Households and businesses are generating unprecedented levels of electrical and electronic wastes (e-waste), fueled by modernisation and rapid obsolescence. While the challenges imposed by e-waste are similar everywhere in the world, disparities in progress to deal with it exists; with developing nations such as South Africa lagging. The increase in e-waste generation increases the need to formulate strategies to manage it. This paper presents an overview of e-waste management on a global and South African scenarios with a specific case for Cathode Ray Tube (CRT) waste management practices in South Africa. CRTs present the biggest problem for recyclers and policy makers because they contain hazardous elements such as lead and antimony. Common disposal practices have been either landfilling or incineration. The research into the South African practices with regards to CRT waste management showed that there is still more to be done to effectively manage this waste stream. This is despite clear waste regulatory frameworks in the country. However, recent developments have placed e-waste as a priority waste stream, which should lead to intensified efforts in dealing with it. Overall, these efforts should aim to maximise diversion from landfilling and to create value-addition opportunities, leading to social and environmental benefits.

The main objective of this study was to compare the removal efficiency of nutrients using Lactuca sativa, Medicago sativa and Phragmites australis in subsurface flow constructed wetlands with horizontal flow. In order to test water quality, fabricated reactors designed and the plants cultivated in the soil while their root were inside the wastewater. A long time study carried out from spring till end of autumn (9 months) in order to evaluate the difference in removal rate based on the seasonal changes. The highest removal rate was during summer which followed by spring and autumn. Thus, the effect of plants on the removal efficiency of organic matter (COD, BOD), TSS and nutrient (P and TN) appeared to be dependent on the seasonal growth. Phragmites australis the most sensitive species in order the removal of nutrient from wastewater.

Assuming a two component, positive and negative mass, superfluid/supersolid for space (the Winterberg model), we model the Higgs field as a condensate made up of a positive and a negative mass, planckion pair. The connection is shown to be consistent (compatible) with the underlying field equations for each field, and the continuity equation is satisfied for both species of planckions, as well as for the Higgs field. An inherent length scale for space (the vacuum) emerges, which we estimate from previous work to be of the order of,

Assuming a Winterberg model for space where the vacuum consists of a very stiff two component superfluid made up of positive and negative mass planckions, theory is the hypothesis, that Planck charge, , was created at the same time as Planck mass. Moreover, the repulsive force that like-mass planckions experience is, in reality, due to the electrostatic force of repulsion between like charges. These forces also give rise to what appears to be a gravitational force of attraction between two like planckions, but this is an illusion. In reality, gravity is electrostatic in origin if our model is correct. We determine the spring constant associated with planckion masses, and find that, , where equals Apery's constant, , and, , is the relaxed, i.e., , number density of the positive and negative mass planckions. In the present epoch, we estimate that, equals, , and the relaxed distance of separation between nearest neighbor positive, or negative, planckion pairs is, These values were determined using box quantization for the positive and negative mass planckions, and considering transitions between energy states, much like as in the hydrogen atom. For the cosmos as a whole, given a net smeared macroscopic gravitational field of, , due to all the ordinary, and bound, matter contained within the observable universe, an average displacement from equilibrium for the planckion masses is a mere , within the vacuum made up of these particles. On the surface of the earth, where, , the displacement amounts to, . All of these displacements are due to increased gravitational pressure within the vacuum, which in turn are caused by applied gravitational fields. The gravitational potential is also derived and directly related to gravitational pressure.

We work within a Winterberg framework where space, i.e., the vacuum, consists of a two component superfluid/super-solid made up of a vast assembly (sea) of positive and negative mass Planck particles, called planckions. These material particles interact indirectly, and have very strong restoring forces keeping them a finite distance apart from each other within their respective species. Because of their mass compensating effect, the vacuum appears massless, charge-less, without pressure, net energy density or entropy. In addition, we consider two variable models, where, , is Newton’s constant, and, , increases with an increase in cosmological time. We argue that there are at least two competing models for the quantum vacuum within such a framework. The first follows a strict extension of Winterberg’s model. This leads to nonsensible results, if increases, going back in cosmological time, as the length scale inherent in such a model will not scale properly. The second model introduces a different length scale, which does scale properly, but keeps the mass of the Planck particle as, the Planck mass. Moreover we establish a connection between ordinary matter, dark matter, and dark energy, where all three mass densities within the Friedman equation must be interpreted as residual vacuum energies, which only surface, once aggregate matter has formed, at relatively low temperatures. The symmetry of the vacuum will be shown to be broken, because of the different scaling laws, beginning with the formation of elementary particles. Much like waves on an ocean where positive and negative planckion mass densities effectively cancel each other out and form a zero vacuum energy density/ zero vacuum pressure surface, these positive mass densities are very small perturbations (anomalies) about the mean. This greatly alleviates, i.e., minimizes the cosmological constant problem, a long standing problem associated with the vacuum.

Assuming a geometrically closed universe, we predict a value for the cosmic curvature, , a value within current observational bounds. We also propose a thermodynamic heat engine model for the universe, which bypasses the need for an inflaton field. Our model is based on a Carnot Cycle where we have isothermal expansion, followed by adiabatic expansion, followed by isothermal contraction, followed by adiabatic contraction, bringing us back to our original starting point. For the working substance, we focus specifically on the CMB radiation filling the collective voids in the universe. Using this construct, we identify cosmic inflation as the isothermal expansion phase, which lasts just under, . The collective CMB volume we see today only increases by a factor of 5.65 times during this process, and homogeneity and perturbations in the CMB are explained. The singularity problem is avoided and we have a clear mechanism for the work done by the cosmos in causing expansion, and later contraction. For scaling laws with respect to the density parameters in Friedmann’s equations, we will assume a susceptibility model for space, where, , the smeared cosmic susceptibility, decreases with increasing cosmic scale parameter, . Within this framework, we can predict a maximum Hubble volume with minimum CMB temperature for the voids before contraction begins, as well as a minimum volume with maximum CMB temperature when expansion starts. The thermodynamic heat cycle deviates from efficiency in converting heat energy into mechanical energy (expansion) by a minuscule amount, namely, . The significance of this number is not known.

First responders, such as police officers, paramedics, and fire-fighters are at an increased risk of experiencing negative mental health outcomes compared to the general population. This predisposition can partially be attributed to common occupational stressors, such as poor workplace culture and mistreatment from leadership, which may provoke strong feelings of betrayal and humiliation. The Workplace Assessment Scale (WAS) was developed as there is currently no appropriate measure to assess such feelings in the first responder population. The scale consists of the Betrayal Subscale and the Humiliation Subscale, each comprised of 5 Likert scale questions which ask participants to report the frequency at which they experience specific feelings associated with their workplace. This pilot validation study was conducted to assess preliminary reliability and validity of the WAS, using data which was originally collected as part of a larger first responder-based observational study. Based on 21/22 (95%) participant responses, the internal consistency appeared to be strong for both sub-scales as well as the overall questionnaire. However, item 9 will likely require modification or deletion from the scale. The validity analysis found no significant correlations between WAS and other psychiatric scales. Additional research is needed for further analysis and validation of the WAS.

We present a new interpretation of the Higgs field as a composite particle made up of a positive, with, a negative mass Planck particle. According to the Winterberg hypothesis, space, i.e., the vacuum, consists of both positive and negative physical massive particles, which he called planckions, interacting through strong superfluid forces. In our composite model for the Higgs boson, there is an intrinsic length scale associated with the vacuum, different from the one introduced by Winterberg, where, when the vacuum is in a perfectly balanced state, the number density of positive Planck particles equals the number density of negative Planck particles. Due to the mass compensating effect, the vacuum thus appears massless, charge-less, without pressure, energy density, or entropy. However, a situation can arise where there is an effective mass density imbalance due to the two species of Planck particle not matching in terms of populations, within their respective excited energy states. This does not require the physical addition or removal of either positive or negative Planck particles, within a given region of space, as originally thought. Ordinary matter, dark matter, and dark energy can thus be given a new interpretation as residual vacuum energies within the context of a greater vacuum, where the populations of the positive and negative energy states exactly balance. In the present epoch, it is estimated that the dark energy number density imbalance amounts to, , per cubic meter, when cosmic distance scales in excess of, , are considered. Compared to a strictly balanced vacuum, where we estimate that the positive, and the negative Planck number density, is of the order, particles per cubic meter, the above is a very small perturbation. This slight imbalance, we argue, would dramatically alleviate, if not altogether eliminate, the long standing cosmological constant problem.

We propose a model for gravity based on the gravitational polarization of space. With this model, we can relate the density parameters within the Friedmann model, and show that dark matter is bound mass formed from massive dipoles set up within the vacuum surrounding ordinary matter. Aggregate matter induces a gravitational field within the surrounding space, which reinforces the original field. Dark energy, on the other hand, is the energy density associated with gravitational fields both for ordinary matter, and bound, or induced dipole matter. At high CBR temperatures, the cosmic susceptibility, induced by ordinary matter vanishes, as it is a smeared or average value for the cosmos as a whole. Even though gravitational dipoles do exist, no large scale alignment or ordering is possible. Our model assumes that space, i.e., the vacuum, is filled with a vast assembly (sea) of positive and negative mass particles having Planck mass, called planckions, which is based on extensive work by Winterberg. These original particles form a very stiff two component superfluid, where positive and negative mass species neutralize one another already at the submicroscopic level, leading to zero net mass, zero net gravitational pressure, and zero net entropy, for the undisturbed medium. It is theorized that the gravitational dipoles form from such material positive and negative particles, and moreover, this causes an intrinsic polarization of the vacuum for the universe as a whole. We calculate that in the present epoch, the smeared or average susceptibility of the cosmos equals, , and the overall resulting polarization equals, . Moreover, due to all the ordinary mass in the universe, made up of quarks and leptons, we calculate a net gravitational field having magnitude, . This smeared or average value permeates all of space, and can be deduced by any observer, irrespective of location within the universe. This net gravitational field is forced upon us by Gauss’s law, and although technically a surface gravitational field, it is argued that this surface, smeared value holds point for point in the observable universe. A complete theory of gravitational polarization is presented. In contrast to electrostatics, gravistatics leads to anti-screening of the original source field, increasing the original value, , to, , where is the induced or polarized field. In the present epoch, this leads to a bound mass, , where is the sum of all ordinary source matter in the universe, and equals the relative permittivity. A new radius, and new mass, for the observable universe is dictated by the density parameters in Friedmann's equation, and Gauss’s law. These lead to the very precise values, , and, , respectively, somewhat larger than current less accurate estimates.

The aim of this study is to evaluate the optimal conditions of membrane filtration process. Both laboratory test and pilot-scale test were conducted to examine a treated water on blending water. The water sample were prepared by blending a raw water and the effluent water filtered through an organic membrane. The optimal efficiency in the treatment of water quality at the lab-scale test was generated under conditions of flux at 2.0 m³/m²∙day, the blending ratio of 4:1, and the optimal dosage of coagulant at 20 ppm. The pilot-scale test resulted in that the optimal efficiency was obtained under conditions of flux at 2.0 m³/m²∙day and the blending ratio of 6.0:1. However, the different results between lab-scale and pilot-scale tests on the optimal dosage of coagulant implied that it is difficult to achieve the stable condition of process operation at the low level of coagulant. In summary, the results indicated that, in the combination process of organic membrane and ceramic membrane, the recovery efficiency was achieved above the level of 98.4 %. Compared to 92.1 % in a single organic membrane process, the combination process is 6.3 % more efficient than the single one. This combination process of water treatment lead to stable recovery rates by the optimal input of dosage, less pollution load to water, and a stabilized filtration system.

The importance of frailty in older people is getting constant recognition as an important aspect both in terms of public health, as well in personal level for the appropriate management of an older person health condition. This is reflected by the continuously increasing number of research studies carried out in several settings across different countries. Sometimes this is very solid, but in other cases there is a considerable gap in terms of accurate and well grounded documentation of frailty status. This is the case in Greece, where we are missing clinically validated tools to approach frailty. We are missing frailty screening tools, such as for instance PRISMA 7, the gold standard tool of Fried criteria is somehow problematic since the question referring to physical activity originates from a questionnaire that has not been translated and validated, while Clinical Frailty Scale has been validated for the translation but not for the capacity to detect frailty. Aim of this study is to validate these tools for their accuracy to detect frailty by using a measurable index of frailty, previously proposed for use in clinical studies: the Short Physical Performance Battery (SPPB). 74 male and female participants have been evaluated for their frailty status using different tools. We observed that PRISMA 7 translation detects frailty only when one question is removed at a cut-off of ≥ 2 and indicated a sensitivity of 88.1%, and specificity of 99.9% with a good correlation with SPPB measurements (r = 0.858; p < 0.001). When CFS was validated using SPPB it demonstrated a very good correlation (r = -0.838; p < 0.001 respectively) as it was the case for the modified Fried Criteria (r = -0.725; p < 0.001). All items demonstrated a good correlation between them. We can here propose that we can accurately assess frailty status in the community setting by using a modified version of Fried criteria, Clinical Frailty Scale translation in Greek and we can screen for frailty by using the Greek translation of PRISMA 7 only after removing the item 6 of the questionnaire.

Little is known about fertility preservation within the TGD community. Few receive adequate counseling placing them at risk for decision regret. The goal of this project was to develop, and pilot test the Transgender Fertility Preservation Knowledge Scale (TFPKS) to support the development and evaluation of health education resources. A community engaged; cross sectional retrospective design was used. Participants (n=189) provided information describing demographics, healthcare decision-making preferences, experiences/knowledge of fertility preservation, and treatment decision regret. The sample included 189 TGD adults. Most were white and aged 26-35 (33.3%) and not offered a consultation (73.0%). Many (41.2%) report they would have participated if offered. Knowledge regarding fertility preservation to support this desire was low. Most participants identified a patient-centered (69.4%) decision making preference. Much remains to address the healthcare inequities within the TGD population regarding fertility preservation. Overall participants had low levels of knowledge to support decision making. Further, healthcare system and individual barriers to fertility preservation remain prevalent. A foundational step towards addressing these disparities, is the identification of a valid and reliable instrument to measure TGD knowledge of fertility preservation.

In the U.S. 44% of low-income households struggle to pay their utility bills, affecting their ability to afford necessities such as food and health expenses. Several government and utility funded energy efficiency programs exist to assist those experiencing energy insecurity. In Salt Lake City, Utah, there is a high demand for, but low availability of, energy efficiency services in underserved neighborhoods creating an opportunity for creative community-based programs to fill this inherent gap. This pilot project, involving the exchanging of LED bulbs in Salt Lake City, highlights the development of a community-based energy efficiency program that aims to bring energy savings to a uniquely targeted portion of the city and determines its feasibility in addressing energy insecurity at a larger scale. Through the 8-month project duration, 1,432 bulbs were exchanged at 23 events reaching 181 households in low-income areas. Through a year of use, these bulbs are estimated to save residents approximately 18,219 USD in electricity bills and reduce CO2 emissions from power plants by 122.23 metric tons, in addition to a savings of 4,400 USD in social cost of carbon as defined by the U.S. Environmental Protection Agency. Since this pilot reached less than 1% of households, we extrapolated a reach of 2%, 5%, and 7.5% and found substantial potential decreases in power plant emissions and financial savings. As this project is ongoing and being expanded, we discuss relevant findings that will help shape future community-based models so that they are appropriately deployed and more effective in alleviating local energy insecurity.

Recently considered modifications to public policy and trends in technology transfer practices have underscored the need for validated instruments to assess the maturity of technologies. This paper details a study that aimed to develop and present a generalized technology readiness level (GTRL) scale that a variety of professionals and researchers could use to assess the maturity of technologies in a range of contexts. Of particular interest is developing and validating an instrument that technology transfer professionals in federal laboratories, universities, and the private sector in the United States of America can use to assess the maturity of technologies to facilitate their technology transfer efforts. The primary goal of the research study was to highlight the need for validated measurement instruments for assessing the maturity of technologies in these contexts, test methods for validating the GTRL scale and other readiness level scales, and fill the knowledge gap regarding methods for properly validating such instruments. This included producing insights to inform future efforts to validate the GTRL scale as well as efforts to develop and validate other instruments to measure technology maturity. The study provides specific recommendations relevant to determining the face validity, content validity, inter-rater reliability, and intra-rater reliability of the GTRL scale and other such instruments for assessing technology maturity.

This study investigated the removal characteristics of N-nitrosamines and their precursors at three pilot-scale water reclamation plants. These plants applies different integrated membrane systems: (1) microfiltration (MF) / nanofiltration (NF) / RO; (2) sand filtration/three-step RO; and (3) ultrafiltration (UF) / NF and UF / RO. Variable removal of N-nitrosodimethylamine (NDMA) by the RO membrane processes could be attributable to membrane fouling and feed water temperature. The effect of membrane fouling on N-nitrosamines removal was extensively evaluated at one of the plants by conducting one month of operation and chemical cleaning of the RO membrane element. Membrane fouling enhanced N-nitrosamines removal by the pilot-scale RO membrane process. This finding contributes to better understanding of variable removal of NDMA by RO membrane processes. This study also investigated the removal characteristics of N-nitrosamines precursors. The NF and RO membrane processes greatly reduced NDMA formation potential (FP), but the UF process had little effect. The contributions of MF, NF, and RO membrane processes for reducing FPs of NDMA, N-nitrosopyrrolidine (NPYR) and N-nitrosodiethylamine (NDEA) were different, suggesting different size distributions of their precursors.

The rural communities are affected by gaseous emissions from intensive livestock production. Practical mitigation technologies are needed to minimize emissions from stored manure and improve air quality inside barns. In our previous research, the one-time surficial application of biochar to swine manure significantly reduced emissions of NH3 and phenol. We observed that the mitigation effect decreased with time during the 30-day trials. In this research, we hypothe-sized that bi-weekly reapplication of biochar could improve the mitigation effect on a wider range of odorous compounds using larger scale and longer trials. The objective was to evaluate the effectiveness of biochar dose and reapplication on mitigation of targeted gases (NH3, odor-ous VOCs, odor, GHGs) from stored swine manure on a pilot-scale setup over 8-weeks. The bi-weekly reapplication of the lower biochar dose (2 kg/m2) showed much higher significant percent reductions of emissions for NH3 (33% without & 53% with reapplication) and skatole (42% without & 80% with reapplication), respectively. In addition, the reapplication resulted in the emergence of statistical significance to the mitigation effect for all other targeted VOCs. Spe-cifically, for indole, the % reduction improved from 38% (p=0.47, without reapplication) to 78% (p=0.018, with reapplication). For phenol, the % reduction improved from 28% (p=0.71, without reapplication) to 89% (p=0.005, with reapplication). For p-cresol, the % reduction improved from 31% (p=0.86, without reapplication) to 74% (p=0.028, with reapplication). For 4-ethyl phenol, the percent emissions reduction improved from 66% (p=0.44, without reapplication) to 87% (p=0.007, with reapplication). The one-time 2 kg/m2 and 4 kg/m2 treatments showed similar effectiveness in mitigating all targeted gases, and no statistical difference was found between the dosages. The one-time treatments showed significant % reductions of 33% & 42% and 25% & 48% for NH3 and skatole, respectively. The practical significance is that the higher (one-time) biochar dose may not necessarily result in improved performance over the 8-week manure storage, but the bi-weekly reapplication showed significant improvement in mitigating NH3 and odorous VOCs. The lower dosages and the frequency of reapplication on the larger-scale should be explored to optimize biochar treatment and bring it closer to on-farm trials.

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 major issue of raw materials depletion and more specifically of phosphorous (an important fertilizer) has currently become an emergent aspect, due to expected depletion problems, needing immediate handling. This was the reason for the implementation of PhoReSe project that aimed to remove and recover phosphorus from the secondary (biologically treated) effluent of a municipal wastewater treatment plant (WWTP “AINEIA”, located near Thessaloniki, N. Greece), treating the wastewaters of the nearby touristic area. Regarding the phosphorous supplementary removal and recovery treatment options, two methods mainly examined, initially in laboratory scale (batch experiments), i.e. (1) the adsorption of phosphorous, and (2) the chemical precipitation of phosphorus. Both methods further applied in pilot-scale, by performing initially the adsorption of phosphorous onto the AquAsZero commercial sorbent, which is a mixed manganese iron oxy-hydroxide, followed by the chemical precipitation of phosphorous, implemented after the de-sorption process of previously saturated adsorbent. The final precipitate of this procedure examined as an alternative/supplementary fertilizer, returning with this way phosphorus into the natural cycle. These experiments, as applied successfully in pilot-scale, set the basis for the larger-scale relevant application for similar WWTP facilities.

As the adoption of renewable energy sources grows, ensuring a stable power balance across various time frames has become a central challenge for modern power systems. In line with the "dual carbon" objectives and the seamless integration of renewable energy sources, harnessing the advantages of various energy storage resources and coordinating the operation of long-term and short-term storage have become pivotal directions for future energy storage deployment. To address the complexities arising from the coupling of different time scales in optimizing energy storage capacity, this paper proposes a method for energy storage planning that accounts for power imbalance risks across multiple time scales. Initially, the Seasonal and Trend decomposition using the Loess (STL) decomposition method is utilized to temporally decouple actual operational data. Subsequently, power balance computations are performed based on the obtained data at various time scales to optimize the allocation of different types of energy storage capacities and assess the associated imbalance risks. Finally, the effectiveness of the proposed approach is validated through hourly applications using real-world data from a province in China over recent years.

In the present study, the problem of the sulfuric acid recycling from spent copper plating solution was solved using a hybrid membrane technology, including diffusion dialysis and electrodialysis. A real solution from the production of copper-coated steel wire, containing 1.45 mol/L of sulfuric acid, 0.67 mol/L of ferrous sulfate and 0.176 mol/L of copper sulfate was processed. Diffusion dialysis with anion-exchange membranes was used to separate sulfuric acid and salts of heavy metals. Then purified dilute sulfuric acid was concentrated by electrodialysis. Energy consumption for sulfuric acid electrodialysis concentration at a current density of 400 A/m2 was 162 W·h/mol with current efficiency 16 %. After processing according to the hybrid membrane scheme, the solution contained 1.13 mol/L sulfuric acid, 0.077 mol/L ferrous sulfate and 0.022 mol/L copper sulfate. The resulting acid solution with a small amount of ferrous sulfate and copper sulfate met the established requirements for a copper plating bath solution and can be reused in production.

Ecosystem physical structure, defined by the quantity and spatial distribution of biomass, influences a range of ecosystem functions. Remote sensing tools permit the non-destructive characterization of canopy and root features, potentially providing opportunities to link above- and belowground structure at fine spatial resolution in functionally meaningful ways. To test this possibility, we employed ground-based portable canopy lidar (PCL) and ground penetrating radar (GPR) along co-located transects in forested sites spanning multiple stages of ecosystem development and, consequently, of structural complexity. We examined canopy and root structural data for coherence at multiple spatial scales ≤ 10 m within each site using wavelet analysis. Forest sites varied substantially in vertical canopy and root structure, with leaf area index and root mass more evenly distributed by height and depth, respectively, as forests aged. In all sites, above- and belowground structure, characterized as mean maximum canopy height and root mass, exhibited significant coherence at a scale of 3.5-4 meters, and results suggest that the scale of coherence may increase with stand age. Our findings demonstrate that canopy and root structure are linked at characteristic spatial scales, which provides the basis to optimize scales of observation. Our study highlights the potential, and limitations, for fusing lidar and radar technologies to quantitatively couple above- and belowground ecosystem structure.

Introduction: Hypertension is a serious public health problem in Morocco. The objective of this pilot study was to estimate the salt intake of Moroccan adults by measuring 24-hour urinary sodium excretion. Methods: 132 participants were recruited from the central region of Morocco. Sodium, potassium and creatinine levels were measured using the 24-hour urine samples. Additional data included anthropometric measurements and socio-demographic questionnaire. Results: The daily sodium, potassium and creatinine excretions were 2779.1±1334.9 mg, 1350.0±642.8 mg and 820.3 ± 381.2 mg, respectively. Data analysis revealed that 71.2% of the participants had a daily sodium intake more than 2000 mg (5g of salt) recommended by the WHO. The mean of potassium excretion was 1350.0±642.8 mg /day, this average was lower than 3.51g per day recommended by the WHO. Conclusion: Public health measures to reduce sodium and increase potassium consumption in order to decrease the population’s risk of high blood pressure and heart disease are recommended.

To meet the growing interest in the development of innovative biological nutrient removal (BNR) alternatives for energy neutrality, resource recovery, and decarbonization, the adsorption/bio-oxidation (A/B) process has been widely studied for carbon capture and shortcut nitrogen (N) removal, while limited research has focused on incorporating enhanced biological phosphorus (P) removal (EBPR), mainly due to the differential carbon usage characteristics of functionally relevant microorganisms. Here, a full-scale pilot testing with an integrated system combining A-stage high-rate activated sludge (HRAS) with B-stage partial (de)nitrification/anammox and side-stream EBPR (HRAS-P(D)N/A-S2EBPR) was conducted treating real municipal wastewater. The results demonstrated that, despite the low influent carbon load, the B-stage P(D)N-S2EBPR system achieved effective and stable P removal performance, especially when the volatile fatty acid (VFA) load from A-stage was elevated. Sludge fermentation in both A-stage and B-stage promoted carbon redistribution and likely provided more competitive advantages for ammonium-oxidizing bacteria and polyphosphate accumulating organisms, leading to carbon-efficient shortcut N removal mainly through partial nitrification pathway and influent carbon-independent EBPR simultaneously. Exposure to high VFA levels was considered a potential selection factor for the suppression of nitrite-oxidizing bacteria in the system. The involvement of internal carbon-accumulating organisms would potentially play an important role in endogenous denitrification. This study provided new insights into the effects of incorporating side-stream EBPR into the A/B process on microbial ecology, metabolic activities, and system performance.

Vaccination, particularly against pneumoccus and influenza, is a low-cost primary prevention, useful to avoid hard complications, particularly among frail older people. In this study, we aimed to assess the effect of a strategy for influenza and pneumococcal vaccination for outpatients, never practiced before, evaluating what could stimulate or demotivate vaccination among older people. This study was conducted during the 2023-2024 influenza season at the outpatient clinics of the Geriatrics section, University Hospital of Palermo (Italy). A total of 101 vaccinations were carried out. Half of the patients could be considered as pre-frail and about 20% frail, according to a comprehensive geriatric evaluation. Among participants, 46.3% received only vaccination against Pneumococcus and 26.8% only anti-influenza or the combination of anti-pneumococcus and anti-influenza. Compared with the previous seasons, a 19.5% increase of influenza and 90.2 % of pneumococcal vaccine uptake was observed. Side effects of vaccination were the main reason of the previous rejections, namely 74.8% for influenza and 29.5% for anti-pneumococcal vaccination. In conclusion, our study indicates how a new vaccination strategy in different settings is possible. Proposing influenza and pneumococcal vaccination for outpatients could be an effective instrument to improve immunization coverage that is still low among older people.

Several pathotypes of enteric E. coli have been identified. The group represented by Shiga toxin-producing E. coli (STEC) is of particular interest. Raw milk and raw milk products are significant sources of STEC infection in humans; therefore, identifying pathogens at the herd level is crucial for public health. Most national surveillance programs focus solely on raw milk and raw milk cheeses that are ready for retail sale, neglecting the possibility of evaluating the source of contamination directly at the beginning of the dairy chain. In order to assess the viability of new molecular methodologies applied to raw milk filters enabling the identification of the presence of STEC serotypes in milk production and apply the same methods to identify the presence of these pathogens in calf feces we analyzed, through a commercial real-time PCR assay, a total of 290 samples coming from 18 different dairy herds; 88 bulk tank milk (BTM), 104 raw milk filters (RMF) and 98 calves’ feces samples. In total 3.4% of BTM, 41.4% of RMF and 73.4% of calves’ feces tested positive for stx presence, supporting our hypothesis that BTM is not a suitable matrix to assess the STEC presence at herd level, underestimating it. Our conclusion is that the surveillance program needs critical and extensive improvements such as RMF and calves’ feces analysis implementation in order to be more efficient in detecting and preventing STEC infections. The epidemiology of these infections and the characteristics of the pathogen clearly show how a One Health approach will be pivotal to improve our capabilities to control the spread of these infections.

We herein provide an overview of the most recent multidisciplinary process advances that have occurred in the food industry as a result of changes in consumer lifestyle and expectations. The demand for fresher and more natural foods is driving the development of new technologies that may efficiently operate at room temperature. Moreover, the huge amount of material discarded by the agro-food production chain lays down a significant challenge for emerging technologies that can provide new opportunities by recovering valuable by-products and creating new applications. Aiming to design industrial processes, there is a need of pilot scale plants such as the “green technologies development platform” that was established by the authors. The platform is made up of a series of multifunctional laboratories that are equipped with non-conventional pilot reactors developed in direct collaboration with partner companies in order to bridge the enormous gap between academia and industry via the large-scale exploitation of relevant research achievements. Selected key, enabling technologies for process intensification make this scale-up feasible. We make use of two selected examples, the grape and olive production chains, to show how cavitational reactors, which are based on high-intensity ultrasound and rotational hydrodynamic units, can assist food processing and the sustainable recovery of waste to produce valuable nutraceuticals as well as colouring and food-beverage additives.

Introduction: Hospitalization in a COVID-19 unit represents a significant source of stress and psychological distress for patients. Our study aims to determine the factors of psychological distress in the therapeutic and psychosocial management of patients hospitalized with a COVID-19 infection. Methods: This cross-sectional study was carried out over 8 months at the COVID-19 zone of the CHU HASSAN II of FES. 99 patients were evaluated within days of diagnosis by psychometric scales of anxiety, depression, and post-traumatic stress. In the course of this follow-up, we found the presence of psychological impacts in these patients, and we tried to find correlating factors between the occurrence of psychiatric disorders and the set of factors related to sociodemographic data, hospitalization course and treatments taken, as well as family support. Results: 35% of patients had scores in favor of post-traumatic stress disorder, 37% of the patients had definite depression and 50% had anxiety. Post-traumatic stress, depression, and anxiety were correlated with sociodemographic factors, hospitalization, treatments received, and length of stay. Conclusion: The prevalence of anxiety-depressive disorders and post-traumatic stress disorder was high in patients with COVID-19, hence the interest in providing psychological and psychosocial care in the emergency department.

While the majority of previous studies assessing pain-related variables in psychopaths used electric shocks, little is known about the effectiveness of alternative pain-inducing methods to increase emotional responses such as fear and anxiety. A small sample of healthy undergraduate men (N = 15) was recruited to assess the effectiveness of a heat stimulus to induce pain in an immediate versus delayed punishment paradigm. Although pain catastrophizing, anxiety, and threat of pain did not increase throughout the experiment, participants experienced a significant increase of fear of pain and pain intensity, indicating that the heat stimulus was effective in inducing pain. Furthermore, subjects were slower in initiating the pain stimulus during the first five trials, but no time difference was found during the 15 remaining trials. No correlation was found between psychopathic traits and pain-related variables, with the exception of inconsistent results within the Fearless Dominance factor. Findings are discussed in terms of improvement for a larger scale study involving psychopathic individuals.

Two pilot scale desalination system employing carbon modified nano-sized, zero valent metals (n-ZVM) were maufactured and tested to determine (1) the degree to which high salt water (20 to 130 mS) could be desalinated and (2) if this degree of desalination could be maintained throughout an extended treatment period. Two pilot systems were tested (referred to as Generation 1 and Generation 2) consisting of parallel lines of 4 individual reactors in series, a settling tank and an activated carbon cell at the end of each reactor line. The system capacity was 300 gal in Generation 1 and 600 gal in Generation 2 total with a total hydraulic residence time of 6 hours per reactor line (one hour per cell/tank). A slurry of n-ZVM was introduced in the first reactor on each line to yield approximately 5 to 45 grams of nano-metal per 100 L of influent salt water. The n-ZVM slurry was made from mixing tea extract with metal salts (eg ferrous sulfate, ferric chloride) to produce the carbon modified metal slurry. Initial runs focused on dosing required to achieve maximum salt removal at each of three influent salt contents, 28 mS, 44 mS and 123 mS. Once dosing was set, continuous runs (14 days, 23 days and 9 days) were carried out to (1) examine the ability of the pilot to maintain the removal efficiency over an extended period, (2) to determine the weaknesses inherent in the pilot systems, and (3) to begin to develop CAPEX and OPEX estimates for the pilot and pre-design full scale mobile desalination unit (MDU) system. Results demonstrated that maximum removal occurred with 10 g/100L of salt for the 30 mS salt solution,16 g/100 L of salt for the 40 mS influent water and 40 g/100 L for the 130 mS influent. Salt removal (expressed as Na and Cl removed) approached 78% for the 30 mS influent and 41 mS influent respectively while removal for the highest salt influent (130 mS) approached 81 %. Addition of greater amounts of carbon modified slurry than those described resulted in a pH less than 6 which inhibits continued salt removal and would require addition of calcium or magnesium oxides/hydroxides or bicarbonate solutions at the influent side to achieve greater salt removal and of course greater cost per gallon. Continuous operation over the extended time-period showed no significant decrease in salt removal with typical day to day variation of no more than 10% suggesting that this approach to desalination could rapidly provide usable water from saline aquifers, seawater or even produced water. Treatment of saline waters at 30 mS or less yields effluent water in the range necessary for irrigation use of many crops while treatment of seawater or produced water levels of salt (40 mS or higher) yields effluent in the range of 8 to 10 mS a range ideal for RO influent that would prevent the production of large volumes of brine. Pilot testing continues with seawater extracted from Puget Sound, Seattle WA and higher levels of salt to better represent produced water.

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

This study aimed to investigate the relationship between sleep duration, dementia severity, age, and ANS regulation. This cross-sectional pilot study included 27 older patients with probable Alzheimer’s disease, hospitalized at a psychiatric center. We measured heart rate variability to assess ANS regulation at night, evaluated dementia severity using the Clinical Dementia Rating scale, and obtained sleep duration data from sleep diaries maintained by psychiatric nurses. The data were analyzed using repeated-measures generalized linear models with age, sex, dementia severity, and medication (antipsychotics) as covariates. A sleep duration of 7–8 h per night was associated with better ANS regulation than other sleep durations, as indicated by sympathovagal balance (p = 0.005). ANS dysregulation was characterized by a 20.7% increase in sympathetic nervous system activity and a 14.8% decrease in parasympathetic nervous system (PSNS) activity. We found a significant correlation between dementia severity and PSNS activity (p = 0.04) and observed an inverted U-shaped association between sleep duration and ANS regulation. This pilot study demonstrated that a sleep duration of 7–8 h per night may be critical in maintaining optimal ANS regulation. Bidirectional associations between sleep duration, inadequate sleep duration, aging, and ANS regulation warrant further investigation.

A multiscale model that enables quantitative understanding and prediction of the size effect on scattering properties of micro- and nanostructures is crucial for the design of LED surface textures optimized for high light extraction efficiency (LEE). In this paper, a hybrid process for combining full-wave finite-difference time-domain simulation and a ray-tracing technique based on a bidirectional scattering distribution function model is proposed. We apply this method to study the influence of different pattern sizes of a patterned sapphire substrate on GaN-based LED light extraction from the microscale to the nanoscale. The results show that near-wavelength–scaled patterns with strong diffraction are not expected to enhance LEE. By contrast, microscaled patterns with optical diffusion behavior have the highest LEE at a specific aspect ratio, and subwavelength-scaled patterns that have antireflection properties show marked enhancement of LEE for a wide range of aspect ratios.

Genome-wide association studies (GWAS) have successfully revealed numerous susceptibility loci for obesity. PREDATORR study (2014) shows that in Romania, 34,6% of adults aged 20-79 y/o are overweight, 31,4% are obese with a high risk of cardiometabolic complications, a number that puts almost 67% of Romania's population in the abnormal weight group. Our study aims to investigate the current staus of genetic foundation in metabolic disease associated with obesity, applied to a pilot group of patients specifically examining the impact of known polymorphisms and their haplotype of six food intake-regulating genes: leptin (LEP), leptin receptor (LEP-R), serotonin receptor (5HTR2A), ghrelin (GHRL), neuropeptide Y (NPY) and fat-mass and obesity-associated (FTO) with the following polymorphisms: LEP A-2548G, LEPR A-223G, 5HTR2A G-1439A, GHRL G-72T, NPY T-29063C, FTO A-T and body mass index (BMI). A notable link between the LEP-2548 rs7799039 gene's AG genotype and the risk of obesity was observed, particularly pronounced in males aged 40-49, with an approximately sevenfold increased likelihood of obesity. The 5HTR2A rs6311 AA genotype was associated with a higher BMI, not statistically significant. The FTO rs9939609 gene's AA genotype emerged as a significant predictor of obesity risk. Besides these significant findings, no substantial associations were observed with the LEPR, 5HTR2A, GHRL and NPY genes. Haplotype association analysis showed a suggestive indication of GRGMLA (rs7799039, rs1137101, rs6311, rs696217, rs16139, rs9939609 sequence) haplotype with susceptibility effect towards obesity predisposition. Linkage disequilibrium (LD) analysis showed statistically significant associations between LEP and LEPR gene (p = 1e-04), LEP and GHRL gene (p = 0.0047), GHRL and FTO gene (p=0.03). The outcomes of this study, to our knowledge, one of the very few on the Romanian population, aimed to be a starting point for further research on the targeted interventional strategies to reduce cardiometabolic risks.

Today, issues related to people’s mental health and well-being have been described as a challenge for society, globally as well as in Sweden. This calls for new approaches to mental health promotion. The aim was to evaluate the adequacy of the content and structure, describing experiences of study circles as a means of supporting participants' self-care and self-compassion. The overall design is a descriptive, QUAL+quan design, where quantitative and qualitative results are integrated. Five participants participated in a focus group interview, of whom four completed questionnaires. One individual interview was conducted with the study circle leader. Study circles can be an arena for mental health promotion as learning and sharing of experience contributes to a sense of coherence, as well as self-compassion and a genuine concern for one’s own and others' wellbeing, but not considered an alternative to psychiatric care, for those in need of professional services. Study circles can be a possible means to support self-care and thereby promote mental health in the general population, and a valuable contribution to public health. However, in addition to modifications of the content, further research is needed on the qualifications for study circle leaders as well as the dissemination of study circles.

Background: Large-cell neuroendocrine carcinoma presents significant treatment challenges owing to its rarity and limited therapeutic options. The LANCE study was designed to explore the survival benefits of incorporating atezolizumab in chemotherapy for metastatic LCNEC. Methods: In this non-randomized study, patients with metastatic LCNEC were treated with ei-ther standard chemotherapy plus atezolizumab or standard chemotherapy alone. The primary outcomes measured were progression-free survival (PFS) and overall survival (OS), with an ex-ploratory analysis of miR375 in plasma as a potential biomarker. Results: Of the 22 screened patients, 17 met the inclusion criteria and were stratified into the atezolizumab and chemotherapy (n=10) or chemotherapy alone(n=7) groups. After a median follow-up of 23.3 months, the 12-month survival rate for the atezolizumab group was 57.1% (95% CI: 32.6%-100%) and 45.7% at 24 months (95% CI: 22.4%-93.2%). In contrast, the chemotherapy group had a 14.3% survival rate at both 12 and 24 months (95% CI: 2.33%-87.7%). The log-rank test for survival showed a statistically significant difference in the atezolizumab-treated group (chi-squared = 4, df = 1, p = 0.04). A non-significant correlation was found between disease pro-gression and elevated levels of miR375. Conclusions: This pilot study suggests that atezolizumab combined with chemotherapy may be effective in treating metastatic LCNEC. The non-significant correlation between plasma miR375 levels and disease progression suggests its biomarker potential, warranting further validation research.

There is a need to find methods to intensify the anaerobic digestion process. One possibility is the use of pre-treatment techniques. Many laboratory tests confirm their effectiveness, but in most cases, there is no verification work carried out on industrial plants. The aim of the research carried out under laboratory conditions and on a large scale was to determine the technological and energy efficiency of the use of hydrodynamic cavitation in the pre-treatment of a waste mixture from dairy farms. It has been shown that hydrodynamic cavitation significantly increases the concentration of organic compounds in the dissolved phase. In the most effective variants, the increase in the content of these indicators was over 90% for both COD and TOC. The degree of solubilisation achieved was 49±2.6% for COD and almost 52±4.4% for TOC. Under laboratory conditions, the highest effects of anaerobic digestion were achieved after 10 minutes of pre-treatment. The amount of biogas was on average 367±18 mL/gCOD and the amount of methane 233±13 mL/gCOD. Further large-scale optimisation trials showed that after 8 minutes of hydrodynamic cavitation, the biogas yield was 327±8 L/kgCOD with a CH4 content of 62.9±1.9%. With this variant, the net energy yield was 66.4±2.6 kWh/day, a value that was 13.9% higher than the original variant with 10 minutes of disintegration and 3.1% higher than the variant without pre-treatment.

Forest ecosystems make a greater contribution to carbon (C) stocks than any other terrestrial ecosystem. To understand the role of regional forest ecosystems in global climate change and carbon exchange, forest C stock and its spatial distribution within the small (2,300 km2) Liuxihe River basin were analyzed to determine the different contributors to the C stock. Forest C stocks were quantified by measuring the biomass of trees, understory vegetation, litter and roots, as well as soil organic C, using data from field samples and laboratory experiments. The results showed that forests stored 38.04 Tg C in the entire basin, with secondary and planted forests accounting for 89.82% and 10.18%, respectively, of the stored C. Five types of forests, a subtropical evergreen broad-leaved forest, a subtropical coniferous and broad-leaved mixed forest, a subtropical coniferous forest, a timber forest, and a non-wood forest, stored 257.55 ± 15.01, 218.92 ± 9.59, 195.24 ± 18.29, 177.42 ± 17.55, and 117.86 ± 6.04 Mg C ha−1, respectively. In the forest ecosystem C stocks of the basin, soils averagely contribute about 73.78%, not including root underground biomass. It provides a comprehensive method for forest ecosystem carbon investigation and forest management in small basin scale.

.Various synthetic nematicides are currently used effectively in the control of plant parasitic nematodes. However, these nematicides have adverse effects on humans and the environment. Neem oil is eco-friendly alternatives to synthetic nematicides. The effectiveness of repeated neem oil application in suppressing the root-knot nematodes infestation in figs seedlings was therefore examined in this study, both in its natural form (10 ml/L) and in its nano-emulsion form (5 and 7 ml/L). The recorded reduction parameters of M. incognita were J2/250g soil, galls and egg masses / 5g roots of infected fig seedlings were measured at that time, and the effects of these natural additives were compared with the Fosthiazate (Krenkel 75%EC). The impact of such soil amendments on some typical plant parameters, the total microbial count of soil, and the overall enzymatic activity of the fig rhizosphere were also included. Obtained results revealed that the soil population density of root knot nematode suppressed by 80.3% , reduction of nematode egg masses (60.4%) due to the application of nano-emulsion of neem oil (at 7ml/L). Present work recommend the use of nano-emulsion of neem oil as one of the effective and eco-friendly means to reduce the root- knot nematode on fig .

Small scale carp polyculture plays a key role for food supply in Bangladesh, however, factors including water pollution, limited infrastructure and inadequate disease management hinder its sustainability. This paper reports on a survey of 231 farmers across the 6 major carp producing regions in Bangladesh, analyzing factors including, farmers’ social aspects, farm characteristics, information on disease and approaches adopted to combat them, and biosecurity practices. Almost half (46.8%) of the farms surveyed experienced disease in carp species, with clear regional variations. Eighty four percent of farms reported carp mortalities during disease outbreak, with an average mortality level 10.23±11.81%. Clinical signs during outbreaks lasted between a week and a month, and there was a peak in disease outbreaks in two seasonal periods between June to July and October to December. Disease incidence was related to a range of factors including the farmer experience, ponds/farm type, stocked species, and biosecurity practice. A combination of disinfecting measures during pond preparation and measures during stocking, including discarding fingerling transport water off-farm, fingerling disinfection and check the health of fingerlings before stocking significantly reduced disease occurrence. Treatments involving the antibiotics, ciprofloxacin, erythromycin, and azithromycin were reported as ineffective, raising concerns about non-prudent use, inadequate dosing (perhaps without appropriate veterinary guidance) and the potential for further driving antimicrobial resistance in the environment. The research unveils a concerning pattern of disease high disease incidence across small-scale carp farms in Bangladesh and the significant potential for disease spread highlights the need for responsible disposal practices. The study emphasizes the need for improving training and awareness programs are vital for addressing biosecurity and disease management challenges, ensuring sustainable aquaculture and community well-being.

In this nano era, nanomaterials and nanostructures are popular in developing novel functional materials. However, the combinations of nanoproducts with materials at micro and macro scale can open new routes for conceiving novel materials with an improved or even new functional performances. In this study, a brand-new hybrid, containing both nanofibers and particles having a microsize, was fabricated using a sequential electrohydrodynamic atomization (EHDA) process. Firstly, the microparticles loaded with drug (berberine hydrochloride, BH) molecules in the cellulose acetate (CA) were fabricated using a solution electrospraying process. Later, these microparticles were suspended into a co-dissolved solution containned BH and a hydrophilic polymer (polypyrrolidone, PVP), and were co-electrospun into the nanofiber/microparticle hybrids. The EHDA processes were clearly recorded, and the resultant products showed a typical hybrid topography, with microparticles distributed all over the nanofibers, which was demonstrated by SEM assessments. FTIR and XRD demonstrated that the components within the hybrids were presented in an amorphous state and have fine compatibility with each other. In vitro dissolution tests verified that the hybrids were able to provide the designed dula-step drug release profiles, a combination of the fast release step of BH from the hydrophilic PVP nanofibers through an erosion mechanism and the sustained release step of BH from the insoluble CA microparticles via a typical Fickian diffusion mechanism. The present protocols pave a new way for developing trans-scale functional materials.

A drug repositioning effort supported the possible use of the anti-HIV drug etravirine as a treatment for Friedreich Ataxia (FRDA). Etravirine increases frataxin protein and corrects the biochemical defects in cells derived from FRDA patients. Because of these findings, and since etravirine displays a favorable safety profile, we conducted this pilot open-label phase 2 clinical trial assessing the safety and potential efficacy of etravirine in FRDA patients. Thirty-five patients were stratified into 3 severity groups and randomized to etravirine 200 mg/day or 400 mg/day. They were treated for 4 months. Efficacy endpoints were represented by changes in peak oxygen uptake and workload as measured by incremental exercise test, SARA score, cardiac measures, measures of QoL and disability. Data were collected 4 months before the start of the treatment (T-4), at the start (T0), at the end (T4) and 4 months after the termination of the treatment (T+4). Etravirine was well tolerated. Etravirine completely stopped the progression of the SARA score during the 4-months treatment period, compared to the 4 months pre and post treatment. It increased peak workload, while the improvement of peak oxygen uptake was not statistically significant. No changes in the cardiac measures were observed. Health and QoL measures showed a worsening at the suspension of the drug. In this open trial etravirine significantly improved neurological function and was generally safe and reasonably tolerated. This suggests that etravirine represents a potential therapeutic agent in FRDA deserving testing in a randomized placebo controlled clinical trial.

It is important to realize the transformation behavior of wüstite because it greatly affects the final structure of the oxide layer and the surface quality of the steel products. In the present study, the transformation behaviors of the wüstite layer are examined under nearly-oxygen-free conditions, to simulate the cooling processes after the hot rolled strip is coiled. As the single phase wüstite was prepared at 950˚C, the 460˚C transformed oxide layer was composed of a mixture of iron and magnetite formed through eutectoid reactions. For the 750˚C-fabricated wüstite, only magnetite was observed after transformation, without iron precipitates and residual wüstite. It is speculated that the unusual transformation behavior of the low-temperature-made wüstite results from the pseudo-structural intermediate phase transformation between wüstite and magnetite. This pseudo-structure is a pre-transformed wüstite and of various concentration of ferrous ion, which is determined by the fabrication conditions. During the hot strip mill process, the so-called wet scale, wüstite, is produced continuously from finish mill to laminar flow sections and ended at 570˚C. Consequently, the final eutectoid transformation below 570˚C is dominantly controlled by the surface temperature ranged from 750˚C to 950˚C for low carbon steel.

The result of the multidisciplinary collaboration of researchers from different areas of knowledge to validate a solar radiation model is presented. The MAPsol is a 3D local-scale adaptive solar radiation model that allows to estimate direct, diffuse and reflected irradiance for clear sky conditions. The model includes the adaptation of the mesh to complex orography and albedo, and considers the shadows cast by the terrain and buildings. The surface mesh generation is based on surface refinement, smoothing and parameterisation techniques and allows the generation of high quality adapted meshes with a reasonable number of elements. Another key aspect of the paper is the generation of a high-resolution digital elevation model (DEM). This high-resolution DEM is constructed from LiDAR data and its resolution if two times more accurate than the publicly available DEMs. The validation process uses direct and global solar irradiance data obtained from pyranometers at the University of Salamanca located in an urban area affected by systematic shading from nearby buildings. This work provides an efficient protocol for studying solar resources, with particular emphasis on areas of complex orography and dense buildings where shadows can potentially make solar energy production facilities less efficient.

In this study, we address the formidable challenge of solving large-scale Max-Cut problems (MCP). We introduce a rapid computational procedure utilizing a hybrid 1-flip/r-flip local search heuristic. This innovative strategy significantly reduces the computational time required for MCP problems while consistently generating solutions of exceptional quality. The paper presents substantial computational insights, showcasing the effectiveness of our approach on very-large-scale Max-Cut instances with varying densities. Our proposed heuristic is rigorously evaluated by comparing its performance against a quantum annealing solver, leveraging a multi-start Tabu Search framework. The results underscore the potency of this unique combination as an efficient and effective solution for large-scale QUBO problems. Notably, our hybrid heuristic consistently delivers high-quality solutions within the stringent CPU time limits of 600 seconds, demonstrating its efficacy across Max-Cut instances ranging from 10,000 to 40,000 variables. This research contributes to advancing the state-of-the-art in large-scale QUBO problem-solving, offering a powerful and time-efficient approach with broad applicability.

In this letter, we advocate that it is possible to mitigate Pilot Contamination in Massive MIMO systems by scrambling the pilot sequences with a Base Station (BS) scrambling sequence. It is possible if a set of sequences is carefully designed to meet the orthogonality property defined in this letter. Each BS possesses its own scrambling sequence that can be reused the same way frequency reuse is applied to cell deployment. The main advantage of the prosed pilot generation scheme is that the frequency reuse factor can be set to 1, the most aggressive one, while the scrambling sequences can be reused with much less aggressive reuse factors (e.g. 4, 7, 9, 12, etc.), which in consequence results in pilot contamination mitigation and increased system's performance.

This study aimed to conduct a cross-cultural adaptation of the development of the cat-owner/dog-owner relationship scales. The method encompassed several stages: conceptual, item, semantic, operational, measurement, and functional equivalence. Processes included translations, synthesis of translations, back-translations, consensus on the English versions, external evaluation by the original authors, expert committee evaluation, and pre-tests. The study involved surveying 342 pet owners throughout Brazil using a 20-item questionnaire. Data analyses utilized confirmatory factor analysis, covariance-based modeling, and multigroup analysis. The techniques confirmed that the scale preserved its psychometric properties and showed no variance between dog and cat owners, indicating that the measured constructs are universal and unaffected by specific cultural nuances. Hence, the cross-cultural adaptation and validation of the scale facilitate applying and testing concepts and measures in diverse contexts, enriching our understanding of the dynamics between owners and their pets (dogs and cats) in different living situations. In addition, this research holds particular significance in Brazil, given the country’s vast cultural diversity.

Earth's global surface temperature shows variability on an extended range of temporal scales and satisfies an emergent scaling symmetry. Recent studies indicate that scale invariance is not only a feature of the observed temperature fluctuations, but an inherent property of the temperature response to radiative forcing, and a principle that links the fast and slow climate responses. It provides a bridge between the decadal- and centennial-scale fluctuations in the instrumental temperature record, and the millennial-scale equilibration following perturbations in the radiative balance. In particular, the emergent scale invariance makes it possible to infer equilibrium climate sensitivity (ECS) from the observed relation between radiative forcing and global temperature in the instrumental era. This is verified in ensembles of Earth system models (ESMs), where the inferred values of ECS correlate strongly to estimates from idealized model runs. For the range of forcing data explored in this paper, the method gives best estimates of ECS between 2.3 and 3.4 K.

Background: Patients with allergic rhinitis (AR) have bothersome symptoms that may assess using the visual analog scale (VAS). Asthma frequently is associated with AR. The present study investigated the role of VAS in children with newly-diagnosed AR. Methods: Parameters were VAS for nasal and asthma symptoms, and doctor’s perception of these diseases, medication use, and asthma comorbidity. Results: 67% of AR children had asthma. Severity of perceived nasal symptoms was associated with more intense asthma symptoms and doctor’s perception of disease severity (p<0.001 and p=0.02, re-spectively. Conclusions: Allergic rhinitis frequently is associated with asthma in child-hood. Symptom perception assessment using VAS is a simple tool for assessing their intensity. Moreover, the severity of nasal symptoms is associated with asthma symptom severity. Therefore, asthma should be carefully considered in AR children and require appropriate symptom perception assessment.

We describe a vision for a national-scale heavy mineral (HM) map generated through automated mineralogical identification and quantification of HMs contained in floodplain sediments from large catchments covering most of Australia. The composition of the sediments reflects the dominant rock types in each catchment, with the generally resistant HMs largely preserving the mineralogical fingerprint of their host protoliths through the weathering-transport-deposition cycle. Heavy mineral presence/absence, absolute and relative abundance, and co-occurrence are metrics useful to map, discover and interpret catchment lithotype(s), geodynamic setting, magmatism, metamorphic grade, alteration or mineralization. Underpinning this vision is a pilot project, focusing on a subset of the national sediment sample archive, which is used to demonstrate the feasibility of the larger, national-scale project. We preview a bespoke, cloud-based mineral network analysis (MNA) tool to visualize, explore and discover relationships between HMs as well as between them and geological setting or mineral deposits. We envisage that the Heavy Mineral Map of Australia and MNA tool will contribute significantly to mineral prospectivity analysis and modeling here, particularly for technology critical elements and their host minerals, which are central to the global economy transitioning to a more sustainable, decarbonized paradigm.

Background: The adoption of self-care behaviors among patients with congestive heart failure (CHF) is essential for the management of their health condition. However, there is a lack of tools for estimating self-care in CHF patients. We aim to develop and validate the Hippocratic heart failure self-care scale (HHFSCS). Methods: the scale includes 22 items which are reviewed by a committee of experts. Individuals indicate the frequency at which they follow each self-behavior on a five-point Likert scale. Adult patients with CHF (n=250) from a General Hospital, in Athens, were participated in the study from June 2020 to March 2021. Reliability coefficients and Explanatory Factor Analysis (EFA), using a Varimax rotation and the Principal Components Method were used to assess the psychometric measurements. Results: The Cronbach’s alpha coefficient of the HHFSCS was 0.807. The exploratory factor analysis identified two domains that accounted for 88.44% of the variance of the scale items; however, each sub-scale could not be used as an independent scale. Finally, the test-retest showed a significant strong correlation (r=0.973, p&lt;0.001). Conclusions: The HHFSCS is a reliable and valid tool for assessing self-behaviors in CHF patients. Health professionals can use it in their clinical practice to improve the management of patient’s health conditions.

Pilots can be one of the factors in many air traffic accidents. When one or both pilots are impaired (e.g. fatigue, drunk), disabled, capable but wrong-headed, don’t have sufficient training, distracted, miscommunicate with the air traffic controller, or follow wrong instructions from the air traffic controller, the risk of accident will increase dramatically. In some of these cases, the risk can be mitigated by using big data and machine learning. The system will collect and analyze large amount of data about the state of the aircraft, e.g., the flight path, the immediate environment around the aircraft, the weather and terrain information, and the pilots’ input to control the aircraft. Additional sensors such as eye tracking devices and biological monitor can also be added to determine the condition of the pilots. If the pilots’ input do not match proper reaction to the situation or the pilots are impaired, the learning machine will first provide an advisory to the pilots. If both pilots are impaired or incapable, a warning will be sent to the flight attendants and air traffic controllers so that they can take appropriate actions. The learning machine will be trained by both accident database and an automatic training system.

The purpose of this study was to examine the problem of violent extremism among young people. Additionally, a youth violent extremism scale (YVES) was developed that takes into account the differences between and within Arab cultures. The goal was to produce a scale that could be used and tested within an Arab country or between Arab countries. The scale was developed in three stages: generation, refinement, and validation. A literature review and nomological network were utilized to show the scale's dimensions, correlations to those dimensions, and other relevant variables (such as the LSC, LSE, and criminality scale). A sample of 6726 young students from fifteen Arab countries and the authorities involved were selected. Findings showed that six factors were obtained through principal component factor analysis using Varimax and Kaiser normalization (29 items). A significant positive association was found (r=.651, p = 0.000), supporting the scale's validity. Using Cronbach's alpha, the scale reliability was strong and assessed at 0.98. The scale's construct validity was estimated by assessing the correlation between the Youth Violent Extremism scale and low self-control. A significant positive correlation (r=.651, p = 0.000) indicates the scale's validity. Findings showed significant differences between males and females in youth violent extremism (F = 13.678, α ≤0.000). Descriptive results showed, however, that females have a slightly higher mean of violent extremism than males (M =85.2 vs. 87.6), with a close variation (26 vs. 27) for males and females, respectively. In this study, a measurement tool was provided that can be used as a knowledge base for security strategies. The scale can be applied to identify legal, social, and educational policies and applications of violent extremism. Future research is needed to test the scale on different professions like teachers, police officers, and parents. Also, a need to test the scale on different age groups, settings, and cultures. A need for atheoretical and empirical framework for understanding and preventing youth violent extremism through promoting a more cohesive and resilient youth society.

Today, concepts such as Emotional Education and Emotional Intelligence are recognized by many authors and researchers, emphasizing the importance of their development in all people, but especially in schools, specifically in teachers or educators and children. However, we still find many shortcomings within the schools that are needed to continue working. The aim of this study is to investigate the presence of emotional intelligence and empathy in teachers, through a sample of 42 participants. The research was conducted based on two validated and highly reliable assessment tools, called TMMS-24 and TECA. The results of the TMMS-24 indicate that a large percentage of participants have an adequate score of emotional intelligence. The results of the TECA indicate that most of the participants are in the middle, high or extremely high scores in relation to the level of empathy.

Artisanal and small-scale gold mining (ASGM) has been an important source of income for communities in the Madre de Dios River Basin in Peru for hundreds of years. However, in recent decades, the scale of ASGM activities in the region has increased dramatically, and exposures to a variety of occupational and environmental hazards related to ASGM, including mercury, are becoming more widespread. The aims of our study were to: (1) examine patterns in the total hair mercury level of human participants in several communities in the region and compare these results to the 2.2 µg/g total hair mercury level equivalent to the World Health Organization (WHO) Expert Committee of Food Additives (JECFA)’s Provisional Tolerable Weekly Intake (PTWI); and (2), to measure the mercury levels of paco (Piaractus brachypomus) fish raised in local aquaculture ponds, in order to compare these levels to the EPA Fish Tissue Residue Criterion of 0.3 µg Hg/g fish (wet weight). We collected hair samples from 80 participants in four communities (one control and three where ASGM activities occurred) in the region, and collected 111 samples from fish raised in 24 local aquaculture farms. We then analyzed the samples for total mercury. Total mercury levels in hair were statistically significantly higher in the mining communities than in the control community, and increased with increasing distance away from the Madre de Dios headwaters (as the crow flies), did not differ by sex, and frequently exceeded the reference level. Regression analyses indicated that higher hair mercury levels were associated with residence in ASGM communities. The analysis of paco fish samples found no samples that exceeded the EPA tissue residue criterion. Collectively, these results align with other recent studies showing that ASGM activities are associated with elevated human mercury exposure. The fish farmed through the relatively new process of aquaculture in ASGM areas appeared to have little potential to contribute to human mercury exposure. More research is needed on human health risks associated with ASGM to discern occupational, residential, and nutritional exposure, especially through tracking temporal changes in mercury levels as fish ponds age, and assessing levels in different farmed fish species. Additionally, research is needed to definitively determine that elevated mercury levels in humans and fish result from the elemental mercury from mining, rather than from a different source, such as the mercury released from soil erosion during deforestation events from mining or other activities.

Keywords: glycerin; Ni-based catalyst; lanthanum; semi-industrial scale; hydrogen production; biorefinery; monitoring.

Sleep quality has been directly linked to cognitive function, quality of life, and a variety of serious diseases across many clinical domains such as psychiatry and cardiology. Standard methods for assessing sleep involve overnight studies in hospital settings, which are uncomfortable, expensive, not representative of real sleep, and difficult to conduct on a large scale. Recently, a number of commercial digital devices have been developed that record physiological data which can act as a proxy for sleep quality in lieu of standard electroencephalogram recording equipment. Each device company makes different claims of accuracy and measures different features of sleep quality, and it is still unknown how well these devices correlate with one another and perform in a research setting. In this pilot study of 21 participants, we investigated whether outputs from four sensors, specifically FitBit, Withings Aura, Hexoskin, and Oura Ring, were related to known cognitive and psychological metrics, including the PSQI and N-back test. We found that sleep metrics extracted from these devices did not predict cognitive and psychological metrics well in our pilot data. However, we did identify certain signification associations, specifically the Oura Ring’s total sleep duration and efficiency in relation to the PSQI measure with p=0.004 and p=0.033, respectively. Additionally, correlation of various sleep features among the devices across the sleep cycle was almost uniformly low. These findings can hopefully be used to guide future sensor-based sleep research.

Recently, there has been renewed interest in the performance, functionality, and sustainability of traditional small-scale storage interventions (check dams, farm bunds and tanks) used across India for the improvement of local water security. The Central Groundwater Board of India is en-couraging the construction of such interventions for the alleviation of water scarcity. It is of critical importance to understand the hydrological effect of these interventions at basin scales to maximise their effectiveness. The quantification of small-scale interventions in hydrological modelling is often neglected, especially in large-scale modelling exercises. A bespoke version of the GWAVA model was developed to assess the impact of interventions on the water balance of the Cauvery Basin and two smaller sub-catchments. Model results demonstrate that farm bunds appear to have a negligible effect on the estimated average annual simulated streamflow at the outlets of the two sub-catchments and the basin whereas tanks and check dams have a more significant effect. In-terventions generally were found to increase evaporation losses across the catchment. The model adaption used in this study provides a step-change in the conceptualisation and quantification of the consequences of small-scale storage interventions in large- or basin-scale hydrological models.

To understand the mystery of final unification, in our earlier publications, we proposed two bold concepts: 1) There exist three atomic gravitational constants associated with electroweak, strong and electromagnetic interactions. 2) There exists a strong elementary charge in such a way that its squared ratio with normal elementary charge is close to reciprocal of the strong coupling constant. In this paper we propose that, can be considered as a compound physical constant associated with proton mass, electron mass and the three atomic gravitational constants. With these ideas, an attempt is made to understand nuclear stability and binding energy. In this new approach, nuclear binding energy can be fitted with four simple terms having one unique energy coefficient with a formula, where is an estimated mean stable mass number. With this new approach, Newtonian gravitational constant can be estimated in a verifiable approach with a model relation of the form, where is the Fine structure constant. Estimated and is 62 ppm higher than the CODATA recommended It needs further investigation. Proceeding further, an attempt is made to fit the recommended quark masses.

Cigarette smoke (CS) is a major driver of many respiratory diseases including chronic obstructive pulmonary disease (COPD) and non-small cell lung cancer (NSCLC). Tobacco causes oxidative stress, impaired phagocytosis of alveolar macrophages (AMs), and alterations in gene expression in the lungs of smokers. MicroRNAs (miRNAs) are small non-coding RNAs that influence several bi-ological processes and interfere with several regulatory pathways. The purpose of this study was to assess the effect of active CS on miRNAs expression in AMs obtained from bronchoalveolar lavage (BAL) of ever- or never-smoker subjects and patients with COPD or NSCLC. BAL specimens were collected from 43 sex-matched subjects to determine the expression of has-miR-34a-5p, 17-5p, 16-5p, 106a-5p, 223-5p, and 20a-5p before and after in vitro CS exposure by RT-PCR. In addition, bioin-formatic analysis of miRNAs target genes linked to inflammation was performed. Distinct and common miRNA expression profiles were identified in response to CS, suggesting their possible role in smoking-related diseases. It is noteworthy that, following exposure to CS, the expression levels of hsa-miR-34a-5p and 17-5p in both ever- or never-smokers, 106a-5p in never-smokers and 20a-5p in ever-smokers, shifted towards those found in individuals with COPD, suggesting them like a risk factor in developing this lung condition. Moreover, we identified miRNA targets involved in the immune system or AMs property regulation using in silico analysis. In conclusion, our study iden-tified miRNA signatures in AMs exposed to CS, indicating that CS is an important driver of epige-netic changes that contribute to the onset of various lung diseases.

The feasibility of hydroelectric plants depends on a variety of factors: water resource regime, geo-graphical, geological and environmental context, available technology, construction cost and eco-nomic value of produced energy. Choices about the building or renewal of hydroelectric plants should be based on the forecast of the future trend of these factors at least during the project life of the system. Focusing on the economic value of the produced energy this paper examines its influ-ence on the feasibility of hydroelectric plants. Analysis, referred to Italian case, were based on three different phases: i) the economic sustainability of small-scale hydroelectric plants under a minimum price guaranteed to the hydroelectric operator; ii) the estimate of the incentives to reach the thresholds of "acceptability" and "bankability" of the investment; iii) the analysis of results ob-tained in the previous phases using a model of the evolution of the electricity price in the period 2014-2100.

Three-dimensional (3D) printing has allowed for production of geometrically complex 3D objects with extreme flexibility, which is currently undergoing rapid expansions in terms of materials, functionalities, as well as areas of application. When attempting to print 3D microstructures in glass, femtosecond laser induced chemical etching (FLICE) – which is a subtractive 3D printing technique – has proved itself a powerful approach. Here, we demonstrate fabrication of macro-scale 3D glass objects of large heights up to ~3.8 cm with an identical lateral and longitudinal spatial resolution of ~20 μm. The remarkable accomplishment is achieved by revealing an unexplored regime in the interaction of ultrafast laser pulses with fused silica which results in aberration-free focusing of the laser pulses deeply inside fused silica.

The Connor–Davidson Resilience Scale (CD-RISC) and the Brief Resilience Scale (BRS) are two widely used scales to measure resilience. Although both scales seek to assess an individual’s ability to recover from and adapt to disruptions or stressful events, they may capture different aspects of resilience. While the CD-RISC focuses on resources that can help individuals recover from and adapt to disruptions or stressful events, the BRS directly measures one’s ability to bounce back or be resilient. The aim of this study is to empirically examine the differences between the CD-RISC and the BRS. Two samples (n = 202, 246) consisting of undergraduate students from Taiwan were used. The results of confirmatory factor analysis show that the CD-RISC and the BRS are highly correlated but still distinct. The results of regression analyses show that the CD-RISC and the BRS have unique predictive effects on depression and life satisfaction. The research findings suggest that the CD-RISC and the BRS capture different aspects of resilience. For future research on resilience, researchers should pay attention to the differences between these scales and choose the one that most closely fits their research purpose.

Within the past decade, the aerospace engineering industry has evolved outside the constraints of using single, large, custom satellites. Due to increased reliability and robustness of commercial off the shelf (COTS) printed circuit board (PCB) components, missions instead have transitioned towards deploying swarms of smaller satellites. This approach significantly decreases the mission cost by reducing custom engineering and deployment expenses. Nanosatellites are able to be quickly developed with a more modular design at lowered risk. The Alpha mission at Cornell Space Systems Studio is fabricated in this manner. However, for the purpose of this mission, only one satellite was initially developed. This manuscript will discuss a systems engineering approach to the development of this satellite. As a disclaimer, this manuscript is written from a systems perspective. Therefore it will follow many subsystems from a wide range of functionalities. The research in this manuscript was kept broad with the hope to contribute to the mission as a system, through a range of development phases including validation and verification of existing methods. The two systems that will be primarily focused on are the Attitude Control System (ACS) of the carrier nanosatellite (cubesat), and the RF communications on the ex-creted picosatellites (chipsat). Milestones achieved in chipsat RF include chipsat to chipsat communication, chipsat to SDR ground station communication, packet creation, error correction, appending a preamble, and filtering the signal. Achievements on the ACS side included controller traceability/verification and validation, software rigidity tests, hardware endurance testing, Kane damper and IMU tuning. These developments matured the technological readiness level (TRL) of our systems in preparation for satellite deployment.

1. Background and Objective: Spontaneous Intracranial Hemorrhage (ICH) is a catastrophic medical condition associated with significant morbidity and mortality. As the accumulation of unbound iron following ICH contributes to secondary brain injury, deferoxamine, an approved chelation drug, has become the center of attention. At the same time, its therapeutic remains a matter of dispute. This double-blinded Randomized Controlled Trial (RCT) aims to investigate the therapeutic potential of deferoxamine in neurological and radiological aspects. 2. Methods and Materials: The study enrolled 42 participants diagnosed with spontaneous ICH and confirmed by CT scan, randomly assigning them to either the deferoxamine treatment group or the placebo control group. While the control group received the routine treatment plus a placebo, the treatment group received routine treatment conjugated with 7.5 mg/kg of deferoxamine per hour intravenously over the first three days. The study compared hematoma and edema volume, GCS score, and mortality rates between the two groups. Our study employed rigorous randomization and blinding procedures to ensure unbiased results. 3. Results: There was a significant (p<0.05) improvement in patients' GCS up until the fourth day, but no significant difference was noted afterward. In addition, the volume of both edema and hematoma was significantly lower in the intervention group, as well as the length of stay, intubation requirement, and mortality. 4. Discussion: Deferoxamine administration can, at least in a short timeframe, improve neurological and radiological parameters.

This paper studies the pilot control strategy and workload of tilt-rotor aircraft dynamic conversion procedure between helicopter mode and fixed-wing mode. A nonlinear flight dynamics model of tilt-rotor aircraft with full flight modes is established. On this basis, a nonlinear optimal control model of dynamic conversion is constructed, considering factors such as conversion corridor limitations, pilot control, flight attitude, engine rated power, and wing stall effects. To assess pilot workload, an analytical method based on wavelet transform is proposed, which examines the mapping relationship between pilot control input's amplitude, constituent frequencies, and control tasks. By integrating the nonlinear optimal control model and the pilot workload evaluation method, the analysis of pilot control strategy and workload during the conversion procedure is conducted, leading to the identification of strategies to reduce pilot workload. The results indicate that incorporating the item of pilot workload in the performance index results in a notable reduction in the magnitude of collective stick inputs and longitudinal stick inputs. Moreover, it facilitates smoother adjustments in altitude and pitch attitude. Additionally, the conversion of the engine nacelle can be achieved at a lower and constant angular velocity. In summary, the conversion and reconversion procedures are estimated to have a low workload (Level 1 ~ Level 2), with relatively simple and easy manipulation for the pilot.

An increasingly frail population in nursing homes accentuates the need for high quality care at the end of life and better access to palliative care in this context. Implementation of palliative care and its outcomes can be monitored by using quality indicators. Therefore, we developed a quality indicator set for palliative care in nursing homes and a tailored measurement procedure using a mixed-methods design. We developed the instrument in three phases: 1) literature search, 2) interviews with experts and 3) indicator and measurement selection by expert consensus (RAND/UCLA). Second, we pilot tested and evaluated the instrument in nine nursing homes in Flanders, Belgium. After identifying 26 indicators in the literature and expert interviews, 19 of them were selected through expert consensus. Setting-specific themes were advance care planning, autonomy and communication with family. The quantitative and qualitative analyses showed the indicators were measurable, had good preliminary face validity and discriminative power and were considered useful in terms of quality monitoring according to the caregivers. The quality indicators can be used in a large implementation study and process evaluation in order to achieve continuous monitoring of the access to palliative care for all residents in nursing homes.

Background. Shoulder in CrossFit should have a balance between mobility and stability. Glenohumeral internal rotation deficit and posterior shoulder stiffness are risk factors for overhead shoulder injury. Objective. To determine the effectiveness of instrument assisted soft tissue mobilization and horizontal adduction stretch in CrossFit practitioners’ shoulders. Methods: Twenty-one regular CrossFitters were allocated to experimental (stretching with isometric contraction and instrument assisted soft tissue mobilization) or control group (instrument assisted soft tissue mobilization). Each session lasted 5 minutes, 2 days a week, over a period of 4 weeks. Shoulder internal rotation and horizontal adduction (digital inclinometer), and posterior shoulder stretch perception (Park scale) were evaluated. Shapiro-Wilk test was used to analyze the distribution of the sample. Parametric student's t-test was used to obtain the intragroup differences. The inter- and intra-rater differences were calculated using a repeated measures ANOVA. Results. Changes were found in the experimental group following intervention (p < 0.05), and when comparing baseline and follow-up assessments (p < .05) in all variables. Significant differences were found in the control group following intervention (p < 0.05), in right horizontal adduction and left internal rotation. When comparing perception of internal rotation and horizontal adduction in both groups in the three assessments significant differences were found. Conclusions. Instrument assisted soft tissue mobilization can improve shoulder horizontal adduction and internal rotation. An instrument-assisted soft tissue mobilization technique yields the same results alone as those achieved in combination with post-isometric stretch with shoulder adduction.

Marketing is the manner of how to make our sales the best in the market, our prices the most accessible, our clients satisfactory, and thus our brand is the largest distributed. This needs sophisticated and advanced understanding of the total network related. Indeed, marketing data may be seen in different forms such as qualitative and quantitative. However, in the literature, it is easily noticed that large bibliography may be collected about qualitative studies, against few studies on the quantitative point of view. This is a major drawback that makes the marketing science still focusing on the design, although the market is strongly depending on quantities such as money and time. Indeed, marketing data may be a time series such as brand sales per specified periods, brand related-prices over specified periods, market shares, ..., etc. The purpose of the present work is to investigate some marketing models based on time series due to brands. We will precisely study the effect of the time scale on the persistence of brands sales in the market and on the forecasting of such a persistence according to the characteristics of the brand and the related market competition or competitors. Our study is acted on a sample of Saudi brands during the period November 22, 2017 to December 30, 2021.

In this paper, we identify issues and possible solutions in the key area of large-scale antenna systems, also know as Massive Multiple Input Multiple Output (MIMO) systems. Additionally, we propose the use of Massive MIMO technology as a means to tackle the uplink mixed-service communication problem. Under the assumption of an available physical narrowband shared channel (PNSCH), the capacity of the MTC network and, in turn, that of the whole system, can be increased by grouping Machine-Type Communication (MTC) devices into clusters and letting each cluster share the same time-frequency physical resource blocks. We study the feasibility of applying sub-optimal linear detection to the problem of detecting a large number of MTC devices sharing the same time-frequency resources at the uplink of a base station (BS) equipped with a large number of antennas, M. In our study, we derive the achievable lower-bound rates for the studied sub-optimal linear detectors and show that the transmitted power of each MTC device can be reduced as M increases, which is a very important result for powerconstrained MTC devices running on batteries. Our simulation results suggest that, as M is made progressively larger, the performance of sub-optimal linear detection methods approach the matched filter bound, also known as perfect interference-cancellation bound.

Walnut trees are grown worldwide for their edible fruits of high nutritional value. To address climate change, researchers have studied walnut phenology to create cultivars adapted to warmer climates. The standardisation of walnut phenological observations is needed and the Biologische Bundesanstalt, Bundessortenamt und CHemische Industrie (BBCH) scale is the most accurate and internationally accepted for this purpose. Here, the principal growth stages (PGS) of Persian walnut (Juglans regia L.) are described using stages from a previously available alphanumerical scale. This standardised phenological scale describes Persian walnut growth from the dormant vegetative state through reproductive budding to senescence. This phenological scale is expected to increase the efficiency of walnut phenological monitoring. Fifty-seven stages were used to describe the life cycle of Persian walnut in this BBCH scale. Of these 57 stages, 3 stages are dedicated to seed germination (PGS-0), 4 stages to bud development (PGS-0), 7 stages to leaf development (PGS-1), 4 stages to stem elongation (PGS-3), 8 stages to inflorescence emergence (PGS-5), 5 stages to male flowering (PGS-6), 5 stages to female flowering (PGS-6), 5 stages to fruit development (PGS-7), 12 stages to fruit ripening (PGS-8) and 4 stages to leaf senescence (PGS-9).

Background: There have been reports of numerous risk factors for Alzheimer's disease. Although widely investigated, some points during the evolution of the disease have been obscure. One of them is a great frustration with therapeutic expectations. Why has there been an increase in suicidal behavior in treatments with anti-beta-amyloid drugs? Interpersonal stress is one of the factors that may be connecting Alzheimer's disease to suicide. Method: To observe possible associations between Alzheimer's disease and suicide, two validated questionnaires were selected. We recruited 20 elderly patients over 65 years old to observe the feasibility of further research using these instruments. The study was considered viable if all participants showed no difficulty in understanding the questions and completed both questionnaires in less than 30 minutes with a tendency to homogeneity. A description of the statistical data obtained was made. Results: All participants adequately understood the questions and completed the questionnaires in less than 30 minutes. In 10% of the sample, suicide attempts occurred throughout their lives. The average age of respondents was 75 years old. The QoSL Pareto diagram demonstrated a large concentration. The data demonstrated homogeneity. Conclusions: The application of the questionnaires in a sample suitable for carrying out analytical statistics was demonstrated. We have two great tools to try to understand the possible association between Alzheimer's disease and suicide.

The cost to train a basic qualified U.S. Navy fighter aircraft pilot is nearly $10M. The training includes primary, intermediate, and advanced stages, with the advanced stage involving extensive flight training and being very expensive as a result. Despite the screening tests in place and early-stage attrition taking place, 4.5% of aviators undergo attrition in this most expensive stage. Key reasons for aviator attrition include poor flight scores, voluntary withdrawals, and medical causes. Reduction in late-stage attrition offers several financial and operational benefits to the U.S. Navy. To that end, this research leverages feature extraction and machine-learning techniques on the very sparse flight test grades of student aviators to identify those with a high risk of attrition early in training. Using about 10 years of historical U.S. Navy pilot training data, trained models accurately predicted 50% of attrition with a 4% false positive rate. Such models could help the U.S. Navy save nearly $20M a year in attrition costs. In addition, machine-learning models were trained that can recommend a suitable training aircraft type for each student aviator. These capabilities could help better answer the need for pilots and reduce the time and cost to train them.

In the current pilot study, we attempt to find out how double neurofeedback influences functional hemispheric asymmetry and activity. We examined 30 healthy participants (8 males; 22 females, mean age = 29; SD= 8). To measure functional hemispheric asymmetry and activity, we used computer laterometry in the ‘two-source’ lead-lag dichotic paradigm. Double biofeedback included 8 minutes of EEG oscillation recording with five minutes of basic mode. During the basic mode, the current amplitude of the EEG oscillator gets transformed into feedback sounds while the current amplitude of alpha EEG oscillator is used to modulate the intensity of light signals. Double neurofeedback did not directly influence the asymmetry itself but accelerated individual sound perception characteristics during dichotic listening in the preceding effect paradigm. Further research is needed to investigate the effect of double neurofeedback training on functional brain activity and asymmetry taking into account participants’ age, gender, and motivation.

We aim to determine the sleep correlates of age-related brain loss in a sample of middle-aged to older males with obstructive sleep apnea. We evaluated consecutive treatment naïve male patients with OSA (AHI≥15 events/hr) without dementia, stroke or heart disease, from January to November of 2019. We collected demographic variables, vascular risk factors, and sleep questionnaires. We also obtained computerized neurocognitive testing with the Go-No-Go Response Inhibition Test, Stroop Interference Test, Catch Game Test, Staged Information Processing Speed Test, Verbal Memory Test and Non-Verbal Memory Test. We derived age and education adjusted domain-specific Z-scores for global cognition, memory, attention, processing speed and executive function. We used brain MRI T1-weighted images to derive total hippocampal and gray matter volumes. Partial correlations evaluated associations between the ISI, AHI, and oxygen level during sleep, with cognitive domains and brain volumes. Sixteen participants, age 40-76 years, 73% Hispanic/Latino, with mean AHI=48.9±25.5 and mean oxygen saturation of 91.4±6.9% during sleep. Hypertension was seen in 66% and diabetes in 27%. We observed that ISI and oxygen level during sleep had strong correlations with brain volumes and cognition. These preliminary findings may aid in developing future strategies to improve age-related brain loss in OSA.

Institutionalized older adults often face complex medication regimens, increasing their risk of adverse drug events due to polypharmacy, overprescribing, medication interactions or the use of Potentially Inappropriate Medications (PIM). However, data on medication use and associated risks in this population remain scarce. This pilot study aimed to characterize the sociodemographic, clinical and pharmacotherapeutic profiles and the use of PIM among institutionalized elders residing in Residential Structures for Elderly People (ERPI) in the Faro municipality, located in the Portuguese region of the Algarve. We conducted a cross-sectional study in a non-randomized sample of 96 participants (mean age: 86.6 ±7.86 years) where trained researchers reviewed medication profiles and identified potentially inappropriate medications using the EU(7)-PIM list. Over 90% of participants exhibited polypharmacy (≥5 medications), with an average of 9.1 ± 4.15 medications per person. About 92% had potential drug interactions, including major and moderate interactions. More than 86% used at least one potentially inappropriate medication, most commonly central nervous system drugs. This pilot study demonstrates that institutionalized older adults may be at high risk of potential medication-related problems. Implementing comprehensive medication review programs and promoting adapted prescribing practices are crucial to optimize medication use and improve the well-being of this vulnerable population.

During the infection by SARS-CoV-2, the virus is changing infected host cell into its own factory producing new viral particles. As infection progresses, infected cell undergoes many changes in various pathways. One of the events caused by changes is cytokine storm, which leads to the severe symptoms. In this study, we investigated transcriptomic changes caused by COVID-19 disease using RNA-seq data obtained from COVID-19-positive patients and COVID-19-negative donors. RNA-seq data were collected for the purpose of identification of potential biomarkers associated with a different course of the disease. Here, the first datasets of 96 samples were analyzed to validate the methods. The aim of this publication is to report pilot results. In search of potential biomarkers associated with different disease severity, we performed differential expression analysis of human transcriptome, focusing on COVID-19 positivity and symptom severity. Since we detected plenty of potential biomarkers, we performed KEGG enrichment analysis to get better view of altered pathways. Results show, that affected were pathways related to immune processes and response to infection, also multiple signaling pathways, while most of them were also reported to be influenced by SARS-CoV-2 infection in previous studies.

Research has consistently found that people with mental illness (known as consumers) experience lower levels of participation in meaningful activities, which can limit their opportunities for recovery support. The aim of this study was to describe the outcomes of participation in a group program designed to address all stages of activity participation, known as Pathways to Participation (P2P). A descriptive longitudinal design was utilized, collecting data at three time points. Outcomes were measured by the Camberwell Assessment of Need Short Appraisal (CANSAS), Recovery Assessment Scale – Domains and Stages (RAS-DS), Behaviour and Symptom Identification Scale (BASIS-24), Living in the Community Questionnaire (LCQ) and time use diaries. All data was analysed using descriptive statistics, and Chi square analyses. Seventeen consumers completed baseline data, eleven contributed post program data and eight provided follow up data. Most were female (63.64%) and had been living with mental illness for 11.50 (± 7.74) years on average. Reductions in unmet needs and improvements in self-rated recovery scores were re-ported, but no changes were identified in either time use or psychosocial health. The findings indicate the P2P program may enable consumers to achieve positive activity and participation out-comes as part of their personal recovery.

Currently 7.6% of the U.S. young adults aged 18-24 years old currently use e-cigarettes. This study piloted three methods of ENDS cessation by measuring cessation rates, motivational techniques that contributed to cessation success, and participants’ changes after decreasing vape use. Participants were randomized into three study arms [nicotine replacement therapy (NRT) + behavioral support, vape-taper + behavioral support, self-guided] in a 1:1:1 ratio. All participants were invited to attend 9 in-person or phone appointments over the 6 month study period. At 12 weeks, 3 of 7 (42.9%) participants in the NRT + behavioral support arm, 6 of 8 (75%) vape-taper + behavioral support arm, and 7 of 9 (77.8%) self-guided arm self-reported being vape- and nicotine-free. At 6 months, 3 of 7 (42.9%) participants in the NRT + behavioral support arm, 6 of 8 (75%) vape-taper + behavioral support arm, 4 of 9 (44.4%) self-guided arm self-reported being vape- and nicotine-free. A challenge to quitting and remain quit is social pressures, but participants identified self-control and establishing new habits to be the best methods to overcome the desire to vape. Participants who received behavioral support and a vape-taper plan from pharmacists were more likely to be vape- and nicotine-free at 6 months.

Convolutional Neural Networks (CNNs) are largely hand-crafted, which leads to inefficiency in the constructed network. Various other algorithms have been proposed to address this issue, but the inefficiencies resulting from human intervention have not been addressed. Our proposed EvolveNet algorithm is a task-agnostic evolutionary search algorithm that can find optimal depth and width scales automatically in an efficient way. The optimal configurations are not found using grid search, instead evolved from an existing network. This eliminates inefficiencies that emanate from hand-crafting, thus reducing the drop in accuracy. The proposed algorithm is a framework to search through a large search space of subnetworks until a suitable configuration is found. Extensive experiments on the ImageNet dataset demonstrate the superiority of the proposed method by outperforming the state-of-the-art methods.

Tungsten fibre-reinforced tungsten composites (Wf/W) have been in development to overcome the inherent brittleness of tungsten as one of the most promising candidate for the first wall and divertor armour material in a future fusion power plant. As the development of Wf/W continues, the fracture toughness of the composite is one of the main design drivers. In this contribution the efforts on size upscaling of Wf/W based on Chemical Vapour Deposition (CVD) is shown together with fracture mechanical tests of two different size samples of Wf/W produced by CVD. Three-point bending tests according to ASTM E399 for brittle materials were used to get a first estimation of the toughness. A provisional fracture toughness value of up to 346MPam1/2 was calculated for the as-fabricated material. As the material does not show a brittle fracture in the as-fabricated state, the J-Integral approach based on the ASTM E1820 was additionally applied for this state. A maximum value of the J-integral of 41kJ/m2 (134,8MPam1/2) was determined for the largest samples. Post mortem investigations were employed to detail the active mechanisms and crack propagation.

We present a summary of the main results within the Scale Invariant Vacuum (SIV) paradigm as related to the Weyl Integrable Geometry. After a brief review of the mathematical framework, we will highlight the main results related to inflation within the SIV [9], the growth of the density fluctuations [8], and the application of the SIV to scale-invariant dynamics of Galaxies, MOND, Dark Matter, and the Dwarf Spheroidals [7]. The connection of the weak-field SIV results to the un-proper time parametrization within the reparametrization paradigm is also discussed [14].

As the Universe is dominated by of baryons, there must have been a process in early Universe creating such a asymmetry via baryon number violation. However, until recently all the confirmed experimental data indicate that lepton and baryon number are conserved in agreement with Standard Model of quarks and leptons. This paper proposes an alternative path of baryogenesis. Once the over abundant magnetic monopoles predicted by grand unification emerged at universe temperature of $10^{16}$ GeV, then their annihilation should first give rise to photons driving the expansion of the early universe. As the universe temperature dropped to the desert scale of around 10 EeV, departure from thermal equilibrium occurred. Thus the annihilation produced photons give rise to electron-positron pairs, which collide with remnant magnetic monopoles and antimonopoles. The resultant unstable intermediate X and antiX particle become asymmetric, and thereby leading to baryon asymmetry. The excess of antimonopoles corresponding to ten times of mass comparing with that of baryons provides a natural candidate for dark matter. The physics of such a desert regime baryogenesis can be simply characterized by three parameters. The collision predicts a ratio of particle and anti-particle equivalent to that of ultra-high-energy neutrino to their anti-particle, which can be tested by future observations, e.g., the constructing IceCube-Gen2.

Development encompasses processes that occur at multiple length-scales, includ- ing gene regulatory interactions, cell movements and reorganisation, cell signalling and growth. It is essential that the timing of events in all of these different processes are coordinated to generate well patterned tissues and organs. However, how the timing of intrinsic cell state changes is coordinated with events at the multi-tissue and whole organism level is unknown. Here, we argue that an important mechanism which accounts for integration of timing across levels of organisation is provided by tissue tectonics: i.e. how morphogenetic events driving tissue shape change result in the relative displacement of signalling and responding tissues and coordinate devel- opmental timing across scales. In doing so, tissue tectonics provides a mechanism by which the cell specification events intrinsic to cells can be modulated by the temporal exposure to extracellular signals. This exposure is in turn regulated by higher-order properties of the embryo such as their physical properties, rates of growth and the combination of dynamic cell behaviours impacting tissue morphogenesis. Tissue tec- tonics creates a downward flow of information from higher to lower levels of biological organisation, providing an instance of downward causation in development.

As gravitation and electromagnetism are closely analogous long-range interactions, and gravitation is formulated in terms of geometry in general relativity (GR), we expect the latter also to appear through the geometry. This unification has however remained an unfulfilled goal. The goal is achieved here in a new theory, which results from the principles of equivalence and Mach supplemented with a novel insight that the field tensors in a geometric theory of gravitation and electromagnetism must be traceless, since these long-range interactions are mediated by virtual exchange of massless particles whose mass is expected to be related to the trace of the field tensors. Hence the Riemann tensor, like the analogous electromagnetic field tensor, must be traceless. Thence emerges a scale- invariant, Machian theory of gravitation and electrodynamics unified, wherein the vanishing of the Ricci tensor appears as a boundary condition. While the field equations of the theory are given by the vanishing divergence of the respective field tensors and their duals, the matter and charge emerge from the spacetime. A quantitative formulation of the emergent fields embodied in ‘energymomentum super tensors’ follows from the respective Bianchi identities for the two fields. The resulting theory is valid at all scales and explains the observations without invoking the non-baryonic dark matter, dark energy or inflation. Moreover, it answers the questions that the GR-based standard paradigm could not address.

Visual inertial odometry (VIO) has recently received much attention for efficient and accurate ego-motion estimation of unmanned aerial vehicle systems (UAVs). Recent studies have shown that optimization-based algorithms achieve typically high accuracy when given enough amount of information, but occasionally suffer from divergence when solving highly non-linear problems. Further, their performance significantly depends on the accuracy of the initialization of inertial measurement unit (IMU) parameters. In this paper, we propose a novel VIO algorithm of estimating the motional state of UAVs with high accuracy. The main technical contributions are the fusion of visual information and pre-integrated inertial measurements in a joint optimization framework, and the stable initialization of scale and gravity using relative pose constraints. To count for ambiguity and uncertainty of VIO initialization, a local scale parameter is adopted in the online optimization. Quantitative comparisons with the state-of-the-art algorithms on the EuRoC dataset verify the efficacy and accuracy of the proposed method.

Face verification for unrestricted faces in the wild is a challenging task. This paper proposes a method based on two deep convolutional neural networks(CNN) for face verification. In this work, we explore to use identification signal to supervise one CNN and the combination of semi-verification and identification to train the other one. In order to estimate semi-verification loss at a low computation cost, a circle, which is composed of all faces, is used for selecting face pairs from pairwise samples. In the process of face normalization, we propose to use different landmarks of faces to solve the problems caused by poses. And the final face representation is formed by the concatenating feature of each deep CNN after PCA reduction. What's more, each feature is a combination of multi-scale representations through making use of auxiliary classifiers. For the final verification, we only adopt the face representation of one region and one resolution of a face jointing Joint Bayesian classifier. Experiments show that our method can extract effective face representation with a small training dataset and our algorithm achieves 99.71% verification accuracy on LFW dataset.

Multimodal traveling is expected to enhance mobility for users, reduce inequalities of car ownership and reduce emissions. In the same context, ride-sharing aims to minimize negative impacts related to emissions, reduce travelling costs and congestion, and increase passenger vehicle occupancy, and public transit ridership when planned for first/last mile trips. The goal of this study is to present the planning of a multimodal pilot demonstration and the challenges that emerged during and after its implementation in Athens, Greece. The demo aims to enhance the connection of low-density Attica Region areas to public transport (PT) modes, and specifically to the metro, through the provision of demand responsive ride-sharing services. During the demo period two different applications were utilized: the “Travel Companion” app and the “Driver Companion” app, which refer to passengers and drivers of the ride-sharing service. Identification of demo participants is performed through a Stated Preference (SP) experiment. Results of the demo implementation, as well as challenges that were faced show that although participants are willing to try new mobility solutions, the readiness and reliability of the new service are essential attributes towards maintaining existing users and engaging new ones.

Pepper leaf segmentation plays a crucial role in monitoring pepper leaf diseases in various backgrounds and ensuring the healthy growth of peppers. However, existing transformer-based segmentation methods suffer from computational inefficiency, excessive parameterization, and limited utilization of edge information. To tackle these challenges, we propose an adaptive multi-scale MLP framework, named AMS-MLP, which combines the multi-path aggregation module (MPAM) and the multi-scale context relation mask module (MCRD) to refine the object boundaries in pepper leaf segmentation. AMS-MLP consists of an encoder-based network, an adaptive multi-scale MLP (AM-MLP) module, and a decoder network. In the encoder network, the MPAM module effectively fuses five-scale features to generate a single-channel mask, improving the accuracy of pepper leaf boundary extraction. The AM-MLP module divides the input features into two branches: the global multi-scale MLP branch captures long-range dependencies between image information, while the local multi-scale MLP branch focuses on extracting local feature maps. Adaptive attention mechanism is designed to dynamically adjust the weights of global and local features. The decoder network incorporates the MCRD module into the convolutional layer, enhancing the extraction of boundary features. To verify the performance of the proposed method, we conducted extensive experiments on three pepper leaf datasets with different backgrounds. The results demonstrate mIoU scores of 97.39%, 96.91%, and 97.91%, as well as F1 scores of 98.29%, 97.86%, and 98.51%, respectively. Comparative analysis with U-Net and state-of-the-art models reveals that the proposed method dramatically improves the accuracy and efficiency of pepper leaf image segmentation.

The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD), which has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as an ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 &amp; 0.91, p values = 0.001, 95% CI: 0.80-0.92 &amp; 0.87 to 0.94, sensitivity = 0.85 &amp; 0.87, specificity = 0.73 &amp; 0.83, Youden index = 0.58 &amp; 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by the irritability expressed stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability resulted from direct and indirect effects of key PTSD symptoms (intrusion, hyperarousal, and numbing). Irritability contributed to traumatic symptoms of sleep disturbance in both samples while the opposite was not true. The findings suggest usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/ co-morbidities (sleep disturbance) in both healthy and diseased groups.

Anatomy education plays a critical role in medical practice, and the level of anatomical knowledge among students and physicians significantly impacts patient care. This article presents a pilot project conducted by the University of Milan aimed at exploring the effectiveness of the Area9's Rhapsode platform, an intelligent tutoring system that uses artificial intelligence to personalize learning and collect data on mastery acquisition. The study focused on liver anatomy and employed a flipped classroom approach, incorporating adaptive learning modules and an interactive in-class session. The project's execution, outcomes and preliminary pedagogical considerations are discussed. The results demonstrated improved learning quality, positive repurposing of study time, enhanced metacognitive awareness among students, with most of students demonstrating conscious mastery of the materials and a clear understanding of their level of competence. This approach, by providing valuable insights into the potential of artificial intelligence-based adaptive learning systems in anatomy education, could address the challenges posed by limited teaching hours, shortage of anatomist and the need for individualized instruction, with recommendations for future research and the expansion of adaptive learning modules to other anatomical districts.

Robot-assisted rehabilitation has emerged as a promising approach for enhancing motor function in stroke survivors. However, the feasibility and effectiveness of home-based robotic training in this population are underexplored, especially in low/middle-income countries. This feasibility study aimed to address this gap by examining the feasibility and effectiveness of independent home-based training using PLUTO, a robotic device for hand training. A total of 7 chronic stroke survivors were recruited, with 5 completing the study. The results revealed high engagement and adherence to the home-based training program, with participants averaging 1659.8 minutes of training over 24.8 days. The PLUTO system demonstrated excellent usability and elicited positive user perceptions. Significant improvements were observed in functional outcomes, as evidenced by a noteworthy increase in Fugl-Meyer Assessment scores (mean increase of 6.2 points, exceeding the minimal clinically important difference (MCID) of 5.35 points). Furthermore, participants showed improvements in the ABILHAND measure (mean improvement of 1.24 logits, surpassing the MCID of 0.2 logits) and the Barthel Index (mean increase of 8.8 points). These findings demonstrate the feasibility and effectiveness of home-based robotic rehabilitation for chronic stroke survivors. This has implications for expanding access to rehabilitation services in low- and middle-income countries, enhancing patient engagement and adherence, and improving functional outcomes. Larger controlled studies are warranted to evaluate the effectiveness of home-based robotic rehabilitation programs.

Female sexual functioning and satisfaction are impaired by the presence of sexual difficulties. Current study aims to analyze the differences on sexual satisfaction in women according to types of sexual problems (absence of sexual problems, self-perceived and assessed by the FSFI cut-off). A total of 329 women answered to a specific question about presence of self-perceived sexual problems, the Sexual Satisfaction Scale for Women, and the Female Sexual Functioning Index. Main findings revealed that sexually health women had better levels of sexual satisfaction when compared to women who self-report sexual difficulties and women who scored clinical levels in FSFI. Also, women who scored clinical levels in FSFI scored lower on sexual satisfaction compared to women who self-report sexual difficulties. Female sexual satisfaction was negatively affected by sexual difficulties assessed according to the FSFI cut-off. Although with lower impact, self-perceived sexual problems also affect negatively sexual satisfaction in women.

Cold brew coffee is a new trend in coffee industry. This paper presents pilot studies into several aspect of this beverage. Using an online survey, the current practices of cold brew coffee preparation were investigated identifying a rather large variability with a preference for extraction of medium roasted Arabica coffee using 50-100 g/l at 8°C for about 1 day. Sensory testing using ranking and triangle tests showed that cold brew may be preferred over iced coffee (cooled down hot extracted coffee). Extraction experiments at different conditions combined with nuclear magnetic resonance (NMR) analysis showed that the usual extraction time may be longer than necessary as most compounds are extracted within only a few hours, while increasing turbulence (e.g. using ultrasonication) and temperature may additional increase the speed of extraction. NMR analysis also revealed a possible chemical differentiation between cold brew and hot brew using multivariate data analysis. Decreased extraction time and reduced storage times could be beneficial for cold brew product quality as microbiological analysis of commercial samples detected samples with spoilage organisms and contamination with Bacillus cereus.

(1) Background: Executive functioning is a concept that suggests a scheme of relationship between brain-mind and behavior, through a plan and control of individuals actions on tasks and context. This work is an approach to the study between relationship of abilities (flair) and the execution, between cognitive development and executive functioning as intelligence and creativity and reading writing learning association. The objective is trying to give a definition of neuropsychological profile of Gifted Students; (2) Methods: We studied 20 Gifted Student assessments by a school counselor, under some characteristics as having greater than 125 IQ. The age range was 6:8 to 11:8 from Primary School. Instruments were WISC-V. BRIEF-2 and TTCT; (3) Results: We observed a positive correlation between IQ and Inhibition, that would keep relation with behavioral mechanism (guide work, autonomy, impulse control, ...) of students to develop cognitive and metacognitive abilities as going in-depth in habits, skill, and strategies of intellectual work in the classroom; (4) Conclusions: There is a distance between executive functioning and IQ. Correlations, considering our sample, would express a halfway association between both variables. Association that would be explained for the connection or underlying cognitive mechanism in some factors of variables.

The clinical interaction between stroke and periodontitis has been consistently studied and confirmed. Hence, forecasting potentially new protein interactions in this association using bioinformatic strategies presents potential interest. In this exploratory study, we conducted a protein-protein network interaction (PPI) search with documented encoded proteins for both stroke and periodontitis. Genes of interest were collected via GWAS database. The STRING database was used to predict the PPI networks, first in a sensitivity purpose (confidence cut-off of 0.7), and then with a highest confidence cut-off (0.9). Genes over-representation was inspected in the final network. As a result, we foresee a prospective protein network of interaction between stroke and periodontitis. Inflammation, pro-coagulant/pro-thrombotic state and ultimately atheroma plaque rupture is the main biological mechanism derived from the network. These pilot results may pave the way to future molecular and therapeutic studies to further comprehend the mechanisms between these two conditions.

Facing the tasks and challenges going forward, a pilot of the Indonesian Naval Aviation Center was required to be brave in taking risks, especially in carrying out its main tasks, so it was expected that a pilot of the Indonesian Naval Aviation Center had intelligence, especially in finding appropriate solutions and alternatives to address every task challenges dynamics in situations that often changed quickly. The purpose of this study was to identify the personal character and performance that should be owned by the pilot of the Indonesian Naval Aviation Center. This research used a qualitative approach with a contextual and constructional meta-analysis study method. The results of this meta-analysis study concluded that in line with the essence of personal character that is defined as the personal aspects of a work that allows workers to achieve superior performance. These personal aspects include nature, emotive-motives, value systems, attitudes, knowledge, and skills, where the personal character would produce an optimal performance on a pilot of the Indonesian Naval Aviation Center.

To evaluate whether autologous mesenchymal cells, adipose derived stem cells and platelet-rich plasma, grafted into the supracoroideal space by surgical treatment according to Limoli retinal restoration technique (LRRT), can produce growth factors in order to exert a beneficial effect in retinitis pigmentosa (RP) patients. Twenty-one eyes underwent surgery and divided based on retinal foveal thickness ≤ 190 or >190 µm into group A and group B, respectively. The specific LRRT triad was grafted in a deep scleral pocket above the choroid of each eye. At 6-month follow-up, group B showed an improvement in residual close-up visus and sensitivity at microperimetry compared to group A. After an in-depth review of molecular biology studies concerning degenerative phenomena underlying the etiopathogenesis of RP, it can be confirmed that further research is needed on tapeto-retinal degenerations both from a clinical and molecular point of view to obtain better functional results. In particular, it is necessary to increase the number of patients, extend observation times, and treat subjects in the presence of still trophic retinal tissue to allow adequate biochemical and functional catering.

Endometriosis is a prevalent chronic inflammatory disease characterized by a considerable delay between initial symptoms and diagnosis through surgery. The pressing need for a timely, non-invasive diagnostic solution underscores the focus of current research efforts. This study examines the diagnostic potential of the menstrual blood lipidome. The lipid profile of 39 samples (23 women with endometriosis and 16 patient of control group) was acquired using reverse-phase high-performance liquid chromatography-mass spectrometry with LipidMatch processing and identification. Profiles were normalized based on total ion counts. Significant differences in lipids were determined using the Mann-Whitney test. Lipids for the diagnostic model, based on logistic regression, were selected using a combination of variance importance projection filters and Akaike information criteria. Levels of ceramides, sphingomyelins, cardiolipins, triacylglycerols, acyl- and alkenyl-phosphatidylethanolamines, and alkenyl-phosphatidylcholines increased, while acyl- and alkyl-phosphatidylcholines decreased in cases of endometriosis. PE P-16:0/18:1 and CL 16:0_18:0_22:5_22:6 serve as marker lipids in the diagnostic model, exhibiting a sensitivity of 81% and specificity of 85%. The diagnostic approach based on dried spots of menstrual blood holds promise as an alternative to traditional non-invasive methods for endometriosis screening.

Background: Infections of Coronavirus Disease-2019 (COVID-19) can cause long-term effects known as long COVID. This pilot study aimed to evaluate the feasibility of a clinical study as well as the efficacy and safety of traditional East Asian herbal medicines in alleviating fatigue and cognitive dysfunction “brain fog” in patients with long COVID. Methods: This prospective pilot study investigated the use of three types of herbal medicines, Bojungikki-tang (BIT), Kyungok-go (KOG), and Cheonwangbosim-dan (CBD), for a 12-week period as potential treatments for fatigue and cognitive dysfunction in patients with long COVID. Forty-five patients with long COVID were recruited, and one of three drugs was given based on the patient’s symptoms and pattern identification. The effect of herbal medications on fatigue and cognitive function outcomes was assessed over a 36-week period, with patient adherence closely monitored. Results: After 12 weeks of herbal drug administration, fatigue symptoms improved significantly across all groups, with treatment success rates of 80%, 53.33%, and 46.67% in the BIT, KOG, and CBD groups, respectively. However, “brain fog” symptoms showed less improvement, with treatment success rates of 40%, 46.67%, and 13.33% in the BIT, KOG, and CBD groups, respectively. All adverse events reported were mild and unrelated to the medication. The study design was found to be feasible with high medication adherence. Conclusions: This study demonstrated the feasibility of conducting a clinical trial with three herbal medicines to treat long COVID symptoms like fatigue and “brain fog.”

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.