Dynamic systems which underly controlled systems are expected to increase in complexity as robots, devices, and connected networks become more intelligent. While classical stable systems converge to a stable point (a sink), another type of stability is to consider a stable path rather than a single point. Such stable paths can be made of saddles which draw in trajectories from certain regions, and then push the trajectory toward the next saddle point. These are chains of saddles are called stable heteroclinic channels (SHCs), and can be used in robotic control to represent time sequences. While we have previously shown that each saddle is visualizable as a trajectory waypoint in phase space, how to increase the fidelity of the trajectory was unclear. In this paper, we hypothesized that the waypoints can be individually modified to locally vary fidelity. Specifically, we expected that increasing the saddle value (ratio of saddle eigenvalues) causes the trajectory to slow to more closely approach a particular saddle. Combined with other parameters that control speed and magnitude, a system expressed with an SHC can be modified locally, point by point, without disrupting the rest of the path, supporting their use in motion primitives. However, even more complex trajectory shape modifications are possible. While some combinations can enable a trajectory to better reach into corners, other combinations can rotate, distort and round the trajectory in the region of a corner. In our example, modifying select saddle values produced a 32% decrease in the trajectory error of a complex trajectory produced using this system. This is an effect not visible in previous 1D studies, that can lead to different learnable and tunable representations of dynamic systems.

Methionine oxidation to the sulfoxide form (MSox) is a poorly understood post-translational modification of proteins associated with nonspecific chemical oxidation from reactive oxygen species (ROS) whose chemistries are linked to various disease pathologies including neurodegeneration. Emerging evidence shows MSox site occupancy is in some cases under enzymatic regulatory control mediating cellular signaling including phosphorylation and/or calcium signaling, raising questions as to the speciation and functional nature of MSox across the proteome. The 5XFAD lineage of the C57BL/6 mouse has well-defined Alzheimer’s and aging states. Using this model, we analyzed age, sex and disease dependent MSox speciation in mouse hippocampus. In addition, we explore chemical stability and statistical variance of oxidized peptide signals to understand needed power for MSox based proteome studies. Our results identify mitochondrial and glycolytic pathway targets with increases in MSox with age as well as neuroinflammatory targets accumulating MSox with AD in proteome studies of mouse hippocampus. Further, the paper establishes a foundation for reproducible and rigorous experimental MSox-omics appropriate for biological discovery novel target identification, and biomarker analysis in ROS and other oxidation linked diseases.

Lung cancer (LC) is the second most common cancer and the leading cause of cancer deaths in the U.S. Insulin therapy, a key treatment for managing Type 2 Diabetes Mellitus (T2DM), may increase LC risk. The impact of non-insulin antidiabetic drugs, particularly GLP-1 receptor agonists (GLP-1RAs), on LC risk is not well understood. This study evaluated LC risk in T2DM patients comparing seven non-insulin antidiabetic agents to insulin. Using the TriNetX Analytics platform, we analyzed de-identified electronic health records of 1,040,341 T2DM patients treated between 2005-2019, excluding those with prior antidiabetic use or LC diagnoses. We calculated hazard ratios and confidence intervals for LC risk and used propensity score matching to control for confounding factors. All non-insulin antidiabetic drugs, except alpha-glucosidase inhibitors, significantly reduced LC risk compared to insulin, with GLP-1RAs showing the greatest reduction (HR: 0.49, 95% CI: 0.41, 0.59). GLP-1RAs were consistently associated with lowered LC risk across all histological types, races, genders, and smoking statuses. These findings suggest that non-insulin antidiabetic drugs, particularly GLP-1RAs, may be preferable for managing T2DM while reducing LC risk.

Long noncoding RNAs (lncRNAs) are known to play key roles in breast cancers; however, detailed mechanistic studies of lncRNA function have not been conducted in large cohorts of breast cancer tumors, nor have inter-donor and inter-subtype variabilities been taken into consideration. Here we provide the first identification and annotation of the human BORG lncRNA gene. Using multiple tumor cohorts of human breast cancers, we show that while BORG expression is strongly induced in breast tumors as compared to normal breast tissues, the extent of BORG induction varies widely between breast cancer subtypes and even between different tumors within the same subtype. Elevated levels of BORG in breast tumors are associated with the acquisition of core cancer aggression pathways, including those associated with basal tumor and pluripotency phenotypes, and with epithelial-mesenchymal transition (EMT) programs. While a subset of BORG-associated pathways was present in high BORG-expressing tumors across all breast cancer subtypes, many were specific to triple-negative breast cancer tumors. Finally, we show that genes induced by heterologous expression of BORG in murine models of TNBC both in vitro and in vivo strongly overlap with those associated with high BORG levels in human TNBC tumors, indicating that human BORG is a novel driver of the highly aggressive basal TNBC tumor phenotype.

Candida (C.) infections represent a serious health risk for people affected by inflammatory bowel disease. An important fungal virulence factor is the capacity to form biofilms on the colonized surface of the host. This research study aimed to determine the effect of C. tropicalis and C. albicans co-infection on dextran sodium sulfate (DSS)-induced colitis in mice. Colitis severity was evaluated using histology and colonoscopy. Mice were mono-inoculated with C. albicans, C. tropicalis or co-challenged with both species. Mice were administered 3% DSS to induce acute colitis. Biofilm activity was assessed using (2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)carbonyl] 2H-tetrazoliumhydroxide (XTT) assay. Abundance of C. albicans in the colon tissues was assessed by immunohistochemistry. Co-challenged mice showed decreased colitis severity compared to mono-inoculated mice. The XTT assay demonstrated a marked decrease of C. albicans biofilm production in a C. albicans culture incubated with C. tropicalis supernatant. Immunohistochemical staining showed that C. albicans was more abundant in the mucosa of C. albicans mono-inoculated mice compared to the co-inoculated group. These data indicate an antagonistic microbial interaction between the two Candida species, where C. tropicalis may produce molecules capable of limiting the ability of C. albicans to adhere to the host intestinal surface leading to a reduction in biofilm formation.

Environmental estrogen pollution and estrogen effects on the female reproduction system are well-recognized scientifically. Among the estrogens, 17 β-estradiol is a priority in environmental estrogen pollution, and it is also a major contributor to estrogen which regulates the female reproduction system. 17 β-estradiol is carcinogen and has a tumor promotion effect relating to breast cancer, lung cancer and others. It also affects the psychological well-being such as depression, fatigue and others. Thus, a simple method of detection of 17 β-estradiol will be important for both environmental estrogen pollution and women’s health care. This study demonstrates a simple-use, cost effective 17 β-estradiol biosensor system which can be used for both environment and women’s health care applications. The bio-recognition mechanism is based on the influence of the redox couple, K₃Fe (CN) ₆/K₄Fe (CN) ₆ by the interaction between 17 β-estradiol antigen and its α-receptor (ER- α; α-estrogen antibody). The transduction mechanism is an electrochemical analytical technique, differential pulse voltammetry (DPV). The levels of 17 β-estradiol antigen studied was between 2.25 pg/mL to 2,250 pg/mL, Phosphate buffered saline (PBS), tap water from the Cleveland regional water district, and simulate urine were used as the test media covering the potential application areas for 17 β-estradiol detection. An interference study by testosterone which has a similar chemical structure and molecular weight as those of 17 β-estradiol was carried out, and this 17 β-estradiol biosensor showed excellent specificity without any interference by similar chemicals.

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

Interrelationships between traditional dental variables are becoming more evident in far reaching aspects of life such as psychosocial interaction, self-esteem, overall health and even occupational performance. This study compares quality of life (QoL) in postmenopausal women (PMW) with poor oral health (POH) with QoL in PMW with good oral health. 200 randomly recruited PMW received a dental evaluation and completed Utian Quality of Life Survey. The participants were divided into POH and healthy groups based on dental exam. Mean scores were calculated for each QoL item, domain and the overall summary score. For each of the four parameters for periodontitis diagnosis, periodontitis patients’ QoL outcomes were compared to those of healthy patients using T-test with threshold of significance at p<0.05. QoL in all fields measured were significantly poorer in the POH compared to the healthy patients, occupational (19.95±5.35vs. 27.56±6.13), health (18.02±8.23 vs. 26.59 ±6.45), emotional (15.68±10.22vs. 21.15±9.15), sexual (6.2±5.98vs. 10.02±5.35), and total score (60.21±25.85 vs. 84.26±22.35). This study finds that PMW with POH, report significantly poorer quality of life. Clinicians caring for PMW should be aware of that oral health impacts QoL and make appropriate referral decisions for patients’ dental care. Keywords: Quality of Life, Oral Health, Post-menopause, Women

The familiar stirred tank reactor poses an inherent challenge of variability. Some inflowing chemicals spend too little time in the reactor, and others stay too long, harming the uniformity of the end product. This issue can be addressed by replacing the continuous operation with a flow of individually treated fluid quanta. Ideally one would devise a universal fluid handling apparatus that can be adjusted to take care of all the needed chemical engineering unit operations. Proposing a cylinder shape capsule containing a rotating piston that moves back and forth between the edges of the capsule. The piston is cut through with certain fluid pass ways (holes) which may be shifting between being open, being closed, and anything in between. The combined movement of holes-drilled rotating piston will allow this universal unit to adjust for pumping, mixing and reacting fluid, and fluid components. By lining up the inner sides of the piston holes with fluid impact materials (FIM) the same generic unit can be used for catalytic reactions and for separation challenges. These generic units are linked "Lego like" to form a compound process, replacing the familiar continuous operation. The multi-mode piston (MMP) unit is completely specified by a digital representation of the shift position , the rotational position and the open/closed positions of the fluid pass ways. This allows for an efficient imposition of control strategy and for optimized manufacturing. The resultant digital representation renders the control strategy to become AI friendly, consistent with supervised learning tools for improving the efficiency of many chemical processes that transform from continuous mode to quantum fluid mode. While appearing promising, the concept is in its preliminary stages and its prospective impact is not yet well determined.

The application of non-uniform spiral gratings to control structure, topological parameters and propagation of orbital angular momentum (OAM) beams was studied experimentally with coherent near-infrared light. Adapted digital spiral grating structures were programmed into the phase map of a high-resolution liquid-crystal-on-silicon spatial light modulator (LCoS-SLM). It is shown that characteristic spatio-spectral anomalies related to Gouy phase shift can be used as pointers to quantify rotational beam properties. Depending on sign and gradient of spatially variable periods of chirped spiral gratings (CSG), variations of rotation angle and angular velocity as a function of propagation distance were measured. Propagation-dependent self-torque is introduced in analogy to known local self-torque phenomena of OAM beams as obtained by the superposition of temporally chirped or phase modulated wavepackets.

Dental anxiety (DA) negatively affects patients’ oral and overall health. This study explored attitudes and clinical practices of licensed Ohio general dentists who treat patients with DA. Methods: An anonymous self-administered mail survey was sent to 500 general dentists licensed and practicing in Ohio. Responses to 21 pre-coded questions were analyzed. Frequencies were examined; cross-tabs, Chi-Square, and Fischer’s Exact Test were calculated for statements according to dentists’ gender. Alpha was set at p = 0.05. Results: Nearly all respondents treated anxious patients; males were more likely to find it challenging than females. Dentists were most familiar with distraction, although half found nitrous oxide to be an effective tool. Female dentists were more likely than males to be familiar with anxiolytics and find them effective. Conclusion: Overall, Ohio general dentists are most familiar with using distraction and nitrous oxide during appointments for anxious patients. Gender differences exist in attitudes towards anxiolytic use for patients with DA. Practice Implications: By identifying techniques that are comfortable for patient and practitioner, oral health disparities associated with DA may be reduced.

In the paper analyzes of Francis turbine failures for a powerful Pumped Hydraulic Energy Storage (PHES) are conducted. The structure is part of the PHES Chaira, Bulgaria (HA4 - Hydro-Aggregate 4). The aim is assessment of the structure-to-concrete embedment for possible cause of damages and destructions of the HA4 Francis spiral casing units. The embedment methods applied in the practice for decades are discussed and compared to that used for HA4. An innovative virtual prototype is built based on the finite element method to clarify the influence of workloads under generator mode. The stages of the simulation include:- complete structural analysis of the spiral case and the concrete under loads in generator mode;- complete structural analysis of the spiral case under loads in generator mode but without the concrete.Both procedures of simulations (with and without the concrete) are of major importance. Since a failure of the surface between the turbine, the spiral case and the concrete is observed the effect of the increasing contact gap (no contact) is analyzed. The stresses, strains and displacements of the turbine units are simulated followed by important analysis for reliability. The conclusions reveal the possible reasons for cracks and destruction in the main elements of the structure.

This paper concerns the effect of proppant embedment related with hydraulic fracturing treatment. This phenomenon occurs if the strength of the reservoir rock is lower than proppant grains. The aim of the research is laboratory determining the loss of width of the proppant pack built of light ceramic grains. The laboratory simulation of the embedment phenomenon was carried out for a shale rock on a hydraulic press, in a specially prepared for this purpose a heated embedment chamber. Tests were conducted at high temperature and axial compressive stress conditions. The surfaces of the cylindrical core plugs (fracture faces) were imaged under an optical microscope equipped with 3D software. The fracture faces were examined and compared before and after the embedment phenomenon. The analysis of the obtained images of the fracture face were made based on the research method of the embedment phenomenon developed at Oil and Gas Institute-NRI. On the basis of laboratory tests, the parameters characterizing the embedment phenomenon were collected and discussed. In addition, the percentage reduction in the width of the proppant pack was determined.

Linear Hashing is an important algorithm for many key-value stores. Spiral Storage was invented to overcome the poor fringe behavior of Linear Hashing, but after an influential study by Larson, seems to have been discarded. Since almost 50 years have passed, we repeat Larson’s comparison with in-memory implementation of both to see whether his verdict still stands. Our study shows that Spiral Storage has slightly better look-up performance, but slightly poorer insert performance.

Micellar Casein Concentrate (MCC) is manufactured from microfiltration (MF) of skim milk utilizing ceramic or polymeric membrane filtration. While ceramic filtration has higher efficiency, use of polymeric is cost effective and the process is familiar to several US dairy processors. The aim of the present study was to develop an optimized membrane filtration process to produce MCC using spiral wound polymeric membrane filtration (SW MF) system by systematic selection of transmembrane pressure (TMP) and level of diafiltration (DF). Using skim milk as feed material, preliminary lab-scale MF experiments were conducted using 0.5 µm polyvinylidene fluoride (PVDF) membrane. Three TMP (34.5, 62.1, and 103.4 kPa) and three levels of DF (70, 100, and 150%) along with a process without DF as control were used in the study. Effect of TMP and effectiveness of DF on flux rates, SP removal, casein to total protein (CN/TKN) ratio, casein to true protein (CN/TP) ratio, rejection of casein (rej CN) and SP (rej SP) were evaluated. At all TMP values used in the study, the overall flux (O Flux) increased with the level of DF. Highest O Flux of 30.77 liter per meter square per hour (LMH) was obtained with 34.5 kPa pressure and 150% DF. The impact of DF was more pronounced at lower pressures than at the higher pressures used in the study. With controlled DF, instantaneous flux was maintained within 80% of initial flux for the entire process run. For all the experiments, casein has a rejection of 0.97 to 1.0, while serum protein has the lowest rejection of 0.10 at 34.5 kPa pressure and 150% DF level. Use of 34.5 kPa and DF level of 150 % contributed to 81.45% SP removal, and casein to true protein ratio of 0.96. SP removal data from the lab-scale experiments were fitted into a mathematical model using DF and square of TMP as factors. The model predicts SP removal within 90-95% of actual SP removal got from the pilot plant experiments.

Keywords: Chronic Obstructive Pulmonary Disease (COPD), Long Non-Coding RNAs (lncRNAs), Molecular Pathogenesis, Inflammation, Lung Cancer, Diagnostic Biomarkers

This paper serves as a seamless continuation of the previous work titled "Special Spirals are Produced by the ROTASE Galactic Spiral Equations with the Sequential Prime Numbers." Upon revisiting the data, a noteworthy observation emerged: the special spirals can be meticulously aligned with the prime spiral on a point-by-point basis through careful scaling and rotation for the parameter ρ remaining a constant greater than one. As ρ increases, both the scaling factor and rotation angle exhibit a corresponding augmentation, albeit with an intriguing caveat—the rotation angle asymptotically approaches its limit of 90°. Notably, the galactic spiral can be perceived as a remarkably close approximation of the Archimedean spiral, with the degree of proximity increasing as ρ grows larger. Furthermore, an intriguing correspondence arises when ρ takes on a value of 1; at this value, the galactic spiral bears a striking resemblance to the Fermat spiral, the space between two consecutive spiral loops undergoes a continuous reduction as the loop's radius expands, yet it never diminishes to zero; simultaneously, the area between two successive loops experiences an augmentation with the value of ρ.

In addition to the classical steroids, which have cholesterol as a precursor, there are steroids with 7-dehydrocholesterol as a precursor. This review describes the identification of these steroids, their biosynthesis and some aspects of their function. There are three classes of these compounds, distinguished by the number of their carbon atoms, 23, 24 and 25. Each class has a spiral steroid and is a phosphodiester. Up until these investigations, no spiral steroids or steroid phosphodiesters were known. There are at least 13 compounds of which six have been purified to near homogeneity. Each one has been characterized by its mass and proposed composition. They function by regulating the NaK-ATPase. Based on the tissues in which they have been detected, each class of compound seems to regulate a different isoform of the NaK-ATPase. This is an important site of endocrine regulation.

This short paper demonstrates that the galactic spiral equations developed from ROTASE model can be used to morphologically simulate the phyllotactic spiral-ring patterns of plants. It is also noticed during this project that although the numbers in the Fibonacci sequence dominate the phyllotactic numbers, there are still significant phyllotactic numbers are not in the Fibonacci sequence, however, most of those numbers are well fit into a Fibonacci sibling sequence starting with numbers 0 and 2. Many plants show the phyllotactic number pairs of 10-16, 16-26 and 26-42 from the Fibonacci sibling sequence, which is the second dominated sequence in the phyllotaxis.

The production of nanoparticles has recently surged due to their varied applications in biomedical, pharmaceutical, textile, and electronic sectors. However, this rapid increase in nanoparticle manufacturing has raised concerns about environmental pollution, particularly due to their potential adverse effects on human health. Among the various concerns, inhalation exposure to nanoparticles poses significant risks, especially affecting the respiratory system. Airway epithelial cells play a crucial role as the primary defense against inhaled particulate matter and pathogens. Studies have shown that nanoparticles can disrupt the airway epithelial barrier, triggering inflammatory responses, generating reactive oxygen species, and compromising cell viability. However, our understanding of how different types of nanoparticles specifically impact the airway epithelial barrier remains limited. To investigate nanoparticle-induced cellular responses and barrier dysfunction, both in vitro cell culture models and in vivo murine models are commonly utilized. In this review, we discuss the methodologies frequently employed to assess nanoparticle toxicity and barrier disruption. Furthermore, we analyze and compare the distinct effects of various nanoparticle types on the airway epithelial barrier. By elucidating the diverse responses elicited by different nanoparticles, we aim to provide insights that can guide future research endeavors in assessing and mitigating the potential risks associated with nanoparticle exposure.

Voronoi mosaics inspired by the seed points placed on the Archimedes Spirals are reported. Voronoi entropy was calculated for these patterns. Equidistant and non-equidistant patterns are treated. Voronoi mosaics built from a sells of equal size which are of a primary importance for decorative arts are reported. The pronounced prevalence of hexagons is inherent for the patterns with an equidistant and non-equidistant distribution of points, when the distance between the seed points is of the same order of magnitude as the distance between the turns of the spiral. Penta- and heptagonal “defected” cells appeared in the Voronoi diagrams due to the finite nature of the pattern. The ordered Voronoi tessellations demonstrating the Voronoi entropy larger than 1.71, reported for the random 2D distribution of points, were revealed. The dependence of the Voronoi entropy on the total number of the seed points located on the Archimedes Spirals is reported. Voronoi tessellations generated by the phyllotaxis-inspired patterns are addressed. The aesthetic attraction of the Voronoi mosaics arising from seed points placed on the Archimedes Spirals is discussed.

Spiral steroids (SS) are a newly discovered type of steroid. Originally, they were described as cardiotonic glycosides because they cross-reacted with digoxin-specific antibodies (Digoxin-Like-Materials-DLM). SS differ from the classical steroids in several ways: [a] they are steroid phosphodiester conjugates and displace digoxin from digoxin-specific antibodies, [b] in contrast to all other steroids, cholesterol is not a precursor, [c] SS have more than 21 carbon atoms; the extra atoms form a 5th ring which includes a lactone, [d] SS bind to NaK-ATPase in membranes rather than receptors in the nucleus. SS have been identified by HPLC- mass spectroscopy in extracts from mammals, birds, and oysters but were not detected in plant extracts. Overall, SS seem to be key components in regulating potassium electrolytes during pregnancy and its related diseases – specifically pre-eclampsia and necrotizing enterocolitis.

Image encryption based on chaotic maps is an important way to ensure the secure communication of digital multimedia on the Internet. To improve the encryption performance and security of image encryption systems, a new image encryption algorithm is proposed by employing a compound chaotic map and random cyclic shift. Firstly, an improved Hybrid chaotic system is designed by coupling Logistic, ICMIC, Tent, and Chebyshev maps (HLITC). Comparison tests with previous chaotic maps in terms of chaotic trajectory, Lyapunov exponent, and Kolmogorov entropy illustrate the new hybrid chaotic map has better chaotic performance. Then the proposed HLITC chaotic system is used to develop a new chaotic image encryption scheme with the double cyclic shift. The improved HLITC chaotic system is performed to generate key sequences used in the image scrambling and diffusion stage. The spiral transformation controlled by chaotic sequence is used to scramble the pixels of the plaintext image, while the XOR operation based on a chaotic map is used for pixel diffusion. Extensive experiments of statistical analysis, key sensitivity, and keyspace analysis are conducted. Experimental results show the proposed encryption scheme has good robustness against brute force attacks, statistical attacks, and differential attacks, and is more effective than many existing chaotic image encryption algorithms.

In genomics analysis, with the development of sequencing technology and the rapid growth of data volume, how to effectively identify and analyze important information in genomic data from massive data has become an important challenge. Identify key patterns and features in genomic data through advanced community testing methods. First, genomic data often contains a lot of noise and redundant information that needs to be processed through steps such as normalization, filtering, and dimensionality reduction. Normalization makes data at different scales comparable, filtering out data points with low quality or missing values, and dimensionality reduction reduces data dimensions through principal component analysis (PCA) and retains the main information. The gene co-expression network establishes the connection relationship between genes by calculating the expression similarity matrix between genes, and applies the Louvain algorithm to maximize the modularity of the network, aggregate nodes layer by layer, form a community structure, and identify the complex relationship and potential structure between genes. Finally, we utilize the cancer dataset to evaluate the proposed model. From our extensive experimental results, we can observe that Louvain's algorithm indicates outperformances and accuracy in the recognition and analysis of genomic data.

Automated machine classifications of galaxies are necessary because the size of upcoming surveys will overwhelm human volunteers. We improve upon existing machine classification methods by adding the output of SpArcFiRe to the inputs of a machine learning model. We use the human classifications from Galaxy Zoo 1 (GZ1) to train a random forest of decision trees to reproduce the human vote distributions of the Spiral class. We prefer the random forest model over other black box models like neural networks because it allows us to trace post hoc the precise reasoning behind the classification of each galaxy. We find that, across a sample of 470,000 Sloan galaxies that are large enough that details could be seen if they were there, the combination of SpArcFiRe outputs with existing SDSS features provides a better machine classification than either one alone on comparison to Galaxy Zoo 1. We suggest that adding SpArcFiRe outputs as features to any machine learning algorithm will likely improve its performance.

Underwater acoustic spiral sources are able to generate spiral acoustic fields where the phase depends on the bearing angle. It allows to estimate the bearing angle relatively to a receiver by subtracting the phases of a spiral and a circular wavefront, and finds application in the bearing angle estimate with a single hydrophone, e.g., for unmanned underwater vehicles localization. This paper presents a new prototype for a spiral acoustic source, which is able to generate the required wavefronts, and is composed of four monopoles in the same piezoceramic cylinder. This paper reports the prototyping and the acoustic tests performed in a water tank where the spiral source was characterized in terms o Transmitting Voltage Response, phase, and horizontal and vertical directivity patterns. A receiving calibration method for the spiral source is proposed and shows a maximum angle error of 1 degree when the calibration and the operation are carried under the same conditions and a mean angle error up to 6 degrees for frequencies above 25 kHz when the same conditions are not fulfilled.

From an industrial point of view, the milling of 2.5D cavities is a frequent operation, 1 consuming time and presenting optimization potential, especially through a judicious choice of 2 the tool trajectory. Among the different types of trajectories, some have a general spiral-like aspect 3 and can potentially offer a reduced machining time. They are called curvilinear trajectories and are 4 obtained by interpolation between structure curves which are the numerical solutions of a partial 5 differential equation. In this case, the machine tool will connect points and the trajectory will be made 6 up of small segments. Even if, macroscopically, these trajectories have all the qualities to allow the 7 tool to move quickly, on a small scale, the discontinuities in tangency, inherent in the discretization, 8 significantly increase machining time. This article suggests to enhancing the continuity level of the 9 toolpath by rebuilding structure curves with a set of Hermite quartic spline patches connected in 10 tangency and curvature. Thanks to this, the tool will machine at an average feedrate closer to the 11 programmed one and will, de facto, reduce traveling time. 12 This article shows that the proposed method increases, on the two tested cavities, toolpath quality 13 indicators, reduces milling time from 10% to 18% for a curvilinear method without a filter and make 14 it possible to generalize the Bieterman and Sandström method for all non convex pockets.

A visual study of spiral galaxies from a subset of spiral galaxies in the Dark Energy Survey Data Release 2 finds that a significant number show long tails of baryonic matter, often much longer than the apparent diameter of the galaxy. Examples from less than 10% of the candidates are shown here and their possible origin is discussed. The tails were only seen connected to spiral galaxies; no examples of tails connected to elliptical galaxies or to artifacts were found. In many examples the tail is associated with what appears to be a colliding galaxy, but in many others there is no sign of one. An intriguing possibility is that in the latter cases the tails are produced by an encounter with an unseen object, either a massive black hole or a compact galaxy with mostly dark matter.

Objectives: Understanding the intersection of age, ethnicity, and disability will become increasingly important as the global population ages and becomes more diverse. By 2060, Hispanics will comprise 28% of the U.S. population. This study examines critical associations between sensory impairment, social isolation, and cognitive functioning among Hispanic older adults. Methods: Our sample consisted of 557 Hispanic older adults that participated in Rounds 1-3 or Rounds 5-7 of the National Health and Aging Trends Study. Longitudinal mediation models across a three-year span were estimated using Mplus with vision, hearing, and dual sensory impairment predicting cognitive functioning directly and indirectly through social isolation. Results: Findings indicated that cognitive functioning was concurrently and, in certain cases, longitudinally predicted by vision and dual sensory impairment, and by social isolation. Contrary to expectations, vision and hearing impairment were not predictive of social isolation. Dual sensory impairment was associated with social isolation, yet no significant indirect associations were found for sensory impairments predicting cognitive functioning through social isolation. Discussion: The finding that social isolation did not mediate the relationship between sensory impairment and cognitive decline among Hispanic older adults in the U.S. is contrary to findings from other studies that were not specifically focused on this population. This finding may be evidence that culturally motivated family support and intergenerational living buffer the impact of sensory impairments in later life. Findings suggest that Hispanic older adults experiencing dual sensory impairments may benefit from interventions that foster social support and include family members.

The COVID-19 pandemic underscores the significance of vaccine hesitancy in shaping vaccination outcomes. Understanding the factors underpinning COVID-19 vaccination hesitancy is crucial for tailoring effective vaccination strategies. This cross-sectional study, conducted in three communities across the United States and Lebanon, employed surveys to assess respondents' knowledge, attitudes, and perceptions regarding COVID-19 infection and vaccination. Among the 7,196 participants, comprising 6,775 from the US and 422 from Lebanon, vaccine hesitancy rates were comparable at 12.2% and 12.8%, respectively. Notably, a substantial proportion of respondents harbored misconceptions, such as attributing the potential to alter DNA (86.4%) or track individuals (92.8%) to COVID-19 vaccines, and believing in the virus's artificial origins (81%). Primary determinants of hesitancy included perceptions that the vaccine poses greater risk than the infection itself (aOR = 8.7 and 9.4, respectively) and negative recommendations from healthcare providers (aOR = 6.5 and 5.4, respectively). Conversely, positive endorsements from healthcare providers were associated with reduced hesitancy (aOR = 0.02 and 0.4, respectively). Targeting healthcare providers to dispel misinformation and elucidate COVID-19 vaccine risks holds promise for enhancing vaccination uptake.

This paper presents a simple model and explanation for the flat rotation curves of Spiral Galaxies without resorting to: (1) The introduction of Dark Matter, (2) a modification of Newton's 2nd law (MOND) or (3) a modification of Einstein's theory of General Relativity. The model that is developed involves a rotating baryonic disk (a rotating frame of reference with an "effective angular velocity" about its center surrounded by a rotating cloud of hydrogen (HI). The model also assumes that the measurements that are made on the rotating HI cloud are made from an earth based inertial frame of reference. The predictions of the model rely on the relationship between velocities as measured by earth based radio telescopes and the velocities as measured in the rotating frame. Calculations of the rotation curves of three galaxies are made using this model and compared with readily available experimental data

This paper questions the potential shift of reproduction towards assisted reproductive technologies due to benefits provided by genetic manipulation of embryos. In order to examine the viability of such a shift and its implications from a regulatory perspective, we relied on two panels of experts from Israel and Spain, using the Delphi method and a series of in-depth interviews. We anticipate, at a first stage, a continuous-steady growth in the use of IVF, supplemented by preimplantation genetic diagnosis and the introduction of CRISPR/Cas. At a second stage, attracting a growing share of fertile people would require developments in genomics. While it is unclear whether these developments will fully materialize, they could be replaced by technoscientific imaginaries generating perceived benefits. We conclude that the regulation of reproductive genetics is becoming more critical and complex. The aim should be to ensure good practices and equity, while providing more information to the public. A broad and inclusive societal debate may overcome the difficulty of drawing a clear line between medical uses and non-medical uses of genetic selection and engineering and may contribute to finding the right balance between allowing autonomous decisions of patients and protecting the public interest.

With the galaxy J101652.52 as a model galaxy, this paper studied on the temporal duration of optically observed spiral patterns in disc galaxies is based on the finite reservoir of hydrogen available without replenishment following the initial formation of these well-isolated galaxies. The galaxy J101652.52 exhibits a grand design spiral pattern of two wide open spiral arms with perfect central symmetry, has only rear side trail effect, which clearly indicates that there is no corotation circle, therefore, the Density wave theory proposed for the spiral arm formation may not be applicable in this galaxy. The results reveal a gradual decline in observable spiral arms regardless of any spiral arm formation mechanism. This reduction occurs after half-loop rotation (as defined in the paper) as hydrogen reserves deplete, hindering new star formation. Ultimately, spiral patterns may possibly become optically invisible at normal conditions after a full-loop rotation (as defined in the paper) with hydrogen depletion, even if the formation mechanism remains active. The spiral galaxies with spiral arms decoupled from galactic bars or having soft spiral structures shall have similar results as long as that the spiral pattern rotation speed is significant different from the galactic matter rotation speed. Most of observed spiral galaxies have soft spiral structures, their spiral patterns dynamically change constantly. The results of this study support the idea of short-lived spiral patterns compared to the lifespan of the spiral galaxies. The spiral arm formation may occur once like the onetime firework show in a galaxy’s life based on the limited availability of hydrogens. A concise, universally applicable mechanism for spiral arm formation across various galaxies should exist which provides a single mathematical formula to describe the broad range of morphologies of the spiral arms with few adjustable parameters. Some exceptions may be explained within this framework. Furthermore, the observed data on spiral pattern and galactic bar rotation speeds in the Milky Way require rigorous verification, particularly concerning the winding problem.

A unified electro-gravity (UEG) theory, which has been successfully used for modeling an elementary particle, is applied in this paper to model gravitation in spiral galaxies. The new UEG model would explain the "flat rotation curves'' commonly observed in the spiral galaxies, without need for any hypothetical dark matter. The UEG theory is implemented in a somewhat different manner for a spiral galaxy, as compared to the simple application of the UEG theory to an elementary particle. This is because the spiral galaxy, unlike the elementary particle, is not spherically symmetric. The UEG constant $\gamma$, required in the new model to support the galaxies' flat rotation speeds, is estimated using measured data from a galaxy survey, as well as for a selected galaxy for illustration. The estimates are compared with the $\gamma$ derived from the UEG model of an elementary particle. The UEG model for the galaxy is shown to explain the empirical Tully-Fisher Relationship (TFR), is consistent with the Modified Newtonian Dynamics (MOND), and is also independently supported by measured trends of galaxy thickness with surface brightness and rotation speed. The UEG theory may similarly be extended to emulate the hypothetical dark matter in galaxy clusters as well as in cosmology.

Inertial focusing based Lab-on-Chips represent nowadays a promising technology for cell sorting in various applications, thanks to their coherence with the ASSURED criteria recommended by the World Health Organization, being: Affordable, Sensitive, Specific, User-friendly, Rapid and Ro-bust, Equipment-free and Delivered. Inertial focusing in spiral microchannel can offer a rapid, portable and ease of prototyping solution for cell-sorting. In literature, different geometries of microfluidic channel have been investigated to understand how hydrodynamic forces, due to primary and secondary flow, influence particle focusing. The balancing of these forces in spiral microchannels allows for high throughput and filtration efficiency across different particle and sizes. The understanding of such mechanism represents a key aspect to address the prototyping of spiral devices for the target application. A clear, complete and orderly overview in the current literature is lacking. For this reason, we aim to compare the main features of inertial focusing depending on various cross-section (rectangular, trapezoidal, triangular, hybrid) in spiral devices. Additionally, details about materials and prototyping techniques will be provided. This review study will provide readers a comprehensive overview of current research, guiding future ex-perimentation by expediting the selection of spiral geometries and materials based on the type of particle to be separated.

The spiral tube heat exchange is widely used in large-scale liquefaction process. However, the research on the friction pressure drop of the two-phase flow in the spiral tube is limited, especially for the offshore sloshing condition. In this paper, an experimental system is designed and built, and the effects of sloshing form (roll, pitch, heave), sloshing period (5-15s), mass flux (200-800 kg/(m2·s)), vapor quality (0.3-0.9) and operating pressure (2-4 MPa) on friction pressure drop of methane/ethane (C1/C2) mixture in spiral tube are studied. The result shows that the growth rate of time-averaged friction pressure drop during condensation under sloshing condition is less than 0, which indicates that sloshing will lead to drag reduction. And under the three sloshing parameters, the growth rate of time-averaged friction pressure drop of C1/C2 is reduced by-5.99%%, 5.97% and -6.70% respectively.

Triple-negative breast cancer (TNBC) lacks the expression of estrogen receptors, human epidermal growth factor receptor 2, and progesterone receptors (PR). TNBC has the poorest prognosis among breast cancer subtypes and is more likely to respond to immunotherapy due to its higher expression of PD-L1 and a greater percentage of tumor-infiltrating lymphocytes. Immunotherapy has revolutionized TNBC treatment, especially with the FDA's approval of pembrolizumab (Keytruda) combined with chemotherapy for advanced cases, opening new avenues for treating this deadly disease. Although, immunotherapy can significantly improve patient outcomes in a subset of patients, achieving the desired response rate for all remains an unmet clinical goal. Strategies that improve responses to immune checkpoint blockade, including combining immunotherapy with chemotherapy, molecularly targeted therapy, or radiotherapy may improve response rates and clinical outcomes.  In this review, we provide a short background on TNBC and immunotherapy and explore the different types of immunotherapy strategies that are currently being evaluated in TNBC. Additionally, we review why combination strategies may be beneficial, provide an overview of the combination strategies, and discuss the novel immunotherapeutic opportunities that may be approved in the near future for TNBC.

Emerging soft actuators with various soft materials and traveling-wave motion have been frequently discussed. Various configurations and the resulting performances have been proposed, and it is very challenging for soft actuators in realizing large strokes. This study presents an experimentally validated nonlinear finite element model to predict the deformation produced by a spiral pneumatic rubber actuator to generate traveling-wave motion. The actuator consists of a membrane mounted on a rubber substrate with three air chambers in a spiral configuration, simplifying the actuator's structure. The sequential deformations of the successive chambers interact with each other and produce radial traveling-waves on the membrane surface, driving the objects placed on the actuator. Finite element analysis using ANSYS computer software analyzed the elastic movement by considering the influence of different initial structural types. The structure with three different length ratios was introduced using the four parameters: membrane thickness, chamber width, chamber depth, and wall thickness. The simulation results indicated an optimal structure with specific ratios. A reasonable correlation was obtained during experimental validation; the predicted displacement values were approximately 17% smaller than the experimental values. Finally, the transportation performance of the prototype was tested and a velocity of 2.28 mm/s in the desired direction was achieved. We expect that our demonstration will expand the range of applications of the spiral pneumatic rubber actuator to include conveying or worm-like robots.

Dirofilariosis is an infectious disease caused by species of the Dirofilaria genus. It is manifested by the appearance of a subcutaneous swelling, especially in the eye region. We present the case of a 29-year-old patient that accused facial asymmetry in the right genian region. Following clinical and paraclinical evaluations, the diagnosis of parasitic cyst was established in the context of dirofilariosis with Dirofilaria repens (D. repens). Treatment consisted of surgical excision of the formation associated with prophylactic antibiotic medication. Macroscopic analysis of the excision piece revealed a structure that contains a cystic cavity and a filamentous form with a length of approximately 10 mM and a diameter of 1 mM. This is the first case of dirofilariosis located in the genian region reported in Romania. The overview of this pathology is important to raise awareness among physicians about its presence and its clinical variations.

Introduction: Peripheral neuropathies are very common and occur due to multiple causes including diabetes, tuberculosis, vasculitis, thyroid disorders, immune mediated diseases, vitamin B12 deficiency and drugs. Drug induced peripheral neuropathy (DIPN) is potentially irreversible, resulting in sensory deficits and paraesthesia. DIPN due to anti-tubercular drugs is common and can be implicated on linezolid, cycloserine and isoniazid.Case: 40-year-old female, diabetic with MDR-TB presented with severe, sharp, burning pain in her lower limbs. The patient was on all longer acting ATT drug regimen and was suspected with drug induced peripheral neuropathy. Conclusion: Linezolid, is used in treatment of tuberculosis and one of the major side effects includes peripheral neuropathy which is usually quite severe, presenting predominantly with sensory symptoms. Cessation of linezolid and neuropathic pain medications reduced the pain of patient from VCPS 8-10 to 1-2. Treatment of DIPN can be challenging as adverse drug reactions while treating tuberculosis should be kept in mind. It also warrants earliest treatment by identification of the drug in disguise and timely discontinuation of the drug.

Relationships of the three bryophyte lineages (liverworts, mosses, and hornworts) to vascular plants is a pivotal question in the study of origin and evolution of land plants. In recent decades, this question has been subject to intense phylogenetic analyses using morphological characters, multigene DNA sequences, and genome structural characters. A tentative consensus reached ten years ago suggested that bryophytes are a paraphyletic group, with liverworts being sister to all other land plants and hornworts being sister to vascular plants. However, several more recent nuclear phylogenomic studies have concluded that bryophytes represent a monophyletic group that is sister to vascular plants. A discussion is presented here on strengths and weaknesses of different types of characters (morphological traits, nucleotide sequences, and genome structural arrangements), and their suitability for resolving deep phylogenetic relationships. Moreover, several criteria for credible phylogenetic reconstruction are proposed. Strong statistical support for reconstructed relationships should be derived from high quality, independent characters selected for suitability to the particular question being addressed. The relationships inferred in a study should be congruent with those from as many other lines of phylogenetic evidence as possible. Any incongruities should be explicable by well-understood biological mechanisms. It is concluded that the relationships of the three bryophyte lineages to vascular plants should currently be viewed as unresolved. This is a difficult phylogenetic problem; the land plants underwent a rapid radiation a long time ago. Yet, further exploration of analytical methods and careful choice of characters should lead to eventual elucidation of diversification patterns among early land plants.

Although the influence of climate on the fire regime is unanimously recognized, most publications are studies on this influence are at the global scale. Therefore, this study aims to demonstrate the role of climate in the incidence of wildfires at the country and regional scale using statistical analysis and machine learning methods. Mainland Portugal was chosen as a case study due to its climate and because it is the European region most affected by wildfires. Results demonstrate the climate signature in the spatial and temporal distribution of the wildfire incidence. The conclusions of the study include (i) the existence of two pyro-regions, with different types of climate (Csb and Csa) composed of NUTS II regions: the northern region composed of the Norte and Centro regions and the southern region composed of Alentejo and Algarve; (ii) the intra-annual variability in the incidence of wildfires, characterized by two peaks, one in spring and the other in summer, are a consequence of the country's type of climate; and, (iii) how the annual cycle of wildfire incidence varies over the years depends on the weather conditions throughout each year. These results are of fundamental importance for wildfire managers, especially in the context of climate change.

Electronic cigarette (ecig) use in pregnancy is common, but potential effects on fetal development are largely unknown. The study goal was to examine the association between ecig exposure and fetal growth. Data were extracted from medical charts in this single site retrospective study. The sample, excluding those with known tobacco, alcohol, illicit drug, opioid, and benzodiazepine use, contained women who used ecigs throughout pregnancy and non-ecig user controls. Fetal size measurements from second and third trimester ultrasounds and at birth were expressed as percentiles for gestational age. Following adjustment for confounding factors, in the second trimester, only femur length was significant, with an adjusted deficit of 11.5 percentile points for ecig exposed compared to controls. By the third trimester, femur length difference was 28.5 points, with fetal weight difference also significant (17.2 points). At birth, all three size parameter differences between groups were significant. Significant size deficits were predicted by prenatal ecig exposure, becoming larger and impacting more parameters with increasing gestation. While additional study is warranted to confirm and expand upon these findings, this study adds to emerging data pointing to specific harms following ecig exposure in pregnancy, and suggests that ecigs may not be a “safer” alternative to combustible cigarette smoking in pregnancy.

Optimizing the magnetic coupling of two coils of a dynamic wireless charging power supply for electric vehicles (EVs) is a challenging and crucial task. This article examines three situations of the magnetic coupling between two identical rectangular spiral coils with the same number of turns as a function of both the horizontal (X axis) and vertical (Z axis) alignment. In the first one, the analysis of the magnetic coupling between two copper air coils is presented. However, the obtained coupling coefficient was very low with a high leakage flux which affected the performance of the charging system. In the second case, a straightforward shielding method that involves inserting a magnetic material of the ferrite type is proposed to circumvent the aforementioned problems. Unfortunately, the obtained results show that simple shielding is still only a partial and insufficient solution. In the third situation, an aluminum sheet was consequently placed on the top of the ferrite to provide an adequate shielding structure. Additionally, a 3D analysis of the proper and mutual induction parameters separating the two coils as well as a magnetic field or induction distribution is also performed using the ANSYS Maxwell software. The results highlight the significance of the enhanced structure.

In this paper, we study the sensing performance of metasurfaces comprised by spiral-disk-shaped metallic elements patterned on polypropylene substrates, which exhibit localized surface plasmon resonances in the low-frequency region of the THz spectrum (0.2-0.5 THz). Optimal designs of spiral disks with C-shaped resonators placed near the disks were determined and fabricated. The experimentally measured transmittance spectra of samples coated with very thin photoresistive layers (d ~ 10^-4-10^-3 λ) showed good agreement with simulations. The resonance frequency shift Δf increases with increasing d, while saturating near d = 50 µm. The narrow-band magnetic dark modes excited on symmetrical spiral disks with a 90⁰-C-resonator demonstrated very high FOM values reaching 1670 [RIU·mm]^-1 at 0.3μm-thick analyte. The hybrid high order resonances excited on asymmetrical densely packed spiral disks showed about two times larger FOM values (up to 2950 [RIU·mm]^-1) as compared to symmetrical distantly spaced spirals that resembles the best FOM results found in literature for metasurfaces fabricated with a similar technique. The demonstrated high sensing performance of spiral disks is evaluated to be promising for bio-sensing applications in the THz range.

Breast cancer (BC) is a prevalent malignancy with various subtypes, each presenting unique diagnostic and therapeutic challenges. Triple-negative breast cancer (TNBC), which comprises 12-17% of breast cancers, is particularly aggressive due to its lack of estrogen receptor (ER), progesterone receptor (PR), and HER2 expression. This case report details the management of a 64-year-old woman with TNBC. Initially presenting with a left breast nodule, she underwent a biopsy that confirmed triple-negative infiltrating ductal carcinoma. Despite negative BRCA genetic testing, her significant family history of cancer and a newly detected right breast lesion led to a bilateral mastectomy. Post-surgery imaging revealed multiple hypodense nodules and a spiculated pulmonary nodule, prompting further investigation. An endoscopic lung biopsy identified a primary pulmonary carcinoma with histological features similar to the breast cancer, indicating the lung as the primary source. This case underscores the complexity of TNBC, the importance of comprehensive diagnostic evaluations, and the need for considering extramammary origins in metastatic cases. The findings emphasize the role of multidisciplinary teams in managing such rare and challenging cases and highlight the necessity for thorough and repeated evaluations in atypical BC presentations.

Background: Endovascular treatment of popliteal aneurysms (PA) has increased in the last few years, quickly becoming the main treatment in many vascular centers, based on the acceptable and promising outcomes reported in the literature. However, endograft infections are the most dangerous complication as a serious local compromise and usually require open surgical conversion and device explantation to preserve the affected extremity. Case report: We reported two patients admitted to the emergency room for pain and edema in the lower leg. Both patients have undergone exclusion of ruptured PA a few years before by endovascular graft. CTA showed a significant volume of fluid-corpuscular collection related to perianeurysmal abscess collection in both cases. Blood cultures and drained material cultures were positive for Staphylococcus Capitis in the first case and S. Aureus in the second. The antibiotics prophylaxis was performed for 10 days, then, patients underwent an open surgical conversion with a complete explantation of endovascular material and a femoro-popliteal bypass using an autologous vein in the first case and biological bovine pericardium prosthesis in the other case. Furthermore, we have questioned the literature and found eight more cases described in case report article referred to popliteal graft infections by different microorganisms, mostly presenting acute limb ischemia as the first symptom and suggesting endograft explantation with open conversion and autologous vein bypass as the commonest therapeutic choice. Conclusions: Open surgical conversion of popliteal endograft infection is the best strategy to manage peripheral infection of the popliteal stent.

In this paper, the sequential prime numbers are used as variables for the galactic spiral equations which were developed from the ROTASE model. Special spiral patterns are produced when prime numbers are treated with the unit of radian. The special spiral patterns produced with the first 1000 prime numbers have 20 spirals arranged in two groups. The two groups have perfect central symmetry with each other and are separated with two spiral gaps. The special spiral pattern produced with natural numbers from 1 to 7919 shows 6 spirals in the central area and 44 spirals in the outer area. The whole 7919 spiral points can be plotted with either 6-spiral pattern or 44-spiral pattern. For the spirals only produced by the prime numbers in the 6-spiral pattern plotting, the spiral 2 and spiral 3 each has only one spiral point produced by prime number 2 and 3, respectively, all other spiral points produced by other prime numbers are located on the spiral 1 and spiral 5. The special spiral pattern is well explained with careful analysis, it is concluded that all prime numbers greater than 3 must meet one of the equations: P₁ = 1 + 6 * n (n > 0) P₅ = 5 + 6 * n (n ≥ 0) In other words, every prime number greater than 3 is either a P₁ prime number or a P₅ prime number, no exception. Matching one of the equations is a necessary condition for a number to be a prime number, not a sufficient condition. Hope such sufficient condition can be found in the future. The number of P₁ prime numbers roughly equal the number of P₅ prime number in the first 2 billion prime numbers. The galactic spiral equations with golden angle can duplicate Vogel’s result for the simulation of sunflower seed head pattern, and a pinwheel pattern can be produced also with galactic spiral equations and 1 degree more than golden angle.

Groove pancreatitis represents a chronic focal form of pancreatitis affecting the zone between the pancreatic head and the duodenal „C” loop, known as the groove area. This is a rare condition that affects the pancreatic periampullary part, including the duodenum and the common bile duct, associated usually with long-term alcohol and tobacco misuse and being more frequent in men than in women. The most common clinical symptoms of groove pancreatitis include weight loss, acute abdominal pain, nausea, and jaundice. This report is about a 66 year old woman with a history of heavy smoking, presenting with weight loss, nausea, and upper abdominal pain. Contrast enhanced computed tomography revealed the existence of a chronic pancreatitis as well as the dilatation of the main pancreatic duct, a cyst of the pancreatic head and enlargement of the biliary tract. Conservatory treatment was initiated but with no improvement of symptoms. Since there was no indication for endoscopic retrograde cholangiopancreatography, we decided to perform a pancreatoduodenectomy, as surgery appears to be the single effective treatment.

Introduction Emergency laparotomy is a surgical procedure associated with significantly higher mortality rates compared to elective surgeries. Awake laparotomy under neuraxial anaesthesia has recently emerged as a promising approach in abdominal surgery to improve patient outcomes. This study aims to evaluate the feasibility and potential benefits of using lumbar spinal anaesthesia as the primary anaesthetic technique in emergency laparotomies. Methods We conducted a case series involving 16 patients who underwent emergency laparotomy for bowel ischemia, perforation, or occlusion. Lumbar spinal anaesthesia was employed as the main anaes-thetic technique. We analysed patient demographics, clinical characteristics, intraoperative details, and postoperative outcomes. The primary outcome measures included the adequacy of postoper-ative pain control, the incidence of postoperative complications, and mortality rates. Results Among the 16 patients, adequate postoperative pain control was achieved, with only 2 patients requiring additional analgesia. Postoperative complications, including sepsis, wound dehiscence, and pneumonia, were observed in 7 patients (44%). The observed mortality rate was relatively low at 6% (1 patient). Notably, conversion to general anaesthesia was not necessary in any of the cases, and no early readmissions were reported. Discussion Our findings highlight the feasibility and potential benefits of using neuraxial anaesthesia in emergency laparotomies. The observed low mortality rate and the avoidance of conversion to general anaesthesia suggest that lumbar spinal anaesthesia may be a useful alternative in emer-gency settings. However, the occurrence of postoperative complications in 44% of patients indi-cates the need for cautious patient selection and close monitoring. Further research with larger sample sizes is warranted to fully elucidate the efficacy, safety, and potential impact of this tech-nique on patient outcomes in emergency laparotomies.

Infantile Neuroaxonal Dystrophy (INAD) is a rare neurodegenerative disorder, affecting 1:1,000,000 population. It results from pathogenic variants in the PLA2G6 gene located on chromosome (22q13.1). The onset of symptoms usually occurs between 6 to 18 months, causing developmental regression leading to debilitating symptoms such as muscle weakness, dementia, and loss of basic skills. Eventually, it progresses to life-threatening symptoms including breathing difficulties, which limits the life expectancy to 5-10 years. While potential genetic therapy for treatment is are being developed, they are yet to be approved for use, and management remains essentially supportive. This case report is of a 9-year-old Pakistani girl with INAD. She presented with recurrent chest infections, developmental regression, loss of speech, paralysis, hypertension, and eventually breathing difficulties. Brain magnetic resonance imaging and genetic testing con-firmed the diagnosis. This case posed diagnostic challenges in view of its overlapping clinical presentation. Through this report, we aim to raise awareness about the condition among practitioners, outline the importance of genetic counseling in susceptible couples and suggest potential areas of further research.

The research reported on this paper was aimed at improving the overall efficiency of a PDO certified artisanal cheese production process. Being a PDO certified foodstuff by the EU, it is considered to have properties and qualities determined by the geographical environment in which is made, with its production taking place in a specific and determined geographical location, in this case the Serra da Estrela region. In that sense, the authors conducted a mapping according to a systemic perspective of the processes involved in the context of manufacturing and distribution of certified Serra da Estrela cheese. Numerous methods were used throughout the process, such as a systemic design analysis, and techniques derived from ethnographic methods, which led to the collection of data in the field and consequently provided the immersion of the researcher in genuine work situations. Critical points were identified and emphasized in the systemic map with the purpose of encouraging initiatives to address and overcome the gaps and inefficiencies detected. The systemic design analysis triggered the development of design work. Observations following an ethnographic approach identified ergonomic risks in cheese making during the process of cutting excess chips, fostering the emergence of musculoskeletal disorders at the wrist. A tool that fits best to the task at hand was developed. A prototype of the new tool enabled collecting feedback from use in the work context, in order to inform product development. The domains of agricultural production and microbiology, considering the specific microorganisms developed trough the ripening process of the cheese, turned out to be aspects of high importance for the issue under focus, contributing to a broader understanding of the ripening process and its risks, simultaneously improving the efficiency and success of cheese production. If it were not for the systemic analysis, which served as a link between the boundaries of distinct domains such as the risk of microorganism contamination, ergonomics, energy efficiency, legislation and regulation policies, transportation challenges and economic viability, approached throughout the research. Simultaneously creating bridges between them, the various problems might not have been detected in the first place, as they are usually addressed in specialized disciplines, predetermined by the restrictions of each specific area of knowledge. As a consequence of the development of this research, which was based on an analysis that sought to establish possible connections between various disciplines and tried to constantly maintain a holistic perspective, making new connections and observing the issues from a new angle, apart from the already established methodologies. All this allowed to lay out the seeds for the development of a plan to tackle the critical points identified by the systemic analysis reported in this paper.

This paper illustrates that the ROTASE model proposed by the author for the formation of spiral arms of galaxies is nicely demonstrated by the spirals generated by rockets venting fuel during free fall. The patterns of spirals by the falling rockets strongly support that the spiral galaxies with perfect central symmetry have to be originated from the galactic centers, and the spiral arms and the galactic bars are bound together as “rigid” body. The exclusive presence of a rear side trail effect in galaxies indicates the absence of co-rotation, and the rotation of spiral arms is faster than the galactic matters. The exact nature of X-matter remains an open question.

Ectopic eruption of teeth rarely occurs in the mandibular condyle, orbit, nasal cavity, skin, and maxillary sinus. Ectopic eruption of teeth in the maxillary sinus can be accompanied by chronic and recurrent sinusitis, including headache, facial pain, and numbness. Fibro-osseous lesions in the paranasal sinuses are discovered incidentally on X-ray images and are often asymptomatic. Osteoma is the most common fibro-osseous lesion that develops in the paranasal and nasal sinuses. Herein, we report a rare case of osteoma (exostosis) containing supernumerary teeth within the maxillary sinus. A characteristic pedicled bone lesion with a clear border on computed tomography was the undefined orthopantomogram radiopacity in the left maxillary sinus, and the lesion contained teeth. The tumor was excised using the Caldwell–Luc procedure. Pathologically, the surgical specimen revealed an osteoma. The patient’s symptoms of chronic sinusitis disappeared, and the patient had no symptoms 2 years after the surgery. Because the patient had no history of midface trauma or surgery, the supernumerary teeth were speculated to have migrated during a reactive osteogenic process caused by chronic sinusitis.

Introduction: The association between epilepsy and myasthenia gravis has rarely been reported, and only in small case series. Objective: To report the frequency of epilepsy and myasthenia gravis and to describe a case series of patients with myasthenia gravis and epilepsy, focusing on their clinical characteristics and searching for a possible physiopathological mechanism. Methods: A retrospective, observational, adult center study was conducted in 2022. Patients were recruited from the database of the outpatient clinic of the Myasthenia Gravis unit and Epilepsy unit. Results: Five patients were included. Frequency of epilepsy in the myasthenia gravis cohort was 5/469 (1.1%), and of myasthenia gravis in the epilepsy cohort was 5/1432 (0.35%). All patients suffered focal epilepsy, mainly fronto-central, and drug-resistant in half of them. Myasthenia gravis was generalized and with exacerbations in half of them. Three patients were thymectomized. Other autoimmune diseases were found in 2 (40%). Epilepsy onset preceded myasthenia gravis onset in all patients. Both diseases were considered autoimmune-related in 3/5 (60%). Conclusion: Epilepsy and myasthenia gravis are only infrequently associated. In adult patients, epilepsy onset precedes myasthenia onset in most cases. In some cases, epilepsy has an autoimmune aetiology and coexists with other autoimmune conditions.

Malignant lymphoma is an unusual form of gallbladder neoplasm. Almost all of these tumors are diffuse large B-cell lymphomas or mucosa-associated lymphoid tissue-type lymphomas. Herein, we report a rare case of a gallbladder Burkitt’s lymphoma (BL) in a child living with HIV. As far as we are concerned, this is the first report in the pediatric population and in an individual living with HIV. The patient attended the Federal Hospital of Lagoa, Rio de Janeiro, Brazil, underwent cholecystectomy and the postoperative pathological analysis of the gallbladder revealed a diagnosis of BL. Also, HIV serology was performed and returned positive. She was transferred to the Martagão Gesteira Institute of Pediatrics and Childcare for oncological treatment, dying from sepsis and disease progression about 18 months later. Patient did not undergo ART/cART. Previous cases of gallbladder BL were analyzed to characterize the clinicopathological features. BL can occur in the gallbladder both in the context of HIV infection and in the pediatric population. Biopsy is mandatory in cases with suggestive findings of lymphoma, and an early diagnosis can change the course of the disease. Furthermore, the case highlights the importance of an early initiation of ART/cART in people living with HIV (PLWH).

This article proposes a particular strategy to proceed with a progressive electrification of public transport systems in cities. Starting from a bus operation model, the possible electrification of two routes is analysed, one urban and another extra-urban in the city of Pisa. An estimate is made of the energy uses associated with certain operating modes. The maximum level of consumption is estimated at approximately 280 kWh per day per bus for the urban route and excluding some special days, less than 215 kWh per day for the extra-urban route, for which a hybrid bus is proposed. Starting from an estimate of the daily consumption for the management of the two routes, the sizing of a photovoltaic system distributed on some modular shelters which serves to power the same routes is carried out. The resulting system has a power of the order of 190-200 kW. The modular solution is also outlined, and an installation is proposed. The analyzed case lends itself to being easily replicated.

Mortality rates in sub-Saharan Africa remains unacceptably high, and disproportionately affecting economically disadvantaged communities. And healthcare delivery which is considered a major contributor to this is challenged by the limited resources and high service costs, prompting many patients to opt for outpatient department services. This study addresses the need for a data-driven approach to healthcare policy formulation by proposing a model for the implementation of a data warehousing system that integrates outpatients into the national healthcare framework. By leveraging data warehousing, healthcare delivery can be made more efficient through a robust repository that supports decision-making and policy formulation. The research focuses on the outpatient department in resource-scarce settings, proposing a novel multidimensional data model and practical framework implementation. The benefits include improved patient experiences, cost-effective service delivery, and enhanced patient management through electronic health records. Additionally, mobile apps are explored for patient navigation and reminders to enhance treatment adherence. The study’s results indicate that data warehousing can significantly improve healthcare delivery by consolidating critical data and facilitating better planning, resource allocation, and policy formulation. Ultimately, this approach offers valuable insights for optimizing healthcare systems in resource-constrained environments, enabling data-driven policies, and improving health outcomes across sub-Saharan Africa.

(1) Background: The study of microbiome is being crucial for his role in major systemic diseases, in particular the oral and gut microbiota. In the last years the study of microorganism correlated for example with neurodegenerative disease is increasing the prospective of a possible link between gut microbiota and brain. Here we report a new case report about a patient evaluated genetically firstly for dementia and late-onset dyskinesia, and then tested with 16S metagenomics sequencing. (2) Methods: Starting from buccal swab, we extracted bacterial DNA and then we performed a NGS metagenomics sequencing based on the amplification of hypervariable regions of the 16S in bacteria. (3) Results: The sequencing revealed the presence of Spirochaetes Phylum, a pathogenic bacterium generally known to be able to migrate to the Central Nervous System and not only. (4) Conclusions: Oral infections as our results shows could be possible contributing factors to various neurodegenerative conditions.

Goal of this article is to provide the numerical and experimental assessments of an effective near-field to far-field transformation (NF–FF T) technique with planar spiral scanning for flat antennas under test (AUTs), which requires a non-redundant, i.e. minimum, amount of NF measurements. This technique has its roots in the theory of non-redundant sampling representations of electromagnetic fields and has been devised by suitably applying the unified theory of spiral scans for non-volumetric antennas to the case in which the considered AUT is modeled by a circular disk having its radius equal to one half the AUT maximum dimension. It makes use of a 2-D optimal sampling interpolation (OSI) formula to accurately determine the massive NF data required by the classical plane-rectangular NF–FF T technique from the non-redundant ones gathered along the spiral. It must be emphasized that, when considering flat AUTs, the developed transformation allows to further and significantly save measurement time as compared to that needed by the previously developed NF–FF T techniques with planar spiral scans based on the quasi-planar antennas modelings, because the number of turns of the spiral and that of NF data to be acquired depend somehow on the area of the modeling surface. The reported numerical simulations assess the accuracy of the proposed NF–FF T technique, whereas the experimental tests prove its practical feasibility.

Evans' Syndrome (ES) is a rare autoimmune disorder characterized by the simultaneous occurrence of immune thrombocytopenia (ITP) and autoimmune hemolytic anemia (AIHA). Thrombotic complications in ES patients are uncommon, particularly involving Buerger's Disease (BD). We report a case of a 49-year-old male with ES and a history of diabetes and heavy smoking, presenting with a necrotic wound on his right great toe. Diagnostic evaluations revealed severe stenosis and thrombosis in the lower limb arteries, diagnosed as BD. The patient underwent successful popliteal-tibioperoneal artery bypass surgery and subsequent disarticulation and revision of the distal phalanx, followed by the application of an acellular dermal matrix (ADM) to promote healing. Post-surgery, the patient showed significant improvement in blood flow and complete epithelialization without complications. This case highlights the importance of a multidisciplinary approach in managing complex wounds in ES patients, suggesting potential treatment pathways for future cases involving BD

In this study, an attempt was made to investigate the Kenya case of multivariate causality of carbon dioxide emissions by employing a time series data spanning from 1961-2011 using the ARDL method of cointegration analysis. The long-run elasticities show that, a 1% increase in financial development increases carbon dioxide emissions by 0.28%, a 1% increase in GDP per capita increases carbon dioxide emissions by 1.32% and a 1% increase in urbanization decreases carbon dioxide emissions by 1.14%. There was a unidirectional causality running from financial development, food production index, GDP per capita, industrialization and urbanization to carbon dioxide emissions. The innovation accounting shows that 20% of future shocks in carbon dioxide emissions are due to fluctuations in financial development, 9% of future shocks in financial development are due to fluctuations urbanization and 22% of future shocks in food production index are due to fluctuations in carbon dioxide emissions.

Construction using earth materials demonstrates ecological sustainability using locally sourced natural materials and environmentally friendly demolition methods. In this study, the environmental impact of adding cement to soil materials for rammed-earth farmhouse construction in rural China was investigated and comparatively simulated using the One Click LCA database, focusing on the conflict between sustainability objectives and the practical aspects of cement addition. By analyzing how the addition of cement aligns with local construction practices and by addressing the debate surrounding the inclusion of cement in rammed earth construction, our objective is to provide insights into achieving a balance between the environmental impact and the pragmatic considerations of using cement in earthen building practices. Three local structure scenarios are evaluated via simulations: a cement-stabilized rammed earth wall, a fired brick wall, and a localized reinforced concrete frame structure. The quantitative environmental impacts are assessed, and the qualitative differences in adaptation, economic sustainability, and other factors are examined in the context of present-day development in rural China. The results show that the use of cement-stabilized rammed earth wall-supported structures is associated with higher embodied carbon emissions compared to structures supported by reinforced concrete frames and enclosed by brick walls; however, these emissions are lower than those for brick wall-supported structures, while effectively meeting the structural requirements. In addition, the use of cement-stabilized earth for perimeter walls simplifies material management and disposal throughout the building's life cycle, and the cost-effectiveness of cement has been found to be substantially greater than that of reinforced concrete frames and brick structures, improving economic viability and social acceptability, especially among low-income communities in rural areas.

As a vital component of the terrestrial ecosystem, grassland accounts for one-third of the global vegetation system. Grassland degradation has been exacerbated due to extreme overgrazing in China's Inner Mongolia Autonomous Region (IMAR). While conservation was carried out as the Ecological Subsidy and Award Program (ESAP) to mitigate grassland degradation, little is known about its effectiveness in improving the biophysical conditions of grassland. This paper integrates the conceptual frameworks of total socio-environmental systems to assess how ecological systems respond to ESAP, investigate spatial heterogeneity of ESAP, and explore the meddling effects of socio-environmental interactions on ESAP. We integrate ecological, climate, and socioeconomic data and developed several hierarchical linear mixed models (HLMM) to investigate how these factors interact with ESAP in IMAR. Our findings prove that the above-ground biomass between 2011 and 2015 responds significantly to variations in socioeconomic conditions and ecological communities. Available land resources, hospital and medical facilities, and net farmer and herdsman income are the most critical factors contributing to grassland productivity. Primary industries like mining, total consumer retail value, farming, forestry, animal husbandry, fishery productions, and GDP are the most damaging factors affecting biomass. Our study recommends a regionally or locally tailored ecological recovery policy, instead of a generalized one, in the future effort to conserve grassland.

Electricity price forecasting has become a crucial element for both private and public decision-making. This importance has been growing since the wave of deregulation and liberalization of energy sector worldwide late 1990s. Given these facts, this paper tries to come up with a precise and flexible forecasting model for the wholesale electricity price for the Italian power market on an hourly basis. We utilize artificial intelligence models such as neural networks and bagged regression trees that are rarely used to forecast electricity prices. After model calibration, our final model is bagged regression trees with exogenous variables. The selected model outperformed neural network and bagged regression with single price used in this paper, it also outperformed other statistical and non-statistical models used in other studies. We also confirm some theoretical specifications of the model. As a policy implication, this model might be used by energy traders, transmission system operators and energy regulators for an enhanced decision-making process.

The demonstration of compliance of rolling stock against disturbance limits for railway signaling, and in particular track circuits, is subject to a large deal of variability, caused by the diverse values of the electrical parameters of the railway line and resulting transfer functions, as well as operating conditions of rolling stock during tests. Instrumental uncertainty is evaluated with a Type B approach and shown to be much less than the experimental variability. Repeated test runs in acceleration, coasting, cruising, braking conditions are considered, deriving both max-hold (spread) and sample dispersion curves compared to the respective mean values (Type A approach to the evaluation of uncertainty). The major source of variability affecting a significant portion of the spectrum is caused by the superposed oscillations of the onboard LC filter, for which different choices of the transformation window duration are discussed. The test runs and the acquired data covered overall 1 day of tests along about 300 km of the Italian 3 kV DC railway network.

With LiDAR (Light Detection and Ranging) time series being used for various applications, optimal realisation of a common geodetic datum over many epochs is a highly important prerequisite with direct impact on accuracy and reliability of derived measures. In our work, we develop and define several approaches to the adjustment of multi-temporal LiDAR data in a given software framework. These approaches ranging from pragmatic to more rigorous solutions are applied to an 8 year time series with 21 individual epochs. The analysis of the respective results suggests that a sequence of bi-temporal adjustments brings the best results while being more flexible and computationally viable than the most extensive approach of using all epochs in one single multi-temporal adjustment. With a combination of sparse control patches measured in the field and one selected reference block, we obtain relative datum discrepancies in the range of 1-2 cm for the complete time series. Based on our findings, we formulate design criteria for setting up and adjusting future time series with the proposed method.

Elizabethkingia anophelis is an opportunistic pathogen causing lifethreatening infections in humans, particularly in immunocompromised patients, neonates and elderly. Infections caused by this species are exceptionally challenging to treat due to its multiresistance to antimicrobials. We report a case of central line-associated bloodstream infection by E. anophelis in a 2.5-year-old girl with acute lymphoblastic leukemia successfully treated with a combination of piperacillin/tazobactam and amikacin. The literature was also reviewed on paediatric infections caused by E. anophelis. Accurate identification with MALDI-TOF, or using molecular techniques, is crucial because of varying susceptibilities among species. Early, accurate diagnosis and prompt effective treatment optimize outcomes.

Some wrong decisions and faulty practices applied during the repair and restoration of traditional buildings cause more damage to the structures due to the materials used in the repair. In this study, brick, mortar, plaster, and wood samples were taken from one registered building in the Konuralp neighborhood of Düzce Province, which has survived to the present day by preserving its original structural features and reflecting the characteristics of traditional housing. Texture, chemical and petrographic analyses were carried out on the samples. In line with these analyses, a scientific basis was created for selecting material properties in the repair and reuse processes of traditional buildings, and suggestions are made for the analysis of materials specific to traditional buildings in Konuralp.

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.

Food-borne transmission is a recognized route for many viruses associated with gastrointestinal, hepatic or neurological diseases. Therefore, it is essential to identify new bioactive compounds with broad-spectrum antiviral activity is needed to exploit innovative solutions against these hazards. Lately, antimicrobial peptides (AMPs) have been recognized as promising antiviral agents. Indeed, while the antibacterial and antifungal effects of these molecules have been widely reported, their use as potential antiviral agents has not yet been fully investigated. Herein, the antiviral activity of previously identified or newly designed AMPs, was evaluated against the non-enveloped RNA viruses, Hepatitis A virus (HAV), and Murine Norovirus (MNV), a surrogate for human Norovirus. Moreover, specific assays were performed to recognize at which stage of the viral infection cycle the peptides could function. Results showed that almost all peptides displayed virucidal effects with about 90% of infectivity reduction on HAV or MNV. However, the decapeptide RiLK1 demonstrated, together with its antibacterial and antifungal properties, a notable reduction in viral infection for both HAV and MNV, possibly through direct interaction with viral particles or inhibition of the viral bonding to the cell receptors. Hence, RiLK1 could represent a versatile ‘antimicrobial agent effective against various foodborne pathogens including viruses, bacteria, and fungi.

Although, promotion of urbanization culture in recent decades has made inevitable development of cities in the world, however, the development can be guided in a direction that leave, to the extent possible, minimum socioeconomic and environmental impacts. For this, it is required to first forecast auto-spreading orientation of cities and suburbs in rural areas over time and then avoid shapeless growth of cities. This paper is an attempt to develop a dynamic hybrid model based on logistic regression (LR), Markov chain (MC), and cellular automata (CA) for prediction of future urban sprawl in fast-growing cities. The model was developed using 12 widely-used urban development criteria, whose significant coefficient was determined by logistic regression, and validated by relative operating characteristic (ROC) analysis. The validated model was run in Guilan, a tourist province in northern Iran with a very high rate of urban development. For this, changes in the area of urban land use were detected over the period of 1989 to 2013 and then, future sprawl of the province was forecasted by the years 2025 and 2037. The analysis results revealed that the area of urban land use was increased by more than 1.7 % from 36012.5 ha in 1989 to 59754.8 ha in 2013, and the area of Caspian Hyrcanian forestland was reduced by 31628 ha. The results also predicted an alarming increase in the rate of urban development in the province by the years 2025 and 2037, during which urban land use is predicted to develop 0.9 % and 1.38 %, respectively. The development pattern is expected to be uneven and scattered, without following any particular direction. The development will occur close to the existing or newly-formed urban basements as well as around major roads and commercial areas. This development, if not controlled, will lead to the loss of 13863 ha of Hyrcanian forests and if the trend continues, 21013 ha of Hyrcanian forests and 20208 ha of Barren/open lands are expected to be destroyed by the year 2037. In general, the proposed model is an efficient tool for the support of urban planning decisions and facilitates the process of sustainable development of cities by providing decision-makers with an overview on future development of cities where the growth rate is very fast.

In emergency scenarios service vehicles must identify potential route(s) and use the best available route. However, route identification requires intelligent decision-support systems which generally use non-traditional approaches with tools characterised by flexible non-hierarchical structures. Conventional models using group decision-support systems have been applied; however, when used in smart urban environments, emergency response services have limitations in their ability to identify unobstructed paths (routes) in dynamic operating environments. In this paper we introduce a novel path planning method for autonomous vehicle control in emergency situations. The proposed model uses self-organizing maps in an integrated Spiral STC algorithm termed the: Hybrid SOM-Spiral STC model which uses hedge algebras and \emph{Kansei} evaluation in group decision-support. The proposed model has been designed to quantify qualitative factors using sensor derived data processed with human sensibilities and preferences in emergency decision support. The experimental results show that the proposed model achieves significant improvements in group decision-support under dynamic uncertainty. We posit that our novel approach holds the prospect of improvements in the provision of emergency services.

The Sustainable Development Center of the University of Brasilia is one of the modernist buildings that make up the Darcy Ribeiro campus. The architectural project contains several recommendations for the execution of the flat roof waterproofing system, as well as details for rainwater runoff and drainage, which reveals a certain concern with watertightness. The research seeks to identify the relationship between the pathological manifestations recognized on the roof and the semicircular shape of the building, assessing the state of conservation through the use of damage maps as an analysis tool. The article is based on a field survey using aerophotogrammetry with a drone, the application of vector drawing software for graphic representation and discussion of the possible causes, agents and mechanisms of degradation at work. The results show the importance of mechanical protection for the good performance of the waterproofing system, as well as the need for correct sizing of expansion joints in order to absorb and relieve the stresses caused by hygrothermal variations. The methodology incorporated proved to be effective and economical in diagnosing and monitoring pathological manifestations, making it possible to plan maintenance actions that extend the useful life and preserve the intrinsic characteristics of building systems.

Background: Diabetes mellitus (DM) and periodontitis are two chronic diseases that are interconnected. The coexistence of these conditions leads to increased severity of periodontitis and challenges in controlling blood glucose levels in diabetic patients. Objectives: The aim of this study was to evaluate both the influence of periodontal disease and its treatment in patients with DM in terms of a reduction in glycosylated hemoglobin levels at 3 and 6 months after treatment. Methods: A sequential, nonprobabilistic, controlled, prospective and longitudinal case−control study was carried out at the University Dental Clinic of the Morales Meseguer Hospital in Murcia, Spain. Thirty diabetic patients were divided into two groups: patients with periodontitis (test group) and patients without periodontitis (control group). The periodontal and endocrine-metabolic variables were measured at baseline and at 3 and 6 months after periodontal treatment for both groups. Results: Statistically significant differences were found at 3 and 6 months after periodontal treatment with respect to HbA1c levels in the group of periodontal patients. However, these differences were not observed in the control group. Conclusion: The presence of periodontal disease increased HbA1c levels in patients with DM. Nonsurgical periodontal treatment significantly decreased the degree of periodontal inflammation and the HbA1c level at 3 and 6 months after treatment.

Corneal ulcers are a common and potentially vision-threatening condition in horses that can be challenging to treat with conventional therapies alone. This case report describes the successful treatment of a non-healing corneal ulcer in a 28-year-old Hispano-Bretón mare using the secretome derived from adipose tissue-derived mesenchymal stem cells (ASCs). Despite initial treatment with antibiotics, anti-inflammatory drugs, and surgical debridement, the corneal ulcer failed to heal properly, exhibiting persistent epithelial defects and stromal complications. As an alternative regenerative approach, the ASC secretome, a rich source of trophic factors, cytokines, and extracellular vesicles, was topically administered to the affected eye. Remarkably, within one week of secretome treatment, the clinical signs of blepharospasm and epiphora resolved, and the corneal ulcer exhibited complete re-epithelialization, regained transparency, and reduced neovascularization. No recurrence was observed during the 1.5-year follow-up period. This case highlights the potential therapeutic benefits of ASCs secretome in promoting corneal wound healing and suggests its promise as a novel cell-free therapy for treating refractory corneal ulcers in horses.

Energy from biogas is one of the most promising renewable energy sources. Significant, for technical, economic, and environmental reasons, is the construction of agricultural microgas plants next to households specialising in cattle rearing. The availability of free substrate makes it possible not only to produce one's electricity and heat but also to produce a more environmentally and human-friendly manure. The operation of biogas plants is, unfortunately, associated with technical problems. This paper presents the results of a study of the quality of electricity generated in an agricultural biogas plant built at a farm specialising in dairy cows, where the owner reported a problem with the voltage in the power supply network. Therefore, selected power quality parameters occurring at the connection point of the biogas plant were analysed in detail. As the authors' research showed, in the case in question, the agricultural biogas plant was connected via a cable with too small a conductor cross-section, which resulted in significant voltage exceedances, making it impossible to switch on the second of the biogas plant's generators. Replacement of the feed-in cable has enabled both generators to run, but significant fluctuations in the feed-in voltage values were still noticeable. Analysis of the subsequent measurements revealed the need for changes in the design of the digester itself. The proposal for change is to replace the two current digester mixers (each rated at 9 kW) with more mixers of lower power. The new mixers would operate in an alternating system, where only one would always be activated.

Introduction: Cleft lip with or without cleft palate (CL/P) is the most common congenital face anomaly in the world of multifactorial etiology. Objective: To determine the prevalence and characteristics of cleft palate. To identify associated risk factors to guide prevention and/or prenatal detection for early intervention and better health outcomes. To assess the rehabilitation protocols after operations in cleft palate. Design: Retrospective descriptive and clinical study. Patients: One hundred and three children with cleft palate treated in the Department of Head and Neck Surgery Clinic for Children and Young Adults, Department of Clinical Pediatrics, University of Warmia and Mazury, were included in the study. Methods: Records evaluation was conducted regarding sex, cleft type, mother occupation, parents education, histories of cleft in any of parents. The data were analyzed using R (R core team 2021) and the ordinal logistic regression analyses. Results: Children of stressed mothers during pregnancy had 9.4 times higher odds of having bilateral cleft. While there was no evidence that children sex, order of birth, and body mass as well as risk of maternal toxicity at work or reporting infections or drugs toxicity had a significant effect on the dependent variable. Conclusions: Children of parents with cleft history and having low educated mothers had higher probability of bilateral cleft palate. Children of stressed mothers during pregnancy had higher odds of having bilateral cleft. In literature, there is a lack of reports about rehabilitation in different operations methods in children with cleft palates.

The paper focuses on the application of a multilevel, integrative and territorial approach to the protection of cultural heritage through planning instruments in Serbia. It points out the problems of the sectoral approach and discusses international recommendations that can be integrated into the planning methodology. The case study is the area of Djerdap National Park, which has an already established international and national importance. The research suggests that the cultural heritage in the area, with the exception of the Roman limes, is still recognized at the level of individual localities. The study emphasizes the importance of aligning all levels of governance to safeguard the whole spatial entity rather than focusing solely on its particular areas. The interna-tional and national importance of the planning area contributes to the strengthening of awareness of heritage and its institutional protection. However, the vitality of the area, which is key to its sustainable development, comes from the local level. Planning documents contribute to the inte-gration of local values and local communities into development programs and projects.

Background: A Morel–Lavallée lesion (MLL) is a traumatic, internal closed degloving injury that results from shearing of subcutaneous tissue away from underlying fascia, usually associated with high-velocity trauma. Case presentation: A 52-year-old man was transported to hospital for further follow-up of a superficial femoral artery injury. Examination on admission showed bruising seen around the left thigh. Contrast-enhanced computed tomography of the left thigh revealed hematoma with extravasation from a branch of the left superficial femoral artery, but no apparent aneurysms or femoral fractures. The patient was treated with compression bandages and discharged on hospital day 6. He left hospital able to walk unaided. He subsequently complained of left thigh pain with swelling and visited the hospital several times. He was treated at another outpatient clinic and was diagnosed with MLL. Single-use disposable portable negative pressure wound therapy (NPWT) was applied for about 2 months, achieving a stable wound site. Conclusion: We encountered a case of MLL successfully treated with single-use portable NPWT. This report presents the case of a patient with isolated MLL without fracture in the left thigh, in which the diagnosis was missed on initial admission. Finally, the patient received minor interventions including drainage along with tissue debridement and portable NPWT. We reviewed the relevant literature and summarize the pathogenesis, clinical manifestations, and treatment strategies for MLL. Emergency physicians require an increased understanding of MLL to avoid misdiagnosis and missed diagnosis.

The consumption of insects in the Democratic Republic of Congo is an ancient practice. The taxonomic identification and characterization of “entomophagy” seem urgent in Kinshasa following the related anthropogenic pressures (demographic pressure, uncontrolled urbanization) leading to a food crisis. This study aims to assess the diversity of edible insects and their consumption by the population of Kinshasa. A total of 360 people were surveyed to identify the insect species consumed in Kinshasa, the ecosystems that provide them, and the preference for species in relation to ethnolinguistic groups, churches (faith) and household size. Three species of insects most consumed in Kinshasa are: Gonimbrasia jamesonii, Cirina forda and Brachytrupes membranaceus. 41.9% of these insects are consumed by the Kongo ethno-linguistic group, 23.6% by the Luba, 20.6% by the Ngala and 13.9% by the Swahili. Inhabitants of the communes of Kassa Vubu (57%), Maluku (54%), Masina (54%) and Mont-Ngafula (39%) mainly consume C. forda and G. jamesonii. Luba and Kongo ethnolinguistic groups mainly consume C. forda while the Swahili and Ngala consume G. jamesonii. Catholic, Revivalist Church, Kimbagu, Islam, Protestant and Johovah's Witness believers mainly consume C. forda and G. jamesonii. This study made it possible to understand the socio-cultural influence on the degradation (pressure) of biodiversity and; contributes to SDGs 2 and 12 by 2023..

Outdoor lighting is becoming increasingly widespread, and residents are suffering from serious light pollution as a result. Residents’ awareness of their rights to protection has gradually increased. However, due to the sometimes-inaccessible nature of residential vertical light incidence intensity data and the high cost of obtaining specific measurements, there is no appropriate hierarchic compensation for residents suffering from different degrees of light pollution. It is therefore important to measure light pollution levels and their damage at the neighborhood scale to provide residents with basic materials for proper protection and to create more politically suitable solutions. This article presents a light pollution assessment method that is easy to perform, is low-cost, and has a short data-processing cycle. This method can be used to monitor residential zone light pollution in other cities. We chose three open areas to test the spatial variation pattern of light intensity. The results are in accordance with spatial interpolation patterns and can be fit, with high precision, using the IDW method. This approach can also be used in 3 dimensions to quantitatively evaluate the distribution of light intensity distribution. We use a mixed-use zone in Beijing known as The Place as our case study area. The vertical illumination at the windows of residential buildings ranges from 2 lux to 23 lux; the illumination in some areas is far higher than the value recommended by CIE. Such severe light pollution can seriously interfere with people's daily lives and has a serious influence on their rest and health. The results of this survey will serve as an important database to assess whether the planning of night-time lighting is scientific and whether it provides residents with a basis for the protection of their rights.

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

Three-dimensional (3D) geological modeling technology offers intricate geological information services and technical support for the research of urban geological conditions and their evolutionary mechanisms. It further facilitates the analysis of environmental geological problems, encompassing their distinguishing features and genetic mechanisms. The precision of such three-dimensional models is predominantly influenced by the caliber of modeling data, the chosen modeling methodologies, and the intricacy of the modeled geological objects. This research, exemplified by the three-dimensional geological structure modeling of the Wuhan metropolitan development area, aims to explore a comprehensive three-dimensional modeling framework for urban geology, particularly in scenarios with large-scale and complex geological conditions. This study holds significant technical value in enhancing the application of 3D geological modeling, as well as practical importance for urban geological investigations and research.

This study analyses regional development in one of the poorest provinces in China, Guizhou Province, between 2000 and 2012 using a multiscale and multi-mechanism framework. In general, regional inequality has been declining since 2000. In addition, economic development in Guizhou Province presented spatial agglomeration and club convergence, which shows how the development pattern of one core area, two-wing areas and a contiguous area at the edge of the province have been developed between 2006 and 2012. Multilevel regression analysis revealed that industrialization and investment level were the primary driving forces of regional economic disparity in Guizhou Province. The influences of marketization and decentralization on regional economic disparity were relatively weak. Investment level reinforced regional economic disparity and the development of core-periphery structure in the province. However, investment level actually weakened the regional economic disparity in Guizhou Province when the variable of time was considered. In addition, both the topography and urban–rural differentiation were the two main reasons for forming a core-periphery structure in Guizhou Province.

In the conservation of monumental heritage, the collection and utilization of information are of primary importance. The Heritage Building Information Modeling (HBIM) procedure harnesses the potential of three-dimensional models, offering significant advantages in accessing documentation, interoperability, multidimensionality of intervention design, cost evaluation and maintenance management. Attention here is focused on the Certosa di Pisa, a large historical complex built in the 14th century as a monastery of the Carthusian order, currently in a state of deterioration and in need of restoration and re-functionalization. The multifaceted nature of this monumental complex, with its intricate interplay of architectural elements spanning different historical periods and featuring diverse techniques, poses a significant challenge for structural safety assessment. This case study presents an opportunity to explore an HBIM approach to streamline the diagnostic process and facilitate the intervention design phase. The goal is achieved by utilizing an accurate 3D model enriched with data from multiple sources and automating certain operations for structural assessment. The usefulness of the HBIM methodology is highlighted as a valuable tool in the realm of Cultural Heritage structures for both technicians and scholars alike.

This study explores the transformative potential of integrating Building Information Modeling (BIM) and Generative Design methodologies in heritage conservation and building management. By utilizing BIM, detailed architectural, structural, and MEP models were created, facilitating precise design and effective stakeholder collaboration. Generative Design enabled the exploration of multiple design solutions, optimizing spatial layouts and structural integrity. The project also integrated automated management systems and IoT sensors to enhance real-time monitoring, energy efficiency, and user comfort through the development of a digital twin. Despite encountering challenges such as technical complexities and budget constraints, the project successfully preserved the cinema's historical essence while incorporating modern functionalities. The findings highlight the contributions of BIM and Generative Design to the AEC industry, emphasizing their role in improving design accuracy, operational efficiency, and sustainability. This research provides valuable insights for future projects in heritage conservation, offering a blueprint for balancing historical preservation with contemporary needs. The revitalization of the "Ex Cinema Santa Barbara" in Paternò exemplifies these advancements, demonstrating how these technologies can restore and modernize culturally significant historical buildings effectively.

European strategic policy directions towards a sustainable blue economy have strengthened interest in maritime investments, thus increasing sectoral competition for marine space. Emerging repercussions out of such a rising interest need to be handled by Marine Spatial Planning (MSP) as a means for: properly allocating marine space to diverse uses; managing conflicts and promoting synergies among them; and pursuing a multi-use perspective of this space. A critical stage of each MSP exercise is the exploration of land-based spatial/developmental directions and their current or potential repercussions in the marine environment in order for constraints but also perspectives in policy choices/maritime uses in the MSP context to be featured; and attainment of a successful coherence or coordination between land and marine spatial/developmental policies to be ensured, by analyzing Land-Sea-Interaction (LSI) and embedding it in the MSP. The latter is the focus of this paper aiming to illuminate critical issues emerging from land-based (terrestrial) policy frameworks for feeding MSP endeavors; and is accomplished in the Northern Aegean Sea, Greece. Towards this end, a multilevel approach is adopted, delving into diverse policy contexts at the local, regional and national/European level and aiming to attain more informed MSP decisions in the specific study region.

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

The study addresses the urgent environmental issue of climate change, focusing specifically on the role of local food, which is produced and consumed locally, helps reduce carbon emissions by eliminating the need for long-distance transportation. Through quantitative analysis, this study elucidates the potential benefits in environmental impact achieved through the consumption of local food: the significant reduction in carbon emissions. Specifically, the consumption of local food is found to yield an annual decrease of 2,421,296 tCO2 emissions, representing 2.5% of South Korea’s total greenhouse gas emissions from the transportation sector. This reduction further translates into an estimated economic value of USD 54.23 million (KRW 70.5 billion). This study underscores the potential of local food consumption as a tangible strategy to overcome environmental problems. Moreover, its academic contribution lies in its comprehensive analysis of the economic and empirical impacts of local food consumption on environment. Moving forward, we propose policies such as supporting local food distribution networks, providing public education on local food, fostering the local food industry, and providing incentives to revitalize local food consumption.

Pulmonary complications are frequently observed in patients with ulcerative colitis (UC), with large airway disease being the most prevalent manifestation. In this case study, we explore the potential for Immunosuppressant, a monoclonal antibody, to induce pulmonary hemorrhage—a side effect not previously documented with its use. The subject, a young male in his twenties with a six-year history of UC, tragically died suddenly. Found in a pool of blood without external injuries, extensive post-mortem examinations were required to determine the cause of death. The patient had been on biologic therapy, receiving Immunosuppressant intermittently over the past two years, including an infusion five days prior to death. External examination revealed bloody, pinkish foamy material expelling from his nose and mouth. An autopsy supported an atypical presentation of UC, while histopathology confirmed diffuse pulmonary hemorrhage, marked by edema and emphysematous changes. Additionally, there was a notable lymphomonocytic infiltration around the arterial walls, and signs of bronchiolitis and focal pleural fibrosis were evident. We concluded that the cause of death was Diffuse Alveolar Hemorrhage (DAH), directly associated with the recent administration of Immunosuppressant. This finding underscores the need for vigilant pulmonary monitoring in patients treated with monoclonal antibodies to promptly identify and manage potential fatal adverse reactions.

Assessment of extreme events and climate change on reservoir inflow is important for water and power stressed countries. Projected climate is subject to uncertainties related to climate change scenarios and Global Circulation Models (GCMs’). Extreme climatic events will increase with the rise in temperature as mentioned in the AR5 of the IPCC. This paper discusses the consequences of climate change that include extreme events on discharge. Historical climatic and gauging data were collected from different stations within a watershed. The observed flow data was used for calibration and validation of SWAT model. Downscaling was performed on future GCMs’ temperature and precipitation data, and plausible extreme events were generated. Corrected climatic data was applied to project the influence of climate change. Results showed a large uncertainty in discharge using different GCMs’ and different emissions scenarios. The annual tendency of the GCMs’ is bi-vocal: six GCMs’ projected a rise in annual flow, while one GCM projected a decrease in flow. The change in average seasonal flow is more as compared to annual variations. Changes in winter and spring discharge are mostly positive, even with the decrease in precipitation. The changes in flows are generally negative for summer and autumn due to early snowmelt from an increase in temperature. The change in average seasonal flows under RCPs’ 4.5 and 8.5 are projected to vary from -29.1 to 130.7% and -49.4 to 171%, respectively. In the medium range (RCP 4.5) impact scenario, the uncertainty range of average runoff is relatively low. While in the high range (RCP 8.5) impact scenario, this range is significantly larger. RCP 8.5 covered a wide range of uncertainties, while RCP 4.5 covered a short range of possibilities. These outcomes suggest that it is important to consider the influence of climate change on water resources to frame appropriate guidelines for planning and management.

Globalization and industrialization have significantly disturbed the environmental ecosystem, leading to critical challenges such as global warming, extreme weather events, and water scarcity. Forecasting temperature trends is crucial for enhancing the resilience and quality of life in smart sustainable cities, enabling informed decision-making and proactive urban planning. This research specifically targets Ahmedabad city in India and employs the Seasonal Auto Regressive Integrated Moving Average with eXogenous factors (SARIMAX) model to forecast temperatures over a ten-year horizon using two decades of real-time temperature data. The stationarity of the dataset was confirmed using the Augmented Dickey-Fuller test, and the Akaike Information Criterion (AIC) method helped identify the optimal seasonal parameters of the model, ensuring a balance between fidelity and predictive accuracy. The model achieved an RMSE of 1.0265, indicating high accuracy within the typical range for urban temperature forecasting. This robust measure of error underscores the model’s precision in predicting temperature deviations, which is particularly relevant for urban planning and environmental management. The findings provide city planners and policymakers with valuable insights and tools for preempting adverse environmental impacts, marking a significant step towards operational efficiency and enhanced governance in future smart urban ecosystems. Future work may extend the model's applicability to broader geographical areas and incorporate additional environmental variables to refine predictive accuracy further.

Heavy rains have created significant threats to human health and life. Floods and other natural disasters, which have a global impact annually, can be attributed to extended durations of intense precipitation. Accurate rainfall predictions are crucial in nations such as Bangladesh, where agriculture is the predominant occupation. The efficiency of machine learning (ML) methods is enhanced by the non-linearity of rainfall, surpassing the effectiveness of other alternative ways. Machine learning techniques show that individual classifiers exhibit worse accuracy than ensemble learning (EL) methodologies. Ensemble Learning techniques are utilized for rainfall prediction and estimating rainfall quantity and daily average temperature to enhance comprehension of the diverse Machine Learning algorithms. This research implements the machine learning techniques and ensemble-based classifier to predict the rainfall occurrence, along with the machine learning regressor models and ensemble-based regressor for the rainfall amount prediction and daily average temperature prediction, using Bangladesh Weather Dataset. The results of the machine learning and ensemble-based models are compared using the Accuracy and F1 score for rainfall occurrence prediction. In contrast, MAE and RMSE evaluation metrics are used for ensemble regressor and regression algorithms for the rainfall amount and daily average temperature prediction. With an accuracy of 83.41% and a recall of 78.17%, the Ensemble Classifier is the best at predicting when it will rain, but its precision of 51.16% stands in for the lowest. The Ensemble Regression model outperforms Linear Regression, Random Forest, and SVR in rainfall amount prediction, with the lowest MAE of 0.36 and RMSE of 0.90. The Ensemble Regression provides the most precise results for daily average temperature prediction with the lowest MAE 0.42 and RMSE 0.54 highlighting its superiority over the other regression models in forecasting temperature with less error. Ensemble approaches consistently lead task performance metrics.

Neurofibromas, rare benign tumors of the peripheral nerve sheath, present diagnostic challenges, particularly in diabetic patients with toe ulcers. This case involves a 55-year-old female with type 2 diabetes mellitus who developed an enlarging ulcer on her right second toe. The initial evaluation suggested a diabetic ulcer; however, advanced imaging revealed a mass-like lesion. Partial excision and biopsy confirmed a neurofibroma with spindle cells within the myxoid stroma and S100 protein expression. One month later, total excision and Z-plasty reconstruction were performed under general anesthesia. The patient’s postoperative recovery was uneventful, and the patient was discharged without complications. Follow-up revealed successful healing with no recurrence or functional issues. This case highlights the importance of considering neurofibromas in the differential diagnosis of diabetic toe ulcers to avoid misdiagnosis and ensure appropriate management.

Candida spondylodiscitis (CS) is a rare disease, for which therapeutic option are limited to fluconazole or echinocandins and the treatment should be administered up to 12 months. In case of reduced azole susceptibility, there is a scarcity of therapeutic options with adequate bone penetration and limited toxicity. We report the first case of successful use of rezafungin for a spondylodiscitis due to Candida parapsilosis with reduced susceptibility to azoles. The patient, affected by paraplegia and short bowel syndrome, was diagnosed with CS with culture on vertebral biopsy guided by a 18-FDG-PET/CT scan. He received rezafungin 200 mg weekly for 26 weeks, after 10 weeks of previous antifungal treatment. He had a full clinical, radiologic and biochemical response to the therapy with rezafungin, with no adverse effects. Rezafungin is a promising therapy for Candida osteomyelitis, especially when first line therapies are ineffective or contraindicated.

Digital transformation provides new drivers for economic performance growth in enterprises, but can it further improve ESG performance and support sustainable development? Based on the perspective of resources and capabilities, this paper uses the relevant data of 1588 listed companies in strategic emerging industries from 2011 to 2021 to study the differential impact of digital transformation on enterprise ESG performance, and further tests the mediating role of absorptive capacity and the moderating role of regional digital level. The research results indicate that: firstly, digital transformation of enterprises can positively promote the improvement of ESG performance; Secondly, there are significant differences in the impact of digital transformation on the ESG performance of enterprises in terms of property rights and industry characteristics. The ESG performance of state-owned enterprises and high-end equipment manufacturing enterprises is more sensitive to digital transformation; Thirdly, absorptive capacity plays a mediating role between digital transformation and corporate ESG performance; Fourthly, the positive regulation of regional digital level promotes the ESG performance of enterprises through digital transformation. The research conclusion is based on a digital perspective, providing relevant insights for improving the ESG performance of strategic emerging industry enterprises and expanding their ESG development paths.

Hemophagocytic lymphohistiocytosis (HLH) is a serious haematologic condition that can be re-lated to various diseases, including tuberculosis (TB). The patient is a previously healthy 26-years-old man, originally from Western Africa, admitted to hospital for fever and weight loss. Given the results of computed tomography (CT) scan, ocular examination and microbiologic tests, a miliary TB with pulmonary, lymph nodal and ocular involvement was diagnosed. Following introduction of antitubercular treatment (ATT) an increase in inflammation indexes and severe pancytopenia were observed; at this point the patient presented six of eight diagnostic criteria for HLH and the diagnosis of HLH secondary to TB was raised. Therefore, HLH treatment with high dose of dexamethasone was started with a good clinical response. We performed a literature re-view of TB-related HLH, which shows a high mortality rate; ATT is necessary to ensure patient survival to remove the antigenic driver. Our patients developed HLH after initiation of ATT as a paradoxical reaction, that may be linked to the release of antigens due to the bactericidal effect of ATT.

Dental agenesis is one of the most common developmental anomaly in humans and it is frequently as-sociated with several other oral abnormalities. The present case describes nonfamilial agenesis of per-manent teeth in a twenty-one-year-old boy, with no apparent systemic abnormalities. The treatment in-cluded a personalized and interdisciplinary approach by the means of endodontics, orthodontics, im-plants supported restorations and prosthetic treatments. The treatment plan was thoroughly elaborated using photographic analysis, study models, orthopantomogram, CBCT and cephalograms. Virtual smile design, diagnostic waxing, and mock-up previsualized the treatment objectives. The edentulous spaces were reconstructed by inserting dental implants, and monolithic Zirconia implant supported restorations. The final results showed a highly aesthetic and functional rehabilitation. Periodic checkups have shown that the stability of the result is well maintained and that the implant supported restorations are an op-timal solution for patients with multiple anodontia.

This study addresses the importance of conducting mass movement susceptibility mapping and hazard assessment using quantitative techniques, including machine learning, in the Northern Lima Commonwealth (NLC). Previous exploration of the topographic variables revealed high correlation and multicollinearity among some of them, which led to dimensionality reduction through principal component analysis (PCA). Six susceptibility models were generated using weights of evidence, logistic regression, multilayer perceptron, support vector machine, random forest, and naive Bayes methods to produce quantitative susceptibility maps and assess the hazard associated with two scenarios: the first being an El Niño phenomenon and the second being an earthquake exceeding 8.8Mw. The main findings indicate that machine learning models exhibit excellent predictive performance for the presence and absence of mass movement events, as all models surpassed an AUC value of &gt;0.9, with the random forest model standing out. In terms of hazard levels, in the event of an El Niño phenomenon or an earthquake exceeding 8.8Mw, approximately 40% of the NLC area would be exposed to the highest hazard levels. It also highlights the importance of integrating methodologies to reduce model uncertainty, such as comprehensive analysis of variables supported by high quality data and organized workflows. The findings of this research are expected to serve as a supportive tool for land managers in formulating effective disaster prevention and risk reduction strategies.