Most of the mid-high permeability sandstone oilfields in China have entered the ultra-high water cut stage, accompanied with the highly-dispersed residual oil, and the control effect of mi-cro-heterogeneity on the residual oil is increasingly prominent. Understanding the microscopic characteristics of pore structural and its evolution during the long-term waterflooding is critical for enhancing the accuracy and efficiency of oil field exploitation. While the previous insights paid more attention to the geometrical and morphological features of pore structure and ignores the relation of pore structure with the fluid flow capacity. In this study, we propose a microscopic pore structure classification method considering pore size and local permeable capacity, which realizes the physical classification and quantitative evaluation of pore structure characteristics for different permeability rocks. The micro-pore structure is classified into 6 types based on the key evaluation parameters of pore diameter and flow flux area. By taking six mid-high permea-bility sandstone core samples from Daqing oilfield in China, a series of long-term waterflooding experiments are carried out and the interior pore structure was captured using high precision CT scanning technique. The results reveals that high-permeability reservoirs exhibit concentrated pores diameters and finer throats, whereas mid-permeability reservoirs exhibit smaller pores and throats in greater quantity. With the increase of water injection volumes, the permeable ca-pacity and connectivity of the high-connectivity pore space in ultra-high- and high-permeability reservoirs are enhanced, and in mid-permeability reservoirs, the micro-heterogeneity intensifies the increase in low-connectivity small pores. These findings provide new insights for the micro-scopic heterogeneity and a solid theoretical basis for investigating the occurrence of microscopic residual oil and optimising enhanced oil recovery strategies at the late stage of ultra-high water cut.

Background: Despite continuous improvements in revascularization techniques, refractory angina without potential revascularization options remains a relevant clinical issue with significant impact on patient’s quality of life. Recently, a novel device, the Coronary Sinus Reducer (CSR), has been introduced into clinical practice as a therapeutic option for patients with disabling angina pectoris. In this single-center, observational study, we evaluated the mid-term (3-month) safety and efficacy of the CSR in a real-world cohort. Methods: The study population consisted of 55 patients with refractory angina without potential revascularization options, predominantly men (87.3%) with a high cardiovascular risk factor burden and advanced angina (baseline CCS angina class 3.15 ± 0.6). In terms of procedure safety, all patients underwent successful device deployment with only one periprocedural complication. Results: At the 3-month follow-up we observed statistically significant improvement in angina control measured CCS class and SAQ-7 Total questionnaire along with increased abolition of physical limitation – 6-MWT (233.3 ± 107.1 vs 305.2 ± 126.8; p<0.0001). Additionally, we observed significant improvement in terms of quality of life measurements SF-36, the EQ-5D-5L questionnaire, and the EQ-VAS. Conclusions: Our real-world data suggest that CSR implantation is a relatively safe procedure and appears to be particularly effective in relieving angina symptoms and improving quality of life in subjects with refractory angina.

Accurate and reliable mid-long runoff prediction (MLTRP) is of great importance in water re-sources management. However the MLTRP is not suitable in each basin and how to evaluate the applicability of MLTRP is still a question. Therefore, the total mutual information (TMI) index is developed in this study based on the predictor selection method using mutual information (MI) and partial MI (PMI). The relationship between the TMI and the predictive performance of five models is analyzed by applying five models in 222 forecasting scenarios in Australia. The results over 222 forecasting scenarios demonstrate that, compared with the MI, the developed TMI index can better represent the available information in the predictors, and has more significant negative correlation with the RRMSE with the correlation coefficient between -0.62 and -0.85. This means the model's predictive performance will become better along with the increase of TMI, and there-fore the developed TMI index can be used to evaluate the applicability of MLTRP. When TMI is more than 0.1, the available information in the predictors can support the construction of MLTRP models. In addition, the TMI is used to partly explain the difference of predictive performance among five models. In general, the complex models, which can better utilize the contained infor-mation, are more sensitive to the TMI, and have more significant improvement in terms of predic-tive performance along with the increase of TMI. This research can provide support for the study of MLTRP.

The forest is a complex and dynamic ecosystem that requires integrated planning and management, considering economic, social, environmental, and ecological dimensions. Different stakeholders often have conflicting goals, making optimal management decisions challenging. This study aims to balance increasing economic benefits for forest users with reducing negative environmental impacts, aligning the interests of managers, government institutions, and policymakers. To achieve this, multi-objective optimization methods and game theory were used. The objectives were to maximize the net present value of wood harvesting and the amount of carbon sequestration. The study was conducted in the Shafarood forest in northern Iran. Data collected included stumpage prices, variable harvesting costs, tree density per ha, volume per ha, growth rates, interest rates, carbon sequestration, and labor costs. Using this data, models were developed for the expected mean price of various species, stored carbon, logistics growth, and labor. After adjusting the objective functions and model constraints, the range of Pareto optimal solutions for the multi-objective model and the Nash equilibrium for the game theory model were determined using the epsilon-constrain method. The results indicate that both modeling approaches can identify optimal points for balancing economic and environmental goals. The Pareto optimal range and Nash equilibrium allow for informed decision-making in managing the Hyrcanian forests, accommodating different user goals. Therefore, both models are effective tools for forest management planning and provide a framework for achieving sustainable management practices.

Background: Pediatric mallet finger injuries lack specific treatment guidelines, necessitating an exploration of effective techniques. Our aim was to evaluate the outcomes of the extension block technique in adolescent mallet finger management. Methods: A comprehensive retrospective analysis was conducted involving 36 adolescents who underwent surgery between 2014 and 2022. Ishiguro’s extension block pinning technique was the primary method employed. Treatment outcomes were evaluated using Crawford's criteria, and complications were also assessed. Results: Bone union was achieved in all cases with a mean union time of 42 days (range: 30-92 days). According to Crawford's criteria, 27 cases (75%) were classified as excellent, 5 cases (14%) as good, and 4 cases (11%) as fair. Minimal complications were observed, including three cases (8%) of superficial infections, one case (3%) of dermal necrosis, and another rare instance (3%) of osteomyelitis. No cases of poor outcomes or significant long-term complications were noted. The average follow-up period was 8.6 months (range: 2-42 months). Conclusions: Ishiguro’s extension block technique is a promising surgical option for adolescent mallet fingers. Its adoption could enhance pediatric orthopedic care, offering a valuable child-friendly treatment alternative.

The optimal surgical approach for thymoma resection is still an object of debate. The increasing experience in robotic-assisted thoracic surgery (RATS) has led to the progressive affirmation of this technique as a valid alternative to Video-Assisted Thoracic Surgery (VATS), sternotomy and thoracotomy in this setting. The present study aims to compare the post-operative and short-term results of RATS Thymectomy for thymoma with those of other main surgical approaches (sternotomy, thoracotomy, and VATS) from a high-volume single center.Between May 2021 - September 2023, 40 consecutive patients underwent RATS Thymectomy for I to limited-stage III thymoma in our center. Three homogenous groups of consecutive patients who received thymic surgery by main alternative approaches (sternotomy, thoracotomy, VATS) over the last 5 years, were identified in order to perform a comparative analysis. Data of operative technique, time of surgery, associated resections, conversion rate, overall morbidity, tumor size, radicality, postoperative pain, length of hospital stay, and cosmetic results were recorded and compared between each control group and the RATS group. Tumor size was higher in the sternotomy group, but not significantly. The mean operative time of RATS interventions was significantly lower than that of sternotomy and VATS. It was significantly shorter compared to thoracotomy if excluding docking-undocking time. Higher rate of associated adjacent structures resection was reported in the sternotomy group (p=0.005). Conversion rate was significantly higher in VATS group (p= 0.026) compared to RATS. Postoperative pain at 24 and 48 hours was significantly lower in RATS group compared to the others. Improved cosmetics results were reported after RATS compared to sternotomy (p= 0.0001) and thoracotomy (p= 0.001) groups, with a trend towards better results compared to VATS (p=0.05). Length of hospital stay was shorter in the RATS group with a significant difference vs. the sternotomy group (p<0.001). These results from a single center confirm the safety and effectiveness of RATS for the treatment of limited stage thymoma. Advantage in terms of operative outcomes, post-operative pain, cosmetic results, and hospital stay was observed if compared to the alternative approaches. Short-term oncologic outcome was excellent based on the high complete excision rate of the tumor.

Background. Carotid artery disease is prevalent among patients with coronary heart disease. The concomitant severe lesions in the carotid and coronary arteries may necessitate either simultaneous or staged revascularization, involving coronary bypass and carotid endarterectomy. However, there is presently a lack of consensus on the optimal choice of surgical treatment tactics for patients with significant stenoses in both carotid and coronary arteries. The aim of the current study was to compare the 30-day and long-term outcomes of coronary and carotid artery revascularization surgery based on the simultaneous or staged surgical tactics. Material and Methods. The single-center, non-randomized retrospective study involved 192 patients with concurrent coronary artery disease and carotid artery stenosis ≥70%, of whom 106 patients underwent simultaneous intervention (CABG+CEA), and 86 patients underwent staged CABG/CEA. The mean time between stages ranged from 1 to 4 months (mean 1.88±0.9 months). Endpoints included death from any cause, nonfatal stroke, nonfatal myocardial infarction (MI), and major adverse cardiovascular events (MACE) (death + nonfatal MI + nonfatal stroke) within 30 days after the last intervention and in the long-term follow-up period (median follow-up - 6 years). Results: The 30-day all-cause mortality, incidence of postoperative nonfatal MI, nonfatal stroke, and MACE did not exhibit differences between the groups after single-stage and staged interventions. However, the overall risk of postoperative complications (adjusted for the risk of any complication per patient) (OR 2.214, 95% CI 0.214-0.954, p=0.034), as well as the duration of ventilatory support (p=0.004), were elevated in the group after simultaneous interventions compared with the staged intervention group. However, this difference did not result in an increased incidence of death and MACE in the group after simultaneous interventions. In the long-term follow-up period, there were no significant differences observed when comparing simultaneous or staged surgical tactics in terms of overall survival (54.9% and 62.6% in groups 1 and 2, respectively, P log-rank = 0.068), nonfatal stroke-free survival (45.6% and 33.6% in groups 1 and 2, respectively, P log-rank = 0.364), nonfatal MI-survival (57.6% and 73.5% in groups 1 and 2, respectively, P log-rank = 0.169), and MACE-free survival (7.1% and 30.2% in groups 1 and 2, respectively, P log-rank = 0.060). Risk factors associated with an unfavorable outcome included age, smoking, BMI, LV EF, and atherosclerosis of lower limb arteries. Conclusions: This study revealed no significant difference in the impact of simultaneous CABG+CEA or staged CABG/CEA on the incidence of death, stroke, MI, and MACE over a 30-day and long-term follow-up period. Although the immediate results indicated an increased risk of a complicated course (attributable to overall complications) after simultaneous CABG+CEA compared with staged CABG/CEA, this did not lead to an increase in fatal complications. Therefore, performing both tactics is deemed safe and eligible after a meticulous postoperative risk assessment.

Outcome of redo-mitral valve replacement in the small mitral annulus with the use of the chimney technology is not well documented. From 2019 to 2020, 77 consecutive patients underwent redo-mitral valve replacement with the use of the chimney technology because of a small mitral annulus. To evaluate heart structural integrity and clinical outcomes, postoperative clinical data and echocardiograms were examined. Mean age was 56.7 ± 15.98 years. All patients underwent mitral valve surgery of which 62 were mitral valve replacements, 7 mitral valve repairs, and 8 double valve replacements. Preoperative Mitral valve mean gradient was 18.07 ± 9.40 mmHg. Postoperative mitral prosthesis size 28.51 ± 1.22 mm. The median increment of mitral size enlargement was 4 (0, 6) valve sizes. Mean mitral gradient coming out of the operating room was 10.34 ± 2.12 mmHg and at follow-up echocardiogram performed at 3 years after the procedure was 10.36 ± 1.70 mmHg. One-year survival was 93.3%, while 4-year survival was 89.3% with no reoperation. Use of the chimney technology in small mitral valve re-mitral valve replacement results in larger valve sizes. Moreover, the mean gradients over the mitral valve are acceptable intraoperatively and over time.

Keywords: mHealth; peritoneal dialysis; functionality; usability

Objectives: Minimally invasive direct coronary artery bypass (MIDCAB) is an alternative for revascularisation of isolated left anterior descending (LAD) or as multi-vessel (MV) procedure for diagonal branch (RD) or circumflex artery (RCX) region. Methods: From 2021 to 2022 91 patients underwent MIDCAB procedure in our heartcenter. 80% were male. Eighty percent of the patients had two or three vessel coronary artery disease. Mean age was 65±10 years. The left internal mammary artery (LIMA) was anastomosed to the left anterior descending via left minithoracotomy approach in all patients. Fourteen patients received multi-vessel MIDCAB (15%) with two or three anastomoses a saphenous vein graft (as T-graft to LIMA) was anastomosed to RD or RCX. Results: Mean operation time was 2.6±0.8 hours. The 30-day mortality was 0. Mean required packed red blood cells (pRBC) was 0.4±1.2 unit. The intensive care unit stay (ICU) was 1.5±1.6 days mean. We observed two patients (2%) with wound infections postoperatively. Four patients underwent rethoracotomy because of bleeding. Mean follow-up time was 1.5±0.5 years. Seventy-eight patients (86%) were in New York Heart Association (NYHA) class 1, 11 patients (12%) were in NYHA class 2. One patient received percutaneous coronary intervention due to de novo stenosis of the RCA. Late mortality was 2%. The Kaplan-Meier survival rate was 98.8% at 1 and 2 years. Conclusion: MIDCAB is technically demanding. Our postoperative and short-term clinical results demonstrate that this procedure is safe and feasible. Optimal patient selection and an experienced surgical team are mandatory.

Congenital breast asymmetry represents a particular challenge to the classical techniques of plastic surgery due to a young group of patients. This study compares traditional breast augmentation using silicone implants to the more innovative lipograft technique regarding long-term results. To achieve this, we not only captured subjective parameters like satisfaction with outcome and symmetry, but also objective parameters such as breast volume and anthropometric measurements. Objective examination was performed manually and by using the Vectra® H2 photogrammetry scanning system. Patients who underwent implant augmentation and lipograft both showed no significant differences in patient´s satisfaction with surgical outcome (p = 0.55) and symmetry (p = 0.69). Furthermore, a breast symmetry of 93 % in both groups was reported. Likewise, no statistically significant volume difference between left and right breast was observed in both groups (p<0.41). However, on average, lipograft patients needed 1.3 procedures more until the desired result was achieved. In contrast, patients treated with implant-based breast augmentation usually need several implant changes during their life. In conclusion, both methods should be considered for patients with congenital breast asymmetry.

In this data deposit, I describe a dataset that is the result of content mining 167,318 published articles for statistical test results. As a result of this content mining, 688,112 results from 50,845 articles were extracted. In order to provide a comprehensive set of data, the statistical results are supplemented with metadata from the article they originate from. The dataset is provided in a comma separated file (CSV) in long-format. For each of the 688,112 results, 20 variables are included, of which seven are article metadata and 13 pertain to the individual statistical results (e.g., reported and recalculated p-value). A five-pronged approach was taken to generate the dataset: (i) collect journal lists, (ii) spider journal pages for articles, (iii) download articles, (iv) add article metadata, and (v) mine articles for statistical results.

Single-phase-to-ground fault in non-effectively grounded systems poses serious public safety concern. Along with increasing deployment of low-voltage (LV) sensors, new opportunities and ways are created for solving this traditional problem in distribution systems. A new approach, identifying primary single-phase-to-ground line fault and locating it through measurement data from smart sensors deployed in the secondary side of distribution transformers, is proposed in this paper. When a fault occurs in primary distribution feeder, the transient aerial mode voltage (AMV) of each LV smart sensor is calculated. The fault line can be identified by an abrupt change value of AMV at LV side. Next, by finding the position of the maximum value of this AMV from LV sensors on the fault line, the fault location can be pinpointed to two neighboring distribution transformers. The proposed method has been proven to be efficient and reliable by simulation studies.

Background: Prediction of neurorehabilitation outcomes after a Spinal Cord Injury (SCI) is crucial for healthcare resource management and improving prognosis and rehabilitation strategies. Arti-ficial neural networks (ANNs) have emerged as a promising alternative to conventional statistical approaches for identifying complex prognostic factors in SCI patients. Materials: a database of 1256 SCI patients admitted for rehabilitation was analyzed. Clinical and demographics data and SCI characteristics, were used to predict functional outcomes using both ANN and linear regression models. The former was structured with input, hidden, and output layers, while the linear regression identified significant variables affecting outcomes. Both ap-proaches aimed to evaluate and compare their predictive accuracy for rehabilitation outcomes measured by the Spinal Cord Independence Measure (SCIM) score. Results: Both ANN and linear regression models identified key predictors of functional outcomes, such as age, injury level, and initial SCIM scores (correlation with actual outcome: R=0.75 and 0.73, respectively). When alimented also with parameters recorded during hospitalization, the ANN highlighted the importance of these additional factors like motor completeness and compli-cations during hospitalization, showing an improvement in its predictive accuracy (R=0.87). Conclusion: ANN seemed to be not widely superior to classical statistics in general, but, taking into account complex and non-linear relationships among variables, emphasized the impact of complications during the hospitalization on recovery, particularly respiratory issues, deep vein thrombosis, and urological complications. These results suggested that the management of com-plications is crucial for improving functional recovery in SCI patients.

On April 17, 2019, a coach with tourists from Germany crashed in Madeira requiring repatriation by the German Air Force. The Advance Trauma Life Support (ATLS) concept was the central component of patient care. Data in Madeira were collected through a structured interview. The analysis of the Aeromedical Evacuation was based on intensive care transport records. In Germany all available were reviewed for data collection. Quality of life (HRQoL) was evaluated by the 12-item Short-Form Health Survey (SF-12). Twenty-eight prehospital patients were transported to the Level III Trauma Center in Funchal (Madeira). Five operative procedures were performed. Fifteen patients were eligible for Aeromedical Evacuation (AE). In the second hospital phase in Germany in total 82 radiological images and nine operations were performed. Hospital stay lasted 11 days (median, IQR 10–18). Median Follow-up (14 of 15 patients) was 16 months (IQR 16–21). 80% (8 out of 10) showed an increased risk for post-traumatic stress disorder (PTSD). Six key findings were identified in this study: divergent injury classification, impact of AE mission on health status, lack of communication, need of PTSD prophylaxis, patient identification, media coverage. Those findings may improve AE missions in the future e.g. required after armed conflicts.

Heat exchangers play a vital role in numerous sectors like power generation and automotive manufacturing. Enhancing the energy efficiency of these exchangers stands as a significant hurdle. Utilizing nanofluids emerges as an optimal solution to augment heat transfer rates, leveraging their superior thermal conductivity while addressing economic constraints linked with traditional heat exchanger technologies. The motivation for this study is to consider the comprehensive synergistic features of MWCNTs, SiO₂, and hybrid MWCNTs–SiO₂ EG-based nanofluids in plate heat exchangers. This was achieved by simulating a plate heat exchanger using CFD (Fluent and Gambit softwares) considering the comparison of two SiO₂, MWCNTs, and their hybrid forms at different mass concentrations. The Reynolds-Averaged Navier-Stokes (RANS) method was employed to model turbulent flows, and the nanoparticles were compared in both single-phase and two-phase states, with their properties derived from experimental studies. Moreover, Nusselt number, convective heat transfer coefficient, and pressure drop variations were computed at different Reynolds numbers. The findings indicated an increase in the Nusselt number with the incorporation of the hybrid nanofluid, achieving a maximum enhancement of 11.19% in comparison to EG at a Reynolds number of 240 and a concentration of 0.86 wt.%. Noticeably, the pressure drop remained negligible at lower Reynolds numbers, exhibiting marginal variations up to 0.3% at higher Reynolds numbers. At a concentration of 0.86 wt.% and a Reynolds number of 480, the introduction of MWCNTs, hybrid, and SiO₂ nano-additives resulted in respective increases in the heat transfer coefficient by 21.02%, 10.76%, and 2.16% and corresponding alterations in pressure drop of 0.11%, 0.04%, and 0.02%.

A large core size and bending resistance are very important properties of mid-infrared energy transfer fibers, but large core sizes usually lead to a deterioration of bending properties. A negative-curvature nested node-free anti-resonant hollow-core fiber (AR-HCF) based on quartz is proposed. It was made by adding a nested layer to a previous AR-HCF design to provide an additional anti-resonance region while keeping the gap between adjacent tubes strictly correlated to the core diameter to produce a node-free structure. These features improve the fiber’s bending resistance while achieving a larger core diameter. The simulation results show that the radial air-glass anti-resonant layer is increased by the introduction of the nested anti-resonant tube, and the weak interference overlap between the fiber core and the cladding mode is reduced, so the fiber core’s limiting loss and the sensitivity to bending are effectively reduced. When the capillary wall thickness t of the fiber is 0.71 μm, the core diameter D is 70 μm, the ratio of the inner diameter of the cladding capillary to the core diameter d/D is 0.62, and the diameter of the nested tube is d0=29 μm, the fiber has a lower limiting loss at the wavelength of 2.79 μm, and the limiting loss is 3.28×10-4 dB/m. At the same time, the optimized structure also has good bending resistance. When the bending radius is 30 mm, the bending loss is only 4.72×10-2 dB/m. To our knowledge, this is the first research to achieve an anti-bending low-loss micro-structure hollow fiber with a bending radius of less than 30 mm in the 2.79 μm band. An anti-bending low-loss anti-resonant hollow-core fiber with this structure constitutes a reliable choice for the light guiding system of a 2.79 μm band erbium laser therapy instrument.

Currently, aortic valve (AV) disease is the most common reason for heart valve surgery. The gold standard of care for people with aortic pathology is thought to be AV replacement. The issue of prosthesis selection has always been important. Although mechanical prosthesis are robust, lifelong anticoagulation medication is necessary due to the significant risk of thromboembolic consequences. Biological prostheses have a flow structure that is similar to the physiological one, and as malfunction gradually sets in, scheduled recurrent surgery can be carried out. The purpose of this study is to evaluate the short- and long-term effects of biological prosthetic aortic valve replacement (AVR) in elderly individuals. The study included 198 patients with AV pathology [85 men (42.9%)/113 women (57.1%)]. The median age was 70 [66–73] years. There were 175 (88.4%) patients with degenerative AV, 5 (2.5%) with infective endocarditis, and 30 patients (15.2%) had bicuspid AV. The median follow-up period was 26.3±1.4 months. Hospital mortality was 4.5%. No wound complications were detected. Thirty-one patients died in the long-term period. The causes of lethality were: cardiovascular disease (13 patients), malignant neoplasm (5 patients), gastrointestinal disease (2 patients), urinary system disease (1 patient), COVID-19 (1 patient), unknown cause (9 patients). Thus, the five-year postoperative survival rate was 63%, respectively. Throughout the observation period, two patients (2.9%) underwent reoperation on AV. 97.1% of patients were free of reoperation after five years. The five-year survival rate was 63% due to the history of severe concomitant pathology and mean age of the patients of 70 years.

Background Limited data are available from randomized trials comparing outcomes between transcatheter aortic valve replacement (TAVR) and surgery in patients with different risks and with follow-up >2 years. Objective In this large, population-based cohort study, long-term mortality and morbidity were investigated in patients undergoing aortic valve replacement (AVR) for severe aortic stenosis using a surgically implanted bioprosthesis (sB-AVR) or TAVR. Methods Individual data from the Austrian Insurance funds from 2010 through 2020 were analysed. The primary outcome was all-cause mortality, assessed in the overall and propensity score–matched populations. Secondary outcomes included reoperation and cardiovascular events. Results From January 2010 through December 2020, a total of 18 882 patients underwent sB-AVR (n=11 749; 62.2%) or TAVR (n=7133; 37.8%); median follow-up was 4.0 (interquartile range 2.1–6.5) years (maximum 12.3 years). The risk of all-cause mortality was higher with TAVR compared with sB-AVR: hazard ratio (HR) 1.552, 95% confidence interval (CI) 1.469–1.640, p<0.001; propensity score–matched HR 1.510, 1.403–1.625, p<0.001. Estimated median survival was 8.8 years (95% CI 8.6–9.1) with sB-AVR vs 5 years (4.9–5.2) with TAVR. Estimated 5-year survival probability was 0.664 (0.664–0.686) with sB-AVR vs 0.409 (0.378–0.444) with TAVR overall, and 0.690 (0.674–0.707) and 0.560 (0.540–0.582), respectively, with propensity score matching. Other predictors of mortality were age, sex, previous heart failure, diabetes, and chronic kidney disease. Conclusions In >2-year follow-up, selection for TAVR was significantly associated with higher all-cause mortality compared with sB-AVR in patients ≥65 years with severe, symptomatic aortic stenosis.

: This article was not intended to be a complete report of a standard clinical trial. It is a report of the outcomes of preliminary data for validation of the CMECD procedure (Coletti Method of EMG ChemoDenervation) protocol for the treatment of chronic pain resulting from chronic muscle spasm. Methods are here detailed on how to approach the patient with chronic pain, identify the presence of chronic muscle spasm, undertake the treatment protocol and how to perform the follow up process to confirm that chronic pain secondary to chronic muscle spasm was the accurate diagnosis. Furthermore, this article presents the results of a cohort of more than 90 patients treated by the CMECD procedure regarding location and duration of prior pain, prior treatment strategies, degree of success in resolving pain and duration of relief. Outcome data consisting of patient and staff reporting of specific situations in which the chronic pain treatment was successful has been included to help establish the “believability” of outcome successes and to elucidate the potential life altering effects of successful treatment of chronic pain secondary to chronic muscle spasm. This article will hopefully increase the interest in this treatment protocol and increase the chance that a classical international clinical trial will be undertaken.

Using desi-cow waste products like Jeevamrit, natural farming is widespread among farmers for improving soil biology and productivity. Jeevamrit enhances soil chemical and microbiological properties without needing large quantities of farmyard manure (FYM), as a sustainable farming practice with a reduced carbon footprint. Despite its traditional use, Jeevamrit faces criticism due to a lack of scientific evidence. This study investigated the comparative effect of Jeevamrit and chemical fertilizers on the growth and yield of marigold cv. Siracole. In this study mother block of marigold was raised for both summer and winter seasons. The cuttings were harvested from the mother block and then kept for rooting. The rooted cuttings were planted at monthly intervals and evaluated for flowering parameters and compared to those treated with RDF (30:20:20 N, P, and K g/m2). Soil supplied with Jeevamrit enhanced bacteria (26.33%), fungi (18.92%), and actinomycetes (31.21%) populations compared over the recommended dose of fertilizers (RDF) (i.e. N:P: K @ 30:20:20 g m-2). Jeevamrit-treated plants have marketable flower yield per square meter (3.98 %) and shelf life (9.93 %) compared to RDF. The study concludes that Jeevamrit @ 2 liter m-2 is a sustainable and effective alternative to traditional fertilizers for enhancing marigold production in the mid-hills of the Himalayan region, where natural farming is already accepted.

Both cementless and cemented stems have exhibited favorable long-term outcomes in total hip arthroplasty. Nonetheless, in elderly patients, cemented hips offer an advantage because of their reduced risk of periprosthetic fractures. The present study aimed to assess the initial outcomes of 28 patients who underwent unilateral cemented total hip arthroplasty utilizing the calcar-guided A2 stem (Artiqo GmbH, Lüdinghausen, Germany). Various types of antibiotic-loaded cement were employed. Demographic data, comorbidities, and standardized clinical assessment tools, including the Harris Hip Score, were utilized during the follow-up. Radiographic assessments included preoperative, postoperative, and follow-up imaging to evaluate subsidence, osteolysis, and bone resorption. The results indicated that among the 28 patients, 5 withdrew consent, and 2 patients passed away from unrelated causes. Additionally, one prosthesis was explanted because of undersizing of the cement stopper, resulting in an inadequate cement mantle. As a result, 20 patients underwent a 1-year follow-up, revealing noteworthy enhancements in clinical scores, with no instances of radiolucent lines or osteolysis. In summary, our short-term experience with this particular cemented short-stem design yielded promising results, exhibiting excellent functional outcomes and no aseptic loosening attributable to the stem. Further clinical studies and registry data are essential to corroborate these findings.

Selection is a fundamental interaction element in Virtual Reality (VR) and 3D user interfaces (UIs). Raycasting, one of the most common object selection techniques, has been known to have difficulties in selecting small or distant objects. Meanwhile, recent advancements in computer vision technology have enabled seamless vision-based hand tracking in consumer VR headsets, enhancing accessibility to freehand mid-air interaction and highlighting the need for further research in this area. This study proposed a new technique called TouchView which utilizes a virtual panel with a modern adaptation of the Through-the-lens metaphor to improve freehand selection for VR UI. TouchView enables faster and less demanding target selection by allowing direct touch interaction with the magnified object proxies reflected on the panel view. Repeated-measures ANOVA on the results of a follow-up user experiment on multitarget selection with 23 participants showed that TouchView outperformed the current market-dominating freehand raycasting technique, Hybrid Ray in terms of task performance, perceived workload, and preference. The user behavior was also analyzed to understand the underlying reasons for these improvements. The proposed technique can be used in VR UI applications to enhance the selection of distant objects, especially for cases with frequent view shifts.

Introduction: Obstructive sleep apnea syndrome (OSAS) is characterized by recurrent episodes of upper airway obstruction and involves intermittent hypoxia and sleep fragmentation, with potentially serious consequences for affected patients. (1–3). Although nocturnal polysomnography is the gold standard, it is an exam that is not readily available and is very expensive. (4). Hence, the need to find new diagnostic methods. Considering that the causes of OSAS can be divided into anatomical-structural ones, related to craniofacial anomalies, it has been hypothesized that anthropometric measurements taken by new 3D stereophotogrammetric systems could be useful as a diagnostic tool in pediatric patients with OSAS (5) (6). The primary objective of the study is, therefore, to evaluate the correlation between mandibular length measured between menton and gonion, obtained through 3D stereophotogrammetry using the "Face Scanner maxi 6", and the severity of OSAS (AHI classification), defined by the score of the Sleep Clinical Record (SCR) questionnaire in a group of pediatric patients with suspected obstructive sleep disorders. The secondary objective concerns the identification of possible correlations between other mandibular parameters estimated by 3D stereophotogrammetry and the severity of OSAS, defined by the McGill Oximetry Score (MOS), and the association between MOS and SCR to determine the AHI level. Materials and methods: The study considered patients who were prescribed a pulseoximetry exam due to suspected obstructive sleep disorders. All participating patients underwent a specialized orthodontic examination, which included completing the SCR questionnaire and taking facial photographs using a 3D stereophotogrammetric system. The SCR questionnaire considers 11 dental, nasal, oropharyngeal, and facial phenotype parameters to determine a final score from 0 to 18, indicating the risk of obstructive sleep apnea syndrome. The acquired stereophotogrammetric images were processed using dedicated software to obtain a three-dimensional model representing the patient's facial phenotype. Subsequently, anatomical landmarks and relevant anthropometric measurements were identified on the model, and it was assessed whether one or more of these showed concordance criteria with the parameters derived from SCR and MOS. The anthropometric evaluation was performed by expert operators, taking into account mandibular variables. Results: Fifteen patients were analyzed, with 2 excluded due to alterations in the stereophotogrammetric images caused by poor patient cooperation during the acquisition of the photographs. Spearman's correlation analysis was performed to investigate the relationship between anthropometric measurements, obtained by 3D stereophotogrammetry, and OSAS severity, by means of SCR, MOS, and SCR+MOS. A significant and negative correlation was observed between right mandibular length (gonion-menton) and MOS (ρ=−0.586, p=0.036). Conclusions: The result obtained has important implications for the field of study and suggests that future attention should focus more on the mandibular length variable as a determining factor for OSAS. However, the sample examined was relatively small, which might obscure the correlation with contralateral mandibular length and potential correlations with other mandibular/facial parameters. Additionally, the small sample size prevented stratification by sex and age. The study thus provides an important contribution to understanding the relationships between 3D stereophotogrammetry and pediatric OSAS but also highlights the need for further research that could potentially influence future developments in diagnosing OSAS in children.

Fires constitute a significant threat due to the pollutants emitted and the destruction they cause. People who take part in fire-fighting operations must be equipped with appropriate tools, including special clothing that will allow them to work and guarantee safety. One of the threats are compounds from the PAH group, which are characterized by high toxicity and carcinogenicity. Therefore, it is important that the materials used constitute a barrier to contamination. Various materials from which individual elements of special firefighter's clothing are made were tested. Additionally, the importance of height on the possibility of sorption of PAH compounds on a given type of material was analyzed. Based on the results obtained, it was found that the type of material and the zone in which the clothing items are used are important in the sorption processes of pollutants. Data in this area may be important for taking further actions regarding the modification of materials used in special fire brigade clothing and in their cleaning processes.

(1) Background: This work aimed to conduct the first comparative study providing long-term data about patient reported outcome measures as well as donor-site scar assessment and aesthetic evaluation of the reconstructed breasts in patients with DIEP versus PAP flap breast reconstruction. (2) Methods: This prospective, single-center, matched cohort study included a total of 36 patients after DIEP and PAP flap breast reconstruction. Evaluation was done using the Breast-Q and POSAS questionnaire as well as the Breast Aesthetic Scale for cosmetic analysis by four plastic surgeons. (3) Results: Post-operative Breast-Q evaluation revealed no significant differences between both patient groups for the categories physical well-being donor-site, physical well-being breast and satisfaction with the breast. Scar evaluation of the donor-site region showed equivalent results for the thigh and the abdomen concerning the overall opinion of patients and observers. There was no significant difference between both methods of reconstruction for all aspects of breast aesthetics. (4) Conclusions: Similar results of donor-site morbidity, scar quality and aesthetic outcome of the breast in both the DIEP and PAP patient group have been demonstrated. Hence, in cases suitable for both types of reconstruction, the decision can be based on factors such as patients’ lifestyle, leisure activities and preferences.

Reducing sedentary behaviours can help prevent non-communicable diseases, particularly among young adolescents with long term illnesses or disabilities (LTID). Much of young people’s voluntary sedentary time is related to screen-time behaviours (STBs) such as TV viewing, playing computer games, and using the computer for other activities. Although public health data on adolescents’ STB is growing, information about adolescents with LTID is currently lacking in a European context. The purpose of this study is to compare time on STBs between adolescents with and without LTID in European Countries through the HBSC 2013/14 study. Young adolescents (n = 61,329; boys 47.8%) from 15 European countries reported the time spent on TV viewing, playing computer games, and using the computer for other purposes on weekdays and the weekend. STBs were dichotomised based on international recommendations of less than 2 h per day, and Chi-square tests of independence were performed to investigate differences. STB time was combined to produce a sum score as dependent variable in multiple analysis of covariance with age and family affluence as covariates. There were statistically significant differences in computer gaming among boys and other computer use among girls for both weekdays and weekends, whereby adolescents with LTID reported higher use. In addition, both boys and girls with LTID spent more time on STBs than their same sex peers without LTID (Boys, F = 28.17, p < 0.001; Girls, F = 9.60, p = 0.002). The results of this study indicate a need for preventive strategies to address high levels of STB among young adolescents with LTID and reduce the risk of poor health outcomes associated with higher levels of sedentary behaviour.

Radial nerve palsies present a challenging clinical scenario, often leading to substantial functional impairment. This study focuses on evaluating the outcomes of tendon transfer surgeries in patients with post-traumatic radial nerve injuries. The radial nerve, vital for upper limb movements, faces various etiologies such as trauma, compression, or idiopathy. Patients with radial nerve palsy encounter difficulties in daily activities, emphasizing the need for effective management strategies. The research introduces a novel evaluation protocol, aiming to comprehensively assess tendon transfer outcomes. This protocol incorporates functional movements of wrist and finger joints, encompassing both objective and subjective parameters. The retrospective study includes eleven patients treated between 2010 and 2022, with a minimum follow-up of one year post-surgery. Tendon transfers demonstrated positive results. The evaluation protocol covers a wide range of parameters, including wrist and finger mobility, thumb function, grip strength, and patient satisfaction. The results indicate successful restoration of motor function, with an average grip strength of 70% compared to the healthy arm. The proposed evaluation protocol facilitates standardized and reproducible assessment, minimizing subjective errors in clinical evaluations. Despite the study's limitations, such as a relatively small sample size, the findings underscore the effectiveness of tendon transfers in treating radial nerve palsies. The introduced evaluation scheme provides a comprehensive and reproducible approach to assess outcomes, contributing to the global standardization of tendon transfer assessments in radial nerve injuries.

Urinary tract infections (UTIs) are highly prevalent in long-term care facilities, constituting the most common infection in this setting. Our research focuses on analyzing clinical characteristics and antimicrobial prescriptions for UTIs in residents across nursing homes (NH) in Spain. This cross-sectional report is part of a before/after intervention study using a multifaceted approach based on the normalization process theory to improve healthcare quality provided by nursing staff in 34 NHs in Spain. In this study we present the results of the first audit including 719 UTI cases, with an average age of 85.5 years and 74.5% being women. Cystitis and pyelonephritis presented distinct symptom patterns. Notably, 6% of asymptomatic bacteriuria cases were treated. The prevalence of dipstick usage was 83%, raising concerns about overreliance, including in the 46 asymptomatic cases, leading to potential overdiagnosis and antibiotic overtreatment. Improved diagnostic criteria and personalized strategies are crucial for UTI management in NHs, emphasizing the need for personalized guidelines on management of UTIs, to mitigate indiscriminate antibiotic use in asymptomatic cases.

Objective: To assess the effects of chronic walnut consumption on body weight and adiposity in elderly individuals. Methods: The Walnuts And Healthy Aging study is a dual-center (Barcelona, Spain and Loma Linda University [LLU]), 2-year randomized parallel trial. This report concerns only the LLU cohort. Healthy elders (mean age 69 y, 67% women) were randomly assigned to walnut (n = 183) or control diets (n = 173). Subjects in the walnut group received packaged walnuts (28–56 g/d), equivalent to ≈15% of daily energy requirements, to incorporate into their habitual diet, while those in the control group abstained from walnuts. Adiposity was measured periodically, and data were adjusted for in-trial changes in self-reported physical activity. Results: After 2 years, body weight significantly decreased (P = 0.031), while body fat significantly increased (P = 0.0001). However, no significant differences were observed between the control and walnut groups regarding body weight (−0.6 kg and −0.4 kg, respectively, P = 0.67) or body fat (+0.9% and +1.3%, respectively, P = 0.53). Lean body mass, waist circumference and waist-to-hip ratio remained essentially unchanged. Sensitivity analyses were consistent with the findings of primary analysis. Conclusion: Our findings indicate that walnuts can be incorporated into the daily diet of healthy elders without concern for adverse effects on body weight or body composition.

Background: Post-acute sequelae of SARS-CoV-2 infection (PASC) is a complicated disease that affects millions of people all over the world. Previous studies have shown that PASC impacts 10% of SARS-CoV-2 infected patients of which 50-70% are hospitalized. It has also been shown that 10-12% of those vaccinated against COVID-19 were affected with PASC and its complications. The severity and the later development of PASC symptoms is positively associated with the early intensity of the infection. Results: The generated health complications caused by PASC involve a vast variety of organ systems. Patients affected by PASC have been diagnosed with neuropsychiatric and neurological symptoms. Cardiovascular system also has been involved and several diseases such as myocarditis, pericarditis, and coronary artery diseases were reported. Chronic hematological problems such as thrombotic endothelialitis and hypercoagulability were described as a condition that could increase the risk of clotting disorders and coagulopathy in PASC patients. Chest pain, breathlessness, and cough in PASC patients were associated with respiratory system in long COVID-19 causing respiratory distress syndrome. The observed immune complications were notable, involving several diseases. Renal system also was impacted and result in raising the risk of diseases such as thrombotic issues, fibrosis, and sepsis. Endocrine gland malfunction can lead to diabetes, thyroiditis, and male infertility. Symptoms such as diarrhea, nausea, loss of appetite and taste were also among reported observations due to several gastrointestinal disorders. Skin abnormalities might be an indication of infection and long-term implications such as persistent cutaneous complaints were linked to PASC. Conclusions: Long COVID is a multidimensional syndrome with considerable public health implications, affecting several physiological systems and demanding thorough medical therapy as well as more study to address its underlying causes and long-term effects.

The Atmospheric Dynamics Mission ADM-Aeolus was successfully launched in August 2018 by the European Space Agency (ESA). The Aeolus mission carried a single instrument, the first-ever Doppler Wind Lidar (DWL) in space, called Atmospheric LAser Doppler INstrument (ALADIN). Aeolus circled the Earth in a polar sun-synchronous orbit at about 320 km altitude with a repeat cycle of 7 days, providing vertical profiles of horizontal line-of-sight (HLOS) winds on a global scale. Exceeding scientific expectations, Aeolus, initially designed for a 3-year lifetime, provided global coverage of wind profiles for almost five years. In this long-term validation study, we assessed the accuracy of the Level 2B (L2B) Rayleigh-clear and Mie-cloudy wind products by collecting radiosonde data from three stations in the Brazilian Amazon: Cruzeiro do Sul (7.62° S, 72.67° W), Porto Velho (8.76° S, 63.91° W), and Rio Branco (10.00° S, 67.80° W). Statistical validation was conducted by comparing Aeolus L2B wind products and radiosonde data, launched daily at 12:00 UTC from October 2018 to March 2023. Considering all data collected during the mission period, Pearson’s coefficient (R) of 0.73 was observed in Rayleigh-clear and 0.85 in Mie-cloudy, revealing a strong correlation between Aeolus and radiosonde winds. No significant biases were detected, with values of -0.14 m/s for Rayleigh-clear and -0.40 m/s for Mie-cloud, fulfilling the mission requirement of having absolute biases below 0.7 m/s. However, when analyzed annually, in 2022, the bias for Rayleigh-clear was -0.95 m/s, exceeding the mission requirements.

A major problem of the technological production process of the metallurgical-grade silicon is formation of a large amount of microsilica. However, this material can be a significant source of raw materials for its own production. Hence, this study is aimed to solve the problem of micro-silica utilization, i.e. the technogenic dust-like waste generated during the melting of the technical-grade silicon. Within this study, the technology of the joint briquetting of microsilica was investigated with the carbonaceous reducing agents, i.e. by obtaining of mono-charge and by melting of the technical-grade silicon from the obtained mono-charge in the 200kVA ore-thermal furnace. Results of the study show that the briquettes in the melting process of the technical-grade silicon can be used in the range from 0 to 50%. The using of briquettes may significantly improve the technological parameters. When briquetted charge is applied only, the technological parameters will deteriorate significantly. The material balance of silicon melting showed the recovery rates of the main elements (Si, Al, Ca and Fe). It recorded a decrease in content of aluminum from 1.9-2.1% to 0.5-0.7%, calcium from 0.2-0.3% to 0.07-0.1% and titanium from 0.2-0.23% to 0.11-0.13% during the transition to briquetted monocharge. Phosphorus content increased from 0.004-0.005 to 0.011-0.013%.

The optimal therapy for patients with non-metastatic biochemically relapsed prostate cancer (BRPC-M0) after local therapy is elusive. Thus, the evaluation of new non-toxic compounds in BRPC-M0 patients is warranted. PectaSol® modified citrus pectin (P-MCP) is a food supplement generally recognized as safe (GRAS) by the Food and Drug Administration (FDA) and is a competitive inhibitor of galectin-3 protein, involved in cancer pathogenesis. P-MCP treatment of BRPC-M0 patients for 6 months led to a 75% prostate-specific antigen doubling time (PSADT) improvement. To determine the longer-term effects of P-MCP we investigated an additional 12 months of treatment (phase II) with oral P-MCP at 4.8 grams X 3/day in patients with no disease progression in the previous 6 months. Of the 46 patients that entered the second phase, 7 patients withdrew consent and continued therapy independently, and 39 received another 12 months of therapy. After a total of 18 months P-MCP treatment, 62% (n=24) had a decreased/stable PSA, 90% (n=35) had improved PSADT, and 85% (n=33) had a durable long-term response, with a decreased/stable PSA, and/or improvement of PSADT, and negative scans. No patient had grade 3/4 toxicity. In conclusion, P-MCP may have long term durable efficacy, and is safe, in BRPC-M0.

The high penetration of distributed energy resources poses significant challenges to the dispatch and operation of power systems. Improving the accuracy of short-term load forecasting (STLF) can optimize grid management, leading to increased economic and social benefits. Currently, some simple AI and hybrid models has issues to deal with and struggle with multivariate dependencies, long-term dependencies, and non-linear relationships. This paper proposes a novel hybrid model for short-term load forecasting (STLF) that integrates multiple AI models with Lasso regression using the stacking technique. The base learners include ANN, XgBoost, LSTM, Stacked LSTM, and Bi-LSTM, while Lasso regression serves as the meta-learner. By considering factors such as temperature, rainfall, and daily electricity prices, the model aims to more accurately reflect real-world conditions and enhance predictive accuracy. Empirical analyses on real-world datasets from Australia and Spain show significant improvements in forecasting accuracy, with a substantial reduction in Mean Absolute Percentage Error (MAPE) compared to existing hybrid models and individual AI models. This research highlights the efficiency of the stacking technique in improving STLF accuracy, suggesting potential operational efficiency benefits for the power industry.

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

The properties of the annual, semiannual and triennial oscillations (AO, SAO and TO) in the middle atmosphere have been investigated using the TIMED/SABER temperature data. The Lomb-Scargle and wavelet spectra were used to determine the dominant oscillations in the background temperature field. The AO is prominent at the mid-latitudes. The AO amplitudes present an asymmetry between the two Hemispheres, being larger in the mesosphere than in the stratosphere. The SAO dominates the tropical regions, with three amplitude maxima at altitudes of 45, 75, and 85 km. The SAOs in the upper mesosphere (75 km) are out of phase with those in the mesopause (85 km) in the tropical regions, which can generate an enhancement of 11 K at each equinox, contributing to the lower mesospheric inversion layer. The TO is significant in the tropical region, with amplitude being maximum at 35, 45 and 85 km. Result shows that there may be potential interaction by the TO with SAO at 85km at the equator. The relation between ENSO and TO has also been discussed. The ENSO signal may modulate the amplitude of the TO, mainly in the lower stratosphere. The real origin of the TO may lie in the wave-mean-flow interaction.

Introduction: Despite its high prevalence and impact on health, metabolic dysfunction-associated steatotic liver disease (MASLD) is inadequately addressed in European primary care (PC), with a large proportion of cases going undiagnosed or diagnosed too late. A multi-country European re-search consortium led a project to design and evaluate a patient-centered, integrated model for MASLD screening, diagnosis and linkage to specialty care for European PC settings. Aim: Based on the lessons from this project, the latest research evidence and existing guidelines for the management of MASLD, we sought to develop a set of practice recommendations for screening, referral and management of MASLD in PC. Methods: The Rand/UCLA modified Delphi panel method, with two rounds, was used to reach consensus on practice recommendations. The international panel consisted of experts from six countries, representing family medicine, gastroenterology, hepatology, cardiology and public health. Initially, fifteen statements were drafted based on a synthesis of evidence from the literature and earlier findings from our consortium. Prior to the consensus meeting, the statements were rated by the experts in a first round. Then, in a hybrid meeting, the experts discussed findings of round one, adjusted the statements and reassessed the updated recommendations in a second round. Results: In round one, there was already a high level of consensus on 10 out of 15 statements. After round 2, there were fourteen statements with a high agreement (>90%). One statement was not endorsed. The approved recommendations addressed the following practice areas: risk screening and diagnosis, management of MASLD – Lifestyle interventions, pharmacological treatment of MASLD/MASH, pharmacological treatment for co-morbidity, integrated care, surgical management and other referrals to specialists. Conclusion: The final set of 14 recommendations focuses on increasing comprehensive care for MASLD in PC. The recommendations provide practical evidence-based guidance tailored to PC practitioners. We expect that these recommendations will contribute to the ongoing discussion on systematic approaches to tackle MASLD and support European PC providers by integrating the latest evidence into practice.

The importance of contact with nature for human health was confirmed by numerous research. One of the sometimes neglected fields is the landscape design of hospital premises. This study focuses on the perception and preferences of prospective patients regarding the hospital site design. The methodology included anonymous survey with images and lists of adjectives. The online questionnaire was distributed using e-mails and social media from 4th May to 8th July 2024. The objective was to include all age groups. The results confirm previous studies and demonstrate the importance of landscape architecture design of hospital premises for the well-being of patients. The findings may inform the design of hospital sites.

The purpose of this study was to compare the long-term clinical outcomes and quality of life measures for two fixation methods in the setting of displaced femoral neck fractures. The two groups included fixation with multiple cancellous screws (group 1) and telescopic femoral neck screws and small locking plate device (Targon FN) (group 2). Patients underwent reduction and internal fixation with either multiple cancellous screws or Targon FN device from March 2000 to January 2012. Failure endpoints included nonunion, osteonecrosis of the femoral head, and revision surgery. Patient reported outcome measures included chronic pain, ability to ambulate, and the use of ambulation assistive devices. Statistical analysis demonstrated a statistically significant lower rate of non-union and overall complication in the Targon FN group (p value < 0.001 and p value = 0.005 respectively). Logistic regression analysis showed that operative fixation with the Targon FN device decreased the odds ratio for overall complication by a factor of 0.34 (P = 0.02). There were no statistically significant differences between groups 1 and 2 in patient reported outcomes (chronic pain (p-0.21), ability to ambulate (p- 0.07), and the use of ambulation assistive device (p-0.07)). When compared to traditional cancellous screw fixation of femoral neck fractures, the Targon FN device has significantly lower complications rates and equivalent patient reported outcomes.

(1) Background: The RDW-CV has predictive value in many pregnancy-related conditions. Re-search question: Can the RDW-CV be utilized predictively in pregnant patients with thrombo-philia? Aim of the study: To carry out a detailed analysis of the RDW-CV in pregnant patients with treated thrombophilia as compared with pregnant patients without thrombophilia who de-livered via cesarean section at term. (2) Methods: We studied 160 pregnant patients, including 80 pregnant patients with treated thrombophilia in the study group, and another 80 patients of a similar age and parity. The patients were referred to our hospital for delivery at term by means of a cesarean section between 1/10/2017 and 1/12/2021. Every patient received a sonogram during the first 1–2 days after the cesarean section, and their uterine evaluation was interpreted using the PUUS (Postpartum Uterine Ultrasonographic Scale). (3) Results: Our PUUS≥1 pregnant and postpartum patients with treated thrombophilia were the only group with an RDW-CV value over 14. No deep vein thrombosis was observed during hospitalization, showing that the antico-agulant treatment was necessary and effective. An RDW-CV of 14.5 was the highest value in the Rh-negative group of pregnant patients with treated thrombophilia. An RDW-CV of 14.48 was the highest level in the Rh-negative postpartum patients with treated thrombophilia. (4) Conclu-sion: An RDW-CV of ≥14 can predict uterine hematometra (PUUS≥1). The RDW-CV values were higher in Rh-negative patients.

Planetary waves in the mesosphere are studied using observational data and models to establish their origin, as there are indications of their generation independently of waves in the stratosphere. The quantitative relationships between zonal wave numbers m = 1 (wave 1) and m = 2 (wave 2) were studied with a focus on the mid-latitude mesosphere at 50N latitude. Aura Microwave Limb Sounder measurements were used to estimate wave amplitudes in geopotential height during the 2020–2021 winter major sudden stratospheric warming. The moving correlation between the wave amplitudes shows that, in comparison with the anticorrelation in the stratosphere, wave 2 positively correlates with wave 1 and propagates ahead of it in the mesosphere. A positive correlation r = 0.5–0.6, statistically significant at the 95% confidence level, is observed at 1–5-day time lag and in the 75–91 km altitude range, which is the upper mesosphere–mesopause region. Wavelet analysis shows a clear 8-day period in waves 1 and 2 in the mesosphere at 0.01 hPa (80 km), while in the stratosphere–lower mesosphere the period is twice as long at 16-days; this is statistically significant only in wave 2. Possible sources of mesospheric planetary waves are discussed.

Safely resuming sporting events while the coronavirus is spreading is challenging – yet possible – if the science is taken into account. Two main ways the coronavirus can spread among football players is through air-suspended microdroplets (and possibly aerosols), and via contact with contaminated surfaces. Here we estimated virus survival in dried saliva droplets on a football pitch (i.e., on the grass) and on the ball itself, and compared these measures between mid-day and nighttime matches. We find, based on experiments with the enveloped phage Phi6 – a surrogate for SARS-Cov-2 – that while the virus survives reasonably well on both pitch and ball during a nighttime match (~10% survival), virtually no viruses survived the 90-minute duration of a mid-day match on a hot, sunny day. These results, taken together with studies reporting rapid deactivation of coronavirus in aerosols by sunlight, suggest that playing football in mid-day reduces the likelihood of transmission between players, and thus increases players’ safety.

Background: The validation of laser usage during laparoscopic procedures, notably by Camran Nezhat in the late 1980s, has been significant. Lasers offer precision and depth control in tissue vaporization without bleeding. Surgical intervention remains central in managing endometrio-sis-associated pain and infertility, especially for patients unresponsive to hormonal therapy. Methods: This retrospective cohort study included 200 patients with SPE who underwent laparo-scopic laser vaporization. Surgery was performed using a CO2 laser, and histological confirma-tion of endometriosis was obtained for all cases. Pain scores and SF-36 questionnaire domains were assessed preoperatively and postoperatively. Fertility outcomes were evaluated among pa-tients desiring pregnancy. Results: Significant improvements in pain score and SF-36 questionnaire domains were ob-served postoperatively (p-value

ABSTRACT Background: To date, the COVID-19 pandemic has been the foremost health concern for humankind in the new millennia. This paper aims to describe the related hospitalizations in Italy during the first two years of the health emergency. Design and methods: This is a retrospective, population-based study of Italian hospitalizations for patients diagnosed with COVID-19 during the 2020-2021 period, extracted from the National Hospital Discharge Registry. The outcome variables considered include hospital admissions, costs, and length of stay, among other hospitalization-level variables. Costs were estimated through the charges associated with the Diagnosis-Related Group and Major Diagnostic Categories coding system, plus an additional cost attributed to COVID-19 admissions. To these charges was added an extra cost defined by the ministry of health. Results: In Italy, there were 357,354 hospitalizations for COVID-19 attributed to 298,856 patients in 2020 and 399,043 hospitalizations for COVID-19 attributed to 333,447 patients in 2021. COVID-19 patients faced a transfer rate thrice that of other patients. Hospitalizations were concentrated predominantly in the northern regions, particularly in the first year. Hospitalization rates varied by age in a sine wave pattern, peaking in the youngest and oldest age groups, with mortality rates escalating with age— tending to remain below 3% for those under 44 but surging to 40% in individuals over 75. The financial impact of COVID-19 hospitalizations was substantial, with total costs reaching €3.97 billion in 2020 and €4.99 billion in 2021. Costs per admission and per day also rose, from €11,112 and €807 in 2020 to €12,503 and €844 in 2021, respectively. Excluding the added financial burden of COVID-19, costs would have been notably lower. Hospitalizations involving continuous invasive mechanical ventilation were particularly costly (about 24.000 euros x admission), reflecting the significant resources required for these treatments. Conclusion: Implementing a protective pad around the entire health system that leverages networks of family doctors and nurses, connected in real time to the entire health system, can be crucial. Such a network, tasked with monitoring the local epidemiological situation, protecting vulnerable individuals also through telehealth visits, and establishing a triage system for infections in the initial phase, may effectively help in managing virus spread and protecting hospitals from unpredictable waves of admission demand. Strengthening primary health care could be a decisive factor for the future and enhance the system's resilience in facing new challenges.

Polarisation analysis in the mid-infrared fingerprint region was carried out on thin (∼1μm) Si and SiO2 films evaporated via glancing angle deposition (GLAD) method at 70∘ to the normal. Synchrotron-based infrared microspectroscopic measurements were carried out on the Infrared Microspectroscopy (IRM) beamline at Australian Synchrotron. Specific absorption bands, particularly Si-O-Si stretching vibration, was found to follow the angular dependence of ∼cos2θ, consistent with the absorption anisotropy. This unexpected anisotropy stems from the enhanced absorption in nano-crevices, which have orientation following the cos2θ angular dependence as revealed by Fourier transforming the image of the surface of 3D columnar films and numerical modeling of light field enhancement by sub-wavelength nano-crevices.

The realization of a perfect absorber A = 1 with transmittance and reflectance T=R=0 by a thin metasurface is one of the hot topics in recent nanophotonics prompted by energy harvesting and sensor applications (A + R + T =1 is the energy conservation). Here we tested optical properties of over 400 structures of metal-insulator-metal (MIM) metasurfaces for a range of variation in thickness of insulator, the diameter of a disc and intra-disc distance experimentally and numerically. Conditions of a near-perfect absorption A > 95% with simultaneously occurring anti-reflection property (R < 5%) were experimentally determined. Differences between the bulk vs. nano-thin film properties at mid-IR of the used materials can be of interest for plasmonic multi-metal alloys and high entropy metals.

Sentiment analysis plays a crucial role in understanding customer feedback, guiding product development, and informing business decisions. This paper introduces term sentiment entropy (TSE), a novel weighting method that leverages the distribution of sentiment labels associated with words to enhance text classification accuracy. TSE complements traditional TF-IDF techniques by capturing the nuances of sentiment variation across different contexts. Experiments across diverse public datasets demonstrate TSE's potential to improve sentiment analysis performance, especially in capturing subtle sentiment shifts and adapting to specific domains. While computational cost and label quality pose challenges, TSE offers a promising avenue for refining sentiment analysis and opening new research frontiers.

To enhance the safety of power grid operations, this study proposes a high-precision short-term photovoltaic power prediction method that integrates information from surrounding pho-tovoltaic stations and the Conv-LSTM-ATT model. In the deep learning prediction model, not only is numerical weather prediction (NWP) data from the target photovoltaic station used as input features, but also highly correlated features from nearby photovoltaic stations are incor-porated. The research begins by analyzing the correlation between irradiance and power se-quences, along with distance factors, to calculate a composite similarity index between the target and other regional photovoltaic stations. Stations with high similarity indices are then selected as data sources. Subsequently, Bayesian optimization techniques are employed to find the optimal data fusion ratios. Ultimately, using the selected data, power prediction mod-eling is conducted via the Conv-LSTM-ATT deep neural network. Experimental results con-firm the superiority of the proposed model, which demonstrates higher predictive accuracy compared to three other classical models. The data fusion strategy determined by Bayesian optimization significantly enhances prediction accuracy, reducing the root mean square error (RMSE) of the test set by 20.04%, 28.24%, and 30.94% for three weather types, respectively.

In this paper, we prove the existence of three solutions for a $p$-Kirchhoff problem with $\psi$-Hilfer fractional derivative. To be more precise, we use the variational method and we prove that the associated functional energy admits a critical point in each of the three constructed sets, these critical points are weak solutions for a studied problem. Moreover, by definition of these sets, one of these solutions is positive, the second is negative, and the third one change sign. At the end of this work, we present an example to validate our main results.

In many European countries over the last decades, arable fields dominate agriculture landscapes, leading to a very intensive land-use practices. This reason seems to be the main cause of popula-tions declines for numerous farmland species, including the European hare (Lepus europaeus Pallas, 1778). The Research institute for Animal Production (National Agricultural and Food Centre, Luzianky, Slovakia) has been engaged in a long monitoring project (project currently run-ning), collecting certain indicators of hare population dynamics during hunting season since 1987 to 2023 in the Slovak Danubian Lowland. In the same macro-area (Čiližská Radvaň and Lehnice) a study was conducted on the influence of permanent semi-natural vegetation in relation to re-cruitment, population density and production. The whole monitored period was aggregated into 5-years intervals (for a total of 7 time-intervals), with the aim of analyzing the brown hare popu-lation dynamics. Spring hare density in the Danubian Lowland is currently 20.8 hares/km2, with harvests of 4.6 hares/km2. During all the monitoring period, bag’s animals have been examined following the regular hunting operations for the purpose of age determination (weight of eye lenses), sex ratio and productivity. The results of our analysis showed that the proportion of juve-nile in bag (PYB) among those shot varied from 37.0 % of the last 5-years interval (2018-2023), to a maximum of 51.0 % in interval of years 1998-2002. On total average there were 1.86 juveniles per adult female (r). The proportion of adult females in gamebag varied from 22.58 % (years in-terval 1992-1997) to 31.26 % (years interval 2018-2023). Sex-ratio (SI; males : females) among shot hares showed a value of 0.50, ranged from 0.48 in the period 2008-2012 to 0.52 in the first observed period (years 1987-1991) and in the last one (years 2018-2023). Average weight of shot hares was 4.04 kg (juveniles 3.83 kg, adults 4.27 kg, adult males 4.21 kg and females 4.32 kg). There was a large positive effect of set-aside with special mixtures, created for hares in large-scale farmed agrarian landscape, on hare density, bag and recruitment. In model hunting grounds with such set-asides increased the spring stock by 25 %, bag by 100 % and recruitment by 20 %. This study reveals that the management of European brown hare is not sustainable, and the population is decreasing. It is proved through the decline of harvest hares and by population dynamics parameters. Environmental improvements lead to the stabilization and increasing of requested parameters.

The influence of short term water absorption on the mechanical properties of halloysite nanotubes-multi layer graphene reinforced polyester hybrid nanocomposites has been investigated. The addition of nano-fillers significantly increased the flexural strength; tensile strength and impact strength in dry and wet conditions. After short term water exposure; the maximum microhardness; tensile; flexural and impact toughness values were observed at 0.1 wt% MLG. The microhardness increased up to 50.3%; tensile strength increased up to 40% and flexural strength increased up to 44%. Compared to dry samples; the fracture toughness and surface roughness of all types of produced nanocomposites were increased that may be attributed to plasticization effect. Scanning electron microscopy revealed that the main failure mechanism is caused by the weakening of nano-filler-matrix interface induced by water absorption. It was further observed that synergistic effects were not effective at concentration of 0.1 wt% to produce considerable improvement in mechanical properties of produced hybrid nanocomposites.

Long-term safety of a nutraceutical combination based on agnus castus and magnolia extracts combined with soy isoflavones (SI) and lactobacilli, and effectiveness on vasomotor symptoms and sleep disorders in postmenopausal women, were assessed. A controlled study was carried-out in menopausal women comparing this nutraceutical combination (ESP group) with formulation containing isoflavones alone (C group), at the dosage recommended. Kuppermann index, PSQI, and SF-36 were determined at baseline, 3, 6 and 12 months. Endometrial thickness, mammary density and liver function were evaluated at baseline and after 12 months. 180 women (100 in ESP group and 80 in C group, mean age 55.5 years, in menopause for about 36 months) were enrolled in the study. At the treatment end, mammary density, endometrial thickness, and hepatic function did not show substantial differences between groups. Kuppermann index, and particularly hot flushes, were progressively and significantly decreased in frequency and severity during ESP versus C treatment. No adverse events were observed. Agnus castus and magnolia, combined with SI + lactobacilli, can effectively and safely be used in symptomatic postmenopausal women, mainly when quality of sleep is the most disturbing complaint. Endometrium, mammary glands and liver function, were unaffected after 12 months treatment.

A U.S. government health agency conducted epidemiological studies to evaluate whether exposures to drinking water contaminated with volatile organic compounds at U.S. Marine Corps Base Camp Lejeune, North Carolina, were associated with increased health risks to children and adults. These health studies required knowledge of contaminant concentrations in drinking water—at monthly intervals—delivered to family housing, barracks, and other facilities within the study area. Because concentration data were limited or unavailable during much of the period of contamination (1950s–1985), the historical reconstruction process was used to quantify estimates of monthly mean contaminant-specific concentrations. This paper integrates many efforts, reports, and papers into a synthesis of the overall approach to, and results from, a drinking-water historical reconstruction study. Results show that at the Tarawa Terrace water treatment plant (WTP) reconstructed (simulated) tetrachloroethylene (PCE) concentrations reached a maximum monthly average value of 183 micrograms per liter (ug/L) compared to a one-time maximum measured value of 215 ug/L and exceeded the U.S. Environmental Protection Agency’s current maximum contaminant level (MCL) of 5 ug/L during the period November 1957–February 1987. At the Hadnot Point WTP, reconstructed trichloroethylene (TCE) concentrations reached a maximum monthly average value of 783 ug/L compared to a one-time maximum measured value of 1,400 ug/L during the period August 1953–December 1984. The Hadnot Point WTP also provided contaminated drinking water to the Holcomb Boulevard housing area continuously prior to June 1972, when the Holcomb Boulevard WTP came on line (maximum reconstructed TCE concentration of 32 ug/L) and intermittently during the period June 1972–February 1985 (maximum reconstructed TCE concentration of 66 ug/L). Applying the historical reconstruction process to quantify contaminant-specific monthly drinking-water concentrations is advantageous for epidemiological studies when compared to using the classical exposed versus unexposed approach.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social interaction and communication, anxiety, hyperactivity, and restricted interest for specific subjects. In addition to the genetic factors, multiple environmental factors have been related to the development of ASD. Animal models can serve as crucial tools for understanding the complexity of ASD and identifying potential therapeutic strategies. In this study, a chemical model of ASD has been developed in zebrafish by exposing embryos to valproic acid (VPA) from 4 to 48 hours post-fertilization. After the exposure, embryos were transferred to fish water and the effects on behavior and neurotransmitters profile were analyzed at both larval and adult stages. Larvae from VPA-treated embryos showed hyperactivity and decreased visual and vibrational escape responses, as well as an altered neurotransmitters profile, with increased glutamate and decreased acetylcholine and norepinephrine levels. Adults from VPA-treated embryos exhibited impaired social behavior characterized by larger shoal sizes and a decreased interest for their conspecifics. Neurotransmitter analysis revealed a significant decrease in dopamine and GABA levels in the brain. These results support the interest of this model in the study of ASD.

(1) Background: Thrombophilia is a tendency towards hypercoagulability, and it is increased by pregnancy, peaking around delivery. Research question: does thrombophilia stimulate the in-flammatory state of the patient, already suppressed by pregnancy? (2) Methods: Eighty thrombo-philia patients admitted for delivery between 1/10/2017 and 1/12/2021 were prospectively stud-ied, together with eighty age- and para-matched control patients. Patients were admitted for de-livery at term by means of cesarean section. The inflammation indexes from the complete blood count values analysis during both the 24 hours before and after labor—extracted from the hospi-tal’s medical records—were calculated and then correlated with uterine involution. (3) Results: Except for the PLR, most of the numerous inflammation indexes studied were not significantly different in treated thrombophilia patients, before and after delivery, compared to non-thrombophilia patients. Only when we split the patients, based on the uterine haematometra in the first 24-48 hours postpartum, we found out that the few treated thrombophilia patients with haematometra (14 with haematometra out of 79 with treated thrombophilia) had elevated SII and AISI antepartum. In pregnant patients treated for thrombophilia, MLR is higher in pa-tients without the Rh factor than in those with the Rh factor. In non-thrombophilia patients, MCVL and NLPR increased with age and before labor, while SII and AISI increased with age postpartum. (4) Conclusions: Thrombophilia did not stimulate the inflammatory state of the pa-tient, already suppressed by pregnancy.

Within the European Union (EU), new plant varieties, to be included at the Common catalog of a member state, has to be registered at the national list, after plant variety testing processes to establish whether the candidate variety is distinguishable, uniform and stable (DUS) and meets the requirement of the cultivation or use value requirement (VCU). Technical development, climate change and changing consumer needs, including the detection of GMOs, necessitate the innovation of plant variety testing methods. Within the EU-funded "InnoVar" project, it has been sent out questionnaires to several countries, which were aimed at analyzing strengths, weaknesses, opportunities and threats (SWOT) of the current methods and with their help it is possible to have look for a new direction, opportunity and strategy, which can incorporate together with the innovation results into the development of the new methods. Our study confirmed that the SWOT analysis could be used to achieve the set goals; according to the answers to the questionnaires, it became necessary to introduce new characters (e.g. cold tolerance) and new test methods (molecular markers, precision techniques, organic farming) into the variety testing procedures. The development of high-yielding, disease and/or pest-resistant plant varieties with good adaptability and the accurate evaluation of genotypes play a crucial role in ensuring that farmers can access high-performing plant varieties and contribute to sustainable food production.

The Zero Trust Architecture (ZTA) security system follows the "never trust, always verify" principle. The process constantly verifies users and devices trying to access resources. This paper describes how Microsoft Azure uses ZTA to enforce strict identity verification and access rules across the cloud environment to improve security. Implementation is time-consuming and difficult. Azure's extensive services and customizations require careful design and implementation. Azure administrators struggle to navigate and change configurations due to its complex user interface (UI). Each Azure ecosystem component must meet ZTA criteria. ZTA's comprehensive policy definitions, multi-factor and pass-wordless authentication, and other advanced features are tested in a mid-size business scenario. These configuration changes require a solid grasp of Azure's architecture and Zero Trust. Implementing an Azure ZTA reduces vulnerabilities and restricts authorized users' access to critical resources. Implementation is time-consuming and expensive, requires a significant commitment to changing IT procedures, and can be confusing because the same features are available in multiple places. Azure ZTA has shown great potential for both hybrid and cloud-native companies.

Almost 50 papers on surface plasmon resonance biosensors, published between 2016 and mid-2018, are reviewed. Papers concerning the determination of large particles such as vesicles, exosomes, cancer cells, living cells, stem cells and microRNA are excluded, as these are covered by a very recent review. The reviewed papers are categorized into five groups, depending on the degree of maturity of the reported solution: ranging from simple marker detection to clinical application of a previously developed biosensor. Instrumental solutions and details of biosensor construction are analyzed, including the chips, receptors and linkers used, as well as calibration strategies. Biosensors with a sandwich structure containing different nanoparticles are considered separately, as are SPR applications for investigating the interactions of biomolecules. An analysis is also made of the markers determined using the biosensors. Concluding, there is shown to be a growing number of SPR applications in the solution of real clinical problems.

Oritavancin is a novel long-acting lipoglycopeptide with in vitro activity against methicillin-resistant (MR) Gram-positive pathogens and a good bactericidal activity even in presence of biofilm forming bacteria. It has been approved for acute bacterial skin and skin structure infections (ABSSSI), but recent reports have demonstrated possible off-label uses, as for prosthetic joint infections (PJI), which, in more than half of cases, are caused by MR Gram positive organisms. We reported a case of a man in his eighties with a late shoulder PJI caused by methicillin resistant Staphyloccus epidermidis (MRSE) with contraindications for surgical replacement and few oral therapeutic options for a long term suppressive antibiotic therapy. The prosthesis was retained, and the patient received ten outpatient sequential doses of 1200 mg of oritavancin during 28 weeks, based on therapeutic drug monitoring (TDM) as a guide for correct timing of administration of each dose. During oritavancin administration, the patient achieved clinical cure, with disappearance of the pain and regaining pre-infection joint mobility, with no side effects reported and no further surgery or hospitalization needed. The treatment is ongoing as a long-lasting suppressive antimicrobial therapy. Oritavancin could represent an excellent solution for treating PJI caused by MR organism, especially in patients who need a long-term suppressive therapy.

Background: The effect of COVID-19 infection, versus the indirect effect of the pandemic on body composition remains unclear. This study investigates long-term changes in body composition in COVID–19 survivors compared to a contemporary control group. Method: This is a prospective study involving adults who had a pre-pandemic whole-body DXA scan (DXA#1) performed between 2017 and 2019. Participants were asked to return for a repeat whole-body DXA scan (DXA#2) after the pandemic. Detailed data were collected including medical and COVID history. Inflammation markers and fasting lipids were measured. For those participants who had a COVID-19 infection between the 2 DXAs, DXA#2 was acquired at least one year after COVID-19 infection. Results: Overall, 160 adults were enrolled; 32.5% females, 51.8% non-white, with mean age of 43.2 years. Half (n=80) of the participants had documented COVID infection between their 2 DXA scans (COVID+ group), and the other half never had COVID. COVID-negative participants had an increase in annualized trunk fat (g) [922.5 vs. 159.7; P=0.01], total fat (g) [1564.3 vs. 199.9; P=0.2], and LBM (g) [974.9 vs. -64.5; P=0.0002], when compared to COVID+ group. However, among the COVID+ group, no differences were seen in annualized trunk fat, total fat mass, or LBM between those with PASC and without (p>0.05). Conclusion: During the pandemic, both COVID-19-survivors and COVID-negative groups exhibited increases in weight, and total and trunk fat, likely associated with pandemic-linked lifestyle modifications. However, only COVID-19-survivors had a decline in lean body mass over the same period, regardless of PASC symptoms.

Deep underground laboratories offer advantages for conducting high-precision observations of weak geophysical signals, benefitting from a low background noise level. It is both valuable and feasible to enhance strong, noisy ground electromagnetic (EM) field data using synchronously recorded underground EM signals, which typically exhibit a high signal-to-noise ratio. In this study, we propose an EM field reconstruction method employing a Long Short-Term Memory (LSTM) recurrent neural network with referenced deep underground EM observations. Initially, a deep learning model was developed to capture the time-varying features of underground multi-component EM fields using the LSTM recurrent neural network. Subsequently, this model was applied to process synchronously observed strong, noisy data from other conventional observation systems, such as those at surface, to achieve noise suppression through signal reconstructions. Both theoretical analysis and practical observational data suggest that the proposed method effectively suppresses noise and reconstructs clean EM signals. This method is efficient and time-saving, representing an effective approach to fully utilizing the advantages of deep underground observation data. Furthermore, this method could be extended to the processing and analysis of other geophysical data.

Background/Objectives: Vitamin B12 deficiency can cause variable symptoms, which may be irreversible if not diagnosed and treated in a timely manner. We aimed to develop a widely accepted expert consensus to guide the practice of diagnosing and treating B12 deficiency. Methods: We conducted a scoping review of the literature published in PubMed since January 2003. Data were used to design a two-round Delphi survey to study the level of consensus among 42 experts. Results: The panelists agreed on the need for educational and organizational changes in the current medical practices for diagnosing and treating B12 deficiency. Recognition of clinical symptoms should receive the highest priority in establishing the diagnosis. There is agreement that the serum B12 concentration is useful as a screening marker, whereas methylmalonic acid or homocysteine can support the diagnosis. Patient lifestyle, disease history and medications can provide clues to the cause of B12 deficiency. Regardless of the cause of the deficiency, initial treatment with parenteral B12 was regarded as the first choice for patients with acute and severe manifestations of B12 deficiency. The use of high-dose oral B12 at different frequencies may be considered for long-term treatment. Prophylactic B12 supplementation should be considered for specific high-risk groups. Conclusions: There is a consensus that clinical symptoms need to receive more attention in establishing a diagnosis. B12 laboratory markers can support the diagnosis. The severity of clinical symptoms, the causes of B12 deficiency and the treatment goals govern decisions regarding the route and dose of B12 therapy.

Urban tourism has witnessed significant growth in recent years, driven by various factors that foster the transformation of urban areas into tourist hotspots. These factors include a rising interest in culture and heritage, ongoing urban redevelopment and conversion processes, and the introduction of new experiences and activities. Two particularly influential factors contributing to this growth are low-cost travel, which facilitates more accessible access to urban destinations, and the emergence of new types of accommodation, such as short-term rental (also known as local accommodation or Airbnb-type accommodation). This sudden and continuous growth of this type of tourist accommodation brings new challenges to cities and local communities. On the positive side, it contributes to job opportunities, the dynamism of the local economy, and urban revitalization. On the other hand, it also represents more difficulty in retaining the local population in city centers, as more and more buildings are converted into hostels and tourist apartments. In this context, it becomes essential to conduct studies evaluating the impacts of these dynamics in urban areas and how they influence residents' and visitors' perspectives. Therefore, this study aims to identify the main transformations resulting from short-term rental (STR) development, focusing on the impacts felt by tourists and residents in Porto. A questionnaire was distributed to tourists and residents in Porto's city center in June 2023. The results reveal differences in opinions between tourists and residents, particularly concerning historical heritage preservation, local population relocation, and reduced housing availability for residents. Nevertheless, there is a similarity in their opinions regarding the stimulus that local accommodation brings to the economy and the rehabilitation of buildings and urban areas. This study reinforces the need to pay more attention to the future development of tourist accommodation in city centers, especially regarding local policies and territorial planning, to balance better tourism development and local communities' quality of life.

Lifestyle interventions can prevent type 2 diabetes (T2DM). However, some in-dividuals do not experience anticipated improvements despite weight loss. Bi-omarkers to identify such individuals at early stages are lacking. IGF-1 and IGFBP-1 were shown to predict T2DM onset in prediabetes. We assessed if these markers also predict the success of lifestyle interventions, thereby possibly guid-ing personalized strategies. We analyzed fasting serum levels of IGF-1, IGFBP-1 and IGFBP-2 in relation to changes in metabolic and anthropometric parameters, including intrahepatic li-pids (IHL) and visceral adipose tissue (VAT) volume measured by MRI, in 345 high-risk prediabetic participants (54% female; aged 36-80 years). Participants were enrolled in three randomized dietary intervention trials and assessed both at baseline and one year post-intervention. Statistical analyses were performed using IBM SPSS Statistics (version 28), significance set at p

The intense motion of a ship can greatly impacts the comfort of crew members and the safety of the vessel. Therefore, accurately estimating and predicting ship attitudes has become an important issue. This paper introduces the latest development in functional deep learning model called DeepOnet. It takes wave height as input and ship motion as output, using a cause-to-result prediction approach. The modeling data used in this study is sourced from publicly available experimental data from the Iowa Institute of Hydraulic Research. Firstly, parameters system tuning was conducted for the neural network's hyperparameters to determine the appropriate combination of parameters. Secondly, the DeepOnet model for wave height and multi-degree-of-freedom motion was established, and the influence of increasing time steps on prediction accuracy was examined. Finally, a comparison was made between the DeepOnet model and the classical time series model LSTM. It was found that the DeepOnet model had a 10-fold improvement in accuracy for roll and heave attitudes. Moreover, as the forecast duration increased, the advantage of DeepOnet showed a trend of strengthening. As a functional prediction model, DeepOnet provides a new promising tool for very short-term prediction of ship motion.

(1) Background: Ectopic pregnancy (EP) is when fertilized ovum implanted outside of uterine cavity. The incidence was 1.5% to 2.0% of all pregnancies [1, 2]. EP decreases fertility ability [3]. This study focused on the pregnancy rate after EP and various parameters influencing pregnancy. (2) Methods: The data was extracted from National Health Insurance Research Database (NHIRD) during 2000-2013. The study group enrolled women with one EP history. Those who did not have EP was put into the control group. Chi-square/Fisher exact test was performed on category variable and t-test was used on continue variables. (3) Results: The EP group had a higher cumulative rate of conceive, 41.55% than control group, 37.14% and 1.16 times higher risk in developing pregnancy (P&lt;0.001). The conceiving rate was lower than the control group in the first 5 years, but higher than the control group in the 10th to 14th years. (4) Conclusions: The fecundability after EP is lower at the beginning, but regained after long term follow.

With the global objectives of achieving a ‘carbon peak’ and ‘carbon neutrality’, along with the implementation of carbon reduction policies, China’s industrial structure has undergone significant adjustments, resulting in constraints on high-energy consumption and high-emission industries while promoting the rapid growth of green industries. Consequently, these changes have led to an increasingly complex power system structure and presented new challenges for electricity demand forecasting. To address this issue, this study proposes a 24-step multivariate time series short-term load forecasting algorithm model based on KNN data imputation and BiTCN bidirectional temporal convolutional networks combined with BiGRU bidirectional gated recurrent units and attention mechanism. The Kepler adaptive optimization algorithm (KOA) is employed for hyperparameter optimization to effectively enhance prediction accuracy. Furthermore, using real load data from a wind farm in Xinjiang as an example, this paper predicts the electricity load from January 1st to December 30th in 2019. Experimental results demonstrate that our comprehensive short-term load forecasting model exhibits lower prediction errors and superior performance compared to traditional methods, thus holding great value for practical applications.

(1) Background: Sleep disordered breathing represent a growing public health concern, especially among children and adolescents. Full-night polysomnography is considered the gold standard for diagnosing obstructive sleep apnea. Our goals are to identify personal and environmental risk factors for the onset and persistence of sleep respiratory disorders. We also want to investigate the differences in neuropsychological profiles; (2) Methods: This is an observational, retrospective cohort study. We collected information on adenoidectomy or adenotonsillectomy. We reviewed the clinical history and preoperative visits and collected data through a telephone questionnaire. Pediatric Sleep Questionnaire (PSQ) and the Pediatric Quality of Life Inventory (PedsQL) are questionnaires used for screening sleep respiratory disorders in children. The data were statistically analyzed it using SPSS version 22.0 for Windows (SPSS Inc., Chicago, IL); (3) Results: The study involved 138 patients, but only 100 parents participated. A higher percentage of patients with sleep disordered breathing were observed to have mothers who smoked during pregnancy. A smaller proportion of patients with sleep disordered breathing had a habit of using a pacifier. A rise in physical results is associated with a reduction in the PSQ at follow-up (p=0.051). An increase of overall academic achievement is associated with an average decrease in the PSQ at follow-up (p&lt;0.0001). A more significant proportion of patients undergoing adenotonsillectomy were observed to have a history of prematurity and cesarean birth (4) Conclusions: These results provide essential information on the effectiveness and effects of adenotonsillectomy intervention compared to adenoidectomy intervention and the factors associated with SDB in children undergoing these interventions.

External motivational stimuli have been shown to improve athletic performance. However, the neurophysiological mechanisms underlying this improvement remain poorly understood. This randomized crossover study investigated the effects of music and verbal encouragement on measures of muscle excitation and myoelectric manifestations of fatigue in the biceps brachii (BB) and brachioradialis (BR) muscles during an endurance task. Fifteen untrained (mean age 29.57 ± 2.77 years) and 13 trained individuals (mean age 32.92 ± 2.90 years) were included. The endurance task, performed to exhaustion, consisted of keeping the dominant arm flexed to 90 degrees while holding a dumbbell loaded to 80% of 1RM with a supine grip in three randomized conditions: standard, with self-selected music, and with verbal encouragement. The untrained subjects showed an increase in task duration of 15.26% (p < 0.003) with music and 15.85% (p < 0.002) with verbal encouragement compared to the condition without external stimuli. There were no significant differences in the myoelectric manifestations of fatigue between the dif-ferent conditions. Regarding the muscle excitation metrics, although the mean amplitude, peak value and area under the curve remained unchanged across conditions, a significant reduction in the trend coefficient, indicating motor unit recruitment over time, was observed with both music (BB: -10.39%, p < 0.001; BR: -9.40%, p < 0.001) and verbal encouragement (BB: -7.61%, p < 0.001; BR: -6.51%, p < 0.001) compared to the standard condition. For the trained participants, no significant differences were observed between conditions in terms of task duration and outcome measures related to muscle excitation and myoelectric manifestations of fatigue, suggesting the possible presence of a ceiling effect on motivation. These results highlight the significant role of external motivational stimuli, such as music and verbal encouragement, in improving task performance in untrained subjects, probably through more ef-fective and efficient recruitment of motor units.

This work is aimed at investigating the capabilities and limits of the mid-fidelity numerical solver DUST for the evaluation of wind turbines aerodynamic performance. In particular, this study was conducted by analysing the benchmarks NREL- 5MW and Phase VI wind turbines, widely investigated in literature by from experimental and numerical activities. The work started by simulating simpler configuration of the NREL- 5MW turbine to progressively integrate complexities such as shaft tilt, cone effects and yawed inflow conditions, offering a detailed portrayal of their collective impact on turbine performance. A particular focus was then given to the evaluation of aerodynamic responses from the tower and nacelle, as well as aerodynamic behavior in yawed inflow condition, crucial for optimizing farm layouts. In the second phase, the work was focused on NREL Phase VI turbine due to the availability of experimental data on this benchmark case. Comparison of DUST simulations results with both experimental data and high-fidelity CFD tools shows the robustness and adaptability of this mid-fidelity solver for this applications, thus opening a new scenario for the use of such mid-fidelity tools for the preliminary design of novel wind turbines configurations or complex environments as wind farms, characterised by robust interactional aerodynamics.

Recent developments in mid-infrared (MIR) spectroscopic ellipsometry enabled by quantum cascade lasers (QCLs) resulted in a drastic improvement in signal-to-noise ratio compared to conventional thermal emitter based instrumentation. Thus, it was possible to reduce the acquisition time for high-resolution broadband ellipsometric spectra from multiple hours to less than 1 second. This opens up new possibilities for real-time in-situ ellipsometry in polymer processing. To highlight these evolving capabilities we demonstrate the benefits of a QCL based MIR ellipsometer by investigating single and multilayered polymer films. The molecular structure and reorientation of a 2.5m thin biaxially oriented polyethylene terephtalate film is monitored during a stretching process lasting 24.5 s to illustrate the perspective of ellipsometric measurements in dynamic processes. In addition, a polyethylene/ethylene vinyl alcohol/polyethylene multilayer film is investigated at continuously varying angle of incidence ( 0∘ – 50∘) in 17.2 s, highlighting an unprecedented sample throughput for the technique of varying angle spectroscopic ellipsometry in the MIR spectral range. The obtained results underline the superior spectral and temporal resolution of QCL ellipsometry and qualify this technique as suitable method for advanced in-situ monitoring in polymer processing.

Existing methods enhance mid-low resolution remote sensing ship detection by feeding super-resolved images to the detectors. Although these methods marginally improve the detection accuracy, the correlation between image super-resolution (SR) and ship detection is under-exploited. In this paper, we propose a simple but effective ship detection method called ShipSR-Det, in which both the output image and the intermediate features of the SR module are fed to the detection module. Using the super-resolved feature representation, the potential benefit introduced by image SR can be fully used for ship detection. We apply our method to the SSD and Faster-RCNN detectors and develop ShipSR-SSD and ShipSR-Faster-RCNN, respectively. Extensive ablation studies validate the effectiveness and generality of our method. Moreover, we compare ShipSR-Faster-RCNN with several state-of-the-art ship detection methods. Comparative results on the HRSC2016, DOTA and NWPU VHR-10 datasets demonstrate the superior performance of our proposed method.

Let BT4l denotes a subclass of bounded turning functions connected with a four-leaf-type domain. The goal of the study is to probe into coefficients of |b6|, |b7|, |b8|, the bounds of the logarithmic coefficients and the third-order determinants of H3,1, H3,2, H3,3 for functions in this class.

Background: Osteoporosis and bone fractures affect health and quality of life. Since bone disease is multifactorial, identifying risk factors is key in prevention. There are multiple reports on how viral hepatitis especially chronic hepatitis B (CHB) and chronic hepatitis C (CHC) are affecting bone disease, but results vary. Here, we analyzed the potential association between CHB/CHC and osteoporosis or bone fractures in a large outpatient cohort in Germany. Methods: We included 3,136 outpatients with CHB and 15,608 matched non-hepatitis individuals as well as 2,867 outpatients with CHC and 14,335 matched non-hepatitis individuals from the Disease Analyzer Database between 2005 and 2022. The main outcome was the 5-year cumulative incidence of osteoporosis and bone fractures as a function of either CHB or CHC. Results: Within 5 years of the index date, 2.9% vs. 1.6% of patients with and without CHB were diagnosed with osteoporosis (p=0.001) and 1.0% vs. 0.4% were diagnosed with bone fractures (p<0.001). Moreover, 3.3% of CHC patients and 2.2% of individuals without hepatitis were diagnosed with osteoporosis (p=0.002). In Cox-regression analyses, CHB was significantly associated with an increased risk for osteoporosis (HR: 1.76) and fractures (HR:2.43) and CHC with osteoporosis (HR: 1.54). For both CHB and CHC, the association with osteoporosis was restricted to the female subgroup. Conclusion: CHB and CHC are associated with osteoporosis in women. CHB in male patients is associated with a higher risk of fractures. More research is are needed to understand the underlying pathophysiological mechanisms.

A tunable quantum cascade laser (QCL) spectrometer was used to develop methods for detecting and quantifying high explosives (HE) in soil based on multivariate analysis (MVA) and artificial intelligence (AI). For quantification, mixes of 2,4-dinitrotoluene (2,4-DNT) with concentrations from 0% to 20% w/w were investigated using three types of soils: bentonite, synthetic soil, and natural soil. A Partial least squares regression model was generated for predicting 2,4-DNT concentrations. To increase its selectivity, the model was trained and evaluated using additional analytes as interferences, including other HEs such as PETN, RDX, and TNT and non-explosives such as benzoic acid and ibuprofen. For detection, mixes of different explosives in soils were used to implement two AI strategies. In the first strategy, the spectra of the samples were compared with those of soils recorded in a database to identify the most similar soils based on QCL spectroscopy. Next, a Classical Least Squares preprocessing (Pre-CLS) was applied to soils spectra selected from the database. The parameter obtained based on the sum of the weights of Pre-CLS was then used to generate a simple binary discrimination model for distinguishing between contaminated and uncontaminated soils, achieving an accuracy of 0.877. In the second AI strategy, the same parameter was added to a principal component matrix obtained from spectral data of samples and used to generate multi-classification models based on different machine learning algorithms. A Random Forest model worked best with 0.997 accuracy and allowing to distinguish between soils contaminated with DNT, TNT, or RDX and uncontaminated soils.

Urea cycle disorders (UCDs) are common inborn errors of metabolism, with an incidence of one in 30,000 births. They are caused by deficiencies in any of six enzymes and two carrier proteins, the most common being Ornithine Transcarbamylase Deficiency (OTCD). OTCD results in impairment to excrete nitrogen, causing toxic buildup of ammonia with resultant encephalopathy. Hyperammonemia (HA) induces the conversion of glutamate to glutamine in the brain. Excess glutamine in the brain causes osmotic changes cerebral edema, changes in astrocyte morphology, and cell death. Acute symptoms of HA include vomiting, hyperventilation, seizures, and irritability. Long-term neurological changes include deficits in working memory and executive function. To date, there are no predictors of prognosis of infants with neonatal onset OTCD outside of plasma ammonia level at presentation and duration of hyperammonemic coma. We provide a comprehensive analysis of a 16-year-old male with neonatal onset of OTCD as an example of how brain biomarkers may be useful to monitor disease course and outcome. This male presented at 8 days post natal with plasma ammonia and glutamine of 677 and 4024 micromol/L and had a missense mutation in Exon 4 (p.R129H). Treatment included protein restriction, sodium benzoate, and citrulline, arginine, and iron. He suffered recurrent acute hyperammonemic episodes despite compliance, triggered by infections or catabolic stressors. We discuss the long-term effects of the hyperammonemic episodes by following MRI based disease biomarkers.

This study introduces a novel method for early prediction of Kimchi cabbage (Brassica rapa subsp. pekinensis (Lour.) Hanelt) height, utilizing drone imagery and a long short-term memory (LSTM) model. The research was conducted on a testbed at the National Institute of Agricultural Sciences (NAS) in South Korea, encompassing two distinct soil types (loam and sandy loam) to investigate their impact on growth. High-resolution drone images were captured throughout the growing season to generate a canopy height model (CHM) for estimating plant height at various stages. Missing height data were interpolated using a logistic growth curve, and an LSTM model was trained on this data to predict the final height of Kimchi cabbage at harvest. Three LSTM models were developed using time-series data collected at 29, 36, and 44 days after planting (DAP). The model trained on data from DAP 44 demonstrated the highest accuracy with a coefficient of determination (R²) of 0.83, a mean absolute error (MAE) of 2.48 cm, and a root mean square error (RMSE) of 3.26 cm, outperforming models trained on earlier data. Color-coded maps were generated to visualize the spatial distribution of predicted Kimchi cabbage heights, revealing variations in growth patterns across the testbed and confirming the model's potential for site-specific management. Considering the trade-off between accuracy and prediction timing, the model trained on DAP 36 data (MAE = 2.77 cm) was deemed optimal for informing cultivation management decisions. This research demonstrates the feasibility and effectiveness of integrating drone imagery, logistic growth curves, and LSTM models for early and accurate prediction of Kimchi cabbage height. The proposed technology enables data-driven decision-making for farmers, facilitating timely interventions based on predicted growth patterns. This could lead to improved crop yields, resource optimization, and a more sustainable agricultural future. Future research will focus on refining the model's accuracy and exploring its applicability to other crops, further expanding the potential of precision agriculture technologies.

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.

The majority of investigations on microbial communities from various environments are presently built on culture-independent methods. Many studies point to the pivotal, selective role of primers targeting hypervariable regions of 16S rRNA in the metabarcoding of bacteria, including cyanobacterial communities. The selectivity of primers designed to amplify targeted regions of the 16S rRNA gene, which has been highlighted by many authors, limited effective amplification. Moreover, the type and specificity of the studied material can also negatively influence the results of 16S metabarcoding. Most of the studies of cyanobacterial communities have been performed for planktonic microbial communities that are often represented by common, well-studied species. In this study, we present the results of 16S metabarcoding analysis using three primer pairs - two already well-known and a third designed in this study - that amplify divergent regions of the 16S rRNA gene (V3-V4, V4-V6, V6) for benthic, microbial mat-forming cyanobacteria communities. Such communities can be a source of toxigenic cyanobacterial taxa and should be monitored with adequate primers. The comparison of three primer pairs suggested that those designed within the present study describe the structure and composition of highly heterogeneous cyanobacterial mats’ communities better than the others

This study examines the Soil Organic Carbon (SOC) within Greek croplands, offering a comprehensive understanding of its dynamics. SOC, a cornerstone in soil health, nutrient cycling, and global carbon dynamics, assumes critical significance in sustainable agriculture and climate change mitigation. Drawing on diverse soil properties, including pH, soil texture as well as different drainage and slope categories, the research explores the nuanced relationships shaping SOC dynamics in the diverse agroecological landscape of Greece. The investigation transcends local boundaries, emphasizing SOC's global role in climate change mitigation by sequestering carbon dioxide. Two maps were used as data sources: 1) SOC stock baseline map (2010) by JRC, 2) SOC stock map (2021) by the Institute of Soil and Water Resources, Hellenic Agricultural Organization – DIMITRA in collaboration with FAO. Greek croplands emerge as a mosaic of agroecological diversity, where anthropogenic activities wield transformative influences on SOC stock, demanding a delicate balance between agricultural productivity and soil health. The study unveils the influence of Soil Order, weaving a tapestry of SOC variability. Microscopic factors, from soil texture to cation exchange capacity, further shape SOC dynamics, emphasizing the role of clayey soils and coarse materials in carbon retention. Although soil organic carbon decreased from 2010 to 2021 the degree of carbon loss varied. This scientific endeavor synthesizes existing knowledge and unveils novel insights, offering a narrative woven from diverse soil properties. The findings contribute valuable insights for sustainable land management practices and climate change mitigation strategies, underscoring the importance of region-specific approaches in addressing global challenges.

Background: Pharmacists need up-to-date knowledge and decision-making support in HIV care. We aim to develop MARVIN-Pharma, an adapted artificial intelligence-based chatbot initially for people with HIV, to assist pharmacists, considering evidence-based needs. Methods: From Dec 2022 to Dec 2023, an online needs-assessment survey evaluated Québec pharmacists' knowledge, attitudes, involvement, and barriers relative to HIV care, alongside perceptions relevant to the usability of MARVIN-Pharma. Recruitment involved convenience and snowball sampling, targeting National HIV and Hepatitis Mentoring Program affiliates. Results: Forty-one pharmacists (28 community, 13 hospital-based) across 15 Québec municipalities participated. Participants perceived their HIV knowledge as moderate (M=3.74/6). They held largely favorable attitudes towards providing HIV care (M=4.02/6). They reported a “little” involvement in the delivery of HIV care services (M=2.08/5), most often ART adherence counseling, refilling, and monitoring. The most common barriers reported to HIV care delivery were a lack of time, staff resources, clinical tools, and HIV information/training, with pharmacists at least somewhat agreeing that they experienced each (M≥4.00/6). On average, MARVIN-Pharma's acceptability and compatibility were in the ‘undecided’ range (M=4.34, M=4.13/7, respectively), while pharmacists agreed to their self-efficacy to use online health services (M=5.6/7). Conclusion: MARVIN-Pharma might help address pharmacists' knowledge gaps and barriers to HIV treatment and care, but pharmacist engagement in the chatbot’s development seems vital for its future uptake and usability.

Knowledge of a lasers beam’s profile throughout a laser system and experiment can help immensely in diagnosing laser problems and assisting in beam alignment and focusing at a sample. Obtaining such profiles is a trivial task in the ultraviolet-visible wavelength range but more challenging with near-infrared to infrared beams. Scientific grade bolometer arrays, suitable for such a task, do exist but are extremely costly, relatively large and have a large pixel size, of the order of 80 μm, which is adequate for profiling larger beams but poses an issue when trying to profile sub 100 μm beams for example at a focal point. This communication identifies a micro-bolometer array for near- to mid-infrared laser beam profiling, which is extremely low cost. In addition, the device is very compact, enabling use in confined spaces, and has a small, 12 μm, pixel size permitting the profiling of focused laser beams. The best scientific grade device identified has a pixel size of 17 μm. This device is a powerful tool for infrared laser spectroscopists, reducing the time required to measure the spot size of beams and to achieve spatial overlap of multiple infrared beams as used in two-dimensional infrared spectroscopy, saving many hours of setup time. The use of the bolometer array as a spectrographic detector and probe of long-term beam drifts is also demonstrated.

This study explores the role of inflammation and oxidative stress, hallmarks of COVID-19, in accelerating cellular biological aging. We investigated early molecular markers—DNA methylation age (DNAmAge) and telomere length (TL)—in blood leukocytes, nasal cells (NC), and induced sputum (IS) one-year post-infection in pauci- and asymptomatic healthcare workers (HCWs) infected during the first pandemic wave (February-May 2020), compared to COPD patients, model for "aged lung". Data by questionnaires, Work Ability Index (WAI), blood analyses, autonomic cardiac balance assessments, heart rate variability (HRV), and pulmonary function tests were collected. Elevated leukocyte DNAmAge significantly correlated with advancing age, male gender, daytime work, and an aged phenotype characterized by chronic diseases, elevated LDL and glycemia levels, medications affecting HRV, and declines in lung function, WAI, lymphocyte count, hemoglobin levels, and HRV (p&lt;0.05). Increasing age, LDL levels, job positions involving intensive patient contact, and higher leukocyte counts collectively contributed to shortened leukocyte TL (p&lt;0.05). Notably, HCWs exhibited accelerated biological aging in IS cells compared to both blood leukocytes (p≤0.05) and NC (p&lt;0.001), and were biologically older than COPD patients (p&lt;0.05). These findings suggest the need for monitoring aging in pauci- and asymptomatic COVID-19 survivors, who represent the majority of the general population.

Early childhood may be a stressful period for families with a significant impact on parents’ mental health and the child’s healthy development. The goal of the SKKIPPI cohort study was to assess the occurrence and determinants of psychosocial stress and mental health disorders in parents as well as in their offspring in early childhood in three German regions. Based on random samples from three residents' registration offices, parents with infants up to 12 months of age at the time of sampling, were invited to participate in the study. A screening online questionnaire was newly developed, available in four languages, to assess common psy-chosocial stressors and mental health problems of parents with small children. The study enrolled 4,984 mothers and 962 fathers. The most common potential psychosocial stressors at baseline were professional problems (mothers 22%, fathers 33%), lack of social sup-port (20%, 14%), and severe, negative experiences in childhood (22%, 16%). Obses-sive-compulsive thoughts (21%, 16%), depressive (9%, 9%) and anxiety symptoms (11%, 7%) were the most frequently reported mental health problems by both parents. Regulatory prob-lems of the child were reported by between 1.5% and 5.1% of parents. The SKKIPPI study showed that a substantial proportion of parents are burdened by psychoso-cial problems and suffer from mental health problems in the first years after birth. Early pre-ventive and low-threshold support measures should be available in the health and social care system. The newly developed questionnaire can be used to screen in the relevant populations in order to avoid disturbances in the mother-child attachment.

This paper is based on a talk given at the 14-th International Workshop on Differential Geometry and Its Applications, hosted by the Petroleum Gas University from Ploiesti, between July 9-th and July 11-th, 2019. After presenting some historical facts, we will consider some geometry problems related to unification approaches. Jordan algebras and Lie algebras are the main non-associative structures. Attempts to unify non-associative algebras and associative algebras led to UJLA structures. Another algebraic structure which unifies non-associative algebras and associative algebras is the Yang-Baxter equation. We will review topics relared to the Yang-Baxter equation and Yang-Baxter systems, with the goal to unify constructions from Differential Geometry.

Lung cancer remains the main cause of global cancer-related deaths. Currently low-dose computed tomography (LD-CT) shows a 20% reduction of mortality. However, its clinical suitability is hindered by cost, radiation, and some false positives. Thus, the discovery non-invasive and less-expensive biomarker is urgent needed. In this scenario, proteins released in biological fluids could be considered interesting biomarkers for their role in cancer development. We conducted a pioneering case-control pilot study aimed at assessing the usefulness of Raf Kinase Inhibitory Protein (RKIP) and its phosphorylated form (pRKIP) as potential early-stage lung cancer biomarkers. Urine and Blood samples of two consecutive and independent cohorts of lung cancer patients and healthy controls were screened by means of a novel experimental ELISA assay designed to evaluate both forms of the biomarker. Although urinary levels of RKIP were not statistically different between the lung cancer group and high-risk healthy group, serum ones instead increased significantly in early stage LC patients and permitted to discriminate LC patients from both low-risk (HS) and high-risk healthy subjects (HR-HS) with an overall 93% accuracy (AUC 0.93) when LC was compared to HS and 74% (AUC 0.73) when it was compared to high-risk group. Of note, the analysis of RKIP/pRKIP ratio also showed a high accuracy (90% - AUC 0.95) in discriminating LC patients from HS and more importantly, it allowed to identify LC patients compared to HR-HS, with a higher accuracy (79% - AUC 0.79) than RKIP alone. We hypothesize that serum RKIP levels may be correlated to the activation of the immune systems against the tumor during the first phases of its development. Our study identified a preliminary, non-invasive, RKIP and pRKIP profile able to discriminate with high specificity and sensitivity the early-stage lung cancer patients from high-risk Healthy Subjects. These results, although preliminary, suggest the utility of measuring RKIP/pRKIP as potential new screening test for lung cancer and provide the basis for future validation studies.

The textile sector is responsible for a number of environmental impacts. Due to the in-creasing quantities of textiles, their share is rising and a trend reversal from a linear to a circular textile chain is needed. This article presents the background, methodological approach and results of a participatory textile development model. In the commercial B2B sector, three textile prototypes were developed together with users and trialled over several months in three application areas. Textile development took into account the requirements of fibre regeneration in the product design and focused on innova-tive chemical recycling solutions. The three sustainably aligned textiles were subject-ed to spectroscopic and textile-technological tests. Screening life cycle assessments an-alysed their environmental profile and compared it with reference textiles that are used as standard. Overall, it is clear that the three textiles can match conventional ref-erence textiles in terms of quality and have considerable environmental benefits com-pared to the reference textiles. The user survey did identify concerns about a high arti-ficial fibre content, although a general rejection of recycled fibres was not observed. The results show that a transformation is possible, but must start with the fibre com-position; recycling, on the other hand, is of minor importance.

This study posits that for appropriately explaining the complex charland (mid-channel island) processes and formulating policy and planning measures, a comprehensive understanding of the dynamic characteristics of the geomorphological, ecological, and human systems holistically is essential. This is also valid for the territorial and maritime areas of Bangladesh. The objectives of this study are: (i) to analyze the salient features and characteristics of the geomorphological and riparian systems of the Bengal Delta; (ii) to analyze the evolutionary discourse of the legal systems concerning eroded (diluvion) and accreted (alluvion) land in Bangladesh; and (iii) to assess characteristics of coping and adaptation strategies of the charland inhabitants. The findings reveal that the delta-building processes, characterized by the dynamic shifts of river channels, and erosion and accretion of charlands have made the land and water systems of the territory very dynamic and unstable – resulting in consistent displacement of settlers and serious deterioration of their socioeconomic status. The historical evolution of land laws and regulations concerning the accreted land favoured vested interests. As no effective institutional framework and structure presently exists in Bangladesh for resettlement planning, formulation of a comprehensive national resettlement policy is therefore urgently needed.

This research investigates the relationship between the long-term orientation of top managers and their strategic decision-making processes, emphasising the comprehensiveness, speed, and inventiveness of decisions. The study employed structural equation modelling to look into the suggested connections using a sample of CEOs. The findings demonstrated a high and positive correlation between long-term orientation and decision comprehensiveness and speed, but not for decision creativity. The study contributes to the growing body of research on how human variations, such as temporal orientation, affect business outcomes and strategic decision-making. Moreover, the fact that a number of the results differed from those of other studies carried out in other contexts highlights how important it is to consider the industry and cultural environment when assessing these connections.

(1) Background: Heart rate variability (HRV) has emerged as a potential prognostic tool in cardiovascular diseases, offering individualized insights into autonomic nervous system activity. However, real-time HRV data during the acute phase of STEMI, particularly during percutaneous coronary intervention (PCI), was not previously explored. (2) Methods: This single-center, observational cohort study included 104 STEMI patients undergoing primary percutaneous coronary intervention (PCI). HRV parameters were measured using a wearable device (CE marked) during PCI, capturing dynamic responses. The association between HRV parameters and adverse outcomes, including in-hospital mortality and major adverse cardiovascular events (MACE), were assessed. (3) Results: HRV parameters significantly decreased after myocardial revascularization, particularly SDNN, RMSSD, pNN50, HF, SD1, and SD2/SD1 ratio. Significant associations were found between reduced SD2/SD1 ratio, approximate entropy, and adverse outcomes, including increased in-hospital mortality and MACE. The SD2/SD1 ratio was significantly lower in patients who died during the hospital stay (p = 0.008) compared to survivors. Approximate entropy was also significantly lower in deceased patients (p = 0.019). (4) Conclusions: Real-time HRV monitoring using wearable technology offers valuable data regarding dynamic physiological changes during primary PCI. The integration of HRV into routine clinical practice, facilitated by wearable devices, could improve the risk stratification and event prediction in STEMI patients.

Background: The Fat-Augmented Latissimus Dorsi (FALD) flap is an autologous flap that combines Latissimus Dorsi (LD) flap with immediate autologous fat transfer (AFT) in order to improve breast reconstruction (BR) volume. In recent years, our team has described the ergonomic FALD flap, an evolution of this technique which helps to achieve a complete BR in a single surgical step. In this long-term study, we analyze morphological variations of the breast after ergonomic FALD flap reconstruction compared to the traditional transverse FALD flap technique. Methods: Between December 2020 and September 2022 we prospectively enroll patients undergoing BR using FALD flap into 2 groups: Group A included ergonomic FALD flap, while Group B included traditional FALD flap. The primary endpoint of the study was to compare the two groups in terms of breast projection (BP), breast width (BW) and breast height (BH), while the second endpoint concerned the analysis of the aesthetic outcomes. Results: 32 FALD flaps (23 patients) were performed for the Group-A and 31 FALD flaps (25 patients) for Group-B. There were no significant differences regarding demographic variables. After propensity score weighting analysis, Group-A showed a statistically significant better breast projection (p<0.0001) compared to Group-B. (6.05 vs 5.60). Final aesthetic analyses showed to be superior in Group-A concerning breast shape (p=0.001) and global score evaluation (p=0.004). Conclusion: The ergonomic FALD flap offers better long-term aesthetic outcomes for autologous BR with higher breast projection compared to the traditional transverse FALD flap.

This article presents raw data of biaxial tensile measurements of rat heart passive myocardium conducted in lab scale environment. The passive myocardium of the rat was divided into three regions, namely: left ventricle, mid-wall and right ventricle. The biaxial dataset of passive rat myocardia is presented as stress vs strain of the passive rat myocardium in various regions. The determination of valid material properties of the heart plays an important role in the development computational models. These computational models are useful in studying various scenarios and mechanisms of heart diseases. In addition, valid and accurate materials are critical in the development of new therapies. The dataset presented here is useful in the area of soft tissue mechanics including studying the mechanisms of heart diseases such as myocardial infarction. Accordingly, the evaluation of stress and strain in left ventricle, mid-wall and right ventricle was performed.

This study integrated coastal-watershed models and combined a risk assessment method to develop a methodology to investigate the impact resulting from coastal disasters under climate change. The mid-western coast of Taiwan suffering from land subsidence was selected as the demonstrative area for the vulnerability analysis based on prediction of sea level rise (SLR), wave run-up, overtopping, and coastal flooding under the scenarios of 2020 to 2039. Database from tidal gauges and satellite images were used to analyze sea level rise using EEMD (Ensemble Empirical Mode Decomposition). Extreme wave condition and storm surge were estimated by numerical simulation using WWM (Wind Wave Model) and POM (Princeton Ocean Model). Coastal inundation was then simulated via WASH123D watershed model. The risk map of study areas based on the analyses of vulnerability and disaster were established using the AHP (Analytic Hierarchy Process) technique. Predictions of sea level rise, the maximum wave condition and storm surge under the scenarios of 2020 to 2039 are presented. The results indicate that the sea level at the mid-western coast of Taiwan will rise in an average of 5.8 cm, equivalent to a rising velocity of 2.8 mm/year. The analysis indicates that Wuqi, Lukang, Mailiao, and Taixi townships are susceptive, low resistant and low resilient, and reaches the high risk level. The assessment provides that important information for making adaption policy in the mid-western coast of Taiwan.

Dry intrusion is an important mid-latitude atmosphere phenomenon within the upper troposphere and lower stratosphere. It is always found to be related to the cyclogenesis, rainstorm, as well as convection generation and precipitation enhancement. Since the atmosphere environment for any of these above-mentioned weather is terribly complicated, those preexisting popular schemes which takes no account of water vapor may not suitable for detecting the dry intrusion related to these weathers. With regard to the merits and demerits of the current preexisting schemes, a new scheme based on Fengyun-2E geo-stationary satellite data is presented in this study to detect the atmospheric dry intrusion. The scheme is set up based on the statistical relationship between water vapor at high level troposphere, the general moist potential vorticity, ozone concentration and upper-level jet. After using the total amount of ozone and ozone profile operational products retrieved by Fengyun-3 Polar Orbiting Meteorological Satellites and the potential vorticity calculated by ECMWF Interim data for validation, this scheme is applied to analyze two typical middle-latitude weather processes. One is the famous Beijing extreme rainfall of 21 July 2012 and the other is a hailstorm occurred on the eastern China during March 19, 2014. A good application effect in both cases suggests that our new method of detecting dry intrusion is feasible and can be helpful in middle-latitude disastrous weather monitoring and forecasting.

Newborn screening (NBS) is hailed as a public health success, but little is known about long-term outcomes following a positive newborn screen. There has been difficulty gathering long-term follow-up (LTFU) data consistently, reliably, and with minimal effort. Six programs developed and tested a core set of minimal LTFU data elements. After an iterative data collection process and the development of a data collection tool, the group agreed on minimal LTFU data elements. The denominator captured all infants with an NBS diagnosis, accounting for children who moved or died prior to the follow-up year. They also agreed on three LTFU outcomes: if the child was still alive, had contact with a specialist, and received appropriate care specific to their diagnosis within the year. The six programs representing NBS public health programs, clinical providers, and research programs provided data across multiple NBS disorders. In 2022, 83.8% (563/672) of the children identified by the LTFU programs were alive and living in the jurisdiction; of those, 92.0% (518/563) saw a specialist, and 87.7% (494/563) received appropriate care. The core LTFU data elements can be applied as a foundation to address the impact of early diagnosis by NBS within and across jurisdictions.

Background: Disparity in adult mortality (AM) with reference to social dynamics and health care has not been sufficiently examined. This study aimed to identify the gap in the understanding of AM in relation to religion, political stability, economic level, and universal health coverage (UHC). Methods: A cross-national study was performed with different sources of data, using the administrative record linkage theory. We created a new data set using data from the 2013 World Bank data catalogue by region, The Economist (Political instability index 2013), Stuckler David et al. (Universal health coverage, 2010), and religious categories of all UN country members. Descriptive statistics, a t-test, an ANOVA followed by a post hoc test, and a linear regression were used where applicable. Result: The average AM rate for males and females was 0.20 ± 0.10 and 0.14 ± 0.10, respectively. AM was significantly higher in economically weak countries, countries with political instability, countries with traditional religion, without achievement of UHC, and Sub-Saharan Africa (p<0.01). There was high disparity of AM between countries with and without UHC (F = male: 61.89, female: 51.85, p<0.001) and between groups with low and high income (F = male: 36.33, female: 42.39, p<0.001). UHC and political stability would significantly reduce AMR by > 0.41 in both sexes and high economic status would reduce male AMR by 0.44, and female AMR by 0.70, in relation to countries without UHC, with political instability, and low economic status. Conclusions: Disparities in AM can be reduced after the achievement of UHC and economically productive activities for those adults affected by conflict and political unrest.

Management of chronic inflammation and wounds has always been a key issue in the pharmaceutical and healthcare sector. Curcumin (CCM) is an active ingredient extracted from turmeric rhizomes that has antioxidant, anti-inflammatory, and antibacterial activities, thus showing significant effectiveness toward wound healing. However, its shortcomings such as poor water solubility, poor chemical stability and fast metabolic rate limit its bioavailability and long-term use. In this context, hydrogels appear to be a versatile matrix for carrying and stabilizing drugs due to the biomimetic structure, soft porous microarchitecture, and pleasant biomechanical properties. The drug loading/releasing efficiencies can also be controlled by use of highly crystalline and porous metal organic frameworks (MOFs). Here, a flexible hydrogel composed of sodium alginate (SA) matrix and CCM-loaded MOFs was constructed for long-term drug release and antibacterial activity. The morphology and physicochemical properties of composite hydrogels were analyzed by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), ultraviolet visible spectroscopy (UV-Vis), Raman spectroscopy and mechanical property tests. The results showed that the composite hydrogel was highly twistable and bendable to mechanically comply with human skin. The as-prepared hydrogel could capture efficient CCM for slow drug release as well as effective killing of bacteria. Therefore, such composite hydrogel is expected to provide a new management system for chronic wound dressings.

With the rapid development of technology and the advancement of Internet technology, various social networking platforms are gradually coming into people's view and occupying a higher and higher position. In the recommendation scenario, the user-item interaction naturally forms a bipartite heterogeneous graph structure and with the development of graph embedding and graph neural network technologies based on deep learning to process graph domain information, the combination of graph information and recommendation systems shows strong research potential and application prospects. The methodological improvement of the recommendation algorithm based on collaborative filtering takes advantage of the nature that user-items can form a bipartite graph in the recommendation scenario. The existing methods still have some shortcomings. The methods that only use weights or convolutional recurrent neural networks to implicitly model different historical behaviors lack explicit modeling of video switching relationships in serialized behaviors. The user's interest is changing all the time, so it is not possible to recommend based on the user's history, and it is necessary to consider both the long-term and short-term interest of the user according to the video content in order to achieve accurate recommendation of short videos. In this paper, we design a recommendation model based on graph neural network, which models users' long-term and short-term interests by two vector propagation methods, respectively.

This study introduces a comparative analysis of two deep learning (multilayer perceptron neural networks (MLP-NN) and the long short term memory networks (LSTMN)) models for transit travel time prediction. The two models were trained and tested using one-year worth of data for a bus route in Blacksburg, Virginia. In this study, the travel time was predicted between each two successive stations to all the model to be extended to include bus dwell times. Additionally, two additional models were developed for each category (MLP of LSTM): one for only segments including controlled intersections (controlled segments) and another for segments with no control devices along them (uncontrolled segments). The results show that the LSTM models outperform the MLP models with a RMSE of 17.69 sec compared to 18.81 sec. When splitting the data into controlled and uncontrolled segments, the RMSE values reduced to 17.33 sec for the controlled segments and 4.28 sec for the uncontrolled segments when applying the LSTM model. Whereas, the RMSE values were 19.39 sec for the controlled segments and 4.67 sec for the uncontrolled segments when applying the MLP model. These results demonstrate that the uncertainty in traffic conditions introduced by traffic control devices has a significant impact on travel time predictions. Nonetheless, the results demonstrate that the LSTMN is a promising tool that can has the ability to account for the temporal correlation within the data. The developed models are also promising tools for reasonable travel time predictions in transit applications.