With reference to Planck scale Hubble parameter, super luminal expansion speeds, super luminal rotation speeds, Mach’s principle and Holographic principle, we review the current cosmological observations with eight simple assumptions. By understanding Yuri N. Obukhov and V.A. Korotky proposed cosmic rotational effects of polarization of radiation due to massive bodies, to some extent cosmic rotation can be deep-rooted in an observational approach and the ratio of current angular velocity and Hubble parameter can be estimated. It is possible to show that, at H₀ =70 km/sec/Mpc, current cosmic temperature, age, radius, mass, mass density are 2.721 K, 4.41x10¹⁷ sec, 90 billion light years, 1.14654x10⁵⁴ kg, 0.0482 times the current critical density respectively. Clearly speaking, current universe seems to constitute 267 Hubble spheres. Important point to be noted is that, current rotational kinetic energy is 0.6667 times the current critical energy. Based on the estimated current mass density and current rotational kinetic energy, current cosmic dark matter density can be shown to be 0.2851 times the current critical density. These numerical coincidences cast serious doubt on the on the real existence of currently believed ‘dark energy’. Initial and current expansion speeds are 3x10⁸ m/sec and 3.56x10⁹ m/sec respectively. With increasing cosmic age and increasing cosmic expansion speed, current universe is expanding with a speed of 11.885c. By knowing the time to time future cosmic temperatures, future Hubble parameters and corresponding future cosmic expansion speeds can be estimated and thus future expansion speed can be understood. Starting from ‘speed of light’, our model assumes a continuous increase in expansion speed and attains a current radius of 90 billion light years (without inflationary concepts) and casts a serious doubt on the actuality of currently believed ‘inflation’.

This research paper examines a cosmological model in flat space-time via $f(R,G)$ gravity where $R$ and $G$ are respectively the Ricci scalar and Gauss-Bonnet invariant. Our model assumes that $f(R,G)$ is an exponential function of $G$ combined with a linear combination of $R$. We scrutinize the observational limitations under a power law cosmology that relies on two parameters - $H_0$, the Hubble constant, and $q$, the deceleration parameter, utilizing the 57-point $H(z)$ data, 8-point BAO data, 1048-point Pantheon data, joint data of $H(z)$ + Pantheon, and joint data of $H(z)$ + BAO + Pantheon. The outcomes for $H_0$ and $q$ are realistic within observational ranges. We have also addressed Energy Conditions, $Om(z)$ analysis and cosmographical parameters like Jerk, Lerk and Snap. Our estimate of $H_0$ is remarkably consistent with various recent Planck Collaboration studies that utilize the $\Lambda$CDM model. According to our study, the power law cosmology within the context of $f(R,G)$ gravity provides the most comprehensive explanation for the important aspects of cosmic evolution.

The conventional measure of cosmic acceleration, denoted as \( q \), relies heavily on the frame of reference and operates within a 3D space-like coordinate system, potentially leading to misinterpretations of underlying physics. In this study, we propose a novel measure, \( q_E \), grounded in distances between causal events in 4D null space. We compare \( q_E \) with the standard \( q \) using observational data from supernovae (SN) and radial galaxy/quasar (QSO) clustering (BAO) to find a better alignment of data with \( q_E \). Our analysis indicates that cosmic expansion, when viewed in the rest frame, is decelerating, with events confined by an Event Horizon akin to that of a Black Hole interior. Rather than invoking new dark energy or modified gravity, we propose that \( \Lambda \) corresponds to a boundary term exerting an attractive influence, analogous to a rubber band resisting further expansion and preventing horizon crossing of events. Contrary to prevailing notions, interpreting current cosmic expansion measurements as deceleration, rather than acceleration, offers a more accurate depiction of observed phenomena and the underlying physics. This reevaluation prompts further investigation into the nature of cosmic expansion, as well as the exploration of alternative frameworks and measures in cosmology.

This paper presents the perspective that universe is relative. The universe, which changes according to the traveler’s proper time, is dynamic. While the universe generally expands, it could also contract if traveler accelerates sufficiently. The Hubble parameter merely represents that change. If the Hubble parameter is dependent on the proper time, the measurement can only be uncertain. Identifying the factors that influence the proper time could potentially lead to a more accurate measurement of the universe’s age, and it could also offer insights into the state of the early universe and the causes of the accelerated expansion observed in the current epoch.

By modifying the basic definition of cosmic red shift, considering ‘speed of light’ as an absolute cosmic expansion rate and adopting ‘Planck mass’ as the basic seed of the observed large scale universe, it is certainly possible to review and revise the basic picture of ‘standard cosmology’ and in near future, a perfect model of ‘white hole cosmology’ can be developed. In this context we have developed five assumptions. First three assumptions are based on ‘time reversed’ black holes and seem to be well connected with General theory of relativity as well as Quantum mechanics. 4^th and 5^th assumptions are helpful in understanding current galactic dark matter and flat rotation speeds. It may be noted that, considering our first three assumptions and considering the Planck Legacy 2018 data’s enhanced lensing amplitude in cosmic microwave background power spectra - conceptually, a closed universe having a positive curvature seems to be a best fit for the observed universe. With reference to our recent publication [26], for clarity on the subject, in this short communication, we make an attempt to review and explain our proposed assumptions at fundamental level. Our aim is to see that, professional and non-professional cosmologists must understand the basics of workable quantum cosmology.

While the standard model accurately describes data at the electroweak scale without inclusion of gravity, beyond the standard model physics is increasingly intertwined with gravitational phenomena and cosmology. Thus gravity mediated breaking of supersymmetry in supergravity models lead to sparticles masses, which are gravitational in origin, observable at TeV scales and testable at the LHC, and supergravity also provides candidate for dark matter, a possible framework for inflationary models and for models of dark energy. Further, extended supergravity models, and string and D-brane models contain hidden sectors some of which may be feebly coupled to the visible sector resulting in heat exchange between the visible and hidden sectors. Because of the couplings between the sectors both particle physics and cosmology are effected. The above implies that particle physics and cosmology are intrinsically intertwined in the resolution of essentially all of the cosmological phenomena such as dark matter and dark energy and in the resolution of cosmological puzzles such as Hubble tension and EDGES anomaly. Here we give a brief overview of the intertwining and implications for the discovery of sparticles, and the resolution of the cosmological anomalies and identification of dark matter and dark energy as major challenges for the coming decades.

The ΛCDM model successfully models the expansion of matter in the universe with an expansion of the underlying metric. However, it does not address the physical origin of the big bang and dark energy. A model of cosmology is proposed, where the state of high energy density of the big bang is created by the collapse of an antineutrino star that has exceeded its Chandrasekhar limit. To allow the first neutrino stars and antineutrino stars to form naturally from an initial quantum vacuum state, it helps to assume that antimatter has negative gravitational mass. While it may prove incorrect, this assumption may also help identify dark energy. The degenerate remnant of an antineutrino star can today have an average mass density that is similar to the dark energy density of the ΛCDM model. When in hydrostatic equilibrium, this antineutrino star remnant can emit isothermal cosmic microwave background radiation and accelerate matter radially. This model and the ΛCDM model are in similar quantitative agreement with supernova distance measurements. Other observational tests of the above model are also discussed.

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

The Schwarzschild metric emerges independent of Einstein's field equations, offering a straightforward derivation solely reliant on Newtonian mechanics and Minkowskian proper acceleration. This approach provides a clear path to understanding the gravitational field around a spherically symmetric mass without the need for the complexities of Einstein's full theory of General Relativity. Transitioning to our exploration of the cosmic Friedmann equations, we adopt a novel perspective rooted in a Lagrangian formulation grounded in Newtonian mechanics and the first law of thermodynamics. Our investigation operates under the assumption that the universe is populated by either a perfect fluid or a scalar field. By elucidating the intricate interplay between the Lagrangian formulation and the cosmic Friedmann equations, we uncover the fundamental principles governing the universe's dynamics within the framework of these elemental constituents. In our concluding endeavor, we embark on the task of harmonizing the classical equations—namely, the conservation, Euler, and Poisson equations—with the principles of General Relativity. This undertaking seeks to extend these foundational equations to encompass the gravitational effects delineated by General Relativity, thus providing a comprehensive framework for understanding the behavior of matter and spacetime in the cosmic context.

The sources of dark matter and its spatial distribution is not in the typical standard model. The study thought to induct the physical causalities with empirical evidence on the theory of black hole and white hole juxtapose. The research applied a mixed method of data analysis and observational cosmology. With the cosmological observations on the traces of white holes, the research finds that the accretion phenomenon of black holes is largely contributed by its thermonuclear binding with the white hole. The antimatter saturated plasma of cold fusion and hot fission are key to the phenomenon of black hole and white hole juxtapose. The force between the black hole and the white hole is stronger than the strong force, and sheds new directions on cosmological and gravitation studies. The research concludes that black holes are white hole entropy. The higher order of the universe in matter forms can exist beyond the observed force. The thermal arrow of time is critical to future general relativity dependent instrumentation discoveries.

A bijective analysis is confirming, the expansion of universal space has never been directly observed, and this assumption is unproven thus far. The measurement of the gravitational redshift, which was confirmed using the Mossbauer experiment, proves only the gravitational redshift and nothing more because there is no causality between the gravitational redshift and hypothetical expansion. Thus, even if the universal space is assumed to expand, the gravitational redshift cannot be assumed to be proof of the expansion. In addition, the Doppler effect was never observed in an expanding space; thus, the claim that the cosmological redshift is partially caused by the Doppler effect, which is caused by the expansion of space, is an unproven assumption. Furthermore, the discovery of cosmic microwave background (CMB) radiation simply proves that the radiation is emitted by the entire universal space, but does not prove the existence of a recombination period. In evidence-based cosmology, every element in the model has a corresponding element in physical reality that is observed and measured. The evidence-based cosmology model is related to the real universe by a bijective function of set theory. Supermassive black holes in the centre of galaxies are rejuvenating systems of the universe. They rotate their local superfluid space which is the physical origin of galactic rotation curves.

In a bid to resolve lingering problems in cosmology, more focus is being tilted towards cosmological models in which physical constants of nature are not necessarily real constants, but varying with cosmic time. In this paper we have study cosmology in nonlinear electrodynamics with the Newton's gravitational constant $G$ not a constant but vary in form of power-law of the scale factor of the universe. The evolution of the scale factor $a (t)$ is studied in this model which depends on nonlinear electrodynamics fine tuning term of $\alpha$. Then we check the stability of the model using the speed of sound.

The Vacuum Energy Parameter (VEP) of standard cosmology denotes the fraction of the critical density attributed to the accelerated expansion of the Universe. Astrophysical evidence sets the numerical range of VEP at 0.692 +, - 0.012, yet the root cause of these values is currently unknown. Drawing from the stochastic interpretation of early-Universe cosmology, we develop here a derivation of the VEP based on classical diffusion theory and the Langevin equation. Predictions are shown to be in reasonable agreement with observations.

We emphasize the point that, standard model of cosmology is basically a model of classical general relativity and it seems inevitable to have a revision with reference to quantum model of cosmology. Utmost important point to be noted is that, ‘Spin’ is a basic property of quantum mechanics and ‘rotation’ is a very common experience. In this context, we propose five assumptions in line with Planck mass as the baby universe. We appeal that, 1) Universe can be modeled as a time-reversed black hole (a white hole) with rotation and light speed expansion, and 2) ‘Light speed expanding cosmic space’ can be called as ‘Flat space’. With reference to light speed expansion, if one is willing to re-define cosmic red shift as [z/(1+z)], without considering Lambda cosmology model of matter density fractions, light travel distances can be reproduced with a marginal error of +8.6% at z =1.2, (i.e. traditional light travel distance is 8.6% higher than our estimate), 0% at z = 11.5 and -5.5% at z = 1200.( i.e. traditional light travel distance is 5.5% lower than our estimate). Advantages of our model are, 1) A quantum model of cosmology can be developed with unification of general theory of relativity and quantum mechanics. 2) Tension in estimating the current Hubble parameter can be eliminated via scaled Hawking’s black hole temperature formula with great confidence. 3) Galactic dark matter and visible matter can be studied in a unified manner. 4) Galactic light travel distances can be estimated very easily without matter density fractions. 5) Big Bang and Inflation like non-general relativistic concepts can be relinquished with further study.

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

We consider a real scalar field in de Sitter background and compute its thermal propagators. We propose that in a dS/CFT context, non-trivial thermal effects as seen by an `out' observer can be encoded in the anomalous dimensions of the d=3 Ising model. One of these anomalous dimensions, the critical exponent eta, fixes completely a number of cosmological observables, which we compute.

Keywords: Oral health, diabetes, periodontal disease, caries, periodontitis.

In the particular configuration of the scalar field K-essence in the Wheeler-DeWitt quantum equation, for some age in the Bianchi type I anisotropic cosmological model, a fractional differential equation for the scalar field arises naturally. The order of the fractional differential equation is $\beta=\frac{2\alpha}{2\alpha - 1}$. This fractional equation belongs to different intervals, depending on the value of the barotropic parameter; when $\omega_{X} \in [0,1]$, the order belongs to the interval $1\leq \beta \leq 2$, and when $\omega_{X}\in[-1,0)$, the order belongs to the interval $0<\beta \leq 1$. In the quantum scheme, we introduce the factor ordering problem in the variables $(\Omega,\phi)$ and its corresponding momenta $(\Pi_\Omega, \Pi_\phi)$, obtaining a linear fractional differential equation with variable coefficients in the scalar field equation, then the solution is found using a fractional power series expansion. The corresponding quantum solutions are also given. We found the classical solution in the usual gauge N obtained in the Hamiltonian formalism and without a gauge. In the last case, the general solution is presented in a transformed time $T(\tau)$, however in the dust era we found a closed solution in the gauge time $\tau$.

We have shown that our varying physical constant model is consistent with the recently published variational approach wherein Einstein equations are modified to include the variation of the speed of light c, gravitational constant G and cosmological constant Λ using the Einstein-Hilbert action. The general constraint resulting from satisfying the local conservation laws and contracted Bianchi identities provides the freedom to choose the form of the variation of the constants as well as how their variations are related. When we choose dG/Gdt=3dc/cdt, ̇the same as in our quasi-phenomenological model, c=c₀ exp⁡(a^α-1), G=G₀ exp⁡[3(a^α-1)] and Λ=Λ₀ exp⁡[(a^-α-1)], where a is the scale factor and α=1.8, we are able to confirm the success of our the model in explaining three astrometric anomalies and the null results on the variation of G and the fine structure constant. We show that the model: (a) fits the supernovae 1a observational data better than the ΛCDM model; (b) determines the first peak in the power spectrum of the cosmic microwave background temperature anisotropies at multipole value of l=217.3; (c) calculates the age of the universe as 14.1 Gyr; and (d) finds the BAO acoustic scale to be 145.2 Mpc. These numbers are within less than 3% percent of the observed values and the values obtained by the ΛCDM model. Surprisingly we find that the dark-energy density is negative in a universe that has significant negative curvature and whose expansion is accelerating at a faster rate than predicted by the ΛCDM model.

In this article we presented an application of the quantum cosmological model in teleparallel gravity. Working with a vacuum solution, the gravitational energy density is quantized with the Weyl procedure and we obtain a discrete expression for the gravitational energy. As an immediate consequence the empty space exhibits an expansion for an early universe.

First, this paper broaches the epistemological status of scientific tenets and approaches: phenomenological (descriptive only), well-founded (solid first principles, conducive to deep understanding), provisional (can be falsified if universal and verified if existential), and imaginary (fictitious entities or processes, conducive to empirically unsupported beliefs). The ΛCDM “concordance model” involves such beliefs: the emanation of the universe out of a non-physical stage, cosmic inflation (invented ad hoc), Λ (fictitious energy), and exotic dark matter. Big Bang cosmology further faces conceptual and pragmatic problems in delimiting what expands from what does not. The problems dissolve after untying inertia from space. The cosmology that emerges appears immediately compatible with the considered observations and the ‘perfect cosmological principle’. Waves and field perturbations that propagate at c expand exponentially with distance (a gravitational effect). The cosmic web of galaxies does not. Potential -Φ varies as H/(cz) instead of 1/r. Inertial forces arise from the gravitational action of the rest of the universe. Due to dilatation, they are reduced disproportionately at low accelerations. A cut-off value a₀ = 0.168 cH is deduced. This explains the successful description of galaxy rotation curves by MoND. A fully elaborated physical theory is still pending. Wider implications are briefly discussed.

This paper explores the interactions of dynamic dark energy with other components of the cosmos, such as dark matter and baryonic matter, and its wide-ranging implications in cosmology. By investigating the interplay between dynamic dark energy and the universe's large-scale structure, we aim to provide a deeper understanding of cosmic evolution and the behavior of dark energy in different cosmological epochs. We also examine the potential of dynamic dark energy to offer novel insights into long-standing cosmological puzzles and their impact on the formation and evolution of cosmic structures.

The main foundations of the standard $\Lambda $CDM model of cosmology are that: 1) The redshifts of the galaxies are due to the expansion of the Universe plus peculiar motions; 2) The cosmic microwave background radiation and its anisotropies derive from the high energy primordial Universe when matter and radiation became decoupled; 3) The abundance pattern of the light elements is explained in terms of primordial nucleosynthesis; and 4) The formation and evolution of galaxies can be explained only in terms of gravitation within a inflation+dark matter+dark energy scenario. Numerous tests have been carried out on these ideas and, although the standard model works pretty well in fitting many observations, there are also many data that present apparent caveats to be understood with it. In this paper, I offer a review of these tests and problems, as well as some examples of alternative models.

In this review article the study of the development of relativistic cosmology and introduction of inflation in it is carried out. We study the properties of standard cosmological model developed in the framework of relativistic cosmology and the geometric structure of spacetime connected coherently with it. We examine the geometric properties of space and spacetime ingrained into the standard model of cosmology. The big bang model of the beginning of the universe is based on the standard model which succumbed to failure in explaining the flatness and the large-scale homogeneity of the universe as demonstrated by observational evidence. These cosmological problems were resolved by introducing a brief acceleratedly expanding phase in the very early universe known as inflation. Cosmic inflation by setting the initial conditions of the standard big bang model resolves these problems of the theory. We discuss how the inflationary paradigm solves these problems by proposing the fast expansion period in the early universe.

The recent Planck Legacy release confirmed the existence of an enhanced lensing amplitude in the cosmic microwave background (CMB) power spectra, which endorses the positive curvature of the early Universe with a confidence level exceeding 99%. In this study, the pre-existing curvature is incorporated to extend the field equations where the derived wave function of the Universe is utilized to model Universe evolution with reference to the scale factor of the early Universe and its radius of curvature upon the emission of the CMB. The wave function reveals both positive and negative solutions, implying that matter and antimatter of early Universe plasma evolve in opposite directions as distinct Universe sides. The wave function indicates that a nascent hyperbolic expansion is followed by a first phase of decelerating expansion away from early plasma during the first 10 Gyr, and then, a second phase of accelerating expansion in reverse directions, whereby both Universe sides free-fall towards each other under gravitational acceleration. Simulations of the predicted conformal curvature evolution demonstrate the fast orbital speed of outer stars owing to the external fields exerted on galaxies as they travel through conformally curved space-time. Finally, the wave function predicts an eventual time-reversal phase comprising rapid spatial contraction that culminates in a Big Crunch, signalling a cyclic Universe. These findings reveal that early plasma could have separated and evolved into distinct sides that collectively and geometrically influencing the Universe evolution, physically explanting the effects attributed to dark matter and energy.

Recently Palle has investigated the chiral vorticity and Cartan torsion in neutrino asymmetries. In his case he addressed this problem in Goedel s like anisotropic Einstein-Catan cosmology. In this paper we discusse how these ideas applied to sheared Bianchi types I Einstein-Cartan (EC) neutrino amisotropic cosmology, affect the handness of neutrinos in the universe. Actually here a novel concept of the chiral metric is introduced where metric functions also possess two distinct signs as in neutrino flipping or helicity. The axial anomaly equation for neutrinos in the presence of torsion and metric chirality is shown to produce left-handed neutrinos from right-handed torsion. Metric chirality is shown to be able to define how the metric would behave far away of neutrino density. Chiral flipping of the chiral neutrinos in the presence of torsion is also investigated. It is shown that when the chiral torsion is left-handed the chemical chiral potential vanishes as the universe expands.

It is shown that the 5D geodetic equations and 5D Ricci identities give us a way to create a new viewpoint on some problems of Modern Physics, Astrophysics, and Cosmology. Specifically, the application of the 5D geodetic equations in (4+1) and (3+1+1) splintered forms obtained with the help of the monad and dyad methods made it possible to introduce a new, effective generalized concept of the rest mass of the elementary particle. The latter leads one to novel connections between the General Relativity and quantum field theories, as well as all of that, including the (4+1) splitting of the 5D Ricci identities, brings about a better understanding of the magnetic monopole problem and the vital difference in the origins of the Maxwell equations and gives rise to surprising connections between them. The obtained results also provide new insight into the mechanism of the 4D Universe’s expansion and its following acceleration.

Background: Music evokes positive emotions and reduces stress and anxiety. Operating Room (OR) staff face various challenges which can lead to high levels of stress. The aim of the study is to assess whether listening to music during intraoperative phases improves the work environment by reducing anxiety and stress in the entire surgical team. Methods. A prospective observational study was conducted from February to September 2023, involving medical personnel, nursing staff, and nursing students. They were divided into two groups: Group 1 with music during surgical procedures, and Group 2 without music. Participants were administered two validated instruments: the Zung Anxiety Self-Assessment Scale (SAS) to measure anxiety, and the Positive and Negative Affect Schedule to assess emotions generating stress. Additional items were included for demographics, job satisfaction, and the organization method. Results. Music did not impact anxiety but increased positive emotions while reducing negative ones. Music had an ancillary effect, highlighting the need for significant organizational interventions aimed at increasing operator satisfaction, including voluntary rather than mandatory assignments for nursing staff. Conclusions. Music appears to reduce stress in the intraoperative team when supported by a positive work environment in which assigned operators have chosen to work in the OR.

This paper seeks to fill in the gaps of modern relativistic Cosmology by utilizing the total symmetry between space and time dimensions and re-interpreting the scale factor of the Universe as a gravitational potential generated by the mass/energy of the entire Universe as a whole. The gradient of this potential is along the cosmological time dimension through which the Universe is falling. This gradient gives us an arrow of time, we find explanations for why the Universe began expanding and why the expansion is accelerating without the need for a Cosmological Constant. In a finite time, the gradient will point in the opposite direction of time turning the expanding Universe into a collapsing one where it is shown that when placing the Schwarzschild metric in the dynamic Cosmological background, gravity becomes repulsive and things like would-be Black Holes become White Holes. The model naturally describes a Universe and an anti-Universe (consisting of antimatter) moving in opposite directions of time that collide at the end of collapse, annihilating and subsequently pair producing two new Universes as the cycle begins again. It is shown that the model's Hubble diagram fits the currently available supernova and quasar data. It is found that Dark Matter can perhaps be understood as ordinary matter that is not connected to us with null geodesics.

There is a formal analogy between the evolution of the universe, when this is seen as a trajectory in the minisuperspace, and the worldline followed by a test particle in a curved spacetime. The analogy can be extended to the quantum realm, where the trajectories are transformed into wave packets that give us the probability of finding the universe or the particle in a given point of their respective spaces: the spacetime in the case of the particle and the minisuperspace in the case of the universe. The wave function of the spacetime and the matter fields, all together, can then be seen as a super-field that propagates in the minisuperspace and the so-called third quantisation procedure can be applied in a parallel way as the second quantisation procedure is performed with a matter field that propagates in the spacetime. The super-field can thus be interpreted as made up of universes propagating, i.e. evolving, in the minisuperspace. The analogy can also be used in the opposite direction. The way in which the semiclassical state of the universe is obtained in quantum cosmology allows us to obtain, from the quantum state of a field that propagates in the spacetime, the geodesics of the underlying spacetime as well as their quantum uncertainties or dispersions. This might settle a new starting point for a different quantisation of the spacetime.

With the increasing occurrence of rotator cuff injuries every year, there is a great need for a reliable treatment option. Wharton’s Jelly contains several components that can positively impact the replacement and repair of musculoskeletal defects. The overall objective of this study is to evaluate the improvement of patient-reported pain scales after applying Wharton’s Jelly (WJ) in rotator cuff defects. Eighty-seven patients with rotator cuff defects who failed at least eight weeks of conservative treatment were selected from the retrospective repository. 2cc of WJ flowable allograft was applied to the specific affected anatomy, the most common being supraspinatus tendon, biceps tendon insertion, labral tear, and subscapularis tear. No adverse reactions were reported. Statistically significant improvements were found from the initial to Day 90 in all scales. Patient satisfaction was calculated using minimal clinically important differences. No statistically significant differences were found in mean changes between gender, BMI, and age. Scanning Electron Microscopy images reveal the similarities between the collagen matrix in WJ and the rotator cuff. The significant improvement in patient outcomes coincides with current literature analyzing WJ applications with other structural defects around the body. WJ is a promising alternative for musculoskeletal defects when the standard of care fails.

“For me then this is the real problem with quantum theory: the apparently essential conflict between any sharp formulation and fundamental relativity. That is to say, we have an apparent incompatibility, at the deepest level, between the two fundamental pillars of contemporary theory...” J. S. Bell (2004, p. 171) The inability to delineate a unified physical ontology that accounts simultaneously for the laws of special relativity and the results of quantum experiments has been a defining problem in physics for more than 100 years. Although various primitive ontologies (including Bohmian pilot wave, spontaneous collapse, and objective collapse theories) along with wave function realism ontologies, many-worlds interpretations, and multi-field theories address the tension between special relativity and quantum mechanics, none has successfully resolved it. This analysis addresses the problem by positing an ontic, mixed ontology composed of a “discrete” 4D spacetime and a physical, ultra-high dimensional (3 x N) “Planck Space.” Together, Planck Space and the three spatial dimensions of 4D spacetime form a tightly integrated ((3 x N) + 3) hyperspace (the “Dual Ontology”). 4D spacetime’s three spatial dimensions and the N dimensions of Planck Space are composed of two substructures: discrete, three-dimensional, quantized units of space ("Planck Spheres") and an ontic State of Absolute Nothingness (the "SOAN") whose sole physical characteristic is onticness. Critically, the Dual Ontology’s structure replaces 1) the continuous, differentiable manifold of 4D spacetime with a discrete 4D spacetime and 2) mathematical 3N configuration spaces with a physical (3 x N) Planck Space. Moreover, structurally and dynamically, the Dual Ontology is predicated on the one-to-one mapping and identity between the Planck Spheres that simultaneously form 4D spacetime and Planck Space. The one-to-one mapping and identity physically and theoretically support an integrated quantum dynamics based upon the dynamic evolution of single and N-body quantum states in 4D spacetime in full compliance with the laws of special relativity and the instantaneous collapse of all quantum states in an ontic Planck Space, where special and general relativity and more generally, 4D spacetime’s laws of physics, do not apply.

Our comprehension of fundamental cosmological principles hinges on a thorough understanding of the early universe. The Lambda Cold Dark Matter (ΛCDM) model has emerged as a valuable framework for elucidating various cosmic phenomena, uniting a cosmological constant (Λ) with cold dark matter (CDM). Nevertheless, recent observations, particularly data from the Planck, WMAP, and DES missions that probe the early universe, alongside local measurements of the Hubble constant, have unveiled significant inconsistencies. These inconsistencies have magnified the perplexing issue known as the Hubble Tension, thereby challenging our current understanding of the universe. To address this conundrum, we adopt a comprehensive approach encompassing a review of cosmological fundamentals, an exploration of the ΛCDM model, an examination of the cosmic microwave background (CMB), power spectrum, and perturbation theory, a thorough review of existing research, and finally, an investigation of real data. By undertaking these early universe processes, we aim to understand more about Hubble constant and its consequence in ΛCDM model.

This brief communication considers and illustrates dark matter and dark energy within the Baryon Phase Transition (BPT) cosmological model as well as some experiments that may confirm (or deny) the validity of the model.

In the present work we consider two modified Chevallier-Polarski-Linder (CPL) models in the background of homogeneous and isotropic FLRW space-time, namely (i) the generalized CPL model (Model I) and (ii) the logarithmic form of the the equation of state for the dark energy. From the observational data sets ((Pantheon+)+BAO+HST), we find that at the present epoch (redshift $z=0$), the equation of state for the dark energy converges almost at the same value $\omega_{fld}\approx -0.86$ and the variation of $\omega_{fld}(z)$ with respect to the redshift parameter is very small for both models. we also find that the present value of the Hubble parameter $H_0$ is almost same for both the models. Finally, we compare the models in the light of Akaike, Bayesian Information Criterion (BIC) and Bayesian Evidence. However, we find that Model II is better compared to the Model I from the estimated value of the deceleration parameter.

We first of all define the arrow of time. Definition of the arrow of time will allow choosing different initial starting points. One of the issues we will also discuss is the interconnection be-tween the arrow of time, entropy and quantum information. Seth Lloyd in his 2001 work made a linkage between entropy, bits, and information via an axiomatic approach involving time in-tervals. Our take is a bit more general. We will discuss as well the t’Hooft’s statement as to in-itial conditions and times arrow, and how different cosmological models may influence initial conditions. Spoilers alert, if a nonsingular start to expansion existed, this would provide the most straightforward way to avoid a datum from classical relativity. That is, that in the actual equations of classical GR, there is no reason to have time asymmetry. Time asymmetry is built into initial conditions and we will detail several candidates. The first half of the paper brings up cosmology models and forming the arrow of time. The second is related to entropy itself and the problem of information. .

The neutrino is perhaps the most elusive member of the particle zoo. The questions about its nature, namely: Dirac or Majorana, the value of its mass and the interactions with other particles, the number of its components including sterile species, are long standing ones and still re- main in large extent without conclusive answers. From the side of the nuclear structure and nuclear reactions, both theories and experiments, the need to elucidate these questions have, and still has, prompt crucial developments in the fields of double beta decay, double charge exchange and neutrino induced reactions. The measurements of neutrino flavor os- cillation parameters contribute largely to restrict models with massless neutrinos. From the particle physics side, the possibilities to extent the standard model of electroweak interactions to incorporate a right handed sector of the electroweak lagrangian are directly linked to the adopted neu- trino model. Here, I would like to address another aspect of the problem by asking the question of the neutrino mass mechanism in the cosmological context, and particularly about dark matter.

We obtain exact solutions to the field equations for 5 dimensional LRS Bianchi type-I spacetime in $f(R,T)$ theory of gravity where specifically the following three cases are considered: (i) $f(R,T)=\mu(R+T)$, (ii) $f(R,T)=R \mu + R T \mu^2$ and (iii) $f(R,T)=R+\mu R^2+\mu T$ where $R$ and $T$ respectively the Ricci scalar and trace of the energy-momentum tensor. It is found that the equation of state (EOS) parameter $w$ is governed by the parameter $\mu$ involved in the $f(R,T)$ expressions. We fine-tune the parameter $\mu$ to obtain effect of phantom energy in the model, however we also restrict this parameter to obtain a stable model of the universe. It is noted that the model isotropizes at finite cosmic time.

Analytical solutions for radiation dominated phase of Quasi Steady State Cosmology in Friedmann-Robertson-Walkar models are obtained. We find that matter density is positive in all the cases (k = 0,-1,1). The nature of Hubble parameter (H) in [0,2] is discussed. The deceleration parameter (q) is marginally less than zero indicating accelerating universe. The scale factor (S) is graphically shown with time. The model represents oscillating universe between the above mentioned limits. Because of bounce in QSSC, the maximum density phase is still matter dominated. The models represent singularity free model. We also find that the models have event horizon i.e. no observer beyond the proper distance rH can communicate each other in FRW mdels for radiation dominated phase in the frame work of QSSC. The FRW models are special classes of Bianchi type I, V, IX space-times with zero, negative and positive curvatures respectively. Initially i.e. at  = 0, the model represents steady model. We have tried to show how a good fit can be obtained to the observations in the framework of QSSC during radiation dominated phase.

With reference to Planck scale, Mach's relation and by introducing two new parameters Gamma and Beta, right from the beginning of Planck scale, we make an attempt to estimate ordinary matter density ratio, dark matter density ratio, mass, radius, temperature, age and expansion velocity (from and about the Planck mass in all directions). In analogy with currently believed cosmic acceleration, with a decreasing trend of total matter density ratio, cosmic expansion velocity can be shown to be increasing. By considering $H_0\cong 70$ km/sec/Mpc, estimated current cosmic mass, radius, total matter density, expansion velocity, temperature and age are: $4.3352\times {10}^{53}\mathrm{kg},$ $3.207\times {10}^{26}\mathrm{m},$ $3.138\times {10}^{-27}\mathrm{kg}{.\mathrm{m}}^{-3},$ $2.43c,$ $2.721\mathrm{K}$ and $19.78\mathrm{Billion}\mathrm{years}$ respectively. Point to be noted is that, with reference to Planck scale, cosmic temperature seems to be redshifted by a factor ${\left(Z_T\right)}_t\cong \sqrt{1+\ln \left(H_{pl}/H_t\right)}-1$ where $\left(H_{pl},H_t\right)$ represent Planck scale and time dependent Hubble parameters respectively. As a peculiar case, considering the equality of current Hubble parameter and current angular velocity, current cosmic rotational kinetic energy can be estimated to be 0.667 times the current critical energy. It needs further study.

In this paper, we investigate an exact Universe which is observational viable and filled with binary mixture of perfect fluid and cosmological constant $\Lambda$. Owning the non-uniform expansion of cosmos, we have considered redshift drift $\dot{z} = -(1+z)H_{0}+H(z)$ and performed statistical test to obtain the best fit value of model parameters of derived Universe with its observed values. Here $H_{0}$ and $z$ denote the present value of Hubble constant and redshift respectively. We estimate the best fit values of Hubble constant and density parameters are $H_{0} = 68.58 \pm 0.84$ km/s/Mpc, $(\Omega_{m})_{0} = 0.26 \pm 0.010$ and $(\Omega_{\Lambda})_{0} = 0.71 \pm 0.025$ by bounding the derived model with latest observational Hubble data (OHD) while with joint Pantheon data and OHD, its values are $H_{0} = 71.93 \pm 0.58$ km/s/Mpc, $(\Omega_{m})_{0} = 0.272 \pm 0.06$ and $(\Omega_{\Lambda})_{0} = 0.74 \pm 0.09$. The analysis of deceleration parameter and jerk parameter show that the Universe in derived model is compatible with $\Lambda$CDM model.

With reference to Planck scale, increasing support for large scale cosmic anisotropy and preferred directions and by considering an increasing ratio of Hubble parameter to angular velocity, right from the beginning of Planck scale, we make an attempt to estimate ordinary matter density ratio, dark matter density ratio, mass, radius, temperature, age and expansion velocity (from and about the baby universe in all directions). We would like suggest that, from the beginning of Planck scale, 1) Dark matter can be considered as a kind of cosmic foam responsible for formation of galaxies. 2) Cosmic angular velocity decreases with square of the decreasing cosmic temperature. 3) Increasing ratio of Hubble parameter to angular velocity plays a crucial role in estimating increasing cosmic expansion velocity and decreasing density ratios of dark matter and ordinary matter. 4) There is no need to consider dark energy for understanding cosmic acceleration.

$\phi$CDM models provide an alternative to the standard $\Lambda$CDM paradigm, while being physically better motivated. These models lead to a time-dependent speed of sound for dark energy that is difficult to replicate by $w$CDM parametrizations. We review the most up-to-date status of observational evidence for the $\phi$CDM models in this paper. We start with an overview of the motivation behind these classes of models, the basic mathematical formalism, and the different classes of models. We then present a compilation of recent results of applying different observational probes to constraining $\phi$CDM model parameters. Over the last twenty years, the precision of observational data has increased immensely, leading to ever tighter constraints. A combination of the recent measurements favors the spatially flat $\Lambda$CDM model, but a large class of $\phi$CDM models is still not ruled out.

Estimating ground surface PM2.5 with fine spatiotemporal resolution is a critical technique for exposure assessments in epidemiological studies of its health risks. Previous studies have utilized monitoring, satellite remote sensing or air quality modeling data to evaluate the spatiotemporal variations of PM2.5 concentrations, but such studies rarely combined these data simultaneously. We develop a three-stage model to fuse PM2.5 monitoring data, satellite-derived aerosol optical depth (AOD) and community multi-scale air quality (CMAQ) simulations together and apply it to estimate daily PM2.5 at a spatial resolution of 0.1˚ over China. Performance of the three-stage model is evaluated using a cross-validation (CV) method step by step. CV results show that the finally fused estimator of PM2.5 is in good agreement with the observational data (RMSE = 23.00 μg/m^3 and R2 = 0.72) and outperforms either AOD-retrieved PM2.5 (R2 = 0.62) or CMAQ simulations (R2 = 0.51). According to step-specific CVs, in data fusion, AOD-retrieved PM2.5 plays a key role to reduce mean bias, whereas CMAQ provides all-spacetime-covered predictions, which avoids sampling bias caused by non-random incompleteness in satellite-derived AOD. Our fused products are more capable than either CMAQ simulations or AOD-based estimates in characterizing the polluting procedure during haze episodes and thus can support both chronic and acute exposure assessments of ambient PM2.5. Based on the products, averaged concentration of annual exposure to PM2.5 was 55.75 μg/m3, while averaged count of polluted days (PM2.5 > 75 μg/m3) was 81, across China during 2014. Fused estimates will be publicly available for future health-related studies.

This paper is dedicated to examining dynamic dark energy models in the context of observational constraints and their implications for the universe's future. By integrating theoretical models with various observational data, we aim to provide a comprehensive view of how dynamic dark energy influences cosmic evolution and the universe's fate. This study tests these models against the latest observational evidence, including the Cosmic Microwave Background, supernovae, and large-scale structure surveys, to refine our understanding of the universe's accelerating expansion and the mysterious nature of dark energy.

Despite the extensive literature on missing data theory and cautionary articles emphasizing the importance of realistic analysis for healthcare data, a critical gap persists in incorporating domain knowledge into missing data problem formulation, assumption specification, and method development. In this paper, we highlight the gap particularly for observational data from healthcare facilities. We address this gap by identifying ten fundamental missingness scenarios arising during data measurement, recording, and pre-processing in observational health data, influenced by physicians, patients, healthcare facilities, and data scientists. We analyze the effect of scenarios on estimand formulation, missing data identification, estimation, and sensitivity analysis. To emphasize how domain-informed analysis can improve method reliability, we conduct simulation studies under the influence of various missingness scenarios. We compare the results of three common methods in medical data analysis (complete-case analysis, Missforest imputation, and inverse probability weighting estimation) for two estimands (variable mean estimation and classification accuracy). We advocate for our analysis approach as a reference for the analysis of observational health data. Furthermore, we posit that the proposed analysis framework is applicable to other medical domains, including medical wearable data analysis.

Background: Myelomeningocele (MMC) is the most common open spinal dysraphism (OSD) and is typically associated with other clinical and/or radiological abnormalities. Chiari type 2 malformation (CM-II) is observed in 80% to 96.7% of patients, and approximately 80% of cases involve posterior fossa abnormalities leading to hydrocephalus. MMC patients can present with syringomyelia, which usually improves by treating hydrocephalus. However, a minority of patients develop a progressive form of syringomyelia requiring more invasive treatments. Through this retrospective observational study, our objective is to elucidate the incidence of syringomyelia, its symptomatic manifestations, and the associated radiological and clinical characteristics in pediatric patients diagnosed with myelomeningocele Methods: A retrospective analysis was conducted on the medical records of 39 pediatric patients diagnosed with myelomeningocele at a tertiary referral institute. The study encompassed individuals born between 1997 and 2022. Descriptive statistics were employed to explore epidemiological aspects and clinical features. Additionally, incidence rates of syringomyelia and its progressive variants were calculated, with a focus on their correlation with diagnoses of hydrocephalus, Chiari type 2 malformation (CM-II), and spinal cord tethering. Results: Over the last twenty-five years, the incidence of syringomyelia in pediatric patients affected by MMC was 46.2%. The incidence of its progressive forms was 16.7%. Two patients improved after the management of hydrocephalus with secondary Endoscopic Third Ventriculostomy (ETV), and only one patient required syrinx-shunting. Conclusions: The occurrence of syringomyelia among patients with myelomeningocele (MMC) in our center aligns with reported rates in existing literature. Our findings indicate that active hydrocephalus, leading to a deterioration of hindbrain herniation, appears to be a significant factor in the development of progressive symptomatic syringomyelia within this population.

We investigated and quantified bacterial accumulation in facemasks used by the general population, using 16S rRNA (Sanger Sequencing), culture and biochemical analysis along with Rose Bengal staining. Additionally, a systematic overview of the literature on face mask contamination was undertaken. We found an average bacterial load of 4.24 × 10⁴ CFU recovered/mask, with a maximum load of 2.85 × 10⁵ CFU. This maximum is 310 times higher than the limit value for contamination of ventilation system outlet surfaces specified by the German standard VDI 6022. Biochemical and molecular identification predominantly found Staphylococcus species (80%), including Staphylococcus aureus, along with endospore-forming Bacillus spp. Literature reports also indicate contamination of masks by bacterial and fungal opportunists of the genera Acinetobacter, Aspergillus, Alternaria, Bacillus, Cadosporium, Candida, Escherichia, Enterobacter, Enterococcus, Klebsiella (including K. pneumoniae), Micrococcus, Microsporum, Mucor, Pseudomonas, Staphylococcus and Streptococcus. Bacterial counts increase linearly with wearing duration, and prolonged use may affect the skin and respiratory microbiomes, promoting consequential eye, skin, oral and airway conditions. These aspects underscore the urgent need for further research and a risk-benefit analysis in respect of mask use, particularly given their unproven efficacy in disrupting the transmission of respiratory viruses and their adverse social consequences.

Deep sky observation is a fascinating activity, but it requires favourable conditions in order to be fully appreciated. Complex equipment, light pollution around urban areas, lack of contextual information often prevents newcomers from making the most of their observations, restricting the field to a niche expert audience. In this paper, we show how combining the usage of smart telescopes with eXplainable Artificial Intelligence makes the practice of astronomy even more accessible and educative, and how it has been applied during outreach sessions In Luxembourg Greater Region.

Background: While the clinical factors of the post-COVID-19 condition (PCC) are becoming clearer, the economic implications remain uncertain, posing a challenge to healthcare professionals in terms of understanding and managing this emerging phenomenon. This article aims to investigate the demographic and clinical characteristics of PCC patients and quantify the economic impact of their healthcare resource utilisation. Methods: A retrospective and case-control observational study was conducted, comparing the case group of PCC population before and after diagnosis with a control group. Demographic and clinical variables were analysed with the objective of describing the population. Economic analysis was performed to evaluate the resource costs in procedures and primary, secondary (both outpatient and inpatient) and emergency care. Findings: PCC patients (N=341) exhibited older age and elevated cardiovascular risk factors compared to controls (N=49,078). There were differences in the socio-economic distribution between male and female patients in the PCC patients. Hypertension and diabetes mellitus type 2 were the most common chronic diseases observed among the case patients. Economic analysis revealed that PCC patients were approximately four times as costly as control patients, with increased utilisation of healthcare resources. However, post-diagnosis PCC patients showed a reduction in costs, primarily driven by decreased primary care visits and hospitalisations. Conclusion: Coordinated care management for PCC patients is associated with reduced costs and improved healthcare resource utilisation. Further research is warranted to investigate long-term health outcomes and establish causal relationships between COVID-19 sequelae and healthcare resource utilisation.

In this contribution to the Festschrift for Prof. Remo Ruffini, we investigated a formulation of quantum gravity based on the Wheeler-DeWitt (WDW) equation combined with the classical concepts of the branch-cut cosmology, which contemplates as a new scenario for the origin of the Universe, a smooth transition region between the contraction phase, prior to the primordial singularity, and the subsequent expansion phase. Through the introduction of an energy-dependent effective potential, which describes the space-time curvature associated with the embedding geometry and its coupling with the cosmological constant and matter fields, solutions of the WDW equation for the wave function of the Universe are obtained. The Lagrangian density is quantized through the standard procedure of raising the Hamiltonian, the helix-like complex scale factor of branched cosmology as well as the corresponding conjugate momentum to the category of quantum operators. As a novelty, ambiguities in the ordering of the quantum operators are overcome with the introduction of a set of ordering factors α, whose values are restricted to the integers α=[0,1,2], since non-integers have no physical meaning, allowing this way a broader class of solutions for the wave function of the Universe. As another novelty, additional energy-dependent parametrizations are considered, more specifically, in addition to a branched universe filled with underlying background vacuum energy, matter and radiation, in order to make contact with standard model calculations, we additionally supplement the formulation with baryon matter, dark matter and quintessence contributions. As an additional novelty, the boundary conditions for the wave function of the Universe are imposed by assuming the Bekenstein criterion. Our results indicate this way, as a novelty conclusion, the consistency of a topological quantum leap, or alternatively a quantum tunneling, for the transition region of the early universe in contrast to the classic branched cosmology view of a smooth transition.

In the same way as the realization of some of the famous gedanken experiments imagined by the founding fathers of quantum mechanics has recently led to the current renewal of the interpretation of quantum physics, it seems that the most recent progresses of observational astrophysics can be interpreted as the realization of some cosmological gedanken experiments such as the removal from the universe of the whole visible matter or the cosmic time travel leading to a new cosmological standard model. This standard model involves two dark components of the universe, dark energy and dark matter. Whereas dark energy is usually associated with the cosmological constant, we propose to interpret dark matter in terms of a pure vibration energy due to positive curvature and held by quarks and/or by a gluon Bose Einstein condensate accompanying baryonic matter at the hadronization transition from the quark gluon plasma phase to the colorless hadronic phase. Such an interpretation, partially based on mass formulae in terms of energy and spin in de Sitter and Anti de Sitter respectively, would comfort the idea that, apart from the violation of the matter/antimatter symmetry satisfying the Sakharov’s conditions, the reconciliation of particle physics and cosmology does not need the recourse to any ad hoc fields, particles or hidden variables.

The definition of Early Cholecystectomy (EC) is still debatable. This paper aims to find whether the timing of EC affects outcomes. This is a multicentric prospective observational study including patients with acute calculous cholecystitis (ACC) who had cholecystectomy within ten days from the onset of symptoms. Kruskall-Wallis test, Fisher’s Exact test and Spearman rank correlation were used for statistical analysis. The patients were divided into three groups depending on the timing of the operation: 0-3 days, 4-7 days, or 8-10 days from the onset of symptoms. 1117 patients were studied over a year. The time from the onset of symptoms to EC did not affect the postoperative complications and mortality, the conversion and the reintervention rate. It was a significant risk factor for intraoperative complications (0-3 days, 2.8%; 4-7 days, 5.6%; 8-10 days, 7.9%; p=0.01) and subtotal cholecystectomies (0-3 days, 2.7%; 4-7 days, 5.6%; 8-10 days, 10.9%; p&lt;0.001). ACC is an evolutive inflammatory process and, as the days go by, the local and systemic inflammation increases which makes surgery more complex and difficult with higher risk of intraoperative complications. We recommend performing EC for ACC as soon as possible within the first ten days of the onset of symptoms.

As the era of omics continues to expand, omics-based experiments have become popular in industrial biotechnology. They promise deeper biological understanding, which may be leveraged to develop novel solutions to bioprocess optimization and cell line engineering strategies. Despite this expansion, naivety about what omic data offers and how to best handle such data can challenge the extraction of actionable value. However, the value of omic experiments in biotechnology research and development can be maximized with deliberate application of omic approaches and forethought about analysis techniques. Here we describe important considerations when designing and implementing omic-based experiments, and discuss how systems biology analysis strategies can enhance efforts to obtain actionable insights in biomanufacturing.

In this study, we investigate Quantum Entanglement Asymmetry (QEA) as a potential explanation for the matter-antimatter imbalance observed in the universe. By integrating quantum mechanics with cosmological phenomena, the study proposes a model in which quantum entanglement among particle-antiparticle pairs in the early universe leads to an asymmetry favoring matter. Through theoretical development and numerical simulations, we explore how this model predicts unique patterns in Cosmic Microwave Background (CMB) anisotropies and the distribution of matter, setting a foundation for empirical verification. The study aims to enhance the understanding of cosmological asymmetries and highlight the significance of quantum entanglement in the universe's evolution.

We use the Stefan-Boltzmann law to derive and investigate what we will call the black hole CMB temperature luminosity. Interestingly, the CMB luminosity is always the same for every black hole at a luminosity distance equal to the Schwarzschild radius, which is fully valid in black hole cosmology, a topic that is actively discussed to this day. The CMB black hole luminosity is always the same , regardless of the mass of the black hole. This is in contrast to the Bekenstein-Hawking luminosity, which is linked to the Hawking temperature, that is mass dependent.

We reduplicate the Book “Dark Energy” by M. Li, X-D. Li, and Y. Wang, zero-point energy calculation with an unexpected “length’ added to the ‘width’ of a graviton wavefunction just prior to the entrance of ‘gravitons’ to a small region of space-time prior to a nonsingular start to the universe. We compare this to a solution worked out using Klauder Enhanced quantization, for the same given problem. The solution of the first Cosmological Constant problem relies upon the geometry of the multiverse generalization of CCC cosmology which is explained in this paper. The second solution, used involves Klauder enhanced quantization. We look at energy given by our methods and compare and contrast it with the negative energy of the Rosen model for a mini sub universe and estimate GW frequencies

COVID-19 generated a scenario for global health with multiple systemic impairments. This retrospective study evaluated the clinical, radiological, and pulmonary functional evolution in 302 post-COVID-19 patients. Regarding post-COVID-19 pulmonary symptoms, dry cough, dyspnea, and chest pain were the most frequent. Of the associated comorbidities, asthma was more frequent (23.5%). Chest Tomography (CT) initially showed a mean pulmonary involvement of 69.7%, and the evaluation in the subsequent months showed an improvement in the evolutionary image, and with less than six months post-pathology, there was a commitment of 37 .7%, from six to twelve months, 20% and after 12 months, 9.9%. And as for most of the sample, 50.3% of the patients presented CT normalization in less than six months after infection, 23% normalized between six and twelve months, and 5.2% normalized the images after twelve months, with one remaining. Percentage of 17.3% who maintained post-COVID-19 pulmonary residual sequelae. Regarding spirometry, in less than six months after the pathology, 59.3% of the patients already showed a regular exam; 12.3% normalized their function within six to twelve months, and 6.3% concluded a normal exam after twelve months of post-pathology evaluation. Only 3.6% of the patients still showed some alteration in this period.

Passive dynamics is an aspect of locomotion which is entirely dependent on the mechanical configuration and linkages of adjacent body segments. Tension distribution along mechanical linkages enables execution of movement patterns with reduced need for complex neurological pathways and may play a role in reestablishing postural stability following external disturbances. Here we demonstrate a uni-directional mechanical relationship between the equine forelimb, head and neck, which may have implications for balance and forelimb loading in the horse. These observations suggest that forelimb, head and neck movement coordination (observed in the horse during unrestrained locomotion) is largely controlled by the mechanical linkages between body segments, rather than being entirely dependent on neurological input as previously thought. This highlights the potential significance of research directed at investigating passively induced movements in understanding common locomotory patterns. Additionally, it suggests a mode of postural control which may provide instantaneous adjustments to postural disturbances, thus promoting rapid and efficient locomotion.

The use of recombinant human PTH (1-84) [rhPTH(1-84)] is approved as hormonal replacement therapy in patients with hypoparathyroidism not adequately controlled with conventional therapy. The objective of this study was to investigate the effects of 12 months of rhPTH (1-84) treatment in a cohort of patients selected according to the indications of recent hypoparathyroidism guidelines. It is a multicenter, observational, retro-prospective, open label study. Eleven Italian Endocrinological centers were involved. Fourteen adult subjects with chronic hypoparathyroidism treated with rhPTH (1-84) for 12 months were enrolled. Main outcome measures included serum and urinary parameters of mineral metabolism, renal function, oral calcium and vitamin D doses, and clinical manifestations. At 12 months, 61.5% of patients discontinued calcium supplement and 69.2% calcitriol. Mean serum calcium levels quickly normalized after initiation of rhPTH (1-84) treatment compared to baseline (p=0.009). Rare hypo-hypercalcemia episodes were reported. Renal function was maintained normal and no renal complications were reported. Serum and urinary phosphate and urinary calcium were maintained in the normal range. Mean phosphatemia levels linearly decreased from 3 months up to 12 months compared to baseline (p= 0.014). No severe adverse events were described. In conclusion, this study confirm the efficacy and safety of rhPTH (1-84) therapy.

Abstract: Purpose: High-grade isthmic spondylolisthesis (HGISL) is a severe condition, associated with low-back pain (LBP) and radiculopathies. The present study is a monocentric prospective observational study investigating the clinical-radiological outcomes of a bilateral minimally invasive TLIF (bm-TLIF) for HGISL. Material and Methods: Patients who underwent bm- TLIF for HGISL at our institution, were considered for inclusion. Clinical-radiological outcomes and complications were collected. Results: Twenty-one patients (14M:7F) were included and the mean clinical follow-up (FU) time was 27(±6) months. There was a significative improvement of the mean VAS-back, VAS-legs, ODI, and SF-36 PCS scores, comparing pre- and last FU measurements. The mean pelvic tilt (p0,05). The univariate analysis showed that residual slip angle (> or  10°) may independently influence VAS-b (p

Long COVID–19 syndrome is another vicious feature of COVID-19 infection, the mechanism remains unidentified. Several observational studies suggest that vaccinations might have protective and therapeutic effect on long COVID-19 and our study aimed to assess the influence of vaccination on COVID-19 patients. We performed an observational cohort study from October 2020 to July 2022, which included 503 patients (291 males and 212 females) with a median age of 65. They were hospitalized due to COVID-19 pneumonia and had persistent symptoms (after 1 month of COVID-19 infection. The clinical and demographic data including vaccination status collected during hospitalization and regular visits at the Community Healthcare Center dr. Adolf Drolc Maribor were analyzed. More non-vaccinated patients acquired long COVID-19 than vaccinated. Patients with type 2 diabetes suffered from long COVID-19 in a smaller percentage than patients without diabetes. Gender, inhalational therapy due to chronic pulmonary disease and the number of complications have significantly influenced long COVID-19 development and the mostly vaccinated patients were older and with asthma/COPD. Our study confirmed that vaccination is a safe and effective measure to prevent the severe progression of acute disease and to lower the incidence of developing long COVID.

As an important follow-up report on the latest study of the first author (H.S.) on an off-shell quantum field causing a dressed photon and dark energy, we further discuss a couple of intriguing subjects based on our new theory. One is the dressed photon constant. If we use it, in addition to h¯ and c, as the third component of natural units, then it is defined as the geometric mean of the smallest and the largest lengths: Planck length and that relating to the cosmological constant. Interestingly, this length (≈ 50 nanometers) seems to give a rough measure of the Heisenberg cut for electromagnetic phenomena. The other is a new perspective on cosmology that combines two original notions, i.e., twin universes and conformal cyclic cosmology, proposed respectively by Petit and Penrose, into one novel picture where universes expand self-similarly. We show the possibility that twin universes having a dual structure of [matter with (dark energy &amp; matter)] vs. corresponding anti-entities, separated by an event horizon embedded in the geometric structure of de Sitter space, undergo endless cyclic processes of birth and death, as in the case of the pair creation and annihilation of elementary particles through the intervention of a conformal light field.

The consumption of sweet beverages, including sugar-sweetened beverages (SSB), artificially sweetened beverages (ASB) and fruit juices (FJ) is associated with the risk of different cardiometabolic diseases and probably with some tumors as well. We carried out a systematic review and meta-analysis of observational studies aimed at evaluating the association between sweet beverage intake and different types of cancer risk. Suitable papers published up to June 2020 were searched through PubMed, Web of Science and SCOPUS databases, using relevant keywords. Overall, 64 studies were identified for the systematic review, of which 27 were selected for the meta-analysis. This was performed by analyzing the multivariable-adjusted OR, RR or HR of the highest compared with the lowest sweet beverage intake categories. Random effects showed significant positive association between SSBs intake and breast (RR: 1.14, 95% CI: 1.01 – 1.30) and prostate cancer risk (RR: 1.18, 95% CI: 1.10 – 1.27), also between FJs and prostate cancer risk (RR: 1.03, 95% CI: 1.01 – 1.05). Associations between SSBs and colorectal and pancreatic cancer risk, FJs and breast, colorectal and pancreatic cancer risk, ASBs and pancreatic cancer risk tended to be positive but did not reach the statistically significant threshold. This study supports the recommendation to limit the consumption of SSBs and FJs for cancer prevention and proposes to further investigate the potential harmful role of ASBs intake in cancer risk.

Motivated by the work of Saridakis (Phys. Rev. D 102, 123525 (2020)), the present study reports the cosmological consequences of Barrow holographic dark energy (HDE) and its thermodynamics. Literatures demonstrate that Dark Energy (DE) may result from electroweak symmetry breaking that triggers a phase transition from early inflation to late time acceleration. In the present study, we incorporated viscosity in the Barrow HDE. A reconstruction scheme is presented for the parameters associated with Barrow holographic dark energy under the purview of viscous cosmology. Equation of state (EoS) parameter is reconstructed in this scenario and quintessence behaviour is observed. Considering BarrowHDE as a specific case ofNojiri-Odintsov (NO) HDE, we have observed quintom behaviour of the EoS parameter and for some values of n the EoS has been observed to be very close to −1 for the current universe. The generalised second law of thermodynamics has come out to be valid in all the scenarios under consideration. Physical viability of considering Barrow HDE as a specific case of NO HDE is demonstrated in this study.

This study investigated the magnitude and direction of inter-limb asymmetry in 21 professional female sepak takraw players across several task-specific tests. Five inter-limb asymmetry assessments were employed: unilateral countermovement jump (Uni-CMJ), bilateral countermovement jump (Bi-CMJ), single leg hop (SLH), triple hop test (THOP), and isokinetic concentric peak torque of the knee flexors and extensors at 60 deg/sec-1, 120 deg/sec-1 and 180 deg/sec-1 angular velocities. A “true” inter-limb asymmetry was only observed for Uni-CMJ jump height (16.62%) and THOP distance (6.09%). Kappa coefficients demonstrated fair agreement in the direction of asymmetry between the Uni-CMJ and Bi-CMJ tests for jump height (Kappa = 26.67), but only slight agreement for peak force (Kappa = 0.11), propulsive impulse (Kappa = -0.12) and eccentric impulse (Kappa = -0.14), respectively. Fair agreement was observed between the SLH and THOP (Kappa = 0.32). Slight to moderate agreement was found for concentric peak torque across angular velocities for the knee extensors (Kappa = 0.08 to 0.48) while fair to nearly perfect agreement was noted for the knee flexors (Kappa = 0.31 to 1). The Uni-CMJ and THOP are most sensitive to detect between-limb asymmetries in female sepak takraw players. However, given the inconsistency in asymmetry direction across tests, monitoring asymmetry direction is crucial for conditioning.

Asthma is a chronic respiratory disease that impairs breathing. Management of asthma presents a significant challenge due to its inherent variability; that is, its symptoms can substantially differ among individuals, thereby complicating the prediction and management of exacerbations. Furthermore, individuals with asthma often have unique triggers that precipitate symptoms or attacks. The identification of these triggers can often prove to be a challenging, and at times, an impractical attempt. To address this, our research proposes a practical, personalized alert system, predicated on individual lung function tests conducted under varying environmental conditions classified by air-quality sensors. To validate this concept, we conducted an observational pilot study involving healthy individuals. We recruited twelve healthy participants and monitored their responses across a broad spectrum of environments, characterized by varying air quality, temperature, and humidity conditions. The lung function for each participant, assessed using peak expiratory flow (PEF) values, was recorded in each of these environments. Our results highlighted substantial variability in pulmonary responses to different environments. Utilizing these insights, we proposed a personalized alarm system that provides real-time air-quality monitoring and issues alerts when environmental conditions may potentially become unfavorable. We also explored the feasibility of employing basic machine learning techniques to predict PEF values in the aforementioned environmental conditions. This proposed system has the potential to empower individuals in actively safeguarding their respiratory health and mitigating discomfort caused by environmental conditions, especially in cases of asthma patients. By enabling timely and personalized interventions, the system aims to provide individuals with the necessary tools to minimize exposure to asthma’s possible triggers.

Pulmonary aspiration is a serious anaesthetic complication with morbidity and up to 9% of all anaesthesia-related mortality. Aspiration risk is especially focused on fastening time. We aimed to evaluate the prevalence of 'risky stomach' defined by ultrasound imagine of solid contents and/or calculated gastric fluid volume >1.25 mL/kg in elective surgery also comparing this definition with the 0-2 qualitative rating scale used for "empty/risky stomach". This prospective study has 97 patients aged 2-18. Ultrasonographic evaluations of the gastric antrum content is scaled with qualitative assessment in supine and right lateral decubitus (RLD) position. Gastric volume was calculated. In our study, stomach content and volume were evaluated by ultrasound in 97% of children and 5.2% had Grade 2 antrum. In RLD position, antral CSA was 2.36 cm², and the median gastric volume was 0.46 mL/kg. In patients with grade 0 antrum has moderate and positive correlation between antral CSA and BMI, and strong and positive correlation between antral CSA and age like grade 1 antrum. We showed that 0.1%-4.7% of elective children had gastric fluid volumes of >1.25 mL/kg as "risky stomach". Ultrasound for gastric contents could be used routine practice to determine pulmonary aspiration risk in emergency and elective procedures.

INTRODUCTION: Cardiovascular prevention is less effective than expected due to the concern about polymedication of professionals and the lack of adherence of patients. Polypills are presented as a possible solution, increasing therapeutic adherence in the medium or long term and improving therapeutic results compared to the administration of drugs separately: they increase effectiveness and Adherence of patients to primary and secondary cardiovascular prevention programs, without increasing the cost of the intervention. OBJECTIVES: Study #Trigeria: to specify the combined prevalence of Atrial Fibrillation, Dyslipidemia and Hypertension and analyze the pharmacological prescription for these pathologies and the possible indications and advantages that would have the prescription of a polypill for these risk factors.METHODS: Observational analytical study on the pathological history in elderly institutionalized in nursing homes and analysis of prescribed oral medication.RESULTS: 169 people analyzed (79.3% women) from 4 nursing homes; 8.9% had a history of Atrial Fibrillation, Dyslipidemia and Arterial Hypertension; these had a higher prevalence of heart disease (42.9%) and Cerebral Vascular Accident (35.7%). Polymedication was present in 88.5%, with an average of 6.94 oral drugs prescribed; among those with the three pathological antecedents, the average number of oral medications was 8.60. Only 26.7% of those with all three factors were prescribed drugs to control them.DISCUSSION: There are high rates of polymedication in the sample and low rates of prescription of antiplatelet agents in people with Atrial Fibrillation (26.5%); the low prescription of statins and antihypertensives of the ACE inhibitor or ARB-II groups may be due to good control with non-pharmacological measures or by the use of other groups of drugs . A polypill holding the drugs that control the three factors studied could increase the prescription rate while simplifying the administration schedule and reducing polymedication by 23.25% improving prescription, increasing adherence and control of risk factors without increasing pharmaceutical expenditure.CONCLUSIONS: There is a low rate of prescription of antiplatelet agents among people with atrial fibrillation. Combination methods (polypills) can increase the suitability of prescriptions in people with polypathology, improving prescribing, simplifying administration and increasing adherence to pharmacological treatments.

Background: Ultrasound measurement of dynamic changes in inferior vena cava (IVC) diameter and collapsibility index (CI) evaluates to estimate the fluid responsiveness and intravascular volume status. We conducted a analysis to quantify the sonographic measurement of IVC diameter changes in adult patients at preoperative and postoperative period. Methods: Ultrasonography was performed on 72 patients scheduled for surgery with American Society of Anesthesiologists physical status I to III. Quantitative assessments of the end-expiration (D_min), end-inspiration (D_max) and CI at preoperative and postoperative period were compared in a prospective, observational study. The patients received intravenous fluid according to standard protocol regimes peroperatively. The cutt-off value of dIVC 40% was accepted as hypovolemia. Results: Ultrasonography of IVC measurement was unsuccessful in 12.5% of patients and 63 patients remained for analyses. The mean age was 43.29 ± 17.22 (range 18 - 86) years. The average diameter of the D_min, D_max and dIVC at preoperative and postoperative were 1.99 ± 0.31 vs. 2.05 ± 0.29 cm, 1.72 ± 0.33 vs. 1.74 ± 0.32 cm, 14.0 ± 9.60 % vs. 15.14 ± 11.18 %, respectively (p<0.05). Using a threshold dIVC of 40%, one patient preoperatively and 5 postoperatively were hypovolemic (p<0.05). CI was also positively associated preoperatively and postoperatively (regression coefficient = 0.438, p<0.01). Conclusion: The diameter of IVC did not change preoperatively and postoperatively in adult patients with standard fluid regimens. The parameters of the IVC diameter increased postoperatively according to preoperative period.

Globally, increasing rates of obesity are one of the most important health issues. The association between breakfast skipping and body weight is contradictory between cross-sectional and interventional studies. The systematic review and meta-analyses aim to summarize this association based on observational longitudinal studies. We included prospective studies on breakfast skipping and overweight/obesity or weight change in adults. Literature was searched until September 2020 in PubMed and Web of Science. Summary RRs with a 95% CI were estimated in pairwise meta-analyses by applying a random-effects model. In total, 9 studies were included in the systematic review and 6 of them were included in the meta-analyses. The meta-analysis indicated an 13% increased RR for overweight/obesity when breakfast was skipped on ≥ 3 days per week compared to ≤ 2 days per week (95% CI: 1.06, 1.21, n=3 studies). The meta-analysis on weight change displays a 21% increased RR for weight gain for breakfast skippers compared to breakfast eaters (95% CI: 1.05, 1.40, n=2 studies). The meta-analysis on BMI change displayed no difference between breakfast skipping and eating (RR=1.02, 95% CI: 0.99, 1.05, n=2 studies). This study provides low meta-evidence for an increased risk for overweight/obesity and weight gain for breakfast skipping.

Transportation tasks in nursing are common and shorten the time for direct patient care in times of nursing shortage and an aging society. There is a lack of research on transportation needs, with most studies focusing on overall nursing task analysis without a deeper analysis of transportation tasks. In July and September 2023, we conducted weekly observations of nurses to assess clinical transportation needs. We aim to understand the economic impact and the methods nurses use for transportation tasks. We conducted a participant observation using a standardized app-based form over a seven-day observation period in two rural clinics. N=1,830 transports were made by nurses and examined by descriptive analysis. Non-medical supplies account for 27.05 % (n=495) of all transports, followed by medical supplies at 17.32 % (n=317), pharmacotherapy at 14.10 % (n=258) and other other categories like meals or drinks contributing 12.68 % (n=232). Most transports had a factual transport time of under a minute, with patient transport and lab samples displaying more variability. In total, 77.15 % of all transports were made by hand. Requirements to collect items or connect transports with patient care were included in 5 % of all transports. Our economic evaluation spotlighted meals as the most costly transport, with 9,596.16€ p.a. in the observed clinics. Budget-friendly robots would amortize over one year by transporting meals. We support understanding nurses’ transportation needs via further research on assistive robots to validate our findings and determine the feasibility of transport robots.

This review will serve as an entry point for international researchers who would like to tap into the vast scientific potential of Chinese-language literature on oceanic fronts. We focused on observational studies in descriptive physical oceanography of marine fronts. A thorough bibliographic search netted 93 papers published in 1982-2023, with a sharp increase of the total number of papers after 2010. This trend continued unabated through the early 2020s. Regionally, the overwhelming majority of papers is focused on the China Seas, particularly the East China Seas (Bohai, Huanghai, and Donghai, especially the Yangtze River Plume) and northern South China Sea (Guangdong Shelf). Elsewhere, a number of papers were dedicated to the Southern Ocean and North Atlantic. Thematically, papers on remote sensing of ocean fronts dominate, with special attention to the development of new advanced front-detection algorithms applied to satellite data on sea surface temperature and chlorophyll. Numerous papers on marine fronts in the China Seas present important results that have to be considered by international researchers. Overall, this review emphasizes the significant contributions made by Chinese oceanographers, particularly to the frontal oceanography of the China Seas.

Background: Cardiovascular disease (CVD) increases the risk of mortality and morbidity in patients with rheumatoid arthritis (RA). Patients with RA have a 50-60% increased risk for CVD compared with the general population. Cardiovascular risk is commonly meas-ured using the Systemic Coronary Risk Estimation 2 calculator modified for patients with RA. Traditional modifiable risk factors for CVD include arterial hypertension, dyslipidemia, insulin resistance, diabetes, cigarette smoking, and low physical activity. In this study, we analyzed the effects of smoking and the risk of CVD in patients with RA. Methods: This was a prospective, clinical, cohort study with an eight-year follow-up pe-riod. A total of 201 patients, 124 with RA (study group) and 77 with osteoarthritis (OA) (control group), were included in this study. However, only 137 patients (82 with RA and 55 with OA) completed the study. Fifty-eight patients (41 with RA and 17 with OA) died during the study period. We compared the prevalence of smoking and its association with the risk for CVD and RA. Results: The prevalence of smoking in the RA group was higher than that in the OA group (p<0.0001). Trends in the prevalence of smoking in both groups did not change signifi-cantly during the follow-up period. In the RA group, smoking was associated with the in-cidence of CVD in current smokers (p=0.028) and in patients with a history of smoking (p=0.016). These results suggest that smokers have an increased risk for RA. The trend of continued smoking in patients with RA may be attributed to attempts to reduce stress caused by RA symptoms. Conclusions: Previous studies have shown that current and former smokers with RA have more severe symptoms, more joint damage, and poorer response to therapy than those who have never smoked. However, the reason underlying the trend of continued cigarette smoking in patients with RA remains unclear. Further studies are needed to clarify the trend of continued smoking in patients with RA.

After three years of the onset of the pandemic, there is scarce evidence about how COVID-19 disease affect the female reproductive system, and consequently, the menstrual cycle. Since the common causes of secondary amenorrhea are considered as exclusion criteria in the studies about menstrual changes following SARS-CoV-2 infection, the prevalence of this event and the influencing factors in formerly menstruating women remains unknown. A retrospective observational cross-sectional study was conducted on Spanish adult women (N= 17,512), using an online survey; a subpopulation of SARS-CoV-2-infected-formerly menstruating women was included in the present analysis (n= 72). Collected data included general characteristics, medical history, and specific information about COVID-19 disease. 38.9% of the respondents experienced menstrual-related disturbances after suffering from the COVID-19 disease, unexpected vaginal bleeding being the most common (20.8%). Other alterations related with the length – “shorter” by 12.5% − and the flow − “heavier than usual” 30.3% − of the menstrual bleeding were reported. The binary logistic regression showed that being a perimenopausal woman (AOR 4.608, CI 95%, 1.018 – 20.856, p = 0.047) and having heavy menstrual bleeding (AOR 4.857, CI 95%, 1.239 – 19.031, p=0.023) are influential factors. This evidence could help health professionals to provide scientifically up-to-date information to their patients, empowering them to actively manage their reproductive health, especially in those societies where menstrual health is still a taboo.

Aims: To assess the occurrence of Chemotherapy-induced nausea and vomiting (CINV) after standard antiemetic therapy in the acute (24 h post-chemotherapy) and delayed (2–5 days post-chemotherapy) phases, as well as to identify risk factors for CINV in the acute and delayed phases. Methods: This prospective longitudinal and observational study analyzed the data of 400 breast cancer patients scheduled for chemotherapy over two cycles in two hospitals. The self-report survey was developed to assess the occurrence of CINV and their associated factors. CINV was evaluated with a Multinational Association of Supportive Care in Cancer Antiemetic Tool (MAT) on days 2 and 6 of chemotherapy. The incidence of acute and delayed CINV were presented by frequency and percentage. Generalized equation estimates (GEE) was used to identify risk factors of acute and delayed CINV. Results: There were 400 evaluable patients with complete Round 1 data, 334 for Round 2 data. Among 400 patients, 29.8% and 23.5% experienced acute and delayed CINV, respectively. Risk factors associated with for acute CINV were pain/insomnia, history of CINV, history of motion sickness (MS), and highly emetogenic chemotherapy regimen, while history of MS, CINV history, number of completed chemotherapy cycle number < 3, and the incidence of acute CINV were risk factors of delayed CINV (all p < 0.05). Conclusions: The findings may help nurses working for Chinese population in identifying patients at risk for CINV and in planning effective program to reduce the occurrence of CINV.

Introduction: We describe the clinical features and inpatient trajectories of older adults hospitalized with COVID-19, and explore relationships with frailty. Methods: This retrospective observational study included older adults admitted as an emergency to a University Hospital who were diagnosed with COVID-19. Patient characteristics and hospital outcomes, primarily inpatient death or death within 14 days of discharge, were described for the whole cohort and by frailty status. Associations with mortality were further evaluated using Cox Proportional Hazards Regression (Hazard Ratio [HR], 95% Confidence Interval). Results: 214 patients (94 women) were included of whom 142 (66.4%) were frail with a median Clinical Frailty Scale (CFS) score of 6. Frail compared to non-frail patients were more likely to present with atypical symptoms including new or worsening confusion (45.1% vs 20.8%, p<0.001) and were more likely to die (66% vs 16%, p=0.001). Older age, being male, presenting with high illness acuity and high frailty were independent predictors of death and a dose-response association between frailty and mortality was observed (CFS 1-4: reference; CFS 5-6: HR 1.78, 95% CI 0.90, 3.53; CFS 7-8: HR 2.57, 95% CI 1.26, 5.24). Conclusions: Clinicians should have a low threshold for testing for COVID-19 in older and frail patients during periods of community viral transmission and diagnosis should prompt early advanced care planning.

A distinction is made between data rescue (i.e., copying, digitizing and archiving) and data recovery that implies deciphering, interpreting and transforming early instrumental readings and their metadata to obtain high-quality datasets in modern units. This requires a multidisciplinary approach that includes: palaeography and knowledge of Latin and other languages to read the handwritten logs and additional documents; history of science to interpret the original text, data e metadata within the cultural frame of the 17th, 18th and early 19th century; physics and technology to recognize bias of early instruments or calibrations, or to correct for observational bias; astronomy to calculate and transform the original time in canonical hours that started from twilight. The liquid-in-glass thermometer was invented in 1641 and the earliest temperature records started in 1654. Since then, different types of thermometers were invented, based on the thermal expansion of air or selected thermometric liquids with deviation from linearity. Reference points, thermometric scales, calibration methodologies were not comparable, and not always adequately described. Thermometers had various locations and exposures, e.g., indoor, outdoor, on windows, gardens or roofs, facing different directions. Readings were made only one or a few times a day, not necessarily respecting a precise time schedule: this bias is analysed for the most popular combinations of reading times. The time was based on sundials and local Sun, but the hours were counted starting from twilight. In 1789-90 Italy changed system and all cities counted hours from their lower culmination (i.e., local midnight), so that every city had its local time; in 1866, all the Italian cities followed the local time of Rome; in 1893, the whole Italy adopted the present-day system, based on the Coordinated Universal Time and the time zones. In 1873, when the International Meteorological Committee (IMO) was founded, later transformed in World Meteorological Organization (WMO), a standardization of instruments and observational protocols was established, and all data became fully comparable. In the early instrumental period, from 1654 to 1873, the comparison, correction and homogenization of records is quite difficult, mainly because of the scarcity or even absence of metadata. This paper deals about this confused situation, discussing the main problems, but also the methodologies to recognize missing metadata, distinguish indoor from outdoor readings; correct and transform early datasets in unknown or arbitrary units into modern units; finally, in which cases it is possible to reach the quality level required by WMO. The focus is to explain the methodology needed to recover early instrumental records, i.e., the operations that should be performed to interpret, correct, and transform the original raw data into a high-quality dataset of temperature, usable for climate studies.

Pancreas transplantation is a high-risk operation that requires significant skill and expertise from the surgeons and the postoperative care team. Prior to candidate qualification, all contraindications to this procedure must be excluded. The use of screening tools and nutritional assessment aims to emphasize the importance of accurately diagnosing nutritional status in order to implement early nutritional interventions and reduce complications associated with malnutrition. This plays a crucial role in improving postoperative outcomes for patients undergoing pancreas and/or kidney transplantation. Objective: The aim of this study was to analyze the parameters of nutritional status in patients eligible for kidney transplantation and kidney with pancreas transplantation. Methods: The study analyzed the database of hospitalized patients in our Center from 2020 to 2023 to identify preoperative parameters of nutritional status in patients eligible for kidney transplantation (Ktx) and kidney with pancreas transplantation (SPKTx). Participants: A total of 59 patients participated in the study, who were candidates for kidney transplantation (23, including 11 females and 12 males) or kidney with pancreas transplantation (36, including 24 females and 12 males). Parameters examined included: Onoder's Prognostic Nutritional Index (PNIO), Nutrition Risk Index (NRI), ideal body weight (IBW) calculated using the Lorenz formula, and the neutrophil-to-lymphocyte ratio (NLR). All patients admitted to the clinic underwent the NRS-2002 clinical assessment scale for nutritional status. Results: Upon analyzing the obtained results, it was found that BMI was not a good differentiating parameter for the studied groups. The PNIO index also insufficiently differentiated the studied groups, and similarly, the NRI index was a weak differentiating parameter. The NRS-2002 index and albumin level were the best indicators of differences between the groups. In the group of transplantation candidates, several parameters indicated that patients in the Ktx group (kidney transplantation candidates) had better nutritional status than SPKtx candidates (kidney with pancreas transplantation candidates), despite the former group being older patients. Conclusion: It seems that more effort should be made to start a proper nutrition plan for SPKTx (and especially peritoneal dialysis) patients. Regular assessment of nutrition status should be performed. SPKtx patients in the perioperative period should receive parenteral nutrition and, as soon as their general condition allows it, enteral nutrition, taking into account the caloric and protein needs

The study aimed to identify clinical pharmacology patterns of prescribed and taken medications in older cardiovascular patients using electronic health records (EHRs) (n = 704) (2019–2022). Medscape Drug Interaction Checker was used to identify pairwise drug-drug interactions (DDIs). Prevalence rates of DDIs were 73.5% and 68.5% among taken and prescribed drugs, respectively. However, total number of DDIs was significantly higher among prescribed medications compared with the list of taken drugs (p < 0.05). Serious DDIs comprised 16% and 7% of all DDIs among prescribed and taken medications, correspondingly (p < 0.05). Median DDI numbers between prescribed versus taken medications were Me = 2, IQR 0-7 and Me = 3, IQR 0-7 per record, respectively. Prevalence of polypharmacy was significantly higher among prescribed medications compared with taken medications (p < 0.05). Women were taking significantly more drugs and had higher rates of polypharmacy and DDIs (p < 0.05). No sex-related differences were observed in the list of prescribed medications. ICD code U07.1 (COVID-19, virus identified) was associated with the highest median DDI number per record. Further research is warranted to improve EHR structure, patient engagement in reporting adverse drug reactions, and genetic profiling of patients to avoid potentially serious DDIs.

Background: The Internet has become an essential component of college students' lives, serving as a tool for academic pursuits, daily activities, and social interactions with individuals and the global community. Productive internet use is associated with student success, while pathological internet use can negatively impact psychosocial performance. This study aimed to assess the impact of internet addiction on the cognitive function, mood, and physical activity of college students. Study design: The study was based on a correlational observational study design. Settings: The study’s participants were taken using a convenience sampling method from the Manav Rachna International Institute of Research and Studies campus, Faridabad, Haryana, having a student strength of more than two thousand. Methods: With a response rate of 69.93%, one hundred male and female college students who could understand the self-administered questionnaires and obtained the internet addiction test (IAT) scores equal to or above twenty participated (aged 18-25 years) in this study. The participants were assessed for the study’s outcomes, such as the internet addiction (viz. average, moderate, and excessive) cognition, mood, and physical activity level, using an internet addiction test questionnaire (IATQ), cognitive failure questionnaire (CFQ), the profile of mood state questionnaire (POMS), and international physical activity questionnaire (IPAQ), respectively. A categorical analysis with mean scores was carried out for all the outcomes. The correlation between internet dependency and cognitive abilities, emotional state, and levels of physical activity among the participants was ascertained using Pearson's correlation coefficient. The threshold of significance was set to 95%, meaning any p-value < 0.05 was considered significant. Results: The study’s outcome variable- internet addiction, revealed a moderate positive correlation with cognition (r=0.793; p=0.001) and mood (r=0.703; p=012), while a moderate negative correlation with physical activity (r=-0.681; p=003). Conclusion: The study concluded that internet addiction is positively linked to cognition and mood disruption; however, it negatively affects physical activities among college students. An awareness program should be executed on “Internet addiction and its effects on college students’ Cognition, Mood, and Physical Activity” and advocating Internet use in a limited manner for getting aroused, feeling better, and avoiding physical inactivity.

To describe the characteristics of patients with uveitis associated with an immunologic or idio-pathic disease that requires immunosuppressive treatment and the response to such treatments in real clinical practice. Observational, descriptive, longitudinal, and retrospective study of a cohort of patients diagnosed with idiopathic uveitis or autoimmune disease-related uveitis. To assess the response to treatment we have evaluated the change in visual acuity and vitritis and the presence of macular edema. We included 356 patients. Twelve percent required treatment with systemic corticosteroids and 66 patients (18.5%) immunosuppressive/biological treatment, with metho-trexate being the most used (55%). Immunosuppressive drugs were used in 59 cases the least re-sponsive being mycophenolate mofetil. Ten patients of the 66 (15%) started treatment with bio-logics. Thirty-five patients (53%) needed to switch drugs due to a lack of response to the first one. There were no differences between different drugs in the resolution of vitritis and improvement of vision. The disappearance of macular edema was achieved in all patients treated with tocilizumab. The use of systemic corticosteroids and Immunosuppressive/biologics was necessary for a high number of patients with non-infectious uveitis. In our series tocilizumab was significantly more effective in the resolution of macular edema.

This article is a logical continuation of the work of Nuritdinov et al. (2021). We analyzed space observations of the apparent surface density of 81 globular clusters (GCs) observed by GAIA DR2 and published in de Boer et al (2019). First, we studied the features of the quality of the GC surface density data, including comparing them with the HST data. Using our 3-parameter model, previously tested on the example of HST space observations, we found the values of the stellar concentration parameter towards the center of the cluster. As a result, we found good correlations of this parameter with the physical characteristics of the GCs. We have also found the corresponding empirical formulas for this parameter.

The present analysis deals with the study of the $f(Q, T )$ theory of gravity which was recently considered by many cosmologists. In this theory of gravity, the action is taken as an arbitrary function $f(Q, T )$ where $Q$ is non-metricity and $T$ is the trace of energy-momentum tensor for matter fluid. In this study, we have taken three different forms of the function $f(Q, T )$ as $f(Q,T)=a_1Q+a_2 T$ and $f(Q,T)=a_3 Q^2+a_4 T$ and discussed some physical properties of the same. Also, we have obtained the various cosmological parameters towards Friedmann-Lemaitre-Robertson-walker (FLRW) Universe by defining the transit form of scale factor which yields the Hubble parameter in redshift form as $H(z)=\frac{H_{0}}{(\lambda+1)} \left(\lambda+ (1+z)^{\delta}\right)$. %We have obtained the approx best-fit values of model parameters using the least square method for observational constraints on available datasets like Hubble dataset $H(z)$, Supernova dataset SNe-Ia, etc., by applying the Root Mean Squared Error formula (RMSE). By applying the Root Mean Squared Error formula (RMSE), we were able to determine the approximate best-fit values of model parameters using the least square approach for observational constraints on the datasets Hubble dataset $H(z)$, Supernova dataset SNe-Ia, etc. We have observed that the deceleration parameter $q(z)$ exhibits a signature-flipping (transition) point within the range $0.623 \le z_{0} \le 1.668$ through which it changes its phase from the decelerated to the accelerated expanding universe with $\omega = -1$ at $z=-1$ for the approximate best-fit values of the model parameters. %For obtained approx best-fit values of model parameters we have observed that the deceleration parameter $q(z)$ shows a signature-flipping (transition) point within the range $0.623 \le z_{0} \le 1.668$ through which it changes its phase from decelerated to the accelerated expanding universe with $\omega = -1$ at $z=-1$.

Immersive experiences in green areas and particularly in forests have long been known to produce beneficial effects for human health. However, the exact determinants and mechanisms leading to healthy outcomes remain to be elucidated. The purpose of this study was to investigate whether inhaling plant-emitted biogenic volatile compounds, namely monoterpenes (MTs), can produce specific effects on anxiety. Data from 505 subjects participating in 39 structured forest therapy sessions in different Italian sites, were collected. Monoterpenes air concentration was measured at each site. STAI State questionnaires were administered before and after the sessions as a measure of anxiety. A propensity score matching analysis was then performed, considering an above-average exposure to inhalable air MTs as the treatment: the estimated effect was -1.28 STAI-S points (95% C.I. -2.51 to -0.06, p = 0.04), indicating that the average effect of exposure to high MT air concentrations during forest therapy sessions is to decrease anxiety.

We propose a novel tensor-based formalism for inferring causal structures from time series. An information theoretical analysis of transfer entropy (TE), shows that TE results from transmission of information over a set of communication channels. Tensors are the mathematical equivalents of these multi-channel causal channels. A multi-channel causal channel is a generalization of a discrete memoryless channel (DMC). We consider a DMC as a single-channel causal channel. Investigation of a system comprising three variables shows that in our formalism, bivariate analysis suffices to differentiate between direct and indirect relations. For this to be true, we have to combine the output of multi-channel causal channels with the output of single-channel causal channels. We can understand this result when we consider the role of noise. Subsequent transmission of information over noisy channels can never result in less noisy transmission overall. This implies that a Data Processing Inequality (DPI) exists for transfer entropy.

A prospective, observational, multicenter, and exploratory study was conducted in 469 gastrointestinal cancer patients undergoing elective surgery. The Malnutrition Universal Screening Tool (MUST) and the Global Leadership Initiative on Malnutrition (GLIM) criteria were used to assess nutritional risk. On admission, 17.9% and 21.1% of patients were at moderate (MUST score 1) and severe (MUST score ≥ 2) nutritional risk, respectively. GLIM criteria used in patients with MUST score ≥ 2 showed moderate malnutrition in 35.3% of patients and severe in 64.6%. Forty-seven percent of patients with MUST score ≥ 2 on admission had the same score at discharge, and 20.7% with MUST score 0 had moderate/severe risk at discharge. Small bowel, esophageal and gastric cancer, and diabetes were predictors of malnutrition on admission. Complications were significantly higher among patients with MUST score 1 or ≥ 2 either on admission (p = 0.001) or at discharge (p &lt; 0.0001). In patients who received nutritional therapy (n = 231), 43% continued to have moderate/severe nutritional risk on discharge, and 54% of those with MUST ≥ 2 on admission maintained this score at discharge. In gastrointestinal cancer patients undergoing elective surgery, there is an urgent need for improving nutritional risk screening before and after surgery, as well as improving nutritional therapy during hospitalization

In 2020, following the World Health Organization's declaration of COVID-19 as a pandemic, dental practices faced unprecedented disruptions globally. This retrospective cross-sectional study, conducted at a leading university dental hospital in the Lisbon Metropolitan Area, investigated the impact of these disruptions on dental caries. The study, spanning June 2019 to June 2021, included a full-mouth X-ray examination, along with sociodemographic, behavioral, and medical data. Our sample comprised 3,380 participants (2,007 females and 1,373 males), aged 18 to 99 years, divided into pre-lockdown and post-lockdown groups. We employed the Decayed, Missing, and Filled Teeth (DMFT) index to measure dental caries. Our findings revealed that nearly 90% of participants in both groups experienced dental caries, indicating a statistically significant difference between the pre-lockdown and post-lockdown periods. However, the impact of COVID-19 confinement varied among different demographic sectors, with age, educational background, and professional status emerging as the key determinants. This study highlights the need for a more nuanced understanding of the impact of the pandemic on oral health, emphasizing the role of sociodemographic factors in shaping dental health outcomes during such global health crises.

Introduction and Aims: COVID-19-associated invasive pulmonary aspergillosis (CAPA) is common and is associated with poor outcomes in critically ill patients. This prospective observational study aimed to explore the association between CAPA development and the incidence and prognosis of cytomegalovirus (CMV) reactivation in critically ill COVID-19 patients. Materials and Methods: We included all consecutive critically ill adult patients with confirmed COVID-19 infection who were admitted to three COVID-19 intensive care units (ICUs) in an Italian hospital from February 25, 2020, to May 8, 2022. A standardized procedure was employed for early detection of CAPA. Risk factors associated with CAPA and CMV reactivation and the association between CMV recurrence and mortality were estimated using adjusted Cox proportional hazard regression models. Results: CAPA occurred in 96 patients (16,6%) of the 579 patients analyzed. Among the CAPA population 40 (41,7%) patients developed CMV blood reactivation with a median time of 18 days (IQR 7-27). The CAPA+CMV group did not exhibit a significantly higher 90-day mortality rate (62.5% vs. 48.2%) than the CAPA alone group (p=0.166). The CAPA+CMV group had a longer ICU stay, fewer ventilation-free days, and a higher rate of secondary bacterial infections than the control group of CAPA alone. In the CAPA population, prior immunosuppression was the only independent risk factor for CMV reactivation (HR 2.33, 95% C.I. 1.21-4.48, p=0.011). Conclusions: In critically ill COVID-19 patients, CMV reactivation is common in those with a previous CAPA diagnosis. Basal immunosuppression before COVID-19 appeared to be the primary independent variable affecting CMV reactivation in patients with CAPA. Furthermore, the association of CAPA+CMV versus CAPA alone appears to impact ICU length of stay and secondary bacterial infections but not mortality.

Background: The COVID-19 transmission has been established to occur through respiratory droplets from coughing and sneezing. Health agencies have strongly recommended the use of facemask as a precaution from cross-transmission. Objective: This study investigated the prevalence of facemask use among visitors to the hospital. This study also investigated the demographic factors contributing to unacceptable facemask practice. Setting: This prospective observational study was done among hospital visitors to a district specialist hospital during COVID-19 pandemic outbreak. Methods: Individuals entering through dedicated entry point were observed for the type, category and practice of wearing personal protective equipment. Inclusion criteria for this study were any individual's ≥ 2 years old entering the treatment facility from selected entry points. Patients were categorized into two groups of acceptable and unacceptable facemask practice. The Pearson chi-square was used to test for differences in investigated variables in the univariate setting and Binary Logistic regression model was used in the multivariate setting. Main Outcome Measure: Prevalence, acceptance practice and odds ratio of unacceptance of facemask use. Results: Among 1652 individuals included in the final analysis, 1574 (96.9%) was observed wearing facemask with 1269 (72.0%) of individuals worn medical-grade facemask. However, among them, only 1397 (88.8%) individuals' facemask practice was acceptable while the reaming 177 (11.2) individuals were perceived with unacceptable facemask practice. Male individuals, Malay ethnic and high risk age group are 1.47 times (Odds Ratio: OR=1.47; 95% CI, 1.06-2.06; p=.023), 2.18 times (OR=2.18; 95% CI, 1.55-3.08; p<.001) and 1.99 times (OR=2.18; 95% CI, 1.42 - 2.77; p<.001) more likely to exhibit unacceptable facemask practice respectively. Conclusion: Extensive use of facemasks coupled with environmental hygiene measures is a public health strategy which can help to mitigate the COVID-19 epidemic impact. However, a targeted comprehensive strategy to improve compliance to proper facemask practice among the high-risk population is needed to achieve maximal protective benefit.

Sleep is a fundamental human need: sleep disruption, in fact, causes an increase in the activity of the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis, metabolic effects, changes in circadian rhythms and pro-inflammatory responses. Sci-entific literature is finally starting to pay attention to the central role of sleep-wake rhythm alterations for patients health. Oxaliplatin is used extensively for the treatment of gastrointestinal cancer and other malignancies, with increased frequency of use in recent years. This study aims to understand the effects of sleep-wake rhythm alterations on health and quality of life on cancer patients treated with oxaliplatin. Study has been conducted through the creation and distribution of questionnaires to patients to inves-tigate the potential alteration of the sleep-wake quality. Evaluating the influence of the collected variables on sleep quality, only liver and biliary tract and pancreas tumor lo-calization, in males, and previous difficulty sleeping, and anxiety, worries and stress, in females, resulted statistically significant. The results obtained may serve as foundation for designing awareness campaigns and updating of patients, healthcare personnel and caregivers, to improve health and quality of patients life.

PURPOSE: The aim of this study was to identify the incidence of early mechanical failure in the first post-surgical year in patients who had undergone spinal surgery, and to assess the related risk factors. METHODS: Retrospective observational study of a prognostic cohort was conducted at an orthopaedic hospital, examining all patients with spine degenerative disease who consecutively underwent arthrodesis surgery between March 2018 and March 2019. The incidence of postoperative mechanical failure during the first year was calculated as primary outcome; the time between the date of the implant surgery and diagnosis of the mechanical failure was calculated as secondary outcome. RESULTS: A total of 237 patients were identified for statistical analysis. The median age of the group of patients was 47 years (IQR of 44), and 66.6% were female. The incidence of mechanical failure in the first postoperative year was 5.1% overall with 12 events and the median time between surgery and the need for revision surgery was 5 months (IQR=7.75). ASA score (OR= 2,39; p=0.134), duration of the surgical procedure (OR=1,27; p=0,006) and inability to walk at discharge (OR=7,86; p=0,072) were independent risk of factor associated with the mechanical failure. CONCLUSION: Higher ASA score and longer duration of surgery are risk factors for mechanical failure in the first year in patients who had undergone spinal surgery and must be carefully considered when planning spinal surgery. During hospitalization, recovery of ambulation must be encouraged to prevent mechanical failure. All these factors are useful in identifying patients with a closer follow-up is needed.

In recent, Chae found that, at weak gravitational acceleration g_N≲10⁻⁹ms⁻², the observed orbit of the wide binary stars is not accordant with current theory of binary star. Here, we present, this finding should be an observational evidence for that Newtonian theory of orbit perturbation is still valid in galactic scale.

Background: Early diagnosis of acute brain injury (ABI) is critical for patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) to guide anticoagulation strategy; however, neurological assessment in ECMO is often limited by patient sedation. Methods: In this pilot study of adults from June 2018 to May 2019, plasma samples of glial fibrillary acidic protein (GFAP), neurofilament light chain (NFL), and Tau were collected daily after VA-ECMO cannulation and measured using a multiplex platform. Primary outcomes were the occurrence of ABI, assessed clinically, and neurologic outcome, assessed by modified Rankin Scale (mRS). Results: Of 20 consented patients (median age=48.5 years; 55% female), 8 (40%) had ABI and 15 (75%) had unfavorable neurologic outcomes at discharge. 10 (50%) patients were centrally cannulated. The median duration on ECMO was 4.5 days (IQR: 2.5-9.5). Peak GFAP, NFL, and Tau levels were higher in patients with ABI vs. without (AUC = 0.77; 0.85; 0.57, respectively) and in patients with unfavorable vs. favorable neurologic outcomes (AUC = 0.64; 0.59; 0.73, respectively). GFAP elevated first, NFL elevated to the highest degree, and Tau showed limited change regardless of ABI. Conclusion: Plasma biomarkers may facilitate early detection of ABIs in VA-ECMO where neurological exam is limited and assist timely clinical decision-making.

Endovenous thermal methods are superseding surgical stripping for treating chronic superficial venous disease but require tumescent anesthesia and can cause heat-related nerve injuries. Endovenous cyanoacrylate ablation is a more recent technique that does not share these drawbacks. Retrospective observational study of consecutive adults managed with endovenous cyanoacrylate in 2018–2021 at a single university center. Follow-up was 18 months. We identified factors associated with target vein closure at 18 months and measured changes in quality of life using the generic 36-item Short-Form tool (SF-36) and the venous disease-specific VEINES-QOL/Sym questionnaire. Adverse events were collected. In the 55 study patients with 67 treated veins, the closure rate at 18 months was 94% (95%CI, 85%–98%). Target vein diameter ≥9.5 mm had 81% sensitivity and 75% specificity for predicting recanalization. Both quality-of-life scores improved significantly (P&lt;0.001 for both). The only adverse event was a type IV allergic reaction to cyanoacrylate that resolved with corticosteroid and histamine-antagonist therapy. Endovenous cyanoacrylate ablation was highly effective and safe in experienced hands. Studies are warranted to determine whether changes in the protocol increase the closure rate in patients with target veins ≥9.5 mm in diameter.

Several studies suggest that children infected with SARS-CoV-2 have fewer clinical manifestations than adults; when they develop symptoms, they rarely progress to severe disease. Different immunological theories have been proposed to explain this phenomenon. In September 2020, 16% of the active COVID-19 cases in Venezuela were children under 19 years. We conducted a cross-sectional study of pediatric patients' immune response and clinical conditions with SARS-CoV-2 infection. The patients were admitted to the COVID-19 area of the emergency department of Dr José Manuel de los Ríos Children's Hospital (2021-2022). The lymphocyte subpopulations were analysed by flow cytometry, and IFNγ, IL-6 and IL-10 serum concentrations were quantified using commercial ELISA assays. The analysis was conducted on 72 patients aged one month and 18 years. The majority, 52.8%, had mild disease, and 30.6 % were diagnosed with MIS-C. The main symptoms reported were fever, cough and diarrhoea. A correlation was found between IL-10 and IL-6 concentrations and age group; lymphocyte subpopulations and nutritional status and steroid use; IL-6 concentrations and clinical severity. The results suggest a different immune response depending on age and nutritional status that should be considered for treating pediatric COVID-19 patients.

Background. To determine the effectiveness and safety of meropenem in routine clinical practice, in terms of clinical and microbiological response. Methods. A real-world, observational, descriptive, longitudinal study with daily monitoring of clinical history records was conducted on all patients who were medically prescribed meropenem during a period between October 2015 and March 2016 at a university hospital in Bucaramanga (Colombia). Results. The study evaluated 84 patients with an average age of 63.2 years, mostly older adults with multiple comorbidities, of whom 54.8% were men. A positive clinical or microbiological response was obtained in 98.8% of the patients. At the end of the treatments, significant improvements in dysthermia (0% vs 29% at the beginning, p = 0.000), tachycardia (13% vs 47%, p = 0.049) and leukocytosis (39% vs 15% at the beginning, p = 0.008) were evidenced. The improvement in the indicator that combines all the SIRS criteria was also significant (p = 0.000). The treatment was well tolerated, although we identified some non-serious and expected adverse reactions. Conclusions. Generic meropenem proved to be effective and well tolerated for different types of infection in routine clinical practice. The results are consistent with the findings of the clinical studies with the innovator drug.

When bone substitutes materials are used, the increased risk of infection due to the none-autogenic graft is often discussed. The treatment of large bone defects in geriatric patients, often with osteoporotic bone, often presents major challenges to surgery. Bone substitutes materials are available indefinitely without the risk of additional surgery in each patient. Can bone substitutes materials be used without hesitation in the geriatric patient?Eighty-three patients suffered traumatic fractures of the distal radius, proximal humerus, and proximal tibia. The defect zones were filled with bone substitute material based on nanocrystalline hydroxyapatite (NHA) or calcium phosphate (CP). For comparison, a reference group without the void filling with a bone graft substitute (void defects, ED) was studied. All patients over the age of 64 years were retrospectively evaluated for complications and radiological outcomes. Results: 106 patients sustained traumatic fractures of the distal radius (68.9%), proximal humerus (5.7%), and proximal tibia (22.6%). No differences in infections were found when comparing the groups (p=1.0). retrospectively evaluated. The KEM group had a nonsignificantly lower rate of pseudarthrosis (p=0.09). A relative risk (RR) reduction of complications of 32.64% was observed when bone grafting material was used. The NNT for the prevention of complications was 5.99. When bone healing was assessed by radiological images, some follow-up studies showed significant differences in fracture bridging (p<0.001).Conclusions: In contrast to previous studies, bone substitutes materials can support the healing process in geriatric patients without relevant disadvantages. With an NNT of 6 regarding complications, many patients could benefit from bone graft augmentation. No increased infection rate was observed.

When bone substitutes materials are used, the increased risk of infection due to the none-autogenic graft is often discussed. The treatment of large bone defects in geriatric patients, often with osteoporotic bone, often presents major challenges to surgery. Bone substitutes materials are available indefinitely without the risk of additional surgery in each patient. Can bone substitutes materials be used without hesitation in the geriatric patient? Eighty-three patients suffered traumatic fractures of the distal radius, proximal humerus, and proximal tibia. The defect zones were filled with bone substitute material based on nanocrystalline hydroxyapatite (NHA) or calcium phosphate (CP). For comparison, a reference group without the void filling with a bone graft substitute (void defects, ED) was studied. All patients over the age of 64 years were retrospectively evaluated for complications and radiological outcomes. Results: 106 patients sustained traumatic fractures of the distal radius (68.9%), proximal humerus (5.7%), and proximal tibia (22.6%). No differences in infections were found when comparing the groups (p=1.0). retrospectively evaluated. The KEM group had a nonsignificantly lower rate of pseudarthrosis (p=0.09). A relative risk (RR) reduction of complications of 32.64% was observed when bone grafting material was used. The NNT for the prevention of complications was 5.99. When bone healing was assessed by radiological images, some follow-up studies showed significant differences in fracture bridging (p<0.001). Conclusions: In contrast to previous studies, bone substitutes materials can support the healing process in geriatric patients without relevant disadvantages. With an NNT of 6 regarding complications, many patients could benefit from bone graft augmentation. No increased infection rate was observed.

Super Typhoon Saola came very close to Hong Kong on 1 and 2 September 2023, necessitating the issuance of No. 10 hurricane signal, the highest tropical cyclone warning signal, in Hong Kong. While there were widespread damages in Hong Kong, no people were killed in the event with effective early warning. It is rare that a super typhoon came very close to Hong Kong and this paper is the first part in the series of the documentation of Saola to summarize the interesting observations of Saola near Hong Kong for future reference by weather forecasters, including sur-face observations, upper air observations, microburst alert from weather radars, and turbulence intensity based on spectral width measurement of radars.