGVHD cases were promising, the results were variable in randomized studies. So, further studies are warranted to fully understand their potential benefits, safety profile, and optimal dosing regimens. In view of these inevitable issues, here we discuss various mechanisms, how MSCs can be employed in managing aGVHD, as a therapeutic option for this disease.

Addressing non-unions involves stabilizing the affected area through osteosynthesis and improving bone biology using bone grafts. However, there is no consensus on the optimal treatment method. This study aims to compare outcomes of non-union revision using conventional treatment methods (metal hardware ± graft) versus osteosynthesis with the human, allogeneic cortical bone screw (Shark Screw®). Thirty-four patients underwent conventional treatment, while 28 cases received Shark Screws®. Patient demographics, bone healing, time to bone healing, and complications were assessed. Results revealed a healing rate of 96.4% for the Shark Screw® group, compared to 82.3% for the conventionally treated group. The Shark Screw® group exhibited a tendency for faster bone healing (9.4±3.2 vs. 12.9±8.5 weeks, p=0.05061). Hardware irritations led to six metal removals in the conventional group versus two in the Shark Screw® group. The Shark Screw® emerges as a promising option for personalized non-union treatment in the foot, ankle, and select lower leg cases, facilitating effective osteosynthesis and grafting within a single construct, promoting high union rates, low complications, and a rapid healing process.

The problem of filling the bone cavity remains relevant in maxillofacial and oral surgery. There is a large selection of osteotropic materials of various natures for filling of bone defects of different etiology. The aim of our research was to improve the result of surgical treatment in a patient with a complicated mandibular fracture with the use of collagenic xenograft during osteosynthesis. In this article, we introduce our experience in the treatment of a patient with a complicated mandibular angle fracture in a combination with the follicular cyst. The obligate steps of treatment included stabilization of the bony fragments, a decrease of risk in fracture line malposition along with titan mini- plates, and shortening in the time of bone regeneration due to a filling of bone defect with the osteotropic material. This approach allowed us to reduce the rehabilitation period and further prosthetic treatment after 4-5 months without additional bone grafting manipulations. Though, the use of collagen osteotropic material, possessing osteoconductive properties, can improve the treatment of patients with mandibular fractures.

Background: The implementation of tyrosine kinase inhibitors (TKIs) in the treatment of chronic myeloid leukemia (CML) has brought a significant improvement in the prognosis for CML patients and a decrease in the number of patients requiring allogeneic hematopoietic stem cell transplantation (allo-HCT). Nevertheless, the impact of TKIs on allo-HCT outcomes have not been thoroughly explored. Objectives: The main endpoint of our research was to assess the impact of prior TKI treatment on acute graft-versus-host disease (aGvHD) and chronic graft-versus-host disease (cGvHD). Methods: In our retrospective analysis we included 240 patients treated between 1993 and 2013, and divided them into 3 groups according to the therapy administered prior to matched related or matched unrelated donor allo-HCT (imatinib group n=41, dasatinib/nilotinib group n=28, TKI naïve group n=171). Results: Both the cumulative incidence of aGvHD (p=0.044) and cGvHD (p&lt;0.001) in individuals receiving second generation TKIs (2G-TKIs) prior to allo-HCT compared to patients receiving no TKIs or imatinib (IMA) (40.7% vs 61.4% vs 70.7%, p=0.044; 25.0% vs 76.4% vs 51.2%, p&lt;0.001, respectively). In case of the 2G-TKI cohort, the number of low-grade aGvHD and cGvHD was significantly lower compared to the IMA and TKI-naïve groups (p=0.018, p=0.004; p&lt;0.001 versus TKI-naïve, respectively). In terms of 3-year overall survival (OS) there were no important variations between TKI-naïve, IMA and 2G-TKI (55% vs 49.9% vs 69.6%, p=0.740). Conclusions: The results of our study suggest that TKI treatment prior to allo-HCT may have protective impact on immune-mediated outcomes.

There is paucity of data in the available medical literature regarding the parameters of volumetric perfusion of pancreas grafts. Materials and methods From February 5, 2016 to December 23, 2021, we performed perfusion computed tomography in 41 patients at different times after simultaneous pancreas and kidney transplantation. The study group consisted of 18 men (44%) and 23 women (56%) with a long history of type 1 diabetes complicated by terminal chronic renal failure. The results of perfusion computed tomography of the pancreas graft were studied, and the effects of post-transplantation timing and graft revascularization peculiarities on volumetric perfusion parameters were evaluated. Results The median arterial blood flow, arterial blood volume, and permeability of the pancreas graft were 115.1 [99.7;130.3] mL/100 mL/min, 46.7 [37.4;56.9] mL/min and 8.6 [4.1;11.4] mL/100 mL/min, respectively. No statistically significant differences in the averaged perfusion values were found in the head, body, and tail of the pancreas graft. The post-transplantation timing and the number of arteries involved in graft revascularization did not have a significant effect on the volumetric perfusion of the graft. Conclusion The volumetric perfusion results of the pancreas graft correspond to those obtained in the study of pancreatic perfusion in healthy participants.

The lack of suitable autologous grafts and poor compliance of existing prostheses have prompted the study of novel materials for vascular graft design. Polyurethanes (PUs) were used in the past because they have high compliance and properties that are similar to those of native tissue. In this work, the mechanical properties of a group of PUs in two states (non-hydrated and hydrated) were studied using uniaxial tensile tests, strain sweep tests, and multi-step creep recovery tests. Additionally, a hyper-elastic model based on the Mooney–Rivlin strain density function was fitted and used to model the performances of the PUs under physiological pressure and geometry conditions. The tensile tests revealed a softening phenomenon after hydration, which could potentially reduce patient discomfort and risk of vascular trauma. The ultimate strength values after hydration were similar to those reported for other vascular conduits. The strain sweep showed a strong strain dependency of the modulus indicating non-linear viscoelasticity. In the creep-recovery tests, increasing the polyethylene glycol(PEG) content enhanced the viscous flow, while the elastic behavior was enhanced with the largest concentration of polycaprolactone diol (PCL). On the other hand, under simulated physiological conditions, the compliance of the PUs showed a cyclic behavior with the time and pressure but was not affected by the radii and thickness variation, which could increase the graft compliance and geometry mismatch. Nevertheless, the compliance could be tuned using the material composition. This paper studied the biomechanics of a group of materials under simulated physiological conditions (Temperature, hydration, and pressure) to select those that could perform better for further vascular graft design.

Although COVID-19 primarily affects the respiratory system, it can have various effects on other organs, including the cardiovascular system. COVID-19 can lead to a prothrombotic status, promoting bloodclotting, which can potentially affect native vessels and implanted de-vices. The exact mechanisms by which it leads to increased clotting are not yet fully understood but may involve inflammation, endothelial dysfunction, and a hyperactive immune response. In the present report, we describe a case of an acute aortic stent-graft thrombosis four days after resolution of Sars-Cov2 infection. The patient required emergent explantation of the stent-graft, after the failure of endovascular bailout procedures.

Pecan (Carya illinoinensis), as a popular nut tree, is widely planted in China in recent years. Grafting is an important technique for its cultivation. For a successful grafting, graft union development generally involves the formation of callus and vascular bundles at the graft union. To explore the molecular mechanism of graft union development, we applied high through-put RNA sequencing to investigate transcriptomic profiles of graft union at four time points (0d, 8d, 15d, and 30d) during pecan grafting process. We identified a total of 12,180 differentially expressed genes. In addition, we found that the content of auxin, cytokinin and gibberellin were accumulated at the graft unions during the grafting process. Correspondingly, genes involved in those hormone signaling were found to be differentially expressed. Interestingly, we found that most genes associated with cell division were up-regulated at callus formative stages, while genes related to cell elongation, secondary cell wall deposition, and programmed cell death were generally up-regulated at vascular bundle formative stages. In the meantime, genes responsible for reactive oxygen species were highly up-regulated across the graft union developmental process. These results will aid in our understanding of successful grafting in the future.

Non-union is one of the severe complications of traumatic fracture and still no standard therapeutic recommendations currently. A total of eleven patients were treated on the lesions for non-union, after the failure of open reduction internal fixation (ORIF) or total hip replacement, by autologous conditioned serum (ACS) for one to three times monthly and followed up. Seven patients received ACS three times, three patients received it two times, and the only one who underwent total hip replacement received it once. Ten patients achieved union at the last follow-up visit, indicating the effectiveness of ACS on patients who suffered from non-union after ORIF. ACS has the potential as an alternative or adjective treatment for non-union and is worthy to be investigated further for the benefits of patients.

Graft injury affects over 50% of liver transplant (LT) recipients, but non-invasive biomarkers to diagnose and guide treatment are currently limited. We aimed to develop a biomarker of graft injury by integrating serum metabolomic profiles with clinical variables. Serum from 55 LT recipients with biopsy confirmed metabolic-dysfunction associated steatohepatitis (MASH), T-cell mediated rejection (TCMR) and biliary complications was collected and processed using a combination of LC-MS/MS assay. The metabolomic profiles were integrated with clinical information using a multi-class Machine Learning (ML) classifier. The efficacy of the model was assessed through the evaluation of the Out-of-Bag (OOB) error estimate. Our ML model yielded an overall accuracy of 79.66% with an OOB estimate of the error rate at 19.75%. The model exhibited a maximum ability to distinguish MASH, with an OOB error estimate of 7.4% compared to 22.2% for biliary and 29.6% for TCMR. The metabolites serine and serotonin emerged as the topmost predictors. When predicting binary outcomes using 3 models: Biliary (biliary vs. rest), MASH (MASH vs. rest) and TCMR (TCMR vs. rest), the AUCs were 0.882, 0.972 and 0.96 respectively. Our ML tool integrating serum metabolites with clinical variables shows promise as a non-invasive, multi-class serum biomarker of graft pathology.

Non-alcoholic fatty liver disease (NAFLD) continues to rise and has become the most common cause of chronic liver disease among all ages and ethnicities. Metabolic disorders such as obesity and insulin resistance are closely associated with sarcopenia and NAFLD. Sarcopenic obesity is a clinical disorder characterized by the simultaneous loss of skeletal muscle and gain of adipose tissue. It is associated with worse outcomes in individuals with NAFLD. It is projected that NAFLD and sarcopenia will rise as the prevalence of obesity continues to increase at an unparallel rate. Recently, sarcopenia and sarcopenic obesity have gained considerable interest, but we still lack a well-defined definition and a management approach. Therefore, it is imperative to continue shining the light on this topic and better understand the underlying mechanism as well as treatment options. In this review article, we aimed to address the pathophysiology, impact, and outcomes of sarcopenic obesity on NAFLD.

Patients with chronic renal failure and vascular diseases require the vascular access for hemodialysis procedure to be performed with the most possible comfort for the patient. Native vein graft has a longer-lasting term in the patients’ limb, lower risk of graft infection and lower price. Native vein graft is constructed from the great saphenous vein, if the diameter of the vessel is smaller than the diameters of vessels (brachial artery, cephalic vein) it is connected to in the cubital fossa region due to the risk of graft folding, that might occur, if the graft diameter is bigger than the diameter of one or both vessels, on which anastomosis is made. The most important sizes, that were taken before graft placement, are the length of the forearm compartment, the distance between the brachial artery and cephalic vein in the cubital fossa region, distance from an expected incision in the brachial artery to the middle of the forearm compartment, the distance between incision in cephalic vein to the middle of the forearm compartment, length of the great saphenous vein (the graft) and diameters of blood vessels, used in the procedure. Finally, the right position of the graft should be determined for the successful outcome of anastomosis creating procedure.

We conducted a hybrid-design study on a historical cohort of 359 adult recipients of a liver graft who received transplants between 1996 and 2002. The study aimed to identify predictors of survival and investigate the prevalence of co-morbidities among long-term survivors. The actuarial (95% CI) patient survival of the overall study cohort was 96% (94.6%-98.3%), 69% (64.2%-73.6%), 55% (49.8%-59.9%), 42.8% (37.6%-47.8%), and 34% (29.2%-38.9%) at 1, 5, 10, 15, and 20 years, respectively. The actuarial (95% CI) graft survival was 93.8% (91.6%-97.2%), 67.6% (62.2%-71.5%), 54.3% (49.6%-59.3%), 42.1% (37.3%-47.4%), and 33.8% (29.0%-38.4%) at 1, 5, 10, 15, and 20 years, respectively. The leading cause of death was hepatitis C virus recurrence (24.6%), followed by extrahepatic malignancies (16.9%), infection (14.4%), and hepatocellular carcinoma recurrence (14.4%). The Cox proportional hazards analysis revealed that several independent factors were associated with the survival probability. These factors include younger donor and recipient ages (p=0.001 and 0.004, respectively), female recipient sex (p<0.001), absence of HCV (p<0.01), absence of HCC (p=0.001), and absence of diabetes mellitus at one year (p<0.01). At the latest follow-up, the leading comorbidities in the long-term survivors were hypertension (53.6%), obesity (18.7%), diabetes mellitus (17.1%), hyperlipidemia (14.7%), chronic kidney dysfunction (14.7%), and extrahepatic malignancies (13.8%), with 73.9% of patients having more than one complication. The Kaplan-Meier probability (95% CI) of complication-free survival was 65.4% (60.2%-70.3%), 38.4% (33.4%-43.7%), 17.8% (14.1%-22.2%), 7.2% (4.8%-10.5%), and 1.94% (0.85%-4.15%) at 1, 5, 10, 15, and 20 years, respectively. Aging with a liver graft is associated with an increased risk of complications and requires ongoing care to reduce the long-term attrition rate resulting from chronic immunosuppression.

This article discusses the outcomes of a quantitative analysis of the competitiveness of grain and its recycling in the countries-members of the Eurasian Economic Union (EEU) through econometric panel data models. The analysis is based on the data of public authorities’ statistics of the countries-members of the EEU, as well as the United Nations Comtrade Database which is a repository of official international trade statistics. The results of the analysis allow to assess the level of competitiveness of produced agro-food products in the countries-members of the EEU and determine the extent to which various factors affect it. The research conclusions can be used to develop and adjust the agreed with the agro-food policy in the EEU.

Evacuation is the primary and most important preparedness initiative to save people from the devastating effects of a cyclone. For proper evacuation, a route is specifically chosen that will play a role during cyclones. In this study, Geographic information system has been applied for evacuation route planning for Mirzaganj Union, Patuakhali, Bangladesh. The study is based on questionnaire surveys; direct observation and literature review on the existing sheltering system and develops an evacuation route using the shortest distance analysis. This study provides us an idea how we can manage our population to find out suitable nearby shelters and the limitations that we should focused on. The result shows that only 12% of the total population gets shelter opportunity with the existing official shelter capacity by identifying evacuation route with the shortest distance and the shortest time needed. Shortest distance and time have been calculated for each cyclone shelters. If we consider the low vulnerable infrastructures as shelter, 75% of the total population can be accommodated. This study demonstrates the utilization of an ideal evacuation route planning in the coastal parts of Bangladesh.

Hepatitis E virus (HEV) is a common cause of acute hepatitis worldwide, accounting for approximately 25% of deaths among pregnant women. We previously reported that pregnancy serum facilitates HEV replication in vitro. However, the differences in host cells with HEV infection induced by pregnancy serum and fetal bovine serum (FBS) are unclear. In this study, differentially expressed proteins were identified in HEV-infected hepatoma cells (HepG2) supplemented with different sera by using isobaric tags for relative and absolute quantitation. Proteomic analysis indicated that HEV infection significantly induced 1014 differentially expressed proteins in HEV-infected HepG2 cells when supplemented with FBS compared with pregnancy serum. Further validation by Western blot confirmed that filamin A, heat-shock proteins 70 and 90, Cytochrome c, and Thioredoxin were associated with HEV infection. This comparative analysis provides an important basis to further investigate HEV pathogenesis in pregnant women and HEV replication.

Chronic graft-versus-host disease (cGvHD) occurs in 20-50% of recipients following allogeneic haematopoietic stem cell transplantation (allo-HSCT). Corticosteroids (CS) remain the first line treatment but have suboptimal efficacy and carry the risk of long-term side effects. New agents with a better safety profile and higher efficacy, ideally combining immunomodulatory and antifibrotic properties, are urgently needed. From 2016 to 2020, we conducted a phase 2 clinical trial with ATO in chronic GvHD (ClinicalTrials.gov ID NCT02966301 - GMED16-001). This study aimed to evaluate the efficacy and safety of a first-line combination of arsenic trioxide (ATO) and CS in adult patients with cGvHD who require systemic therapy after a first allo-HSCT for a haematological disease. In this prospective, national, multicenter, single-arm, open-label phase II study, conducted in 5 university hospital centers in France, ATO was initiated within 10 days of starting CS at 1 mg/kg/day. Patients received 11 infusions of ATO per 4-week cycle, at a dose of 0.15 mg/kg per infusion. Patients received 1 or 2 cycles of treatment depending on the clinical response and the assessment of the treating physician. The results were published in July 2022 in a paper entitled "High Response Rate and Corticosteroid Sparing with ATO-Based First-Line Therapy in Chronic Graft-versus-Host Disease after Allogeneic Hematopoietic Stem Cell Transplantation". The GMED16-001 study demonstrated convincing efficacy and safety characteristics of the intravenous drug (Trisenox^®/Arscimed^®): the first-line use of ATO in addition to corticosteroids was associated with a high clinical response rate and correlated with rapid corticosteroid (CS) sparing in moderate to severe cGvHD after allo-HSCT. We performed a post-hoc analysis of the data to determine the best schedule for treating cGvHD patients with ATO. Our post-hoc analysis leads us to the conclusion that two cycles of ATO, at 0.15 mg/kg/day, 5 days per week for 4 weeks each, separated by a 4-week therapy-free interval, appears to be the most promising treatment schedule.

Competition over environmental and natural resources characteristically lies at the heart of armed conflicts in Africa. It is also common knowledge that some companies dealing in products such as laptops, smart phones and jewellery; import minerals from conflict-affected areas, thereby indirectly fuelling conflicts in these areas or undermining human rights. For a continent endowed with natural resources including minerals, Africa has suffered the brunt of this predicament. This state of affairs has lent impetus to the adoption of several regulations geared towards curbing irresponsible business practices by companies relying on such minerals, the goal being, amongst others, to guarantee the protection of human rights. In May 2017, the European Union adopted Regulations intended to stop the importation of conflict minerals in Europe, debatably making giant strides in the direction of protection of human rights. These Regulations are to come into force in 2021. However, can these regulations advance the much-desired goal of protection of human rights in Africa on issues pertaining to conflict minerals? By analyzing the 2017 EU Regulations in light of previous regulations of a similar nature, the paper concludes that the said regulations constitute a weak normative framework and could in fact have unintended consequences on the fundamental rights of civilians in natural resource-rich conflict areas of Africa.

Background: in this paper, a new physical penetration technology for transdermal administration with traditional Chinese medicine (TCM) characteristics - Fu’s cupping therapy (FCT) - was established and studied by in-vitro and in-vivo experiments; the penetration effect and mechanism of FCT physical penetration technology (FCT-PPT) was preliminarily discussed. Method: Indomethacin (IM) as a model drug，by transdermal in vitro tests the establishment of the high，medium and low reference were finished as the chemical permeation system；chemical penetration enhancers and iontophoresis as a reference，the percutaneous penetration effect of FCT for IM patch was evaluated with 7 species diffusion kinetics model and in vitro drug distribution；naproxen as an internal standard，using UPLC-MS/MS technology，the IM quantitative analysis method in vivo was established，and pharmacokinetic parameters (AUC0-t，AUC0-∞，AUMC0-t，AUMC0-∞, Cmax and MRT) as indicators were used evaluate to FCT penetration role in vivo；in the same time，the group used 3K factorial design to study joint synergistic penetration effect on FCT and chemical penetration enhancers (CPEs)；by SEM and TEM，the skin micro and ultrastructural changes of the stratum corneum (SC) surface were observed, to explore pay tank penetration mechanism. Results: In vitro and in-vivo skin permeation experiments revealed that both the total cumulative percutaneous amount and in-vivo percutaneous absorption amount (AUC and AUMC) of indomethacin that permeated SD mouse skin using FCT techniques were greater than the amount observed using CPE and iontophoresis: Firstly, in contrast to the control group, the indomethacin percutaneous rate (PR) of the FCT lower group (FCTL) was 35.52%, and the enhancement ratio (ER) at 9h was 1.76X, which was roughly equivalent to the penetration enhancing effect of the CPEs and iontophoresis; secondly, the indomethacin PR of the FCT middle (FCTM) group and the FCT high intensity group (FCTH) were respectively 47.36% and 54.58%, ER at 9h were separately 3.58X and 8.39X; thirdly, pharmacokinetic studies showed that in-vivo indomethacin percutaneous absorption of the FCTs was higher than that of the control group, that of the FCTM group was slightly higher than that of the CPEs group, and that of the FCTM group was significantly higher than that of the others. Meanwhile, the variance analysis indicated that the combination of the FCT penetration enhancement method and the CPE method had beneficial effects in penetration enhancing of the skin: the significance level of the CPE method was 0.0004, which was apparently lower than the 0.001, meaning the difference was markedly significant; the significance level of the FCT was under 0.0001, its difference markedly significant; and the significance level of factor interaction A×B was lower than 0.0001, indicating that its difference of the synergism was markedly significant. Moreover, SEM and TEM images showed that the SC surfaces of SD rats treaded with FCT-PPT was damaged, and hard to observe the complete surface structure with its SC pores growing bigger and its special “brick structure” becoming looser, indicating that it broke the barrier function of skin, which revealed potentially a major route of skin penetration. Conclusion: FCT, as percutaneous penetration new technologies, has penetration effects significantly, with Chinese characteristics and highly clinical value, worth promoting development.

The cross-linkable PCL-PEG analogues block-graft copolymer was designed and synthesized, which with the copolymer of the MEO₂MA and OEGMA as graft chains to improve the mPEG-b-PCL-b-mPEG copolymer the aqueous solution properties. And successfully prepared two hydrogels via a copper-catalyzed 1, 3-dipolar azide-alkyne cycloaddition reaction of alkyne-terminated poly[glycidyl methacrylate-co-2-(2-methoxyethoxy) ethyl methacrylate-co-oligo (ethylene glycol) methacrylate] [P(GMA-co-MEO₂MA-co-OEGMA)] with azide end-functionalized PCL-PEG analogues block-graft copolymer, and tetrakis (2-propynyloxymethyl) -methane (TPOM) and with azide end-functionalized PCL-PEG analogues block-graft copolymer. The copolymer's chemical structure was characterized by proton nuclear magnetic resonance spectroscopy and fourier transform infrared spectroscopy. The molecular weights of the copolymers were decided with gel permeation chromatography. The water solubility and temperature sensitivity of the copolymers were studied by taking digital photos and transmittance change measured by UV spectrophotometer at different temperatures. Fluorescence probes, surface tension, dynamic light scattering and transmission electron microscopy were used to analyze the micelles that copolymers self-assembly in aqueous solution. The sol-gel behavior of copolymer solutions at high concentrations was explored by vial inversion experiments. Finally, the network structure of the gels was observed by scanning electron microscopy. These conclusions indicate that these hydrogels are expected to be used as a new material in the field of biomedicine.

Background: In regenerative dentistry the graft material influences the success. It should act as an osteoconductive scaffold, providing a mineral substrate during resorption and inducing the activity of osteoinductive cells capable of producing new bone, platelet growth factors, and cell differentiation factors inducing the differentiation of undifferentiated mesenchymal cells into. Given that dentin shares many biochemical characteristics with bone tissue, it has recently attracted considerable interest as a biomaterial for bone repair. The aim of this study is to compare two grinder types in order to determine the optimal method for producing dentinal particles using a mechanical grinder. Materials and methods: A sample of 40 natural human teeth without restorations, prostheses or root canal treatments was used and divided into two groups subjected to two different grinder speeds (high-speed and low-speed). The high-speed showed a greater dispersion (53.5+-9.89% of the tooth) due to the pulverisation (highly thin granules) of part of the tooth. The low-speed grinder does not pulverize the dentin and the percentage of tooth loss is 9.16+/-2.34%. Conclusion: The low-speed gringer allows to save a major part of the tooth and to have a maximum quantity of graft material but requires more time. Further studies must be promoted to optimise the grinding procedures.

In this paper, we have analysed the level of advancement in circular economy (CE) in the EU-28 countries. Firstly, we used a synthetic measure to examine CE advancement in EU countries in each of the Eurostat CE distinguished areas, i.e. production and consumption, waste management, secondary raw materials, and competitiveness and innovation. For the empirical analysis, we applied 17 Eurostat indicators to the CE areas. To find the synthetic measure in 2010, 2012, 2014, and 2016, we used multidimensional comparative analysis, i.e. a zero unitarisation method. Secondly, based on the synthetic measures of the CE areas, we created a general synthetic measure of the CE advancement of the EU-28 countries as well as the countries’ rankings. Thirdly, we classified the countries into groups according to their level of advancement in CE, i.e. high level, medium-high level, medium-low level, and low level groups. Finally, we applied a similarity measure to evaluate the correlation between obtained rankings in two most extreme moments in the period of analysis (2010, 2016). Our analysis covers all EU member states, as well as "old" and "new" EU countries separately. Our results confirm that highly developed Benelux countries, i.e. Luxembourg, the Netherlands, and Belgium, have the highest CE advancement level. Malta, Cyprus, Estonia, and Greece are the least advanced in CE practice. Apart from that, on average, there is some progress in CE implementation, significant disproportions between the EU countries were observed, especially among the "new" member states.

This research investigates the alignment of soft power and institutional skills in Montenegro's journey towards accession to the European Union (EU), with a particular focus on the environmental sector. An online survey targeting individuals employed in state institutions directly engaged in negotiation processes, notably the Ministry of Sustainable Development and Tourism and the Agency for Nature and Environmental Protection, was conducted. The research conducted an online survey, distributed before and after the summer recess to accommodate the transition of power following parliamentary elections, aimed at assessing the effectiveness of current personnel and identifying areas for improvement in staffing and negotiation strategies within Montenegro's environmental sector. Employing diverse methodologies, the survey's analysis delved into the demographic, social, and professional backgrounds of respondents. It explored their roles within institutions, involvement in environmental negotiations, and possession of relevant skills and expertise. Furthermore, respondents' knowledge of environmental issues, legislation, and challenges facing the country was assessed to gauge institutional capacity for environmental governance. Demographic data, including gender, age, education and regional origin, were collected to understand gender-specific attitudes and regional disparities in environmental perspectives. The sample of 84 individuals, comprising executives and employees from both institutions, provided insights into the age structure and regional diversity of personnel involved in negotiation tasks for Chapter 27. The selection of the Ministry of Sustainable Development and Tourism and the Agency for Nature and Environmental Protection reflects their pivotal roles in shaping Montenegro's environmental policies and addressing climate change challenges. This study aims to illuminate the dynamics of environmental governance within Montenegro's state administration, contributing to the country's path towards EU accession. The research findings highlight the critical need for Montenegro to prioritize strategic initiatives in personnel management, skill development, and institutional capacity-building within its environmental sector. The implications of this research extend beyond academia to inform policymaking and societal action, emphasizing the urgency for Montenegro to bolster its environmental sector capabilities, fostering both EU alignment and sustainable governance practices for the benefit of present and future generations.

Subclinical inflammation in protocol biopsies relates to tacrolimus exposure and human leukocyte antigen (HLA) matching. We aimed to characterize transcripts associated with rejection and tacrolimus exposure and its association with transplant outcome. We tested whether gene expression is associated with rejection using strictly normal protocol biopsies (n = 17) and biopsies with TCMR or ABMR according to Banff criteria (n = 12). Subsequently, we analyzed these transcripts in a set of 4-month protocol biopsies (n = 137) to assess their association with donor and recipient characteristics, the intensity of immunosuppression, and graft outcome. Differential expression (FDR&gt;3) between normal and rejection biopsies yielded a set of 111 genes. Nineteen out of these 111 genes were correlated with tacrolimus trough levels (TAC-C0) at the time of biopsy in the protocol biopsy cohort (n=137) and allowed us to define 2 clusters of biopsies. The 2 clusters differed in donor age and tacrolimus levels. Subclinical rejection, including borderline lesions, tended to occur in the same cluster. Logistic regression analysis indicated that TAC-C0 at the time of biopsy (OR: 0.83, 95%CI:0.72-0.06, p=0.0117) was associated with cluster 2. In a follow-up averaging 70±30 months, this patient group displayed a significant decline in renal function (p=0.0135). The expression of rejection-associated transcripts in early protocol biopsies is associated with tacrolimus exposure and a faster decline in renal function.

Purpose: Kidney Transplant Recipients (KTRs) tend to develop infections with characteristic epidemiology, presentation and outcome. While infective endocarditis (IE) is among such complications in KTRs, literature is scarce. We describe the presentation, epidemiology, and factors associated with IE in KTRs. Methods: We performed a retrospective case/control study which included patients from two centers. First episodes of definite or possible IE (Duke criteria), in adult KTRs from January 2007 to December 2018 were included, as well as two controls per case, and followed until December 31 2019. Clinical, biological, and microbiological data and the outcome were collected. Survival was studied using the Kaplan-Meier method. Finally, we searched for factors associated with the onset of IE in KTRs by the comparison of cases and controls. Results: Seventeen cases and 34 controls were included. IE was diagnosed after a mean delay of 78 months after KT, mostly on native valves of the left heart only. Pathogens of digestive origin were most frequently involved (six Enterococcus spp, three Streptococcus gallolyticus and one Escherichia coli), followed by Staphylococci (three cases of S. aureus and S. epidermidis each). Among the risk factors evaluated only age was significantly associated with the occurrence of IE in our study (63.8 years for cases vs. 55.6 years for controls, P=0.03) Patient and death-censored graft survival were greatly diminished five years after IE compared to controls being 50.3% vs. 80.6% (p<0.003) and 29.7% vs. 87.5% (p<0.002), respectively. Conclusion: IE in KTRs is a disease that carries significant risks both for the survival of the patient and the transplant.

Pesticides have a vital contribution to the agricultural industry in Australia. However, pesticide applications may not always selective to its target organism. Exposure to pesticide has been associated with negative impacts to human health. One of the ways to reduce pesticide risk to the population and the environment is through government regulations. To put Australia pesticide regulations into perspective, comparisons were made between Australia and other nation’s pesticides regulations. The EU pesticide regulatory system was chosen for comparison with the Australian’s in the aspect of protecting the population from pesticide exposure. The comparison showed that the assessment to authorize a pesticide in Australia is based on the risk while in the EU, the assessment is based on the hazard of the pesticide. A registered active substance in Australia can be authorized for use indefinitely unless it is nominated for reconsideration while the period of registration of an active substance in the EU lasts for 10 years. In addition, no routine systematic chemical residue surveys are conducted in Australia for food commodities. The results highlight areas for improvement in the Australian pesticide regulatory system from the perspective of controlling undue exposure among the general population.

The economic downturn caused by the financial crisis of 2008-2009 and the intensifying glob-al climate policy trends forced changes in the energy management of the European Union. The study examined how the most relevant energy economic variables affected the economic growth of the EU between 2010-2019. The study examined the relationship between GDP (dependent variable) and energy consumption, greenhouse gas emissions, the average energy price, and renewable energy use (independent variables) using the PSL-PM methodology. The results show an asymmetric picture because the independent variables influenced the eco-nomic growth of the EU in the examined period with different correlations and with different strengths. One of the significances of the study is that the presented and analyzed variables, as well as the results of the relationships between them, can contribute to the optimization of the EU's currently critical energy management and economic growth.

Patients with non-union fractures spend extended periods in the hospital following poor healing. Patients have to make several follow-up visits for medical and rehabilitation purposes. However, the clinical pathways and quality of life of these patients are unknown. This prospective study aimed to identify the clinical pathways (CPs) of 22 patients with lower limb non-union fractures whilst determining their quality of life. Data were collected from hospital records on admission through discharge, utilising a CP questionnaire. We used the same questionnaire to track patients' follow-up frequency, involvement in activities of daily living, and outcomes at six months. We used the short form-36 questionnaire to assess patients’ initial quality of life. The Kruskal-Wallis test compared the quality of life domains across different fracture sites. We examined CPs using medians and inter-quantile ranges. During the six-month follow-up period, 12 patients with lower limb non-union fractures were readmitted. All of the patients had impairments, limited activity, and participation restrictions. Lower limb fractures can have a substantial impact on emotional and physical health, and lower limb non-union fractures may have an even greater effect on the emotional and physical health of patients, necessitating a more holistic approach to patient care.

Pullulan is a kind of natural polymer, which is widely used in medicine and food because of its solubility, plasticity, edible, non-toxicity and good biocompatibility. It is of great significance to improve the yield of pullulan by genetic modification of microorganisms. It was previously reported that Aureobasidium melanogenum TN3-1 isolated from honey-comb could produce high-yield of pullulan, but the molecular mechanisms of its production of pullulan had not been completely solved. In this study, the reported strains of Aureobasidium spp. were further compared and analyzed at genome level. It was found that genome duplication and genome genetic variations might be the crucial factors for the high yield of pullulan and stress resistance. This particular phenotype may be the result of adaptive evolution, which can adapt to its environment through genetic variation and adaptive selection. In addition, the TN3-1 strain has a large genome, and the special regulatory sequences of its specific genes and promoters may ensure a unique characteristics. This study is a supplement of the previous studies, and provides basic data for the research of microbial genome modification in food and healthcare applications.

The ingestion of ethanol presents a significant global public health challenge. Chronic alcohol consumption is associated with the development of conditions such as cancer, cirrhosis, hepatic diseases, cardiovascular diseases, and diabetes, as well as neurological impairments that may predispose individuals to dementia, schizophrenia, and behavioral disorders such as violence and suicide. Alcohol-related fatalities constitute 5.3% of worldwide deaths annually, totaling approximately 3 million. Notably, alcohol consumption is implicated in 25% of cirrhosis-related deaths and 4.1% of cancer-related deaths. Taurine (2-aminoethanesulfonic acid) is a non-protein β-amino acid essential for cellular homeostasis, possessing antioxidant, anti-inflammatory, and cytoprotective properties crucial for life maintenance. This study aimed to evaluate the effects of taurine administration on hippocampal neurogenesis, neuronal preservation or reverse damage in rats exposed to forced ethanol consumption. Results demonstrated the neuroprotective effects of taurine on ethanol-treated rats, promoting tissue regeneration and suggesting its pivotal role in this process. However, this aminoacid failed to induce neurogenesis in the tissues of healthy rats, implying that its activity may be contingent upon post-injury stimuli.

This paper outlines the ongoing development of a specialised mobile application to address the mental health needs of vulnerable populations in the European Union (EU). Conducted as a mixed-methods research within two EU Science and Technology Cooperation Actions, the study prioritises stakeholder feedback to identify features for initial testing and strategies to improve application uptake, using critical digital health analysis. With a focus on marginalised groups such as refugees, migrants and socio-economically disadvantaged individuals, the application aims to provide an accessible and culturally sensitive platform for mental health support, integrating evidence-based interventions such as cognitive behavioural techniques and mindfulness exercises. Key features include multilingual support, habit tracking, personalised recommendations for support and services, and real-time crisis intervention. Collaboration with stakeholders and ongoing rigorous usability testing are driving the refinement process to ensure usability, acceptability and effectiveness, underscoring the importance of user engagement in technology-based mental health interventions in the EU context and highlighting the importance of collaborative science and technology for societal benefit.

With the growing awareness of entrepreneurs and consumers of the tourism market in the field of sustainable development, it seems necessary to base hotel classification systems on an integrated approach to management quality, including fulfilment of ecological and environmental criteria. The article aims to indicate how environmental standards are implemented in the European system of hotel classification- HotelstarsUnion and the one in force in Poland. With regards to these systems, the differences in the classification criteria taken into account within the systems of hotel categorization by certifying organizations in the European Union in relation to the administrative hotel categorization system in Poland were pointed out. Particular emphasis was placed on the criteria related to environmental management in the hotel industry. Criteria related to environmental management were identified through analysis of the content of criteria of eight environmental management systems that are applicable to the contemporary hotel market. The results of the research proved that even though the HotelstarsUnion system takes into account the principles of sustainable development to a much greater extent than the Polish one, its primary weakness is that most of its criteria related to environmental ones are optional. In addition, the optional ones have higher weights than the obligatory ones. In turn, the Polish classification system makes very little reference to environmental standards. Moreover, it is not detailed and the assessment criteria are not up to date. Therefore, it is recommended that a greater number of environmental criteria is included when updating the HotelstarsUnion system, which should be obligatory for hotels to meet. In addition, the sustainability criteria included in the HotelstarsUnion system should be adapted to the policy system aimed at the hotel industry in Poland and other EU countries.

This study aimed to investigate the healing effect of advanced platelet-rich fibrin (A-PRF) clot membranes in the reduction of palatal wounds resulting from free gingival graft (FGG) harvesting, in the re-epithelization rate and in the pain experience after surgery. Twenty-five patients requiring soft tissue augmentation (gingival recession coverage or keratinized gingiva augmentation) participated in this prospective randomized clinical study. After FGG harvesting, the test group (n=14) received A-PRF clot membranes at the palatal wound and the control group (n=11) a gelatin sponge. Epithelialization rate of the palatal wound, wound healing area, correspondent percentage of reduction and post-surgical pain experience were assessed. The follow-up period was 90 days. There was a significantly higher reduction of the palatal wound area in the A-PRF group vs. the control group, at 7 (p<0.001), 14 (p=0.009) and 30 days (p<0.001) follow-up. The maximum difference between groups was attained at 30 days (91.5% for A-PRF vs. 59.0% for the control group). At 14 days a significant difference in the proportion of patients showing total epithelization was found: 64.3% for A-PRF vs. 9.1% for the control group (p=0.012). At 90 days, both groups showed total recovery. Overall, the control group experienced a higher level of pain and discomfort until the 14th day, being significantly higher on the second day (p=0.013). The results suggest that A-PRF membranes haste the healing process by promoting a greater reduction along the recovery period and an apparent less painful postoperative period.

Purpose: The aim of the present experimental 3D-finite element study was to evaluate the influence of an augmented sinus lift with an additional inserted bone graft block. The bone graft block stabilizes the implant in addition to conventional augmented bone. We placed the block in three different positions. The implants were loaded with axial force and forces secondary to laterotrusion and protrusion. Material and Methods: A simplified U-shaped 3D finite element model of the upper jaw and a more complex anatomical model of the left maxilla were created. The bone graft block was placed in three positions: in the lower third in contact with the sinus floor, the middle, and the upper third of the implant. Van Mises’ stress distribution was calculated and analyzed for the different models. We also compared the complex anatomical model with the simplified one. Results: The position of the bone graft block significantly influences the magnitude of stress distribution. A bone graft block positioned in the upper third or middle of the implant reduces the quantity of stress compared to the reference model without a bone graft block. The low bone graft block position is clearly associated with lower stress distribution in compact bone. We registered no significant differences in stress in compact bone with regard to laterotrusion or protrusion. Conclusions: Maximum values of von Mises stresses in compact bone can be reduced significantly by using a bone graft block. The reduction of stress is nearly the same for positions in the upper third and the middle of the implant. It is much more pronounced when the bone graft block is in the lower third of the implant near the sinus floor, which appeared to be the best position in the present study.

Compared to the general population, patients with inflammatory bowel disease (IBD) are less likely to be vaccinated, putting them at an increased risk of vaccine-preventable illnesses. This risk is further compounded by the immunosuppressive therapies commonly used in IBD management. Therefore, developing new treatments for IBD that maintain immune function is crucial, as successful management can lead to better vaccination outcomes and overall health for these patients. Here, we investigate the potential of recombinant banana lectin (rBanLec) as a supporting therapeutic measure to improve IBD control and possibly increase vaccination rates among IBD patients. By examining the therapeutic efficacy of rBanLec in a murine model of experimental colitis, we aim to lay the foundation for its application in improving vaccination outcomes. After inducing experimental colitis in C57BL/6 and BALB/c mice with 2,4,6-trinitrobenzene sulfonic acid, we treated animals orally with varying doses of rBanLec 0.1-10 µg/ml (0.01 – 1 µg/dose) during the course of the disease. We assessed the severity of colitis and rBanLec’s modulation of the immune response compared to control groups. rBanLec administration resulted in a dose-dependent reduction in colitis severity (less pronounced weight loss, less shortening of the colon) and an improved recovery profile, highlighting its therapeutic potential. Notably, rBanLec-treated mice exhibited significant modulation of the immune response, favoring anti-inflammatory pathways (primarily reduction in a local [TNFα]/[IL-10]) crucial for effective vaccination. Our findings suggest that rBanLec could mitigate the adverse effects of immunosuppressive therapy on vaccine responsiveness in IBD patients. By improving the underlying immune response, rBanLec may increase the efficacy of vaccinations, offering a dual benefit of disease management and prevention of vaccine-preventable illnesses. Further studies are required to translate these findings into clinical practice.

Background: Arthroscopic revision rotator cuff repair (ARRCR) is challenging. Biologic strategies seem to be promising. The aim was to evaluate the effectiveness of combination of microfractures of the greater tuberosity, augmentation with collagen patch graft, and platelet concentrate injections in ARRCR. Methods: A retrospective comparative study was conducted on patients that underwent ARRCR with minimum two-years follow-up. Patients in the augmentation group underwent ARRCR combined with microfractures, collagen patch graft, and postoperative subacromial injections of platelet concentrate. A standard rotator cuff repair was performed in the control group. Primary outcome: Constant Murley score (CMS). Secondary outcomes: disease-specific health-related quality of life by using the Disabilities of the Arm, Shoulder and Hand (DASH) score; assessment of tendon integrity with magnetic resonance at least six months after surgery. Significance was set at p < 0.05. Results: Forty patients were included. Mean follow-up was 36.2 + 8.7 months. The mean CMS was greater in the augmentation group (p = 0.022). No differences could be found for DASH score. Healing failure rate was higher in the control group (p = 0.002). Conclusion: Biologic augmentation of ARRCR by combination of microfractures, collagen patch graft and subacromial injections of platelet concentrate is an effective strategy in improving tendon healing rate.

The purpose is to verify trends of scientific production from 2010 to 2020, considering the best universities of the United States, China, the European Union (EU) and private companies. The top 30 universities in 2020 in China, the EU, and the US and private companies were selected from the SCImago institutions ranking (SIR). The positions in 2020, 2015, 2010 in SIR and three sub-indicators were analyzed by means of non-parametric statistics, taking into consideration the effect of time and group on rankings. American and European Union universities have lost positions to Chinese universities and even more to private companies, which have improved. In 2020, private companies have surpassed all other groups considering Innovation as sub-indicator. The loss of leadership of European and partly American universities mainly concerns research linked to the production of patents. This can lead to future risks of monopoly that may elude public control and cause a possible loss of importance of research not linked to innovation.

The study aimed to evaluate implant success and bone height variations after transcrestal sinus floor elevation (tSFE) using the osseodensification technique (OD) combined with beta-tricalcium phosphate (β-TCP), as bone graft material and simultaneous implant placement. Thirteen patients requiring the placement of one implant in the upper posterior maxilla, with a residual bone height of

Allogeneic hematopoietic stem cell transplantation (allo-HCT) is a potentially curative treatment modality, frequently applied in patients suffering from haematological malignancies. In the last two decades, there have been multiple randomised controlled trials (RCTs), review articles, and meta-analyses addressing the efficacy of rabbit anti-thymocyte globulin (r-ATG) as a graft-versus-host disease (GvHD) prophylaxis. Nevertheless, only a few aimed to compare the effectiveness of different r-ATG formulations. We performed a systematic literature review of articles published since 2017 to this day utilising PubMed, Scopus, Cochrane, and MEDLINE, with the main endpoints being prophylaxis of acute GvHD (aGvHD) and chronic GvHD (cGvHD). We subjected to scrutiny a total of 5 studies, of which 4 compared the differences between Thymoglobulin (ATG-T) and Grafalon (ATG-G), and 1 discussed the impact of ATG-T dose. Overall cGvHD, aGvHD grades II-IV, TRM, OS, NRM, LFS, relapse, overall infections, and EBV reactivation do not seem to be affected by the type of utilised rATG. However, data on aGvHD grades III-IV, GRFS, moderate-severe cGvHD, and CMV reactivation is conflicting. Through our research, we sought to summarise the most recent findings concerning r-ATGs in allo-HCT, and provide insight into the differences between the targets and origin of various ATG formulations.

Abstract A variety of surgical techniques have been developed to reconstruct the posterior maxilla when bone volume is insufficient. A barrier membrane or bone window pushed inside the sinus cavity as the ‘‘roof’’ of the sinus cavity for preserve the space and help bone. The heterologous cortical lamina is used for the mechanical support, without any grafting material, of sinus membranes resulting in only bone tissue formation and not mixed with the graft.

We evaluated epidemiological evolution and economic impact of COVID-19 pandemic in the European Union (EU) and worldwide, and the effects of control strategies on them. We collected incidence, mortality, and gross domestic product (GDP) data between the first quarter of 2020 and of 2023. Then, we reviewed the effectiveness of the mitigation and zero-COVID control strategies. The statistical analysis was done calculating the incidence rate ratio (IRR) of two rates and its 95% confidence interval (CI). In the EU, COVID-19 presented six epidemic waves. The sixth one at the beginning of 2022 was the biggest. Globally, the biggest wave occurred at the beginning of 2023. Highest mortality rates were observed in the EU during 2020-2021 and globally at the beginning of 2021. In mitigation countries, mortality was much higher than in zero-COVID countries (IRR= 6.82; CI:6.14-7.60; p<0.001). A GDP reduction was observed worldwide, except in Asia. None of the eight zero-COVID countries presented a GDP growth percentage lower than the EU percentage in 2020, and 3/8 in 2022 (p=0.054). COVID-19 pandemic caused epidemic waves with high mortality rates and a negative impact on GDP. The zero-COVID strategy was more effective in avoiding mortality and potentially had less impact on GDP.

Background: The optimisation of this return to athletic activity pass by a better understanding of the behaviour of the muscle involved in knee function.In this study, we focused on the muscular activity of the muscle involved in the flexion of the knee. Preciseley on the relation between the muscular activity of the gastrocnemius and the hamstring among the patient that underwent an anterior cruciate ligament reconstruction with hamstring graft.Objective : The objective of the study is to compare, the muscular activity of the flexor knee muscle in patient that underwent an anterior cruciate ligament reconstruction with hamstring autograft and the individuals that have not undergone surgery.Methods : The participants have been divided into two groups : an healthy group and an experimental group that underwent an anterior cruciate ligament recontruction with hamstring graft. The participants had to performe a strenght test on a isocinetik dynamometer. The activity of the medial gastrocnemius, lateral gastrocnemius, femoral biceps and the semitendinosus were mesured during this test.The muscular activity of the muscle mentioned of the individuals in the first group were compared to the ones in the second group via a statistical analysis. Then, a ratio of the activity of the gastrocnemius muscle on the activity of the hamstring was calculated The results of the experimental group were then compared to the results of the control groupResults : The results showed a significative difference activity of the medial gastrocnemius, the femoral biceps and the semitendinosus muscles : the experimental group results were superior to the control group results However the evaluation of the activity reporting has shown significant differences in the two groupsConclusion : This study has allowed us to show a difference in muscular activity of the gastrocnemius and hamstring muscle between patient that underwent an anterior cruciate ligament reconstruction surgery and the heathy participants. However our approch has not allowed us to identify the relation between a heihtened gastrocnemius activity and a diminished hamstring activity following an anterior cruciate ligament reconstruction with hamstring graft. Quite on the contrary, we observed a higher activity of the two muscle groups. Nevertheless, it seem to be necessary to have a variation in situations during the analysis of the gastrocnemius muscle to fully understans its purpose in the functional activity of the knee of patient that have undergone an anterior cruciate ligament reconstruction.

One in 12 babies is born with a rare genetic disease. Sadly, most cases are undetected until later age, missing time for early treatment and opportunity to prevent complications. Humanity has entered a new era where Big Data collected by governments, including 2D and 3D facial scans, are available. Many rare genetic diseases can be identified by artificial intelligence (AI) analysis of the facial photo. Phenotyping AI utilizations facilitate comprehensive and accurate genetic evaluations. AI processing of this Big Data to identify rare genetic diseases could bring unimaginable benefits to healthcare, although this would be a questionable step in terms of citizen privacy and could lead to future "Orwellian" ramifications with government abuse. Going forward, a balance must be found between protecting the privacy of citizens and the enticing use of AI for their health risks and cost savings through prevention. The unimaginable potential of AI early diagnostics from facial photos also raises various ethical and legal concerns. This paper presents concept, protentional methods and legal and other limitations within EU legal framework in contrast with potential benefits. This paper is focused on AI utilization to early diagnostic of rare genetic diseases. Shift of paradigm in the screening for rare genetic diseases in population with AI face analysis is expected to have a significant impact. The potential of AI algorithms utilizations similar to face2gene app in general population or systematically on Big governmental datasets recording facial traits changes in time can have significant impact on public health but at the same time give raise to profound concern as violation of one’s privacy.

The binary metal oxide mesoporous interfacial layers (bi-MO meso IF layer) templated by a graft copolymer is synthesized between a fluorine-doped tin oxide (FTO) substrate and nanocrystalline TiO2 (nc-TiO2). Amphiphilic graft copolymers, Poly(epichlorohydrin)-graft-poly(styrene), PECH-g-PS, was used as a structure-directing agent, and the fabricated bi-MO meso IF layer exhibits good interconnectivity and high porosity. Even if the amount of ZnO in bi-MO meso IF layer increased, it was confirmed that the morphology and porosity of bi-MO meso IF layer was well maintained. In addtion, bi-MO meso IF layer coated onto FTO substrates show higher transmittance compared with a pristine FTO substrate and dense-TiO2/FTO, due to the reduced surface roughness of FTO. The overall conversion efficiency (η) of a solid state photovoltaic cells, dye-sensitized solar cell (DSSC) fabricated with nc-TiO2 layer/bi-MO meso IF layer TZ1 used as a photoanode reaches 5.0% at 100 mW cm-2, which is higher than that of DSSC with a nc-TiO2 layer/dense-TiO2 layer (4.2%), resulting from enhanced light harvesting, good interconnectivity, and reduced interfacial resistance. The cell efficiency of the device did not change after 15 days, indicating that the bi-MO meso IF layer with solid-state electrolyte has improved electrode/electrolyte interface and electrochemical stability. Additionally, commercial scattering layer/nc-TiO2 layer/bi-MO meso IF layer TZ1 photoanode fabricated solid state photovoltaic cells (DSSC) achieved an overall conversion efficiency (η) of 6.4% at 100 mW cm-2.

In 1982, MIT physicist Frank Wilczek predicted and named ANYONS, quasiparticles (particle-like formations) that are confined to 2 dimensions and were discovered in 2020. The name might come from Prof. Wilczek's lighthearted comment "anything goes". This article's main goal is to show that anyons could be another name for 1) virtual particles, 2) Mobius strips, and 3) figure-8 Klein bottles. Along the way, we'll see the picture painted by the article confirm that Einstein's dream of gravitational-electromagnetic unity fits in with anyons being Mobius strips. The topological hypothesis offers an explanation of dark matter and dark energy. We'll also have encounters with intergalactic travel and imaginary computers. They really could exist but are imaginary in the sense that they use imaginary time (as well as space-time warping).

Today, rupture of the anterior cruciate ligament is the most common heavy injury in athletes, but it can also occur in sedentary subjects. Its treatment, always adapted to the lifestyle, age and will of the patient, often remains surgical. However, despite its frequency and universality, there are still walking disorders following the operation. These disorders sometimes persist for several months, or even several years after surgery. The present study is therefore interested in determining the risk factors linked to walking disorders following reconstruction of the anterior cruciate ligament. The objective of this study is to determine what risk factors associated with walking disorders are after reconstruction of the anterior cruciate ligament by hamstring graft. This study focused on factors that may exist at 3 and 6 months postoperatively. Two populations participated in this study, a healthy population and a population having benefited from reconstruction of the anterior cruciate ligament. The operated test group is divided into two subgroups, one with a postoperative period of 3 months and the second at 6 months. All subjects were subjected to the same protocol, their gait on the treadmill was analyzed and evaluated with an Optogait® analysis system. A univariate analysis was carried out first. Then, a multivariate analysis by adjustment method was carried out in order to eliminate the potential confounding factors. The comparison of the results between the populations in the univariate analysis shows an absence of significant results however there are trends. The statistical results of the multivariate analysis showed interactions in the two subgroups of the operated population.In fact, it turns out that at 3 months there is a tendency to worse gait disorders in subjects with a high BMI reflecting overweight, when an associated surgical procedure has taken place on the meniscus, in subjects over 35 years of age and males. On the other hand, at 6 months, the tendency to worsening is visible only in the strata represented by subjects with a BMI corresponding to overweight, as well as in subjects having benefited from a meniscal suture associated with ACL reconstruction. .The results of the present study show that there are certain factors which tend to increase the risk of these walking disorders after reconstruction of the anterior cruciate ligament by hamstring graft, these factors are different depending on the time postoperative.

Adopting Building Information Modeling (BIM) within the Architecture, Engineering, and Construction (AEC) industry presents an opportunity to address enduring challenges, including chronic productivity deficits and emerging imperatives such as cleaner production and sustainability. However, the pace of BIM implementation (BIMI) across European Union (EU) countries is uneven due to varying contexts and the inherent complexity of BIM adoption. Notably, Portugal lags in BIMI among these countries. Using the Portuguese context, the manuscript endeavours to identify the main barriers to BIMI by the late-adopting countries in the EU and, based on the dynamics of their relationships, design effective mitigation measures to lessen their impact and eventually leverage BIMI. A comprehensive list of barriers was compiled from the literature and ranked by experts through a Delphi survey, resulting in 15 critical barriers. Subsequently, an Interpretive Structural Modelling (ISM) model was constructed to elucidate the hierarchical relationships among these barriers, while a fuzzy Impact Matrix Cross-Reference Multiplication Applied to a Classification (MICMAC) analysis was employed to determine their driving and dependence powers. The resulting main barriers were the lack of evaluation and feedback mechanisms on BIMI, ignorance of BIM capabilities/benefits, scarcity of BIM-capable professionals, lack of experience and cooperation in BIMI, resistance to change, and lack of support from top management. Finally, experts formulated mitigation measures aimed at tackling these main barriers. These measures were designed to not only address each barrier individually but also to have a comprehensive and practical impact on the entire barrier system as a whole. These findings will assist researchers, policymakers, and practitioners in comprehending the barriers and hierarchical structures affecting BIMI in EU late-adopting countries.

Background: Delayed graft function (DGF) is common after kidney transplantation from de-ceased donor and may significantly affect post-transplant outcomes. This study aimed to evaluating whether an innovative approach, based on the administration of intravenous prostaglandin-analogue iloprost, could be beneficial in reducing the incidence of DGF occurring after kidney transplantation from deceased donors. Methods: This prospective, randomised (1:1), place-bo-controlled study enrolled all consecutive patients who received a kidney transplantation from a deceased donor from January 2000 to December 2012 and who were treated in the peri-transplant period with the prostaglandin-analogue iloprost at 0.27 μg/min through elastomeric pump (treatment group) or placebo (control group). Results: A total of 476 patients were included : DGF was reported in 172 (36.1%) patients in the entire cohort. The multivariate analysis showed that donor’s age > 70 years (OR 2.50, 95% Confidence Interval (CI) 1.40-3.05, p < .001), cold ischemia time > 24 h (OR 2.60, 95 CI 1.50-4.51, p < .001), donor’s AKI (OR 2.71, 95% CI 1.61-4.52, p = .021) and, above all, recipient’s arterial hypotension (OR 5.06, 95% CI 2.52-10.1, p < .0001) were the strongest risk factors for developing post-transplant DGF. The incidence of DGF was 21.4% in the treatment group and 50.9% in the control group (p< .001). Interestingly, among patients who developed DGF, those who received iloprost had a shorter duration of post-transplant DGF (10.58.3 v s13.46.7, days, p= .016). Conclusions: This study showed that the use of a continuous infusion of iloprost could safely and effectively reduce the incidence of DGF in recipients of deceased donor kidneys, allowing a better graft functionality as well as a better graft survival.

Objetives: Adequate donor-recipient matching is necessary to achieve the best renal function after transplantation. The nephron load received from the donor, which can be reflected in variables such as age, sex and body mass index, may influence the evolution of the graft. Our objetive was develop a combined score according to the donor-recipient pairing in age, sex and body mass index, and assess its influence on the evolution of the renal graft. Materials and methods: Transplant patients between 2013 and 2020 who had at least 1 year of post-transplant follow-up. A ranking of 0 to 2 points was awarded according to the match between donor and recipient for sex, age and body mass index individually, with higher rank to greater mismatch. Subsequently, a Score with value of 0 to 6 points was created with the combined ranking of the indivudual variables, analyzing its influence on the evolution of the graft by multivariate linear regression. Results: 280 patients followed for 4.3 years of median. Worse renal function was observed at the end of follow-up as the range of each variable increased separately, and the Score created, with a worsening of renal function as the combined Score increased in the multivariate analysis: Coefficient B= -2.4 ml/min, p=0.018. Conclusions: An adequate match between donor and recipient in age, sex and body mass index using this combined Score can help achieve better kidney function after transplantation.

A significant part of the global economy is focused on financial technologies, such as digital wallets, a rapidly growing sector. In 2020, 2.4 billion people used digital banking services globally, and this figure is projected to rise to 3.6 billion by 2026. This study aims to evaluate the current state and future trends in research on digital wallets using scientific databases. The methodology employed was a scoping review that analyzed 778 documents after the eligibility process. The terms used were “digital wallet,” “mobile wallet,” and “e-wallet.” Results indicate that India, the United States, and China lead in digital wallet research. Factors such as data security, ease of use, and integration with traditional payment systems significantly influence the adoption of digital wallets. Despite numerous studies, this article provides the first in-depth bibliometric analysis using Scopus and Web of Science. There has been an exponential research increase over the last decade, with a shift towards technological adoption and innovation. Less developed but key topics such as “digital wallets,” “blockchain,” and “block-chain” are fundamental yet have potential for further development. Driving themes like “electronic money,” “e-wallet,” and “electronic commerce” are central and highly developed, indicating their relevance and high research activity.

Digitalisation is one of the European Union's priorities. The European Parliament is shaping and helping to shape new legislation in this area. Digitisation should also help in the transition to a greener economy and in achieving climate neutrality. E-government is one area of digitisation that has been under way for several years in European countries. In this paper, we have focused on identifying different indices that are aimed at measuring digitalization or e-Government. The results of the analysis showed that there are several indices that focus on this area within the EU, such as EGDI, EPI, LOSI, DGI, e-Government benchmark, Eurostat - internet use, GII, DSGI, Going Digital toolkit and DESI. Subsequently, the index areas to be used in the DEA method to measure the effectiveness of e-Government related inputs and outputs within the EU were identified. As can be seen from the analysis, the DEA method has various uses. In order to be able to use the method properly it was necessary to select the most appropriate parameter and to verify their suitability by means of correlation analysis. Among the input and output indices were chosen Internet usage, DSGI, GII, e-Government benchmark, Interaction with public administration online. From the analysis 3 inputs and 3 outputs were used. After implementing the correlation, it can be said that the values between the selected sub-variables are suitable for DEA analysis. Two models were chosen for the calculation, namely CCR and BCC model. CCR model evaluated 10 states as efficient and BCC model evaluated 13 states as efficient. In addition, in the close analysis, we have taken a closer look at the CCR model's inference. Countries such as Denmark, Finland, Estonia, Malta, Portugal, etc. were efficient outliers. When comparing the regions within the EU, we can conclude that the countries of Northern Europe are the most efficient in the field of digitalization (e-Government). As many as 4 countries out of 7 are efficient. In a future study it would be useful to use the SBM model and try to measure the impact of digitalization on selected areas such as economy, society, environment, etc.

The present study set out to explore the option of developing food portion size for nutritional labelling purposes using two European Union (EU) dietary surveys. The surveys were selected as they differed in (a) methodologies (food diary v food frequency questionnaire), (b) populations (Irish National Adult Nutrition Survey: NANS) versus a seven-country based on the pan EU study Food4Me), (c) food quantification (multiple options v, solely photographic album) and (d) duration (4 consecutive days v recent month). Using data from these studies, portion size was determined for 15 test foods, where portion size was defined as the median intake of a target food when consumed. The median values of the portion sizes derived from both the NANS and Food4Me surveys were correlated (r = 0.823; P<0.00) and the mean of the two survey data sets were compared to US values from the Recognized as Customarily Consumed (RACC) database. There was very strong agreement across all food categories between the averaged EU and the US portion size (r = 0.947; P<0.00). It is concluded that notwithstanding the variety of approaches used for dietary survey data in the EU, the present data supports using a standardized approach to food portion size quantification for food labelling in the EU.

Rehabilitation following anterior cruciate ligament reconstruction with hamstring graft allows the patient to regain his functional capacities and to support him in the resumption of sports activities. Rehabilitation also aims to minimize the risk of recurrence, which is why it ensures that the patient's muscular capacities develop properly until they return to sport. Isokinetics helps strengthen and assess the strength of muscle groups in the thigh, but controversy exists as to its use by resistance to the open kinetic chain knee extension that would cause the transplant to distend. The objective of this study is to determine the influence of isokinetic muscle strengthening on the possible laxity of the anterior cruciate ligament and to be able to determine risk factors. The study relates to a population having benefited from anterior cruciate ligament reconstruction with hamstring graft from 3 to 6 months after surgery. Two groups are differentiated, one group exposed to isokinetism during rehabilitation, the other group, named unexposed, undergoes rehabilitation without the use of isokinetism. An anterior knee laxity test is performed 6 months postoperatively using the GNRB® machine for all subjects according to the same protocol. The test results were statistically analyzed to determine a relative risk of transplant distension for each group in the study. Comparison of the results of each group by univariate analysis did not reveal any significant result. Multivariate analysis showed interactions in the two strata of the study. It was argued that the use of isokinetics seems to have no effect on the risk of developing distension for the majority of subjects in the exposed group. A tendency towards transplant protection was perceived for each variable except the age under 25 years (RRa = 1.07). The use of isokinetics does not appear to be a cause of transplant distension in patients undergoing an anterior cruciate ligament reconstruction when this method is introduced 3 months postoperatively.

Systemic lupus erythematosus (SLE) is a prevalent autoimmune condition, yet its alignment with a specific host immunological pathway remains unclear. The THαβ host immunological pathway, recognized for its defense against viruses and prions, has recently emerged as a response to DNA, RNA, and protein pathogens. SLE patients often produce anti-double strand DNA antibodies and anti-nuclear antibodies, suggesting a potential association with the THαβ host immune reaction. Throughout the course of SLE, elevated levels of type 1 interferons, type 3 interferons, interleukin-10, IgG1, and IgA1 are commonly observed. These cytokines and antibody isotypes are indicative of the THαβ host immunological pathway. Similarly, Myasthenia gravis, Grave’s disease, Graft versus host disease, autoimmune hemolytic anemia, immune thrombocytopenia, dermatomyositis, and Sjogren’s syndrome are also linked to THαβ-related type 2 hypersensitivities. Considering the potential association of these diseases with dysregulated THαβ immune responses, therapeutic strategies such as anti-interleukin-10 or anti-interferons α/β could be explored to manage these disorders effectively.

Software is increasingly vital, with automated systems regulating critical functions. As development demands grow, manual code review becomes more challenging, often making testing more time-consuming than development. A promising approach to improving defect detection at the source code level is the use of artificial intelligence combined with natural language processing (NLP). Source code analysis, leveraging machine-readable instructions, is an effective method for enhancing defect detection and error prevention. This work explores source code analysis through NLP and machine learning, comparing classical and emerging error detection methods. To optimize classifier performance, metaheuristic optimizers are used, and a modified algorithm is introduced to meet the study’s specific needs. The proposed two-tier framework uses a convolutional neural network (CNN) in the first layer to handle large feature spaces, with AdaBoost and XGBoost classifiers in the second layer to improve error identification. Additional experiments using Term Frequency-Inverse Document Frequency (TF-IDF) encoding in the second layer demonstrate the framework’s versatility. Across five experiments with public datasets, the CNN achieved an accuracy of 0.768799. The second layer, using AdaBoost and XGBoost, further improved these results to 0.772166 and 0.771044, respectively. Applying NLP techniques yielded exceptional accuracies of 0.979781 and 0.983893 from the AdaBoost and XGBoost optimizers.

Maxillary sinus augmentation with a lateral approach (MSA) is a well-established treatment. In this prospective study, we evaluated risk factors for postoperative bone-graft displacement and report the clinical application of long-term resorbable GMEM-B-2 (L-lactic acid/-caprolactone [P(LA/CL)]) as a barrier membrane to cover the open window in the lateral wall in MSA. Twenty-four patients underwent MSA according to the relevant criteria; CT data obtained before and 1 week (1W) and 5–6 months (5M) post-MSA, bone height changes, bone height reduction rates at 1W and 5M post-MSA, bone-graft displacement measurements, and risk factors were examined. All patients showed bone height increments (p &lt; 0.005). However, no difference was observed between 1W and 5M post-MSA. Bone-graft displacement was observed in eight patients; the reduction rate from 1W to 5M post-MSA was 8.38% ± 4.88%. Sex, septa, maxillary sinus floor–palatal bone distance, and maxillary sinus floor–natural mouth distance were associated with bone-graft displacement (p &lt; 0.05). Height from the maxillary sinus floor to the palatal bone and the sinus angle influenced the augmentation amount (p &lt; 0.05). The L-lactic acid/ε-caprolactone [P(LA/CL)] membrane compared favourably with other membranes and may be useful as a barrier membrane for the MSA open window.