Global warming may increase the potential evapotranspiration (Etp), thereby affecting the amount of clean water resources available in a region. In this study, the systematic biases in temperature outputs of 24 global climate models (GCMs) under 3 emission scenarios are corrected by using 8 bias correction methods. The trend of Etp in Yangzi River Delta in the 21st century is projected by using 4 Etp calculation formulas. The uncertainty of the projections is estimated and decomposed by using multi-way analysis of variance. The influence of uncertainty on the projected change signal is quantified by using the signal-to-noise ratio. The results show that, relative to the reference period (1971~2000), the annual mean daily Etp in Yangzi River Delta will increase by 0.14~0.17mm/d during the period 2021~2050 and by 0.21~0.41mm/d during the period 2061~2090, respectively. During 2021~2050, the uncertainty of Etp increase projections is dominantly contributed by the main effects of GCM (63%) and Etp calculation formula (24%). During 2061~2090, it is mainly contributed by the main effect of GCM (36%), followed by the main effects of emission scenario (34%) and Etp calculation formula (18%). The increase projections of Etp are generally reliable and robust during the two projection periods.

Resveratrol (RSV), a naturally occurring phytoalexin, is the most important stilbenoid synthesized by plants, as a defense mechanism, in response to microbial aggression, toxins or ultraviolet radiation. RSV came to the attention of researchers both as a potential chemopreventive agent and a possible explanation for the low incidence of cardiovascular disease (CVD) in French people with a high-fat diet. RSV is mainly administered as a food supplement, its properties being evaluated in vitro or in vivo, on various experimental models. RSV modulates signaling pathways that limit the spread of tumor cells, protects nerve cells from damage, is useful in the prevention of diabetes, and generally acts as an anti-aging natural compound. It was highlighted that RSV could ameliorate the consequences of an unhealthy lifestyle caused by an exaggerated caloric intake. This paper reviews the evidence supporting the beneficial effect of RSV for various pathological conditions, e.g., neoplastic diseases, neurodegeneration, metabolic syndrome, diabetes, obesity, CVDs, immune diseases, bacterial, viral, and fungal infections. The study also focused on the chromatographic analysis of trans-RSV (tRSV) in Romanian wine samples, providing a comprehensive overview of tRSV content across different types of wine.

Rosemary is one of the most important medicinal plants for natural therapy due to its multiple pharmacological properties, such as antioxidant, anti-inflammatory, neuroprotective, antiproliferative, antitumor, hepato- and nephroprotective, hypolipidemic, hypocholesterolemic, antihypertensive, anti-ischemic, hypoglycemic, radioprotective, antimicrobial, antiviral, antiallergic, wound healing. Our study reports for the first time, over a 12-month period, the identification and quantification of polyphenols and the investigation of the antioxidant and acetylcholinesterase (AChE) inhibitory activity of the Rosmarinus officinalis L. species harvested at flowering from the flora of southwestern Romania (Oltenia Region). Identification and quantification of polyphenolic acids was made by ultra-high-performance liquid chromatography/mass spectrometry (UHPLC/MS). Total phenolic content was determined using the spectrophotometric method. In situ antioxidant and anticholinesterase activity was evaluated using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and AChE inhibitory assay, respectively, on high-performance thin-layer chromatography (HPTLC) plates. DPPH radical scavenging activity was also assessed spectrophotometrically. The results revealed significant correlations between specific polyphenolic compounds and the measured biological activities, understanding the role of seasonal variations and providing insights into the optimal harvesting times and medicinal benefits of rosemary. Our research brings new information on the phytochemical profile of R. officinalis, as a natural source of polyphenols with antioxidant and AChE inhibitory properties.

Background: Heracleum sphondylium, a medicinal plant used in Romanian ethnopharmacology, proved to have a remarkable biological activity. The escalating concerns surrounding antimicrobial resistance led to a special attention to new efficient antimicrobial agents based on medicinal plants and nanotechnology. We report the preparation of a novel, simple phytocarrier that harnesses the bioactive properties of H. sphondylium and silver nanoparticles (HS-Ag system). Methods: The H. sphondylium low-metabolic profile was determined through gas chromatography–mass spectrometry and electrospray ionization–quadrupole time-of-flight–mass spectrometry. The morphostructural properties of the innovative phytocarrier were analyzed by X-ray diffraction, Fourier-transform infrared spectroscopy, Raman spectroscopy, dynamic light scattering, scanning electron microscopy, and energy-dispersive X-ray spectroscopy. The antioxidant activity was evaluated using total phenolic content, ferric reducing antioxidant power, and 2,2-diphenyl-1-picrylhydrazyl (DPPH) in vitro assays. The antimicrobial activity screening against Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa, and Escherichia coli was conducted using the agar well diffusion method. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay estimated the in vitro potential cytotoxicity on normal human dermal fibroblasts (NHDF) and cervical cancer (HeLa) cells. Results: A total of 88 biomolecules were detected, such as terpenoids, flavonoids, phenolic acids, coumarins, phenylpropanoids, iridoids, amino acids, phytosterols, fatty acids. HS-Ag phytocarrier heightened efficacy in suppressing the growth of all tested bacterial strains compared to H. sphondylium and exhibited a significant inhibition of HeLa cell viability. Conclusions: The new HS-Ag phytocarrier system holds promise for a wide range of medical applications. The data confirms the capacity to augment pertinent theoretical understanding in the innovative field of antimicrobial agents.

Background: Handheld cameras may increase access to teleretinal diabetic retinopathy screenings (TDRS), as they are more economical and nimbler than traditional desktop cameras. However, their use in safety-net clinical settings is less understood. Methods: The Los Angeles County Department of Public Health collaborated with the Los Angeles County Department of Health Services (DHS) to pilot the use of handheld cameras in DHS’s TDRS program. This study assessed screening metrics and interviewed TDRS coordinators and photographers about their experiences using these cameras. Results: Handheld cameras are harder to operate and performed less optimally on key screening metrics (e.g., image quality) compared to desktop cameras. However, this challenge appeared to be linked to the selected model, rather than to all handheld cameras. The adoption of handheld cameras in DHS was aided by their integration into an existing agency infrastructure that already supports the use of desktop cameras; these operational supports include an established workflow, a data platform, and experienced photographers. Conclusions: The use of handheld cameras for TDRS is a promising practice for assuring equitable access to screenings. Handheld cameras are portable, smaller in size, and lower in cost than desktop cameras. Future projects should invest in and assess the performance of higher-quality models of these cameras, especially their use in safety-net clinical settings.

Only a handful of microbial mosquito larval pathogens have been described to date. Sampling of several natural enzootic infections of mosquito larvae in southwestern Florida indicated the presence of microbial pathogens capable of extensive larval mortality. Microscopic analysis of one sample site revealed extensive apparent growth of a Pythium-like microbe on mosquito lar-vae, with highest infection observed on the siphon and head regions. Structures consistent with sporangia were seen on infected insects after lactophenol blue staining, and higher resolution scanning electron micrographs (SEM) showed sporangia and encysted zoospores targeting the head and siphon regions. The isolate was single colony purified and molecular identification targeting the ITS and COX1 loci coupled to phylogenetic reconstruction indicated that the isolate belonged to the Pythium genus, but was distinct from its closest characterized species, P. angusta-tum. Morphological features were characterized, with the isolate showing rapid growth on all mycological media tested and relatively high thermotolerance, capable of robust growth at 37oC, and hence was designated, P. thermoculicivorax. Sampling from a second series of natural infec-tions of mosquito larvae resulted in the molecular identification of three Trichoderma isolates, one with high similarity to T. strigosum, and the other two clustering with, but distinct from, T. asperellum. These data highlight the occurrence of natural enzootic infections of mosquito larvae, potentially as a resource for the identification of new mosquito pathogens.

This study focuses on the design, installation, and performance evaluation of a photovoltaic farm situated in Tulcea County, Romania, connected to a 20 kV distribution network. The farm, with a peak capacity of approximately 2800 kWp, benefits from Romania’s favorable climate conditions and supportive renewable energy policies. The analysis encompasses both the photovoltaic panel array and the electrical energy evacuation system. The substation at the park is equipped with technology that adheres to European standards and incorporates advanced features typical of modern electricity distribution networks. The assessment includes an evaluation of the park’s operational efficiency, with detailed calculations of the performance ratio and various power losses attributed to factors like temperature fluctuations, fouling, inverter efficiency, grid-related challenges, and availability issues. The farm contributes around 3620 MWh of electricity to the grid annually, demonstrating the effectiveness of photovoltaic installations in promoting sustainable energy solutions within regional energy networks.

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

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

Water quality assessment in pastoral of Tibetan Plateau, which is water sources for about 40% of world's population and the runoff-yield area of Yellow rivers, is very important. In this paper, Xiahe county which belongs to Tibetan Plateau pastoral was investigated. Six parameters(via, chloride, COD, ammonia nitrogen, nitrate, fluoride, sulfate) were selected to assess the water quality and health degree by using fuzzy comprehensive evaluation methods. The hydrochemical type in surface water was of HCO3--Mg2+-Ca2+ type. The cations and anions in surface water were mainly from weathering and dissolution of carbonate rock. Results showed that the water quality in all 69 sampling sites was all of class Ⅰ. The integrated health degree reached more than 0.85 and the health rate were 100%. Although ammonia nitrogen was regarded as the main contamination factor, but it had a little effect on the entire body of water. Overall, the surface water qualities of most samples in Xiahe County was good condition.

Hydrodynamic modeling and hazard mapping are essential tools for urban flood mitigation and spatial planning. Leveraging software like HEC-RAS (Hydrologic Engineering Center - River Analysis System) and ArcGIS, this study aimed to map flood-prone areas along the Jijia River in the Ungheni administrative unit of Iasi County. Human-induced environmental changes and global climate shifts have heightened flood risks worldwide, particularly in urbanized areas. Hydrological and hydraulic modeling anticipate and assess flood events, while hydrodynamic modeling accurately simulates flow propagation, in-forming flood extent, timing, and volume. Flood hazard maps offer essential insights into flooded areas, water depths, and velocities, assisting in risk assessment and mitigation strategies. Through the use of different scenarios, river modeling aims to accurately replicate real-world conditions. This study focuses on Ungheni commune in Iasi County, Romania, situated along the Prut River's eastern bank. Utilizing a combination of fixed-grid and irregular mesh elements in modeling al-lows for fine-tuning of flow details and optimization of simulation times. Model accuracy, particularly regarding peak river levels, hinges on hydrograph duration. While a 30-minute error is typically accepted, greater tolerances may apply to river basins with longer response times. The extraction and processing of model results, including maximum water depths, flood extents, and velocity maps, are facilitated by ArcGIS, providing valuable data for effective flood management strategies.

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

This paper addresses the cosmological constant problem, a significant discrepancy highlighted by \cite{Weinberg:1988cp} that underlines a fundamental inconsistency between quantum field theory (QFT) and general relativity (GR). QFT examines matter dynamics within Lorentzian spacetime under standard model symmetry, while GR uses Riemannian geometry but adapts it to ensure local Lorentzian behavior in small regions. Despite the experimental successes of both theories, a major challenge exists in theoretical understanding. This letter seeks to clarify this critical misunderstanding. As the universe cools from its hot beginning, the \(SU(3) \times SU(2) \times U(1)\) standard model gauge symmetry evolves. This symmetry breaks to \(SU(3) \times U(1)\) upon cooling at the electroweak scale and ultimately to \(SU(3)\) alone as temperatures approach near-absolute zero kelvin, facilitated by the experimental Meissner effect. This suggests that \(SU(3)\) symmetry forms the foundational "atoms" of vacuum energy. Calculating the number of \(SU(3)\) vacuum atoms across the universe results in a value that perfectly aligns the theoretical predictions with the observed vacuum energy densities, thereby resolving the cosmological constant problem. Since \(SU(3)\) atoms account for the cosmological constant, they must be unbreakable. The third law of thermodynamics, which states that it is impossible to reach absolute zero Kelvin, provides the protection that prevents SU(3) atoms from breaking at zero Kelvin. This reveals the connection between the third law of thermodynamics and the quark confinement. This leads to the \(SU(3)\) atom creating a mass gap within the universe. This solution serves as a symmetric evidence of gauge-gravity duality as well as gravity-superconductor duality.

Recently, the destructive impact of wildfires has proliferated; for instance, the August Complex wildfire in 2020 burned around 4% of California's landmass. This has caused increased economic damage and risk to human life. Additionally, climate change is anticipated to increase the severity of wildfires, making it imperative for accurate and efficient detection of wildfires. Machine Learning approaches allow for the automatic detection of wildfires, simultaneously prioritizing accuracy and efficiency, with minimal human intervention, thus decreasing the likelihood of increased economic damage and increasing firefighting responses. Convolutional Neural Networks (CNNs), while showing promise, are often limited by their inability to learn and capture deep spatial dependencies in satellite imagery tasks. In this paper, we propose FlameViT, a novel wildfire detection architecture based on Vision Transformers (ViT). Satellite images are more efficient to obtain and can cover wide areas prone to wildfires. We obtain a dataset of 40K+ satellite images from Canada's Open Government Portal, allowing FlameViT to be optimized to detect wildfires in satellite imagery. FlameViT uses Patch Extractor and Patch Embedding layers, followed by multiple Transformer Encoder layers with Multi-Head Self-Attention and feed-forward neural networks. FlameViT is hyperparameter-tuned and achieves a validation accuracy of 95%, outperforming various baselines in the wildfire detection task. FlameViT shows the power of Vision Transformers for wildfire detection tasks, and in conjunction with the use of satellite imagery, can provide an efficient and accurate way of detecting wildfires.

The aim of the current study has been to assess externalizing problems from a gender perspective in the juvenile population. This objective has been evaluated though the Child and Adolescent Assessment System questionnaire (SENA), to measure the dimension of externalized problems. A total of 128 Spanish students took part in the survey, comprising 58 (45.3%) male and 67 (52.3%) female, aged between 12 and 16 years old (M= 13,7; Sd= 1,14). The sample was taken from three High- Schools (state and private-subsidized) in Madrid, Spain. The research for this study was conducted through a descriptive, inferential, quantitative, ex post facto design. The data analysis was performed using SPSS 27.0. The result revealed an increase in externalized problems: Attention (M= 2.65, Sd=.88), Anger Control (M= 2.27, Sd=.85) and Hyperactivity- Impulsivity (M= 2.26, Sd=.68). In addition, female students score highly in Attention Problems (F= 4.124; Sig.: .004), Hyperactivity-Impulsivity (F: 6.18; Sig.: <.001), and Anger Control (F: 2.3; Sig.: .062). This study highlights the impact and increase on students externalized mental health problems currently. It is essential to have a protective environment and promote the development of emotional intelligence, encouraging the mental health in young people. This article is part of the findings of the research project “Therapeutic Innovation Classroom for the accompaniment of teenager with Serious Mental Disorder” (Reference: 2021V/EU-UNED/02).

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

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

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

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

To mitigate the adverse impacts of urban stormwater on streams, watershed managers are increasingly using low impact development and green infrastructure (LID-GI) stormwater control measures such as rain gardens—vegetated depressional areas that collect and infiltrate runoff from rooftops and driveways. Their catchment-scale performance, however, can vary widely, and few studies have investigated the cumulative performance of residential rain gardens for event runoff control in intermediate-sized (i.e., 1-10 km2) suburban catchments. We modeled three years of continuous rainfall-runoff from a 3.1 km2 catchment in Columbia, MD, USA, using the Storm Water Management Model (SWMM). Various extents of rain garden implementation at residential houses were simulated (i.e., 25%, 50%, 75%, and 100% coverage) to determine the effects on peak flow, runoff volume, and lag time. On average, treating 100% of residential rooftops in the catchment reduced peak flows by 14.3%, reduced runoff volumes by 11.4%, and increased lag times by 3.2% for the 223 rainfall events during the simulation period. Peak flow reductions were greater for smaller storm events (p&lt;0.01). Our results show that residential rain gardens can significantly improve the runoff response of suburban catchments, and that they represent an effective and relatively low-cost option for urban watershed management and restoration.

Background and objective: Analysis of inflammatory biomarkers, along with the neutrophil/lymphocyte ratio (NLR) or platelets/lymphocyte ratio (PLR), supports the connection between inflammation and carcinogenesis. Methods: We conducted a retrospective observational study at the Clinical County Hospital Mureș, including patients with lung cancer. The parameters analyzed included: histopathological type (NSCLC - squamous cell carcinoma or adenocarcinoma; SCLC), molecular mutations (EGFR, ALK, PD-L1), parameters from the complete blood count, inflammatory parameters and associated comorbidities. Results: 380 patients were included: 115 patients in the cancer group and 265 patients in the control group. Among patients in the lung cancer group, 88 were diagnosed with NSCLC (44 adenocarcinomas, 44 squamous cell carcinomas) and 27 with SCLC. Both NLR and PLR were significantly higher in cancer patients than in the control group (5,30 versus 2,60, p&lt;0,001; 217 versus 136, p&lt; 0.001, respectively). NLR and PLR differs between men and women (p = 0.005, respectively p=0.056). C-reactive protein was not correlated with either NLR (p-value: 0.0669) or PLR (p-value: 0.6733) in lung cancer patients. Conclusion: The NLR and PLR values ​​may serve as new predictive biomarkers for the diagnostic of disease in patients with lung cancer, especially those with NSCLC.

Nasal high-frequency oscillatory ventilation (nHFOV) has emerged as an effective initial and rescue noninvasive respiratory support mode for preterm infants with respiratory distress syndrome (RDS). Multiple noninvasive respiratory support modes are currently available in Romania, but little is known about nHFOV use in Romanian neonatal intensive care units (NICUs). We aimed to identify the usage extent and clinical application of nHFOV in Romania. A structured web-based questionnaire was designed to find the rate of nHFOV use and knowledge of this new method of noninvasive respiratory support in Romanian level III NICUs. The questionnaire was addressed to the leaders of all level III Romanian NICUs. Using multiple-choice, open-ended, and yes/no questions, we collected information on the NICU’s size, noninvasive respiratory support modes used, nHFOV use, indications, settings, nasal interfaces, secondary effects, and equipment used. Descriptive statistics and comparisons were performed using IBM SPSS Statistics 26.0. A total of 21/23 (91.3%) leaders from level III NICUs (median [IQR] number of beds of 10 [10-17.5]) responded to the survey. The most frequently used noninvasive ventilation modes were CPAP mode on mechanical ventilators (76.2%), followed by NIPPV (76.2%), heated, humidified high flow nasal cannula (HHHFNC) (61.9%), and nHFOV (11/21 units; 52.4%); 5/11 units reported frequent nHFOV use (in 2 or more newborns/month) in both term and preterm infants. The main indications reported for nHFOV use were CPAP failure (90.9%), hypercapnia (81.8%), and bronchopulmonary dysplasia (72.7%). 10/11 units reported setting a mean airway pressure (MAP) equal to the CPAP level plus 1-2 cmH₂O on rescue nHFOV after CPAP failure. Both dedicated equipment (45.5%) and hybrid ventilators (63.6%) were used for nHFOV delivery, with face/nasal masks and short binasal prongs being the most commonly used nasal interfaces (90.9% and 72.7%, respectively). Air leaks at the interface level (90.9%), thick secretions (81.8%), and airway obstruction (63.6%) were the most frequently mentioned adverse effects of nHFOV; none of the units mentioned pneumothorax as an adverse effect. Only 3 of the NICUs had a written protocol for nHFOV use. Initial, minimum, and maximum amplitude and initial and minimum MAP settings used were significantly higher with hybrid ventilators as compared to dedicated equipment (p<0.05). Most units not yet using nHFOV cited lack of equipment, experience, training, or insufficient information and evidence for the clinical use and outcome of nHFOV use in neonates as the main reasons for not implementing this noninvasive respiratory mode. Our survey showed that nHFOV is already used in more than half of the Romanian level III NICUs to support term and preterm infants with respiratory distress despite a lack of consensus regarding indications and settings during nHFOV. A need for training for nHFOV use was identified, and efforts are needed at the national level to develop courses and training sessions, including using simulation workshops, to offer more information on optimal nHFOV use in clinical practice.

Background and Objective: Although possible risk factors associated with maternal postpartum depression (PPD) have been elucidated, it is still unknown how some newborns characteristics could influence the appearance of PPD. Our research aimed to unravel the impact of newborn’s characteristics on PPD. Methods: The study was conducted in the Obstetrics &amp; Gynecology Department, from our University Emergency County Hospital, between August 2019 and April 2021. We included women in the 2 nd day of the postpartum period (n=904), divided into 2 groups: women with PPD (n=236) and control (women without PPD, n=668), by using the Edinburg Postpartum Depression Scale. Characteristic information on newborns (i.e., the months in which they were born, premature delivery, birth weight, or gender) were assessed. Results: Our findings suggest that the winter season (i.e. December and January, p=0.01) births and male newborns (p=0.02) were associated with the appearance of depressive symptoms during postpartum. Conclusions: Therefore, our study showed that women who give birth to male newborns in winter are likely to develop PPD. This should be considered by all public health systems in order to prevent such manifestations in certain groups of women.

Since the turn of the millennium, many individuals and groups, including Diane Moore (2007), Stephen Prothero (2007), the American Academy of Religion (2010), and The National Council for the Social Studies (2014, 2017, 2021), have advocated for better religious literacy education (RLE) in K-12 curriculum and public schools. Despite these calls, RLE has yet to make significant inroads in K-12 curriculum and public schools. This paper aims to define religious literacy and RLE, provide current rationales for its inclusion in K-12 curriculum and public schools, identify barriers to RLE, and explore the potential of global competence in promoting RLE.

The Ballynoe barite deposit is a conformable, mineralized horizon of Lower Carboniferous age overlying a diastem and mass faunal extinction demarking the transition from a quiet water environment to one of dynamic sedimentation. The geometry of the barite orebody correlates with the palaeo-topography of the footwall, which acted as an important control over the lateral extent, thickness and nature of the mineralization. Sedimentary features within the barite horizon suggest that it was precipitated in the form of a cryptocrystalline mud which underwent major diagenetic modification resulting in extensive stylolitisation, recrystallisation and remobilization. There is abundant and compelling geological and isotopic evidence for early local exhalation from the presence of a hydrothermal vent fauna consisting of a delicately pyritized worm tubes hosted and haematized filaments of apparent microbial origin. The worm tubes are remarkably similar to examples from modern and ancient volcanic-hosted massive sulphide deposits, and the filamentous microfossils have similarities to modern Fe-oxidizing bacteria. Strontium in the barite has a 87Sr/86Sr ratio indistinguishable from sea-water between 350 and 344Ma whilst oxygen isotopes from barite and chert suggest a diagenetic origin in equilibrium such sea-water around 60-70°C. Fluid inclusion studies have shown that, in general, low temperature inclusions are very saline (20-25%) whilst at higher homogenization temperatures they are more dilute (9-12%).

There has been a growing awareness of the need to implement environmentally friendly operations in the hotel industry, but most studies focus on guest behaviors. Only a few studies investigate employees’ willingness to comply with hotels’ green practices. This study seeks to further the investigation from the human resource perspective. Using alumni from a tourism and hospitality programs, this study collected 233 responses. The study hypothesizes that the employees’ green ability consisting of environmental awareness, environmental knowledge, and environmental skill creates a positive impact on hotels’ green ability. The results indicate that employees contribute approximately a fifth of hotels’ ability to implement greener practices.

Domestic crime, conflict, and instability pose a significant threat to many contemporary governments. These challenges have proven to be particularly acute within modern-day Mexico. While there have been significant developments in predicting intrastate armed and electoral conflict in various contemporary settings, such efforts have thus far been limited in their use of spatial as well as temporal correlations, as well as in the features they have consid- ered. Machine learning, especially deep learning, has been proven to be highly effective in predicting future conflicts using word embeddings in Convolutional Neural Networks (CNN) but lacks the spatial structure and, due to the black box nature, cannot explain the importance of predictors. We develop a novel methodology using machine learning that can accurately classify future anti-government violence in Mexico. We further demonstrate that our approach can identify important leading predictors of such violence. This can help policymakers make informed decisions and can also help governments and NGOs better allocate security and humanitarian resources, which could prove beneficial in tackling this problem. Using a variety of political event aggregations from the ICEWS database alongside other textual and demographic features, we trained various classical machine learning algorithms, including but not limited to Logistic Regression, Random Forest, XGBoost, and a Voting classifier. We considered a mix of CNN + Long Short Term Memory (LSTM) networks to decode the spatial and temporal relationship in the data. The performance of all the black box deep learning models was not at par with the classical machine learning models. We also evaluated the temporal relationships in the data to identify important predictors that fuel anti-government violence along with their directions using Shapley additive values. The voting classifier, utilizing a subset of features derived from LASSO across 100 simulations, consistently surpasses alternative models in performance and demonstrates efficacy in accu- rately classifying future anti-government conflicts. Notably, Random Forest feature importance indicates that some features, including but not limited to homicides, accidents, material conflicts, and positive worded citizen information sentiments emerge as pivotal predictors in the classification of anti-government conflicts. Finally, we conclude the research by analysing the spatial structure of the data using Moran’s I index extended version for spatiotemporal data to identify the global spatial dependency and local clusters followed by modelling the data spatially and evaluating the same using Gaussian Process Boost(GPBoost). The global spatial autocorrelation is minimal, characterized by local- ized conflicts cluster within the region. Furthermore, in Phase 3, the Voting Classifier method demonstrates superior performance over GPBoost, leading to the inference that no substantial spatial dependency exists among the various locations.

Background: Acute kidney disease (AKD) is a known risk factor for increased mortality and evolution towards chronic kidney disease (CKD) in adults. The data regarding children are scarce. The purpose of our study is to explore the risk factor for AKD and impact of AKD following an acute kidney injury (AKI) episode in children on mortality and new-onset CKD. Methods: We retrospectively evaluated 736 children with ages between 2 and 18 years old with AKI admitted in a tertiary care hospital from the west Romania over a 9 years period. Results: AKD incidence following AKI was 17%. Patients that developed AKD were older, with higher baseline serum creatinine values, urea, C reactive protein and lower proteins, haemoglobin and sodium. They were more often exposed to sepsis, critical illness and nephrotoxic medications and presented certain susceptibilities like CKD, neoplasia, anemia, heart failure, arterial hypertension, stem cell transplant and female gender. AKI causes that increased the risk of AKD were intrinsic ones. AKD increased the overall mortality by three times. The factors that independently increased the risk of evolution towards CKD were AKD, acute tubular necrosis and higher baseline serum creatinine values. Conclusions: AKD is an independent risk factor for mortality and new-onset CKD in children.

An off-grid solar energy storage system (ESS) in National Pingtung University of Science and Technology (NPUST) was built and officially operated on Jun. 16th 2022. The system is installed in a 40' general container with PV panels of solar power 8250 W_p on top of the container. The ESS is made by repurposed lithium iron phosphate (LFP) batteries of 20 kWh capacity, where a battery management system (BMS) is adopted to ensured the safety of the battery system. An energy management system (EMS) is built to receive, process, analyse, store, and output the energy information. In this manuscript, a brief engineering report about the system is given.

Colorectal cancer is one of the most common causes of cancer mortality worldwide, and innovative drugs for the treatment of colorectal cancer are continually being revealed. 5-Fluorouracil (5-FU) is a common clinical chemotherapeutic drug. Acquired resistance to 5-FU is a clinical challenge in colorectal cancer. Parecoxib is a selective COX-2-specific inhibitor, which has been demonstrated to inhibit metastasis in colorectal cancers in our previous study. This study aimed to investigate the synergistic antimetastatic activities of parecoxib to 5-FU in human colorectal cancer cells and determine the underlying mechanism. parecoxib and 5-FU synergistically suppressed metastasis in colorectal cancer cells. Treatment with the parecoxib /5-FU combination induced an increase in E-cadherin and decrease in β-catenin. The parecoxib/5-FU combination could inhibit MMP-9 and MMP-2 expression and MMP-9 activity, and the NF-κB pathway might be suppressed as well. Mechanistic analysis denoted that the parecoxib/5-FU combination hindered the essential molecules of the PI3K/Akt route to obstruct metastatic colorectal cancer. Furthermore, the parecoxib/5-FU combination could inhibit reactive oxygen species. Our work showed the antimetastatic capacity of the parecoxib/5-FU combination for colorectal cancers via targeting the PI3K/Akt /NF-κB pathway.

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

The reconstruction of standard at-grade intersection into roundabout is very often motivated by the need to improve the safety of a part of the road network. To assure the effect of the reconstruction before-after analyses based on traffic accidents or some other indirect traffic safety parameter is needed. This paper presents a detailed analysis of four roundabouts reconstructed from the at-grade intersection according to the Croatian Guidelines for Roundabout Design. The analysis included a comparison of speeds at the location - a standard intersection- before and a roundabout – after reconstruction, time distribution of operational speed and applied design elements as well as their correlations. Experimentally gathered data on operational speed showed that the expected effect of speed reduction was not achieved in most of the analyzed cases. The conclusion is that given that the Croatian Guidelines set a very wide range for roundabout elements, the designer has a great influence on the selection and, consequently, on the effects of the roundabout implementation. The revision of the Guidelines is suggested.

With the increasing incidents of fatal road injuries, there is an urgent need for developing effective road safety management systems. The study aims to develop predictive models based on machine learning to forecast the likelihood of road collisions depending on factors like weather, road condition, time, and driver behaviour in Chicago, USA. A machine learning approach has been applied to the crash dataset to evaluate the factors affecting the prevalence of road accidents. Python programming and the Jupyter Notebook platform have been used for performing descriptive statistics, correlation and three classification algorithms (Random Forest, K-Nearest Neighbor (KNN), Decision Tree and MLP Classification). Obtained accuracy of the KNN classifier is slightly higher than the other two classification models. The research explored insights into collision patterns related to roads, locations, and intersections. The study helps to increase road safety through targeted interventions with resource prioritisation, reducing the frequency and severity of traffic incidents by leveraging historical accident data with diverse spatial analysis techniques.

Culex quinquefasciatus is an important target for vector control because of its ability to transmit pathogens that cause disease. Most populations are resistant to pyrethroids and often to organophosphates, the two most common classes of active ingredients used by public health agencies. A knockdown resistance (kdr) mutation, resulting in a change from a leucine to phenylalanine in the voltage gated sodium channel, is one mechanism contributing to the pyrethroid resistant phenotype. Enzymatic resistance has also been shown to play a very important role. Recent studies have shown strong resistance in populations even when kdr is relatively low which indicates factors other than kdr may be larger contributors to resistance. In this study, we examined on a statewide scale (over 70 populations), the strength of the correlation between resistance in the CDC bottle bioassay and the kdr genotypes and allele frequencies. Spearman correlation analysis showed only moderate (-0.51) and weak (-0.29) correlation between the kdr genotype and permethrin and deltamethrin respectively. The frequency of the kdr allele was an even weaker correlate. These results indicate, in contrast to Aedes aegypti, assessing kdr in populations of Culex quinquefasciatus is not a good surrogate for phenotypic resistance testing.

Congestion not only represents a cardinal sign of heart failure but is also now recognized as the primary cause for hospital admissions, rehospitalizations, and mortality among patients with acute heart failure. Congestion can manifest through various heart failure phenotypes in acute settings: volume overload, volume redistribution, or both. Recognizing the congestion phenotype is paramount, as it implies different therapeutic strategies for decongestion. Complete decongestion is hardly achieved among patients with acute heart failure, as more than half still have residual congestion at discharge. Residual congestion is one of the strongest predictors of future cardiovascular events and poor outcomes. Through this review, we try to provide a better understanding of the congestion phenomenon among patients with acute heart failure by highlighting insights into the pathophysiology mechanisms behind congestion and new diagnostic and management tools to achieve and maintain efficient decongestion.

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.

This paper addresses pastoral resilience by drawing out the coping strategies and mechanisms utilized by the Maasai Pastoralists through a food system approach, based on the study findings of an anthropological study of pastoralism in Laikipia County, Rift Valley, Kenya. This paper is guided by the specific objectives aimed at establishing actors and their roles, and describing the institutional settings and changes in pastoralism. Using a new institutionalism approach, the paper focuses not only on the actors and their roles in pastoralism but also on how internal and external forces regulate access and use of common pool resources (CPRs) resulting in sustainability of the food system. We argue that this has an impact on the practice of pastoralism that continually defines and redefine the actors’ roles as well as elicit the value of pastoral economies and benefits accrued to a wide range of actors hence reinforcing pastoral resilience. The study also identified institutional settings and changes that lead to pastoral survival resulting from the country’s devolved system of governance. Data collection was through in-depth interviews, key informant interviews, focus group discussions and unstructured observations in the pastoral regions. The findings reveal that actors at the household, state, non-state, and service providers have developed varied coping strategies and mechanisms that sustain pastoralism. The study also identified institutional settings and changes that promote pastoral resilience; notably, private land ownership patterns, co-management of livestock markets, commercialization of herding, decentralization of livestock services, holistic management of pasturelands and the use of water-shed management plans. As a result, increased scholarship and advocacy in regards to the concept of co-management of livestock markets, is recommended as a means of understanding pastoral resilience that the food system exhibits.

In Taiwan, mountainous areas account for approximately two-thirds of the total area. The steep terrain and concentrated rainfall during typhoons cause landslides, which pose a considerable threat to mountain settlements. Therefore, models for analyzing rainfall-induced landslide hazards are urgently required to ensure adequate land use in mountainous areas. In this study, focusing on Pingtung County in southern Taiwan, we developed a landslide hazard index (IRL) to land use. Using FORMOSA-2 and SPOT-5 satellite images, data were collected before and after four typhoons (one in 2009 and three in 2013). The ArcGIS random tree classifier was used for interpreting satellite images to explore surface changes and disasters, which were used to analyze slope disturbances. The product of the maximum 3-h rolling rainfall intensity and effective accumulated rainfall was used as a rainfall trigger index (IRT). Considering environmental and slope disturbance factors, an index of slope environmental strength potential (ISESP) was developed through logistic regression (LR). Landslide hazard to land use was estimated using IRT and ISESP. The average coefficient of agreement (Kappa) was approximately 0.71 (medium to high accuracy); the overall accuracy of slope environmental strength potential analysis was approximately 80.4%. At a constant ISESP, IRT increased with the increasing hazard potential of rainfall-induced landslides. Furthermore, IRT and ISESP were positively correlated with landslide occurrence. When large ISESP values occur (e.g., fragile environment and high land development intensity), small IRT values may induce landslides.

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

Nighttime lights (NTL) are a popular type of data for evaluating economic performance of regions and economic impacts of various shocks and interventions. Several validation studies use traditional statistics on economic activity like national or regional Gross Domestic Product (GDP) as a benchmark to evaluate the usefulness of NTL data. Many of these studies rely on dated and imprecise Defence Meteorological Satellite Program (DMSP) data and use aggregated units such as nation-states or the first sub-national level. Yet applied researchers who draw support from validation studies to justify their use of NTL data as a proxy for economic activity increasingly focus on smaller and lower level spatial units. This study uses a 2001-19 time-series of GDP for over 3100 US counties as a benchmark to examine the usefulness of the recently released version 2 VIIRS nighttime lights (V.2 VNL) products as proxies for local economic activity. Contrasts are made between cross-sectional predictions for GDP differences between areas and time-series predictions of GDP changes within areas. Disaggregated GDP data for various industries are used to examine what types of economic activity are best proxied by NTL data and comparisons are also made with the predictive performance of earlier NTL data products.

Background and objective: Research shows that 60–90% of school children have caries, representing a serious public health issue. Here, we present a model of oral health promotion that has been conducted in the Primorje-Gorski Kotar County (PGC), Croatia, from 2008 to 2019. We assessed the oral status of first and fifth grade elementary students and determined the sustainability and influence of our model on the status and behavior regarding the children’s oral status. Additionally, during the observed period, promotional and preventative activities aiming to improve oral health were conducted. Since 2014, the Program has begun to be continuously, comprehensively, and systematically introduced into preschools as well. Material and methods: We assessed the number of children with caries by analyzing the changes in the decayed, missing, and filled teeth for primary teeth (dmft)/decayed, missing, and filled teeth for permanent teeth (DMFT) index mean during the observed period. Results: From 2008 to 2019 we assessed 44422 children in the PGC (21714 first grade and 22708 fifth grade students). The average response rate throughout the Program has been 83%. We have noted a dmft/DMFT index decrease from 4,66 to 3,73 (first graders) and from 2,50 to 1,00 (fifth graders). Conclusions: The Program has improved the behavior and oral health of children; stakeholders from various professions have been included, such as health visitors, school medicine teams, and pediatricians, avoiding additional financial expenses, increasing the number of children in care, and proving the sustainability of our oral health improvement model.

In 2015 in Brazil, Zika virus showed features of geographic expansion and potentially increased virulence. In 2016, New York State issued emergency regulations after the World Health Organization declared Zika virus a Public Health Emergency of International Concern. In this study, mosquito surveillance was conducted in Westchester County, New York, to identify Zika virus and other arboviruses. Twenty trap sites were used for surveillance of Aedes albopictus mosquitoes, the Zika virus vector. The Westchester County Department of Health performed testing for Zika, West Nile, Eastern equine encephalitis, and other flaviviruses on 369 batches comprising 8,891 mosquitoes. Aedes albopictus mosquitoes were identified in Nassau, Rockland, Suffolk, Westchester, and New York City. Despite the increased capacity for specimen analysis, Zika virus was not detected. This study provides the first evidence of appropriate Zika virus surveillance. However, the results do not allow determination of the potential mechanism of local vector-to-human transmission of Zika virus among Aedes albopictus mosquitoes. This study adds to the evidence regarding the distribution, emergence, and trapping capabilities of potential Zika virus vectors.

Background and Objectives: Infections are the most common and potentially life-threatening complications of the treatment of children with acute lymphoblastic leukemia (ALL). The aim of this study was to determine epidemiological, clinical and microbiological characteristics of infections in pediatric patients with ALL. Materials and Methods:  Twenty-three children (16 male and 7 female, mean age 5.9 years [range 1.3 to 12.2 years]) with ALL, treated at the Division of Hematology, Oncology and Clinical Genetics, Department of Pediatrics, Clinical Hospital Center Rijeka, Croatia, from January 1, 2015 to December 31, 2020, were included in the study Results: One hundred and four infectious episodes (IEs) were reported (average 4.5 IE per patient). IEs were more frequent in the intensive phases of antileukemic treatment. Neutropenia was present in 48 IEs (46.2%) with a duration greater than 7 days in 28 IEs (58.3%). The respiratory tract was the most common infection site (48.1%). We documented 49 bacterial (47.1%), 4 viral (3.9%), 4 fungal (3.9%) and 10 mixed isolates (9.6%), while in 37 IEs (35.6%) pathogen was not isolated. The most common causes of bacteremia were coagulase-positive staphylococci. The most frequent empirical therapy was third- and fourth-generation cephalosporins, followed by piperacillin/tazobactam. Modification of the first-line antimicrobial therapy was performed in 56.9% of IEs. Granulocyte-colony stimulating factor was administered in 53.8% of IEs, and intravenous immunoglobulins in 62.5% of IEs. One patient required admission to the intensive care unit. No infection-related mortality was reported. Conclusions: ALL patients have frequent IEs. Close monitoring, identification of risk factors, rapid empirical use of antibiotics in febrile neutropenia, and timely modification of antimicrobial therapy play a key role in reducing infection-related morbidity and mortality in children with ALL.

A nation's vitality, dynamism and economic strength will always be related to its demographic component, and a healthy and vigorous population will ensure its long-term future. However, the current realities demonstrate the existence of an obvious population decrement at the level of the entire country particularly triggered by the birth rate decrease and the high demographic aging to which other factors add ap specific to local communities, which in their turn determined a particular type of demographic behaviour. Therefore we aim to analyze those elements with a major population dynamics impact such as family stability and demographic potential that can generate a specific demographic behaviour, as a result of the major changes that have occurred in the last period of time. These elements are translated through several demographic indicators that characterize the family, such as the nuptiality index and the divorce index whose evolution was registered and analyzed for the period 1992-2021. Their evolution indicates the demographic potential of Romania, as well as of Bihor county.

Background/Objectives: Patient positioning during surgery can influence intra- and postoperative complications. Therefore, we assessed the impact of the sitting and park-bench positions on anesthetic parameters and complications in neurosurgical patients. Methods & Patients: For this retrospective study, 314 adults who underwent neurosurgical procedures for posterior fossa pathologies were divided into two groups: sitting (n=231) and park bench (n=83). The following data were collected, monitored, recorded and compared: age, sex, tumor type, surgical approach, cardiovascular and respiratory complications, and postoperative surgical complications. The association of hypotension with position was further investigated through multivariate logistic regression models by adjusting for CO2 decrease, desaturation and documented gas embolism. Results: The average age was significantly lower in the sitting group (55 years, interquartile range (IQR)=43-63; female proportion=59.74%) than in the park-bench group (62 years, IQR=45-74; female proportion=57.83%) (p<0.001). Cerebellopontine angle tumors were detected in 37.23% of the patients who underwent operation in the sitting position and in 7.26% who underwent operation on in the park-bench position (p<0.001). Patients in the sitting position had significantly greater anesthetic complication (91.77% vs. 71.08%, p<0.001), hypotension (61.9% vs. 16.87%),and >2-mmHg CO2 decrease (35.06% vs. 15.66%, p<0.001) incidences. Hypoxemia and death occurred more frequently in the park-bench group (8.43% vs. 1.73% and 6.03% vs. 1.3%, respectively). Conclusions: Compared with the park-bench position, the sitting position was associated with a greater specific anesthetic complication incidence and lower postoperative mortality rate, indicating a need for careful risk‒benefit assessment when selecting each individual patient’s surgical position.

Seaweed farming has been growing in prominence in the coastal region of Kwale County, Kenya, as a livelihood led by women since the turn of the century, however the sector remains far below its full productive capacity. As such, this study explores the factors that influence women’s ability to access seaweed farming through engagements with the theories of intersectionality. The Blue Empowerment Project is seeking to upscale seaweed farming in this region to promote women’s empowerment and this study questions the extent to which men should be included in such an endeavour. It finds that several factors may intersect with gender to create varying levels of (dis)advantage amongst women in this region, and that we may need to reframe the conceptualisation of women’s empowerment to be inclusive of men. This study therefore makes a range of recommendations for the BEP, development practitioners in general, and researchers to inform them of how women’s empowerment initiatives may be made more inclusive and transformational.

Proper blood-brain barrier (BBB) function is essential to maintain homeostasis keeping the central nervous system healthy. Disruption of the BBB has been described in nearly all neurological disease and injury contexts. Given the various physical and metabolic roles of the BBB and gliovascular unit (GVU), dysfunction should be assessed across multiple levels to pinpoint the exact nature of the impairment. Here we describe imaging techniques for evaluating various aspects of BBB and GVU integrity and function, tailored for use in mouse models with protocols for quantitative image analysis. These imaging techniques complement classical dye tracer experiments and reveal underlying molecular causes of BBB dysfunction.

Preserving and passing on folk traditions and gastronomic culture to the next generations was an important task of the older age group in every historical era. The most important objective of this study is to reveal people's attitudes regarding to the values of gastronomy and culture in a West Hungarian county. The combined presence of the Szigetköz Nature Park and the World Heritage sites (Fertő-Hanság National Park, Pannonhalma Abbey) in the offer requires re-sponsible, environmentally, socially and economically sustainable tourism planning. In the framework of a quantitative research (questionnaire survey), the tourists’ knowledge of gas-tronomy values and also their knowledge regarding to the architectural, cultural and natural attractions will be analysed. Four hypotheses were formulated in the study. The data collec-tion took place between September 1. 2023 and October 30. 2023 (N=666). The sample is not representative, the respondents were selected arbitrarily and randomly. The most important novelty of the study is that in contrast to previous studies, in this study, tourists' visits to different destinations were measured, while previous studies focused on tourists' interests.

Tumid Lupus Erythematosus has been the subject of heated debate as to its correct nosographic classification. In particular, its definition has changed over time, depending on the different studies performed. In this review we address the initial definition of TLE, the changes that have taken place in the understanding and placement within the classification of Lupus Erythematosus (LE), and focus on clinical, histopathological, immunophenotypical and differential diagnosis aspects.

Background: This study investigates microvascular changes in the dermis and muscle following a balneotherapy regimen prescribed by therapeutic protocols. Methods: Thirty-five inpatients participated in a two-week balneal course involving the application of mud and hypersaline water. Mud was applied outdoors in the summer as cold mud ointment and indoors year-round as mud packs or mud baths alternated with hypersaline water baths. Biopsies of the skin and muscle were obtained twenty-four hours post-discharge and prepared histologically. Results: Analysis focused on the epidermis, dermis, and muscle. Microvascular changes observed included increased caliber and number of open capillaries, as well as the presence of angiogenesis vessels. Statistical analysis showed significant differences in angiogenesis vessels between cold mud ointment and mud pack treatments compared to control and mud bath groups. A higher number of angiogenesis vessels were observed in the dermis in the mud pack group and in the muscle with mud cold ointment. Repeated thermal stimulation with mud and hypersaline water over two weeks produced histologically evident tissue modifications, persisting in the dermis and muscle at least twenty-four hours post-treatment completion.

This study explores religious diversity in Romania and how the trends of indices of religious fractionalization and polarization manifest at the county level in the post-communist period. The county is selected as the relevant level for analysis due to its spatial confessional dynamics being more clearly visible. Recent studies have revealed that erosion of diversity represents an important aspect for any country and needs to be considered as an important aspect of democracy. This paper highlights that religious polarization and fractionalization in Romania has been generally maintained, although the regions of Transylvania, Banat, Dobrogea and Western Moldova remain areas where there are different confessions. Besides the general aspect of religion diversity depending the ethnic trends, there is a rise of Pentecostals and Baptists at the county level. This aspect can inform policymakers to create new institutions for dialogue between majority Orthodox communities and Protestants so that potential conflicts do not appear between the Orthodox and emerging religious communities, but also to ensure objective, cultural, religious coherence.

Hospitalizations for patients with diabetes and dementia take a significant health and economic toll on older adults in the United States. The present study sought to examine the differences in hospitalization characteristics and outcomes associated with diabetes and dementia separately and together using discharge record data of Los Angeles County residents aged 50+ from the California Department of Health Care Access and Information for the period 2019-2021. Results from multiple linear regression analyses indicated that when compared to those with no diabetes or dementia, patients with diabetes alone exhibited the highest total charges, while those with comorbid diabetes and dementia exhibited lower charges (p≤.05). Results of a multinomial logistic regression found that patients with comorbid diabetes and dementia had the highest odds of having a length of stay of 7+ days (AOR=1.49; 95% CI=1.44-1.53). A matched-case control analysis found that comorbid diabetes and dementia was associated with significantly lower odds of hypertensive disease than diabetes alone (MOR=0.81; 95% CI=0.67-0.97). These results highlight the complexity of factors affecting variation in hospitalization outcomes across these distinct disease profiles. Findings suggest a need to carefully consider this complexity when developing health policies or strategies to improve hospitalization outcomes involving these disease conditions.

Under physiological conditions the blood-brain barrier (BBB) is required for regulating the passage of substances between the bloodstream and the brain. To date, disruption of the BBB has been associated with nearly all neurological diseases. Dye and tracer experiments have been used to assess BBB integrity for decades, yet quantitative assessment of these experiments has only recently been implemented. Further, interpretation of these results requires the consideration of tracer-specific properties. Here, we describe a protocol for evaluating BBB leakage using the small molecule cadaverine in quantitative way. We also cover advantages/disadvantages of using some reagents and highlight limitations in data interpretations based on assays used to assess BBB permeability.

As the largest carbon pool on Earth, forest ecosystems are essential to maintaining carbon sink balance. However, accurately estimating the carbon sequestration and carbon storage of forest resources remains an urgent issue to address. Plot investigation, model estimation, and machine learning are examples of current approaches. Nevertheless, because of variables such as regional characteristics and plot size, large-scale and extensive region estimates are comparatively scarce. This study, which focuses on Tianzhu County, aims to comprehensively analyze and estimate the Net Primary Productivity (NPP), carbon storage, and carbon density of the forest ecosystem in this area by integrating data from forest resource inventory and the CASA model. The main conclusions are as follows: (1) The main vegetation types in Tianzhu County include coniferous forests, broad-leaved forests, mixed forests, and shrub forests; (2) Accordin g to the CASA model calculations, the annual cumulative NPP in Tianzhu County in 2020 ranges from a maximum of 249.63 gC/m² to a minimum of 3.40 gC/m², with the forest NPP amounting to 134,674.65 tons of carbon. Based on MODIS observation data, the forest’s NPP is 171,728.32 tons of carbon, with a maximum of 325.36 gC/m² and a minimum of 0.02 gC/m²; (3) At the pixel scale, the carbon storage of forests in Tianzhu County is 361,700 tons. Specifically, 46,500 tons of carbon are stored in coniferous forests, 1,100 tons in broad-leaved forests, 500 tons in mixed forests, and 313,600 tons in shrub forests.

Flash flood is one of the most significant natural disasters in China, particularly in mountainous area, causing heavy economic damage and casualties of life. Accurate risk assessment is critical to an efficient flash flood management. There are more than 530,000 small watersheds in 2058 counties in China where flash flood should be prevented. In practice, with limited fund and different risk levels, the priorities of each small watershed for flash flood prevention and control are also needed for an efficient flash flood management. This paper, take Licheng county in China as an example, aims to give out these priorities for management. First, sensitive indexes are identified among index system, which includes 9 indexes based on underlying surface characteristics of small watershed in hilly region. Second, the range of each index and the rank division of each index for evaluation are determined. Based on the rank divisions for evaluation, the flash flood risk grade eigenvalue (H) is calculated by Variable Fuzzy Method (VFM ) using 1000 samplings generated by Latin hypercube sampling method. Third, the key sensitivity factors that affect flash flood risk grade eigenvalue (H) are assessed by two different global sensitivity analysis methods -- stepwise regression analysis and mutual entropy. Both results indicate that watershed slope (S) is the most sensitive factor; the second is antecedent precipitation index (CN); while other factors are slightly different sensitive in sequence. This study shows that stepwise regression analysis and mutual information analysis are appropriate for the sensitivity analysis of mountain flash flood risk. Finally, based on watershed slope (S), the priorities of flash flood prevention and control of 119 small watersheds in Licheng county are given out.

The purpose of this article is to investigate and analyze the practices of scientific management within the County Departments of Sports and Youth (CDYS) in Romania. Conducted through a comprehensive research endeavor spanning from January to June 2022, the study utilized a standardized questionnaire as its primary instrument for data collection, distributed among CDYS directors. A notable finding from the study indicates that a significant proportion of respondents (44.9%) perceive notable disparities in the normative-functional elements governing the National Sports System in Romania compared to international standards. Moreover, the majority (51%) consistently adhere to regulatory acts, while a substantial portion (69.4%) underscore the importance of strict adherence to internal regulations in strategy formulation. Furthermore, an overwhelming majority (88.9%) acknowledge the substantial influence of available resources on strategy development, with collaboration with authorities primarily occurring through direct communication channels. Respondents prioritize multiple objectives (44.9%), affirm the necessity of various competencies (53.1%), and identify a lack of human and financial resources (59.2%) as the most significant obstacle. Notable achievements highlighted in the study include the improvement of the county's sports performance (53.1%). Respondents also believe that setting clear and realistic objectives (38.8%) is pivotal to enhancing CDYS management, while considerations in formulating strategies emphasize trends in the sports domain (42.9%) and the specific needs of the local sports community (42.9%). Overall, this research contributes to the understanding and promotion of more efficient practices in managing sports and youth departments within Romania's counties.

The nephrite belt in Altun Mountain-Western Kunlun Mountain region spanning approximately 1300 km in Xinjiang, NW China, constituting the world's largest preeminent nephrite deposit. The Qiemo region in the Altun Mountain is a crucial nephrite-producing area in China with demonstrating substantial prospects for future explorationl. While extant research has extensively study on secondary deposits in the Karakash River and native black nephrite deposits in Guangxi Dahua, a lacuna exists in the comprehensive investigation of black nephrite from original deposits in Xinjiang. Margou nephrite represents a recent discovery of black-toned nephrite deposits in Qiemo County, Xinjiang, warranting a comprehensive investigation into this primary source of black nephrite within the region. This scholarly inquiry deploys a suite of sophisticated analytical techniques, encompassing Polarizing microscope, electric microprobe, Backscattered Electron Image, X-ray Fluorescence, Inductively Coupled Plasma Mass Spectrometry. The rigorous experimental test is dedicated to elucidating the chemical and mineralogical composition, and further clarify the type of its genetic types of black-black cyan nephrite from Margou deposit in Qiemo, Xinjiang. Results delineate the mainly composed of tremolite-actinolite, characterized by Mg/(Mg + Fe2+) ratios ranging from 0.86 to 1.0. Minor minerals include diopside, epidote, pargasite, apatite, zircon, pyrite and iron hydroxide. Bulk-rock rare earth element patterns exhibit distinctive features such as negative Eu anomalies (δEu=0.00~0.17), decreasing light rare earth elements, a relatively flat distribution of heavy rare earth elements, and low with total REE concentrations (1.64~38.9 μg/g), concurrently, the Cr (6~21 μg/g) and Ni (2.5~4.5 μg/g) contents are conspicuously low. The magmatic influence of granite emerges as pivotal factor in the genesis of magnesia skarn hosting the Margou nephrite. The distinctive black-black cyan colour is attributed to heightened iron content, mainly associated with FeO (0.08~6.29%). The discerned chemical composition characteristics posit the Margou nephrite as an exemplar of the magnesia skarn-type nephrite deposit.

Background: Swept-source anterior segment optical coherence tomography (SS-AS- OCT) is a suitable examination for the vitreolenticular interface. Methods: In a prospective study using Anterion (Heidelberg Engineering, Heidelberg, Germany) 102 eyes of 102 patients were examined, in pupil dilation, preoperatively and 6 times over 1-year follow-up. Preoperatively anterior hyaloid membrane (AHM) visibility was determined with Imaging App with high reliability. Postoperatively capsular bag–AHM distance was measured on six points by using Metrics App. Results: The AHM was visible in 18.6% preoperatively and postoperatively as well (Group 1), 49% of the preoperatively adherent AHMs became visible (Group 2A), 32.4% remained attached (Group 2B). Group 1: the average deepest point first day was 782.5 ± 324.1 microns, and it significantly differed from the later follow-up values. Group 2A: the average deepest value was 184.1 ± 220.1 microns, and there was no statistically significant difference between the postoperative visit values. The difference between the groups was statistically significant at every location and at each time points. Conclusions: AS-SS-OCT can be used to check BS both preoperatively(with limitations) and postoperatively.

Abstract: NFinFET transistors with fin channel length 90nm and a planar MOSFET transistor with channel length 180nm and 90nm are presented with characteristic curves at various gate biases. A finalized algorithm with kink effects is effectively responsible for addressing the field effect transistors. The algorithm includes the modified conventional current-voltage formula and a nonlinear heat-associated kink solution which is simplified as a Gaussian form. Three parameters in modified model includes kN (related with channel width, channel length, and gate oxide capacitor, and proportional to the mobility of carriers)Vth(Threshold Voltage), and (the inverse of Early Voltage). Those parameters are determined to minimize the discrepancies between the measured data and the fitting values, but leave kinks located at around (VGS－Vth), which are deliberately eliminated by the Gaussian form because of the agitation of thermal kink effects. The whole fitting is made to be as close as the as-measured IDS-VDS. In the mean time, those determined parameters are physically meaningful after the analysis has been done.

The “Pay-as-you-throw” scheme, PAYT, is an economic instrument of waste management that implements the “polluter pays” principle by charging inhabitants of municipalities according to the amount of residual, organic and bulky waste they send for third-party waste management. When combined with well-developed infrastructure to collect the different waste fractions (residual waste, paper and cardboard, plastics, bio waste, green cuttings, many recyclables) as well as with a good level of citizen’s awareness, its performance has frequently been linked to high collection rates of recyclables. However, the establishment and operation of PAYT systems can require significant resource inputs from municipalities. In this paper, PAYT is analysed through a case study from the German County of Aschaffenburg, covering nearly 20 years of implementation across 173,000 inhabitants. Key performance indicators applied include temporal trends in the county’s recyclables collection rate, waste treatment fees for residents and municipal waste management costs, benchmarked against German municipalities not implementing PAYT.

Considering the worldwide impact of heart failure, it is crucial to develop approaches that can help us comprehend its root cause and make accurate predictions about its outcome. This is essential for lowering the suffering and death rates connected with this widespread illness. Cardiomyopathies frequently result from genetic factors, and the study of heart failure genetics is advancing quickly. Dilated cardiomyopathy (DCM) is the most prevalent kind of cardiomyopathy, encompassing both hereditary and nongenetic abnormalities. It is distinguished by the enlargement of the left ventricle or both ventricles, accompanied by reduced contractility. The discovery of the molecular origins and subsequent awareness of the molecular mechanism is broadening our knowledge of DCM development. Additionally, it emphasizes the complicated nature of DCM and the necessity to formulate several different strategies to address the diverse underlying factors contributing to this disease. Genetic variations that can be transmitted from one generation to another can be a significant contributor to causing family or isolated DCM. Genetic variation also plays a significant role in determining susceptibility for acquired triggers for DCM. The genetic causes of DCM can have a diverse range of phenotypic expressions. It is crucial to select the most probable patients to have advantages from genetic testing. The purpose of this research is to emphasize the significance of identifying genetic DCM, the crucial relationships between genotype and phenotype, and the usefulness of genetic testing in the therapeutic care of both those affected and their relatives. This approach is expected to gain importance once treatment is guided by genotype-specific advice and disease-modifying medications.

Over the past two decades, persistent occurrences of harmful algal blooms (HAB; Karenia brevis) have been reported in Charlotte County, southwestern Florida. We developed data-driven models that rely on spatiotemporal remote sensing and field data to identify factors controlling HAB propagation, provide a same-day distribution (nowcasting), and forecast their occurrences up to three days in advance. We constructed multivariate regression models using historical HAB occurrences (213 events reported from January 2010 to October 2017) compiled by the Florida Fish and Wildlife Conservation Commission and validated the models against a subset (20%) of the reported historical events. The models were designed to specifically capture the onset of the HABs instead of those that developed days earlier and continued thereafter. A prototype of an early warning system was developed through a threefold exercise. The first step involved the automatic downloading and processing of daily Moderate Resolution Imaging Spectroradiometer (MODIS) Aqua products using SeaDAS ocean color processing software to extract temporal and spatial variations of remote sensing-based variables over the study area. The second step involved the development of a multivariate regression model for same-day mapping of HABs and similar subsequent models for forecasting HAB occurrences one, two, and three days in advance. Eleven remote sensing variables and two non-remote sensing variables were used as inputs for the generated models. In the third and final step, model outputs (same-day and forecasted distribution of HABs) were posted automatically on a web-based GIS (http://www.esrs.wmich.edu/webmap/bloom/). Our findings include the following: (1) the variables most indicative of the timing of bloom propagation are bathymetry, euphotic depth, wind direction, SST, chlorophyll-a [OC3M] and distance from the river mouth, and (2) the model predictions were 90% successful for same-day mapping and 65%, 72% and 71% for the one-, two- and three-day advance predictions, respectively. The adopted methodologies are reliable, dependent on readily available remote sensing data sets, and cost-effective and thus could potentially be used to map and forecast algal bloom occurrences in data-scarce regions.

The utilization for water resource has been of great concern to human life. To assess the natural water system in Kangding County, the integrated methods of hydrochemcial analysis, multivariate statistics and geochemical modelling were conducted on surface water, groundwater and thermal water samples. Surface water and groundwater were dominated by Ca-HCO₃ type, while thermal water belonged to Ca-HCO₃ and Na-Cl type. The analyzing results concluded the driving factors that affect hydrochemical components. Following the results of the combined assessments, hydrochemcial process was controlled by the dissolution of carbonate and silicate minerals with slight influence from anthropogenic activity. The mixing model of groundwater and thermal water was calculated using silica-enthalpy method, yielding cold-water fraction of 0.56-0.79 and estimated reservoir temperature of 130-199 ^oC, respectively. δD and δ¹⁸O isotopes suggested surface water, groundwater and thermal springs were of meteoric origin. Thermal water should have deep circulation through the Xianshuihe fault zone, while groundwater flows through secondary fractures where it recharges with thermal water. Those analytical results were used to construct a hydrological conceptual model, providing a better understanding of the natural water system in Kangding County.

Understanding the vulnerability of areas and the likelihood of specific disasters, particularly earthquakes, is one of the most important issues in Iran. One of the major concerns in Iran is the resilience of rural communities. The present study is devoted to spatial analysis of risk in rural areas and the evaluation of preparedness in the rural districts of the city of Abhar. In particular, this study evaluates the resilience to earthquakes. The research was conducted in two parts in which the first part has used the VIKOR Multiple criteria decision making model as well as the employment of this model in the ArcGis. The second part of the study used field studies, in the form of questionnaires, to evaluate the readiness of the local population against the risks of earthquakes. Four indicators, individual, physical, economic abilities and access, were assessed. The population included rural districts, where statistical samples were villagers. Results of the spatial analysis indicated that 15 villages are in the high-risk areas, 24 villages were in the medium-risk areas and all other villages were in low-risk areas. In terms of readiness of the locals, the results indicated a lack of planning with regards to the four mentioned indicators.

Fermented foods have long been known to have immunomodulatory capabilities and fermentates derived from the lactic acid bacteria of dairy products can modulate the immune system. We have used skimmed milk powder to generate novel fermentates using Lb. helveticus strains SC234 and SC232 and we demonstrate here that these fermentates can enhance key immune mechanisms that are critical to the immune response to viruses. We show that our novel fermentates SC234 and SC232 can positively impact on cytokine and chemokine secretion, nitric oxide (NO) production, cell surface marker expression, and phagocytosis in macrophage models. We demonstrate that fermentates SC234 and SC232 increase the secretion of cytokines IL-1β, IL-6, TNF-α, IL-27, and IL-10, promote an M1 proinflammatory phenotype for viral immunity via NO induction, decreases chemokine expression of Monocyte Chemoattractant Protein (MCP), increasing cell surface marker expression, and enhance phagocytosis in comparison to their starting material. These data suggest that these novel fermentates have potential as novel functional food ingredients for the treatment, management and control of viral infection.

Introduction: Papatasi fever, or three-day fever, is a viral disease transmitted by a species of female sandfly called Phlebotomus papatasi that has symptoms similar to influenza. Robat Karim County, due to the high abundance of Sandfly and climate change in recent years, provides a suitable environment for the growth and reproduction of Sandfly, especially Phlebotomus papatasi Therefore, the aim of this study was molecular monitoring of Papatasi fever virus in Sandfly of Robat Karim County, Tehran province. Materials and methods: In 7 selected areas in Robat Karim County, 679 Sandfly using sampling methods including traps and aspirators were caught and 500 samples were randomly selected according to the fishing location and transferred to the laboratory of the Medical Entomology Department. After fixing Sandfly on the slide surface, identification and percentage of frequency of sandfly species were determined and then by Real-time PCR method, molecular examination of Papatasi virus infection was performed at Tehran Pasteur Institute. Findings: Out of 679 samples taken, 310 (45.65%) belonged to males and 369 (54.35%) belonged to females. 7 species including 3 species of Sandfly of the genus Phlebotomus and 4 species of the genus Sergentomyia were identified among the samples, the highest percentage of catch belonged to Phlebotomus sergenti (28.57%). Of the 500 samples sent to the laboratory for testing for phleboviruses by Real-time PCR, no positive cases of Papatasi virus infection were observed in them. Conclusion: Robat Karim is one of the endemic areas of infectious diseases such as leishmaniasis. Due to climate change in this region that conditions for the growth and reproduction of Sandfly, especially Phlebotomus papatasi as a Vector of sandfly fever and since the sandfly fever disease is not vaccinated therefore, preventive measures to control and reduce diseases transmitted by Sandfly are important.

Visceral leishmaniasis (VL) is a severe parasitic disease transmitted by phlebotomine sandflies. VL is endemic in West Pokot County, Kenya, where effective strategies to interrupt transmission are impeded by the limited understanding of VL risk factors. Therefore, this case-control study aimed to explore environmental, behavioral and household determinants of VL in West Pokot. From November 2022 to January 2023, a structured questionnaire was administered to 36 symptomatic primary VL cases attending the Kacheliba Sub-County Hospital and to 50 controls from local villages. The VL status of all participants was confirmed using an rK39 rapid diagnostic test. In an age-corrected univariate logistic regression analysis, significant associations were found between VL and housing characteristics, such as window presence and floor type. Furthermore, outdoor activities, including traveling outside the residence for more than 2 weeks, activities near termite mounds, and forest activities during the rainy season increased the risk of VL. VL cases more frequently reported the presence of cattle, dogs and sheep in their house yards at night. VL was also associated with cutting down trees in the house yard and house proximity to several Acacia tree species. To conclude, this work reports a number of previously undescribed risk factors for VL in the understudied West Pokot focus. Our findings warrant further research into sandfly ecology and potential zoonotic parasite reservoirs in West Pokot.

In June 2020, a door-to-door household survey was conducted in Mvolo County, an onchocerciasis endemic area in South Sudan. A total of 2,357 households containing 15,699 individuals agreed to participate in the study. Of these, 5,046 (32.1%, 95%CI: 31.4-32.9%) had skin itching and 445 (2.8%, 95% CI: 2.6-3.1%) were blind. An epilepsy screening questionnaire identified 813 (5.1%) persons suspected to have epilepsy. Of them, 804 (98.9%) were seen by a medical doctor and in 798 (98.1%) the diagnosis of epilepsy was confirmed. The overall epilepsy prevalence was 50.8/1000 (95% CI: 47.6-54.4/1000) and prevalence of nodding syndrome was 22.4/1000 (95% CI: 20.1-24.9/1000). Younger age, being male, skin itching, blindness and living in a village close to the Naam river were risk factors for epilepsy. The annual incidence of epilepsy was 82.8/100,000 (95% CI: 44.1-141.6/100,000). In conclusion, a high prevalence and incidence of epilepsy was observed in Mvolo, South Sudan. Strengthening the onchocerciasis elimination programme is urgently needed to prevent epilepsy in this region.

Revealing the multidimensional value of cultivated land resources, improving calculation methods, and exploring their spatial distribution characteristics and influencing factors are crucial for the enhancement of natural resource accounting system and the protection of cultivated land resources. This study take Guangxi, China as an example and construct a comprehensive multidimensional value evaluation system for cultivated land resources at the county scale. The income capitalization method, substitution market method, and value equivalent correction method were applied to calculate the economic, social, and ecological values of cultivated land resources in 111 counties. Furthermore, spatial autocorrelation analysis was employed to study their distribution characteristics and influencing factors. The results show that: (1) The total value of cultivated land resources in Guangxi reach 19,729.2 billion yuan, and the average cultivated land value is 5.3511 million yuan/hm2, of which the ratio of economic, social and ecological values is about 6:1:2; (2) The value of cultivated land has a certain distribution pattern in the global space, and the average economic and social value show the spatial distribution patterns of "low in the west and high in the east" and "low in the northwest and high in the southeast" respectively."(3) There is a significant spatial clustering effect of all values of cultivated land resources in local space, with "high-high" and "low-low" clustering. (4) Economic development level is significantly negatively correlated with the ecological value of cultivated land, while has a significant positive correlation with social value; (5) Natural conditions, economic development and agricultural development approaches are the key factors affecting the value of cultivated land resources.

Objectives: This study assessed the associations between parent intent to have their child receive COVID-19 vaccination, and demographic factors and various child activities including attendance at in-person education or childcare. Methods: Persons undergoing COVID-19 testing residing in Minnesota and Los Angeles County, California with children aged <12 years completed anonymous internet-based surveys between May 10 and September 6, 2021 to assess factors associated with intention to vaccinate their child. Factors influencing parents’ decision to have their child attend in person school or childcare were examined. Estimated adjusted odds rations (AORs, 95% CI) were computed between parents’ intentions regarding children’s COVID-19 vaccination and participation in school and extra-curricular activities using multinomial logistic regression. Results: Compared to parents intending to vaccinate their children (n=4,686 [77.2%]), those undecided (n=874 [14.4%] or without intention to vaccinate (n=508 [8.4%]) tended to be younger, non-White, less educated and themselves not vaccinated against COVID-19. Their children more commonly participated in sports (aOR:1.51 1.17-1.95) and in-person faith or community activities (aOR:4.71 (3.62-6.11). They further indicated that additional information regarding vaccine safety and effectiveness would influence their decision. COVID-19 mitigation measures were the most common factors influencing parents’ decision to have their child attend in-person class or childcare. Conclusions: Several demographic and socioeconomic factors are associated with parents’ decision whether to vaccinate their <12-year-old children for COVID-19. Child participation in in-person activities was associated with parents’ intentions not to vaccinate. Tailored communications may be useful to inform parents’ decisions regarding safety and effectiveness of vaccination.

International data suggests that exposure for nature is beneficial for mental health and well-being. The restrictions related to Covid-19 pandemic have created a setting that allows us to investigate the importance of greenness exposure on mental health during a period of increased isolation and worry. Based on 2060 responses from an online survey in the Stockholm County, Sweden, we investigated: 1) weather the Covid-19 pandemic changed peoples’ life-style and nature-related habits, and 2) if peoples’ mental health differed depending on their exposure to greenness. Neighbourhood greenness levels were quantified by using the average Normalized Difference Vegetation Index (NDVI) within 50m, 100m, 300m, and 500m buffers surrounding the participant’s place of residence. We found that the number of individuals that reported that they visited natural areas “often” was significantly higher during the pandemic than before the pandemic. Higher levels of greenness surrounding one’s location of residence were in general associated with higher mental health/wellbeing and vitality scores, and less symptoms of depression, anxiety, and perceived and cognitive stress, after adjustments for demographic variables and walkability. In conclusion, the results from the present study provided support to the suggestion that contact with nature may be important for mental health in extreme circumstances.

Experiences of homelessness, although widely varied, are characterized by extensive time in public spaces, often outdoors. However, there has been little empirical research about the ways in which environmental factors affect individuals experiencing homelessness (IEHs). Therefore, the purpose of this study was to use an environmental justice approach to understand how cardiopulmonary health of IEHs is affected by episodic poor air quality in Salt Lake County. It was hypothesized that people who had experienced unsheltered homelessness and those who had been experiencing homelessness for longer periods of time would report greater health difficulties from poor air quality exposure. Through a combination of in-person semi-structured interviews with IEHs (n = 138) and access to corresponding state-based service provider databases, researchers examined both overall descriptives of and relationships between types (sheltered and unsheltered) and duration (chronic and non-chronic) of homelessness. More than 61% of IEHs reported physical reactions to air pollution, 37% reported air pollution-related emotional stress, and more than 89% had sought medical attention for a condition related to air pollution. Findings indicate that while IEHs report a number of health effects related to poor air quality, there were no significant differences between individuals based on either sheltered status or duration of their experiences of homelessness. This study provides an initial empirical inquiry to understand how environmental disamenities negatively influence IEHs, as well as noting that sheltered status and duration of homelessness are less impactful than originally hypothesized.

Chronic kidney disease patients treated by hemodialysis present a high cardio-vascular morbidity and mortality. There is an imperative need for novel biomarkers in identifying and to offer possible therapeutically intervention in these patients. We performed a prospective observational cohort study on 77 patients in the period October 2021 – October 2023. We measured serum plasma levels of Interleukin 1-Beta, Galectin 3, human suppression of tumorigenicity factor 2, bone morphogenetic protein 2 and fibroblastic growth factor 23 at the inclusion. We evaluated the correlations of these biomarkers with cardiac function and structure evaluated by echocardiography. Mean age was 61.02 (±11.81) years, 45 (56.2%) males and with a dialysis vintage of 4.95 (2.4-7.8) years. Median ejection fraction was 51 (43-54 %) and more than two thirds of the patients presented valvular calcifications. Overall mortality was 22%. Interleukin 1-Beta correlated positively with ejection fraction and global longitudinal strain and negatively with left atrium diameter and left ventricle tele systolic diameter. Galectin 3 values negatively correlated with aortic valve fibrosis and mitral valve calcifications and human suppression tumorigenity factor 2 negatively correlated with mitral valve calcifications. Some of these novel biomarkers could be used to better asses the cardio-vascular disease in patients on maintenance hemodialysis.

With around one billion of the world's population affected, the era of Metabolic-associated fatty liver disease (MAFLD) pandemic has entered the global stage. MAFLD is a chronic progressive liver disease with accompanying metabolic disorders such as type 2 diabetes mellitus and obesity which can progress asymptomatically to liver cirrhosis and subsequently to hepatocellular carcinoma (HCC), and for which, to date there is almost no approved pharmacologic options. Because MAFLD has a very complex etiology and it affects also extrahepatic organs, a multidisciplinary approach is required when it comes to finding an effective and safe active substance for MAFLD treatment. The optimal drug for MAFLD should diminish steatosis, fibrosis and inflammation in the liver, and the winner for MAFLD drug authorisation seems to be the one that significantly improves liver histology. Saroglitazar (Lipaglyn®) was approved for Metabolic dysfunction associated steatohepatitis (MASH) in India in 2020; however, the drug is still being investigated in other countries. Despite that a pharmaceutical industry is still lagging behind to develop an ap-proved pharmacologic therapy for MAFLD, research has been recently intensified and many molecules which are underway in the final stages of clinical trials are expected to be approved in the coming few years. Already this year, the first drug (Rezdiffra™) in the United States was ap-proved via accelerated procedure for treatment of MAFLD, i.e. of MASH in adults. This review underscores the most recent information related to the development of drugs for MAFLD treatment, focusing on the molecules that have come furthest towards approval.

The building sector accounts for nearly 40% of total primary energy consumption in the U.S. and E.U. and 20% of worldwide delivered energy consumption. Climate projections predict an increase of average annual temperatures between 1.1-5.4°C by 2100. As urbanization is expected to continue increasing at a rapid pace, the energy consumption of buildings is likely to play a pivotal role in the overall energy budget. In this study we used EnergyPlus building energy models to estimate the future energy demands of commercial buildings in Salt Lake County, Utah, USA, using locally-derived climate projections. We found significant variability in the energy demand profiles when simulating the study buildings under different climate scenarios, based on the energy standard the building was designed to meet, with reductions ranging from 10% to 60% in natural gas consumption for heating and increases ranging from 10% to 30% in electricity consumption for cooling. A case study, using projected 2040 building stock, showed a weighted average decrease in heating energy of 25% and an increase of 15% in cooling energy. We also found that building standards between ASHRAE 90.1-2004 and 90.1-2016 play a comparatively smaller role than variation in climate scenarios on the energy demand variability within building types. Our findings underscore the large range of potential future building energy consumption which depend on climatic conditions, as well as building types and standards.

The Roma population constitutes the largest ethnic minority in Europe, however, data regarding the prevalence of non- communicable diseases are still scarce in the medical literature. The aim of this study was to assess the clinical and metabolic particularities of a Roma population with diabetes, in comparison with a group of Romanian Caucasians. We conducted an observational, transversal study and evaluated 808 adult patients with diabetes mellitus, from a tertiary hospital providing diabetes care, aged between 18 and 89 years old, of whom the majority were men (52.84%). Most of them had type 2 diabetes mellitus (T2DM), reaching 95.1% the Caucasian group and 87.8% among the Roma patients. 81.1% of the Caucasian patients had hypertension, approximately 15% higher than the Roma group, while more than half of the patients in both groups had obesity. There were no differences concerning myocardial infarction, however, the number of patients with history of stroke was 2.1 times higher in the Roma group compared to Caucasians. Chronic kidney disease was present in 22.1% of the Roma patients, 33.25% had retinopathy, and 72.7% presented polyneuropathy. The prevalence of cardiovascular risk factors, cardiovascular disease and microvascular complications among the study Roma population are quite significant, underscoring the importance of ethnic disparities in approaching healthcare management strategies.

The formation of sinkholes in Winkler County, Texas is concerning due to the amount of oil and gas infrastructure and the potential for catastrophic losses. Evidences of new and potential sinkholes have been documented, and determining the cause of these sinkholes is paramount to mitigate the devastating consequences thereof. Studies shown that the Wink sinkholes result from both natural and anthropogenic influences. Data depicting land-cover changes, alterations in the hydrologic systems, climate changes, and oil and gas activity were analyzed in an effort to better understand the link between these processes and sinkhole formation. Results indicate that the combination of these processes lead to the current state; Land cover changes were highest in shrub versus grasses, undeveloped to developed and croplands. Rises in temperature and a decrease in precipitation indicate a shift towards a more arid climate. Changes to the hydraulic system are a direct result of these land cover changes while the groundwater quality depict an environment prone to dissolution. Historical oil and gas activities have created pathways of meteoric water infiltration to the underlying limestone and evaporite formation. The combination of these processes create an environment that accelerates sinkhole formations. Understanding these processes allows for the development and implementation of better land practices, better groundwater protections, and the need for monitoring and maintaining aging oil and gas infrastructure.

The study sought to determine solar irradiation in Homa Bay County which can be tapped and utilized in improving lives of residents of the region by converting the solar thermal energy in Home Bay to other forms of energy such as electric form, mechanical form and light. The study was done by assessing the local atmospheric conditions which included sunshine duration data and air temperature records for the period of two years and the data obtained subjected to statistical analysis to determine the localized characteristics of the resource. The characteristics that were examined include; seasonal and annual power expectations as well as resource reliability. The solar irradiance of Home County was found to be 768.0 W/m².

Landslide is a sliding movement of rock mass, debris and soil along the slope under the action of gravity. Small Baseline Subset (SBAS) is an established method for the investigation and monitoring of landslide moments. This study focuses on monitoring the long-temporal displacement of mountainous terrain in Danba County, Sichuan Province via SBAS technique, based on 31 scenes of L-band ALOS/PALSAR data from Feb. 2007 to Oct. 2010.The results show that the largest velocity rates in LOS direction are ±120 mm/yr and maximum accumulated displacement is up to -300, which indicates fast movement of the mountainous terrain during the observation time. These results get good consistency against the results of previous study. This demonstrates the strong potential of SBAS technique for monitoring the landslides geohazard.

Climate variability and change has been found to be one of the factors that affect economies leading to food insecurity in various parts of the world. Kenya is no exception. This study looks at how climate variability has contributed to food insecurity in Kisii County, Kenya. The objectives of this study is therefore to, (i) to examine the rainfall and temperature trends in Kisii County for a period of approximately 30 years, (ii) to examine the effect of climate variability on food production and (iii) to assess the perception of local farmers on weather and climate information, (iv) to evaluate the coping strategies adopted at to bridge the gap on food deficit at different household level and (v) to assess the nutritional status of children and the elderly. The study was conducted in two sub-counties of Kisii County; Marani and Bomachoge Chache. The data used was mainly rainfall and temperature data from meteorological stations and sample data gathered from selected groups. The study population comprised of children between 6 months and 59 months, household heads, elderly people and agricultural officers. Purposive sampling was used to select agricultural officers while multistage sampling was used to select respondents at household level. Data was collected by use of a pre-tested questionnaire. The MUAC tape was used to collect nutritional status of children while BMI data was obtained from elderly people. Mann Kendall statistic was used to determine whether the trend of rainfall and temperature observed is significant while Chi-square test was used to determine whether the coping strategies observed varied significantly at household level. From the analysis, rainfall has not shown any significant change in Kisii County while temperature trend has been significantly increasing over the years at 95% confidence level. This could explain the observed reduction in river levels. Analysis of crop production and price trends of major food crops in Kisii County showed a decreasing trend of food production leading to increase in price over the years. This meant that farmers could not produce enough to take them to the next harvesting season making farmers to adopt different coping strategies at household level which differed significantly according to Chi-Square test. Malnutrition status of both elderly people above 59 years and children between 6-59 months were similar with 23% of both children/elderly being severely malnourished/malnourished. This study has only looked at climatic factors such as rainfall and temperature. Other aspects such as depth of underground water, ph level of soil and the effects of land fragmentation also need to be looked at. This study is important to both farmers in choosing the right crop to plant, and policy makers and planners in formulating the best mitigation and intervention strategies for Kisii County food insecurity problem. This will further contribute to national efforts towards achievement of vision 2030.

Any malocclusion can be associated with various face development patterns, including hyper, neutral and hypodivergent growth patterns. We measured face height ratios, angle formed by Y axis to SN and growth patterns in various malocclusions in a group of patients from Timis county. The pretreatment digital cephalograms of 350 participants were split into three groups based on Angle's classification of dentoalveolar malocclusion. Every cephalogram was digitally traced and analyzed using a composite cephalometric method analysis utilizing the WebCeph imaging cephalometric program, which included two linear and one angular. In general, patients from Timis county have a hypodivergent development pattern. Hypodivergent development pattern predominated in group I, II, and III. Group I hyperdivergent 5.14%, normodivergent 16.01%, hypodivergent 78.85%. Group II hyperdivergent 2.78%, normodivergent 14.44%, hypodivergent 82.78%. Group III hyperdivergent 10.53%, normodivergent 10.53%, hypodivergent 78.94%. In all three groups, the value of the angle formed by Y axis to SN is within normal limits group I 65.4 ±4.34°, group II 63.87± 3.86° and group III 64.66 ±5.28°. A strong negative correlation was found between angle: Y axis to SN and facial height ratio (r= -0,766; p &lt;0.001). In all kinds of malocclusion, patients from Timis county show primarily a hypodivergent development pattern.

Orthohantaviruses can cause two types of human infections: hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). HFRS is a zoonotic disease transmitted by multiple rodent species. Yunnan Province in southwest China is the natural foci of HFRS, and Dali Prefecture in Yunnan Province has the highest incidence of HFRS; however, the precise status of orthohantavirus infection in Dali Prefecture remains unknown. To this end, we obtained clinical data of HFRS patients from the medical records of the People's Hospital of Xiangyun County in Dali Prefecture from July 2019 to August 2021. We collected epidemiological data of HFRS patients through interviews and investigated host animals using the night clip or night cage method. We systematically performed epidemiological analyses of patients and host animals. The differences in the presence of rodent activity at home (2=8.75, P=0.031&lt;0.05), of rodent-proof equipment in the food (2=9.19, P=0.025&lt;0.05), and of rodents or rodent excrement in the workplace (2=10.35, P=0.014&lt;0.05) were statistically different in the four clinical types, including mild, medium, severe, and critical HFRS-associated diseases. Furthermore, we conducted molecular detection of orthohantavirus in host animals. The total orthohantavirus infection rate of rodents was 2.7% (9/331); the specific infection rate of specific animal species was 6.1% (5/82) for the Apodemus chevrieri, 100% (1/1) for the Rattus nitidus, 3.8% (2/53) for the Rattus norvegicus, and 12.5% (1/8) for the Crocidura dracula. In this study, a total of 21 strains of orthohantavirus were detected in patients and rodents. The 12 orthohantavirus strains from patients showed a closer relationship with Seoul orthohantavirus (SEOOV) L0199, DLR2, and GZRn60 strains; the six orthohantavirus strains from Rattus norvegicus and Apodemus chevrieri were closely related to SEOOV GZRn60 strain; One strains (XYRn163) from Rattus norvegicus and one strain (XYR.nitidus97) from Rattus nitidus were closely related to SEOOV DLR2 strain; the orthohantavirus strain from Crocidura dracula was closely related to the Luxi orthohantavirus (LUXV) LX309 strain. In conclusion, patients with HFRS in Xuangyun County of Dali Prefecture are predominantly affected by SEOOV, with multiple genotypes of orthohantavirus in host animals, and most importantly, these orthohantavirus strains constantly demonstrated zoonotic risk in humans.

In this paper, based on our previous expertise on ceramic artifacts, several archaeometric methods applied to some samples collected from the Dudești archaeological site (Oltenia region, Romania) are reported for the first time in the literature. The chemical composition and microstructural and morphological characterization of these samples offer important conclusions about the processing conditions. Some specific techniques such as X-ray diffraction (XRD), wave-length-dispersive X-ray fluorescence (WDXRF), Optical microscopy (OM), stereomicroscopy, scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy and Raman spectroscopy, provide composition information about pigments and their decay processes. Additionally, the Brunauer-Emmett-Teller (BET) method helps to estimate pore sizes and specific surface areas. Thermal analysis (TGA) was used to establish details regarding the production technology and the raw materials source used to make the ceramics, too. The obtained results indicated that the ceramics are based on a paste of muscovite, feldspar, with high plasticity, quartz, melanterite, and calcite, the latter in very low concentrations. According to the obtained results, we could assume that non-calcareous clays are present in the investigated samples because calcium exists in low concentrations. Gypsum is present, too, in very low concentration, identified by the presence of sulfate group in WDXRF. In the same context, iron oxides significantly impact the firing atmosphere of iron-rich clay, resulting in blackening under reducing conditions and reddish coloration under oxidative conditions. Using hematite and gypsum as pigments further contributes to the color variations in the pottery. The consistent firing temperature range of 200-600 °C in Dudești pottery implies a standardized production process, the variation in color being dependent on the specific reducing/oxidative regime conditions. This relationship between clay composition and local sources suggests a connection to Neolithic pottery production in the region and their color depending on the reducing/oxidative regime conditions.

Soil quality is related to food security and human survival and development. In recent years, due to the acceleration of urbanization and the increase of abandoned land, land degradation occurs, poor topsoil quality. In this study, the minimum data set (MDS) was constructed through principal component analysis (PCA) to determine the indicator data set for evaluating topsoil quality in Tieling County, China. In addition, the soil quality index (SQI) was calculated to analyze the spatial distribution characteristics and influencing reasons of topsoil quality in Tieling County. The re-sults showed that MDS included total potassium (TK), Clay, zinc (Zn), soil organic matter (SOM), soil water content (SWC), cation exchange capacity (CEC), pH, and copper (Cu). The MDS indicators can well replace all indicators to evaluate the topsoil quality in the study area. The overall soil quality of Tieling County showed a trend of low in the east and high in the west, and gradually increased from the hilly area to the plain area. The evaluation results are consistent with field research, which can provide reference for other topsoil quality evaluation, and it also provide a basis for the formulation of soil quality improvement measures.

Aflatoxin contaminated maize is of public health concern in Kenya. Training farmers on good agricultural practice (GAP) has been touted as a mitigative measure. Little is known of the effect of such training on aflatoxin levels in maize grown in Kenya. This study evaluated what effect training farmers on GAP has on aflatoxin levels in maize grown in in maize grown in Kaptumo, Kilibwoni, and Kipkaren divisions in Nandi County. Ninety farmers were recruited for the study and interviewed on GAP. Maize samples were additionally collected from the participating farmers and analyzed for aflatoxins using competitive enzyme-linked immunosorbent assay (c-ELISA). All farmers prepared the land before planting, did correct spacing between the planted crops, carried out weeding, cleaned their stores before use, checked the condition of the maize after harvesting, sorted maize after shelling, and knew aflatoxins. A majority of the farmers (90%) used fertilizers, dried maize after harvesting, knew that aflatoxins were harmful to humans, and used clean transport in transporting the harvested maize. About 98% of farmers did stooking after harvesting and 97% used wooden pallets in the maize stores. The percentage of farmers who practiced early planting, top dressing, crop rotation, raising stores above the ground, applying insecticide after shelling and feeding damaged/rotten seeds to their animals was 84–96%, 62–80%, 67–85%, 86–98%, 63–81%, and 7–21% respectively. About 18/90 (20%) of all farmers reported that they had a relative who had died from liver cancer and the mean aflatoxin levels in season 1 were significantly different from season 2 (1.92 ± 1.07 ppb; 1.30 ± 1.50 ppb). Our findings suggest that although training farmers to adopt good agricultural practices was observed to be efficient in mitigating the problem of aflatoxins, the receptiveness of farmers to different aspects of the training may have differed. Therefore, in designing an optimized regional aflatoxin contamination strategy, local applicability should be considered.

The implications of urban revitalization, gentrification, and residential migration have attracted widespread interest and ongoing debate among scholars across a range of disciplines. While a significant body of literature explores race and class interactions within urban gentrifying neighborhoods, few have examined the environments that await those displaced by this process. This study explores the social and political impact of urban gentrification and class stratification within the black community by examining responses of black middle class residents in Prince George’s County, MD to the growing in-migration of low-income and minority residents from Washington, DC. Drawing on data from the U.S. Census Bureau, a multi-neighborhood sample of ninety-five black middle class residents of Prince George’s County, and informal interviews with subject-area experts, this study explores how race and class shape residential decisions and their impact on residential mobility initiatives. Residents responded to a 26-item survey that covered demographic information, political and community engagement, and their attitudes and beliefs about the poor, changes in their community, and racial unity and responsibility. Findings from cross tabulations and binary logistic regression indicate that lower middle class residents are the most likely to resist in-migration by exiting their communities and/or voting against proposals to create affordable housing options. Core and upper middle class residents were the most likely to stay in their neighborhoods despite increases in low-income migration, to vote in support of policies to create affordable housing options and to believe their responsibility to poor blacks could include sharing residential space.

Drainage systems are usually dimensioned for design storms based on intensity-duration-frequency (IDF) curves of extreme precipitation. For each location, different IDF curves are established based on local hydrological conditions. Recent research shows that these curves also vary with time, and should be updated with recent data. The purpose of this study is to evaluate IDF curves obtained from precipitation simulations from the Eta RCM, comparing them with IDF curves obtained from data of a rainfall station. Climate models can be a useful tool for assessing the impacts of climate changes on drainage systems, referring precipitation forecasts. In this study, the Eta RCM was forced by two global climate models: HadGEM2-ES and MIROC5. The bias of the precipitation data, generated by RCM models, was corrected using a Gamma distribution. The Juqueriquerê River Basin, in the cities of Caraguatatuba and São Sebastião, São Paulo State, Brazil, was chosen as a case study. The results show a good correlation between the IDF curves of simulated and observed rainfall for the control period (1960-2005), indicating the strong possibility of using the Eta RCM precipitation forecasts for 2007 - 2099 to establish future IDFs thereby, taking into account climate changes in urban drainage design.

This review aims to explore the intricate relationship between epigenetic mechanisms, stress, and affective disorders, focusing on how early life experiences and coping mechanisms contribute to susceptibility to mood disorders. Epigenetic factors play a crucial role in regulating gene expression without altering the DNA (deoxyribonucleic acid) sequence, and recent research has revealed associations between epigenetic changes and maladaptive responses to stress or psychiatric disorders. A scoping review of 33 studies employing the PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta-Analyses – Statement) guidelines investigates the role of stress-induced epigenetic mechanisms and coping strategies in affective disorders' occurrence, development, and progression. The analysis encompasses various stress factors, including childhood trauma, work-related stress, and dietary deficiencies, alongside epigenetic changes such as DNA methylation and altered gene expression. Findings indicate that specific stress-related genes frequently exhibit epigenetic changes associated with affective disorders. Moreover, the review examines coping mechanisms in patients with bipolar disorder and major depressive disorder, revealing mixed associations between coping strategies and symptom severity. While active coping is correlated with better outcomes, emotion-focused coping may exacerbate depressive or manic episodes. Overall, this review underscores the complex interplay between genetic predisposition, environmental stressors, coping mechanisms, and affective disorders. Understanding these interactions is essential for developing targeted interventions and personalized treatment strategies for individuals with mood disorders. However, further research is needed to elucidate specific genomic loci involved in affective disorders and the clinical implications of coping strategies in therapeutic settings.

Fermented foods and ingredients, including fermentates derived from lactic acid bacteria (LAB) in dairy products, can modulate the immune system. Here we describe the use of reconstituted skimmed milk powder to generate novel fermentates from Lactobacillus helveticus strains SC232, SC234, SC212, and SC210, and from Lacticaseibacillus casei strains SC209 and SC229, and demonstrate using in vitro assays that these fermentates can differentially modulate cytokine secretion by bone marrow derived dendritic cells (BMDCs) when activated with either the viral ligand, loxoribine, or an inflammatory stimulus, lipopolysaccharide. Specifically, we demonstrate that SC232 and SC234 increase cytokines IL-6, TNF-α, IL-12p40, IL-23, IL-27 and IL-10, and decreased IL-1β in primary bone marrow derived dendritic cell (BMDCs) stimulated with a viral ligand. In contrast exposure of these cells to SC212 and SC210 resulted in increased IL-10, IL-1β, IL-23, and decreased IL-12p40 following activation of the cells with the inflammatory stimulus LPS. Interestingly SC209 and SC229 had little or no effect on cytokine secretion by BMDCs. Overall, our data demonstrates that these novel fermentates have specific effects and can differentially enhance key immune mechanisms that are critical to viral immune responses, or can suppress responses involved in chronic inflammatory conditions, such as Ulcerative Colitis (UC), and Crohn’s disease (CD).

Background: The enduring psychological effects of the COVID-19 pandemic continue to affect individuals long after the immediate health concerns have subsided. This research aims to identify specific groups within the Romanian population who are at a higher risk of experiencing mental health challenges that can interfere with everyday life and may lead to more serious mental health disorders. Methods: Conducted as a cross-sectional survey, this study evaluated the prevalence and intensity of psychological distress using the DASS-21 questionnaire. An online survey distributed via Google Forms also gathered socio-demographic data and COVID-19-specific information. Statistical analyses included the Shapiro-Wilk test, Fisher's exact test, and Z-tests with Bonferroni correction. Quantitative independent variables that lacked a normal distribution were compared between groups using either the Mann-Whitney U test or the Kruskal-Wallis H test. Results: Analysis of 521 questionnaires, filled out by a predominantly middle-aged cohort of 320 women and 201 men, revealed that 63.72% of participants worked outside the healthcare field. Those unemployed or retired reported significantly higher anxiety levels than individuals in other sectors. Moreover, living alone, experiencing the loss of close relatives (6.14%) or friends (33.59%), and undergoing hospitalization or reinfection due to COVID-19 were linked to significantly elevated distress scores. Conclusion. By identifying the segments of the population most vulnerable to psychological distress, as evidenced by higher scores among the unemployed, retirees, individuals living alone, and those directly affected by COVID-19 through personal health or loss, targeted initiatives for psychological screening and therapy can be established. Such measures are essential for enhancing the post-pandemic mental well-being of Romanians, addressing the specific needs uncovered in this study.

Background and Objectives: Since the beginning of COVID-19 pandemic, the infection primarily affected patients with following chronic conditions: cardiovascular disease, hypertension, chronic obstructive pulmonary disease, diabetes mellitus, obesity and cancer. The aim of this study was to explore clinical and epidemiological characteristics associated with COVID-19 outcomes in patients at the primary health care centre from March 2020 to September 2022. Materials and Methods: The study included 40,692 citizens of Banja Luka County, Bosnia and Herzegovina, who were confirmed and registered as RT-PCR positive on COVID-19. Differences regarding the distributions of patients between groups were analysed using Pearson chi square test and Mantel-Haenszel chi square test for trends, while differences in mean values were compared using independent samples t test. Relationship between mortality and independent variables were examined using logistic regression. Results: Out of 40,692 COVID-19 positive patients, 7.76% were hospitalized. The average age of hospitalized patients was significantly higher than the age of non-hospitalized patients (64.2±16.1 vs. 45.4±18.7; p&lt;0.001). The average age of patients with lethal outcome was nearly twice higher compared to patients with non-lethal outcome (74.6±11.5 vs. 45.7±18.6; p&lt;0.001). Male patients had higher hospitalization and mortality rate, compared to females (9.8% vs. 5.9%, p&lt;0.001; 4.8% vs. 3%, p&lt;0.001, respectively). The highest hospitalization rate was in patients with chronic renal failure, diabetes and cardiovascular diseases, while the death rate was the highest among patients with CRF and hearth comorbidities. Fever, cough, fatigue, nausea and vomiting, chest pain, shortness of breath and appetite loss favoured hospitalization. Patients with fatigue and appetite loss had higher percentage of lethal outcome. Vaccinated patients had significantly lower rate of lethal outcome. Conclusions: Clinical symptoms, signs and outcomes, are posing as predictive parameters for further management of COVID-19. Vaccination has an important role in clinical outcomes of COVID-19.

China’s rural e-commerce has been developing rapidly. Taobao Villages are combination of e-commerce and rural industries. When rural e-commerce coverage evolves from Taobao village to Taobao town, the scale of industrial clusters has been expanding synchronously. This paper investigates flower and seedling industrial cluster in Xinhe Town, Yanji Town and Miaotou Town of Shuyang County, China, and conducts the econometric analysis of the expansive determinants of flower and seedling industrial cluster of Taobao Villages. An effective sample of 263 was obtained through a face-to-face survey of e-merchants of flower and seedling in the Shuyang County of Jiangsu Province. Bases on the structural equation modeling, series of test results show that the data can be used to calculate the path regression. The outcomes shows that creation of e-merchants of flower and seedling, integration of e-commerce platform, supply chain friendliness, involvement of e-commerce service providers, and governmental policy guidance are driving expansion of flower and seedling industrial cluster together, moreover, the five forces interact with each other. This implies that expansion of flower and seedling industrial cluster is a systematic process, each stakeholder needs to pay attention to the role of other forces, and five forces achieve a balanced situation in the cluster.

Polluted rivers are a primary problem in Changhua County, Taiwan, due to rapid and massive developments in agriculture and industry. In this study, samples consisted of water influent from the Yangzi-Cuo River, Ci-Tong Jiao, Changhua County. Ecology technology, a combination of gravel contact oxidation and surface flow constructed wetlands, was employed to enhance the water quality. Ecology technology is a useful and ordinary process that focuses on original treatment of pollution through chemical, physical, and biological procedures based on the mediums of soil, plant, water, and microorganisms from pure environments. Moreover, this study aimed to minimize the river pollution index (RPI) of the Yangzi-Cuo River by using combinations of gravel contact oxidation and surface flow constructed wetlands. The inflow volume of the water samples in situ was found to be 1534–2261 cubic meters per day (CMD). The pollution in the water sample mostly involved suspended solid (SS), ammoniacal nitrogen (NH₃–N), total phosphorus (TP), total nitrogen (TN), and biochemical oxygen demand (BOD), and the values of the above indexes were found to be 10.0–26.7 mg/L, 0.9–14.0 mg/L, 1.2–14.1 mg/L, 11.1–18.2 mg/L, and 0.5–3.6 mg/L, respectively. Efficiencies of pollution elimination in SS, NH₃–N, TP, TN, and BOD were found to be 24.2–93.1%, 58.3–86.2%, 5.2–85.0%, 59.4–77.2%, and 46.3–76.4%, correspondingly, after purification treatment via ecology technology. Thus, ecology technology is a valid means of purification treatment for polluted rivers.

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

The Double U-pipe ground heat exchanger, recognized for its straightforward process, cost-effectiveness, high heat exchange efficiency, and low thermal resistance, stands as the predominant ground heat exchanger type in today's shallow geothermal energy development and utilization. Recent years have seen significant research into the heat transfer influencing factors and heat exchange performance of Double U-pipe ground heat ex-changers via experimental testing methods. Yet, studies integrating numerical simulation with in-situ testing have been less frequent. Drawing on the cylindrical heat source model theory and the outcomes of regional in-situ thermal response tests, this paper develops a Double U-pipe ground heat transfer model by establishing physical, mathematical, and heat transfer geometric models. It assesses the impact of varying inlet temperatures, flow rates, and initial ground temperatures on heat exchange efficiency under heating conditions. The results validate the precision of the double U-pipe ground heat exchanger model based on in-situ testing. They show that enhancing the temperature differential between the inlet and initial temperatures, elevating the initial ground temperature, and moderately increasing the flow rate can boost the system's heat exchange efficiency.

Abstract: Rural digital governance is an inevitable requirement to improve the efficiency of rural governance, and is also an important means to realize the modernization of rural governance. In the context of the digital rural development strategy, the index measurement system of rural digital governance level is built around five key governance areas of "digital economy, digital ecology, digital culture, digital people's livelihood, and digital government affairs". The entropy weight Topsis model is used to measure and evaluate the level of rural digital governance in 31 provinces in China in 2021. The results show that there is a large gap in the level of digital governance in China's counties and villages, and the level of each region presents a decreasing spatial distribution from "east - middle - west". In terms of digital economy, the eastern region has a high score and good development, while the central and western regions have poor development. In terms of digital ecology, only the eastern region is higher than the national average; In terms of digital culture, only the central region is higher than the national average; In terms of digital livelihood and digital government, the central and eastern regions are slightly higher than the national average; The top three provinces in overall scores are Zhejiang, Guangdong and Jiangsu.

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

Background. Respiratory distress syndrome (RDS) is the primary cause of respiratory failure in preterm infants, but it also affects 5-7% of term infants. Dysfunctions in pulmonary surfactant metabolism, resulting from mutations of the lung surfactant genes, are rare diseases, ranging from fatal neonatal RDS to interstitial lung disease, associated with increased morbidity and mortality. This study aims to clarify the clinical significance of ABCA3 variants found in a specific family case, as existing data in the literature is inconsistent. Material and methods: A family case report was conducted; targeted panel genetic testing identified a variant of the SFTPB gene and two variants of ABCA3 genes. Comprehensive research involving a systematic review of PubMed, Google Scholar databases, and genome browsers was used to clarify the pathogenicity of the two ABCA3 variants found in the index patient. Advanced prediction tools were employed to assess the pathogenicity of the two ABCA3 variants, ensuring the validity and reliability of our findings. Results: The index case exhibited fatal neonatal RDS. Genetic testing revealed the presence of the SFTPB p.Val267Ile variant, not previously reported, a benign variant based on family genetic testing and history. Additionally, two ABCA3 gene variants were identified: c.697C&gt;T, not yet reported, and c.838C&gt;T. These variants were found to affect ABCA3 protein function and were likely associated with neonatal RDS. Prediction tools and data from nine other cases in the literature supported this conclusion. Conclusions: Based on in silico predictors, analysis of the presented family, and cases described in the literature, it is reasonable to consider reclassifying the two ABCA3 variants identified in the index case as pathogenic/pathogenic. Reclassification will improve genetic counseling accuracy and facilitate correct diagnosis.

This investigation delves into the profound interplay between the e-commerce environment and the agricultural system, while scrutinizing the intricate human-land coupling dynamics engen-dered by transformations within the agricultural domain. Focusing on the expansion of orchards in Pinghe County, a pivotal epicenter for Chinese sweet pomelo production, this study eluci-dates the reverberations of Rural E-commerce Environment Development on Orchard Expansion through the lens of Tele-coupling. In doing so, it unveils the nuanced tapestry of the human-land coupling associations latent within the evolutionary trajectory of the agricultural system amidst the blossoming information society. The findings underscore a symbiotic relationship between the augmentation of orchard acreage and the burgeoning rural e-commerce landscape, effec-tively propelling the economic prosperity of the agricultural system. Moreover, a tele-coupling phenomenon has emerged, underscoring the intricate web of interconnections binding the mat-uration of the rural e-commerce ecosystem with the proliferation of orchards. The research illu-minates that the transformation of land utilization, imbricated within the agricultural system, manifests as a distinctive form of tele-coupling intricately woven into the fabric of urbanization and information technology advancements. Consequently, adopting a comprehensive theoreti-cal perspective, amalgamating disparate domains across distinct geographic realms, becomes imperative for discerning the intricate nuances of the human-land coupling nexus within these multifaceted, open systems.

Food insecurity is a pervasive issue for Allegheny County as one in five residents experience food insecurity. Food insecurity is linked to chronic health conditions like heart disease and hypertension and disproportionately affects women in the United States, particularly women who are head of household. There are multiple dimensions used to measure regional food insecurity, one of which is food accessibility. Prior research has examined the linkages between food access and food insecurity, and this study aims to further explore the relationship between equitable access to sustainable food and levels of regional food insecurity. This study examines food outlets in Allegheny County to determine if there is a significant relationship between food outlet availability and food insecurity. Both the presence and accessibility of these food outlets were examined. To measure accessibility, the walking distance to the nearest public transportation stop was calculated for each public transportation stop. The minimum distance to each food outlet was compared to food insecurity rates on a Census Tract level. Results showed that communities without grocery stores did, on average, have higher rates of food insecurity. Also, communities with a higher proportion of female-headed households experienced greater food insecurity, regardless of access to food outlets. However, there was no statistically significant relationship between the distance from public transportation stops to grocery stores and rates of food insecurity. Based on these findings, we suggest that sole reliance on distance as an indicator of food insecurity can be misleading, and there should be a greater focus on walkability within the community as using opposed to physical distance alone.