Near-field (NF) integrated sensing and communication (ISAC) has the potential to revolutionize future wireless networks. It enables simultaneous communication and sensing operations on the same radio frequency (RF) resources using a shared hardware platform, maximizing resource utilization. NF-ISAC systems can improve communication and sensing performance compared to traditional far-field (FF) ISAC systems by employing the unique propagation characteristics of NF spherical waves with an additional distance dimension. Despite its potential, the NF-ISAC literature covers just a few specialized topics. A comprehensive survey encompassing all aspects of NF-ISAC systems has thus far been lacking. To this end, this paper systematically explores the prodigious potential of NF-ISAC technology. Specifically, an in-depth analysis of both NF and FF systems is provided, investigating their applicability in communication and sensing scenarios. Various channel model scenarios for NF and FF are discussed, emphasizing their distinguishing features. The advantages and philosophies of ISAC are further explored, opening opportunities to investigate both narrow-band and wide-band systems within NF ISAC. Case studies and simulation examples for each NF-ISAC design philosophy are provided to gain deeper insights into these system designs. An extensive literature review of existing NF-ISAC studies is conducted, exploring various methodologies, potentials, prospects, and conclusions. Finally, prospective research areas, remaining challenges, and applications of future NF-ISAC systems are discussed.

HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a chronic progressive neurological disorder and shares many radiological and clinical features with other more prevalent myelopathies. Here, we quantified spinal cord and brain volumes in adults with HAM/TSP in comparison with healthy volunteers (HVs) and participants diagnosed with multiple sclerosis (MS). Clinical disability and MRI were assessed in 24 HVs, 43 HAM/TSP, and 46 MS participants. Spinal cord cross-sectional area (SCCSA) and brain tissue volumes were measured and compared. HAM/TSP participants had significantly lower SCCSA at C2-3 (54.0±8 mm2), C4-5 (57.8±8 mm2), and T4-9 (22.7±4 mm2) and significantly elevated brain white matter hyperintensity (WMH) fraction (0.004±0.008) was compared to HVs (C2-3: 69.4±8 mm2, C4-5: 75.1±9 mm2, T4-9: 34.1±4 mm2; all p < 0.0001; and WMH: 0.0004±0.0007; p < 0.001). In HAM/TSP, SCCSA at all levels but not WMH showed the significant correlation with clinical disability scores. Brain white matter hyperintensities in HAM/TSP, therefore, may not be related to clinical disability. SCCSA and WMH in our limited MS cohort were higher than the HAM/TSP cohort (67.6±8 mm2, 72.7±9 mm2, 33.4±5 mm2; p < 0.0001). Principal component analysis suggested that SCCSA and WMH may be used to differentiated HAM/TSP from MS. Understanding these differences may help establish early diagnostic criteria for HAM/TSP patients.

The nature of the interaction between Th17 cells and the blood-brain barrier (BBB) is critical for the development of autoimmune inflammation in the central nervous system (CNS). TNF-a or IL-17 stimulation is known to enhance the adherence of Th17 cells to the brain endothelium. The brain endothelial cells (bEnd.3) express VCAM-1, the receptor responsible for inflammatory cell adhesion, which binds VLA-4 on migrating effector lymphocytes at the early stage of brain inflammation. The present study examines the effect of the pro-inflammatory cytokines TNF-a and IL-17 on the adherence of Th17 cells to bEnd.3 The bEnd.3 cells were found to increase production of CCL2 and CXCL1 after stimulation by pro-inflammatory cytokines, while CCL2, CCL5, CCL20 and IL17 induced Th17 cell migration through a bEnd.3 monolayer. This interaction between Th17 cells and the brain endothelium appears to be mediated by VCAM-1 and some chemotactic cytokines. This observation may suggest potential therapeutic targets for the prevention of autoimmune neuroinflammation development in the CNS.

Solvent free copolymerization of epoxides derived from fatty acid esters of waste cooking oil with phthalic anhydride using (salen)CrIII Cl as catalyst and n-Bu4NCl/DMAP as co-catalyst was carried out for the first time under microwave irradiation, where reaction time was reduced from number of hours to minutes. The polyesters were obtained with molecular weight (Mw = 3084-6740 g/mol) and dispersity values (D = 1.18-1.92), when (salen)CrIII Cl/n-Bu4NCl was used as catalysts. While in case of DMAP as a co-catalyst, polyesters with improved molecular weight (Mw = 5537-6925 g/mol) and narrow dispersity values (D = 1.07-1.28) were obtained even at reduced concentrations of (salen)CrIII Cl and DMAP. The obtained products were characterized and evaluated by attenuated total reflection-fourier transform infrared spectroscopy (ATR-FTIR), proton nuclear magnetic resonance (1H-NMR) spectroscopy, gel permeation chromatography (GPC) and thermogravimetric analysis (TGA) Techniques.

Optimal upper extremity motor control and range of motion are necessary to achieve even the basic Activities of Daily Living (ADL) function. Stroke, with resulting hemiparesis, can significantly and negatively impact an individual’s ADL function. Functional Independence Measure (FIM) self-care score can provide assessment of what aspects and to what degree ADL functions are impaired. FIM self-care assessment can also track changes in ADL function during stroke recovery and rehabilitation. Recently, sensor-acquired 3D motion analysis of stroke patients’ upper extremity has shown promise as a potential alternative to assess ADL function. This observational study evaluates whether the sensor-acquired upper extremity reachable workspace (RWS) measure correlates with clinician-evaluated FIM self-care score in stroke patients. Seventeen patients with stroke were enrolled in the study. FIM self-care, NeuroQoL upper extremity, and reachable workspace outcome measures (relative surface area, RSA) were collected upon rehabilitation hospital admission, at discharge, and at 3-month visit. Pearson and Spearman’s rank correlation coefficients as well as multiple linear regression analyses were used to determine the relationships between FIM self-care, NeuroQoL, and reachable workspace RSAs. Moderately strong correlation between total reachable workspace RSA and total FIM self-care score at discharge and at 3-month were noted (r=0.619, r=0.661, p<0.05), and similarly strong correlation was also noted with the upper extremity NeuroQoL total score (r=0.690, r=0.815, p<0.05). Multiple linear regression analyses revealed a change in bilateral total RSA of 0.1 unit from admission to 3-month follow up correlated with respective change in FIM self-care score of 2.011 points (95%CI: 0.663-3.360). Longitudinal improvement in ADL function during stroke rehabilitation and recovery process is correlated with improvement in reachable workspace.

The process of developing therapies to treat rare diseases is fraught with financial, regulatory, and logistical challenges that have limited our ability to build effective treatments. Recently, a novel type of therapy called antisense therapy has shown immense potential for the treatment of rare diseases, particularly through single-patient N-of-1 trials. Several N-of-1 antisense therapies have been developed recently for rare diseases, including the landmark study of milasen. In response to the success of N-of-1 antisense therapy, the Food and Drug Administration (FDA) has developed unique guidelines specifically for the development of antisense therapy to treat N-of-1 rare diseases. This policy change establishes a strong foundation for future therapy development, and addresses some of the major limitations that previously hindered the development of therapies for rare diseases.

Background: Early risk stratification tools for COVID-19 patients were indicated but little is known about their ability to effectively detect clinical deterioration among COVID-19 patients. Objectives: To assess the prognostic accuracy of NEWS2 in predicting severe morbidity and mortality in hospitalization for COVID-19 patients. Methods: A prospective cohort study was performed among adult patients with a confirmed diagnosis of COVID-19 who were admitted to the inpatient units at COVID-19 Martyrs Medical Military Complex and Palestinian Red Crescent Society Hospital, located at Nablus, Palestinian Authority. NEWS2 scores were measured at admission, on 6, 12, 24, and 48 hours after their admission to the hospital using Receiver Operating Characteristic Curves (ROC). Results: Overall, 192 adult COVID-19 patients aged 25-94 years (mean=62.1, SD=13.9) were enrolled. Of those, 49.0% were males, 47.4% were vaccinated, and 53.6% were with diabetes. The mean NEWS scores during the patient’s hospital stay were excellent predictors of mechanical ventilation, admission to the ICU, and mortality, as indicated by an AUROC of 0.94 (95% CI: 0.88-1.00, P<0.001), 0.91 (95% CI: 0.87-0.96, P<0.001) and 0.96 (95% CI: 0.92-1.00, P<0.001), respectively. The classification of 192 patients into NEWS score categories indicated that 12.5% were classified as high-risk at admission. Conclusion: The NEWS2 had moderate sensitivity and specificity in predicting the deterioration of patients with COVID-19. Our findings support the utility of NEWS2 monitoring as a sensitive approach for initially assessing COVID-19 patients. It could be helpful to improve predictive performance by supplementing the score parameters with additional measures besides the clinical judgment.

Diagnosis and treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) in women remain insufficient. Fluctuations of reproductive hormones during the premenstrual period, postpartum period and (peri)menopause are neglected, even though they impact ADHD symptoms and as-sociated mood disorders [1]. Therefore, we created a female-specific treatment group for women with ADHD and premenstrual worsening of ADHD and/or mood symptoms. We describe the group programme and underlying rationale, offering a qualitative analysis of the participants’ evaluation. The 7 two-weekly sessions foreground the menstrual cycle and address several ADHD-specific topics in relation to this cyclical pattern: emotional regulation; impulsivity; setting boundaries, and triggers. Concurrently, women track their menstrual cycle and (fluctuating) ADHD and mood symptoms with an adjusted premenstrual calendar. In total, 18 women (25-47yrs) participated in three consecutive groups. We analysed the evaluation of the last group. Participants experienced the group as a safe and welcoming space. Recognition was valued by all. The topics discussed were deemed valuable and the structure suited them well. Completing the premenstrual calendar augmented awareness and recognition of individual cyclical symptoms. Discussing ADHD throughout the lifespan increased self-understanding. Participants took their menstrual cycle more seriously, prioritising self-acceptance and self-care in the luteal phase of the cycle. Exploring a cyclical approach in a group setting seems to be a positive addition to treatment for female ADHD.

Mediterranean Diet (MD), rich in minimally processed plant foods and in monounsaturated fats, but low in saturated fats, meat and dairy products, represents one of the most studied diets for cardiovascular health. It has been shown, from both observational and randomized controlled trials, that MD reduces body weight, improves cardiovascular disease surrogates such as waist-to-hip ratio, lipids, and inflammation markers, and even prevents the development of fatal and non-fatal cardiovascular disease, diabetes, obesity, and other diseases. However, it is unclear whether it offers cardiovascular benefits from its individual components or as a whole. Furthermore, limitations in the methodology of studies and meta-analyses have raised some concerns on its potential cardiovascular benefits. MD is also associated with characteristic changes in the intestinal microbiota, mediated through its constituents. These include increased growth of species producing short-chain fatty acids, such as Clostridium leptum and Eubacterium rectale, increased growth of Bifidobacteria, Bacteroides and Faecalibacterium prausnitzii species, and reduced growth of Firmicutes and Blautia species. Such changes are known to be favorably associated with inflammation, oxidative status, and overall metabolic health. This review will focus on the effects of MD on cardiovascular health through its action on gut microbioma.

CT scans are currently the most common imaging modality used for suspected stroke patients due to their short acquisition time and wide availability. However, MRI offers superior tissue contrast and image quality. In this study, eight deep learning models are developed, trained, and tested using a dataset of 181 CT/MR pairs from stroke patients. The resultant synthetic MRIs generated by these models are compared through a variety of qualitative and quantitative methods. The synthetic MRIs generated by a 3D UNet model consistently demonstrated superior performance across all methods of evaluation. Overall, the generation of synthetic MRIs from CT scans using the methods described in this paper produces realistic MRIs that can guide the registration of CT scans to MRI atlases. The synthetic MRIs enable the segmentation of white matter, gray matter, and cerebrospinal fluid using algorithms designed for MRIs, exhibiting a high degree of similarity to true MRIs.

A retrospective cohort study was performed to determine the likelihood of malignant stroke after mechanical thrombectomy via ASPECTS-PASS score(A-P score), a novel scoring system using ASPECT score and number of arterial-passes. This prediction score is designed to help clinicians take early measures. Malignant stroke is defined as a large MCA infarct with mass effect that develops during the first 5 days following presentation and is associated with approximately 80% mortality. Previous studies have shown an association of low ASPECTS and high number of passes with poor outcome.We performed a retrospective cohort analysis on 78 patients with anterior circulation stroke who underwent mechanical thrombectomy at our hospital. We analyzed the likelihood of developing malignant stroke post thrombectomy in the first 5 days following successful recanalization (TICI ≽ 2b). Malignant stroke is defined as severe symptoms secondary to edema as evidenced by midline shift, cistern engorgement, and hemorrhagic conversion with edema. Patients with ASPECTS of 0-5 were excluded. We used two variables to predict the outcome: ASPECT score and number-of-passes. We used the equation ASPECT score minus number-of-passes (A-P) to arrive at a single number to predict the risk of malignant stroke. A-P scoring scale ranged from 0-9. Our study showed a statistically significant inverse relationship of A-P score and risk of malignant stroke. Approximately 90% of patients with A-P score < 5 developed malignant stroke in our study. A-P score can help predict malignant stroke post thrombectomy even after successful recanalization. Thus, A-P score of ≤ 5 suggests very high risk. (A-P) Score can assist clinicians to take early measures, and thereby prevent worse outcomes.

Spinal muscular atrophy (SMA) is a severe neuromuscular disorder that is caused by mutations in the survival motor neuron 1 (SMN1) gene, hindering the production of functional survival motor neuron (SMN) proteins. Antisense oligonucleotides (ASOs), a versatile DNA-like drug, are adept at binding to target RNA to prevent translation or promote alternative splicing. Nusinersen is an FDA-approved ASO for the treatment of SMA. It can effectively promote alternative splicing in SMN2, an analog of SMN1, to produce a greater amount of full length SMN protein, to compensate for the loss of functional protein translated from SMN1. Despite its efficacy in ameliorating SMA symptoms, the cellular uptake of these ASOs is suboptimal and their inability to penetrate the CNS necessitates invasive lumbar punctures. Cell-penetrating peptides (CPPs), that can be conjugated to ASOs, represent a promising approach to improve the efficiency of these treatments for SMA and have the potential to transverse the blood-brain barrier to circumvent the need for intrusive intrathecal injections and their associated adverse effects. This review provides a comprehensive analysis of ASO therapy, their application for the treatment of SMA, and the encouraging potential of CPPs as delivery systems to improve ASO uptake and overall efficiency.

Extracellular vesicles represent a large heterogeneous class of near and long-distance intercellular communication mediators, released by both prokaryotic and eukaryotic cells. Specifically, the scientific community has shown a growing interest in exosomes, which are nano-sized vesicles with an endosomal origin. Not so long ago, the physiological goal of exosome generation was largely unknown and required more investigation; at first, it was hypothesized that exosomes are able to remove excess, rejects and unnecessary constituents from cells to preserve cellular homeostasis. However, thanks to recent studies, the central role of exosomes in regulating cellular dialogue has emerged. Exosomes act as vectors on cell-cell signaling by their cargo, proteins, lipids, and nucleic acids, and influence physiological and pathological processes. The findings on exosomes are widespread in a large spectrum of biomedical applications from diagnosis and prognosis to thera-pies. In this review, we describe exosome biogenesis and the current methods for their isolation and characterization, emphasizing the role of their cargo in female reproductive processes, from gametogenesis to implantation, and the potential involvement in human female disorders.

Background: Current management of COPD is predominantly focused on respiratory aspects. A multidimensional assessment including nutritional assessment, quality of life and disability provides a more reliable perspective of the true complexity of COPD patients. Methods: Prospective observational study of 120 elderly COPD patients at high risk of acute exacerbations. The Mini-Nutritional Assessment (MNA) was administered in addition to the usual respiratory assessment. The primary outcome was a composite of moderate or severe acute exacerbations during 52 weeks of follow-up. Results: The median MNA Short Form (SF) score was 11 (8-12), 39 participants (32.50%) had normal nutritional status, 57 (47.5%) were at risk of malnutrition and 24 (20%) were malnourished. Our multivariate linear logistic models showed that the MNA score was associated with dyspnea and respiratory symptoms severity assessed by the Modified British Medical Research Council (mMRC) and the COPD Assessment Test (CAT) score, with spirometric variables, in particular with the severity of airflow limitation based on the value of FEV1 and with poorer QoL as assessed by the EQ-5D-3 questionnaire. Cox regression analysis according to nutritional status based on the MNA score showed that COPD participants "at risk of malnutrition" and "malnourished" had a higher risk of moderate to severe acute exacerbations with a hazard ratio (HR) of 3.54 (p=0.002) and 8.20 (p=0.0001), respectively. Conclusion: Our study confirms the importance of assessing nutritional status in elderly COPD patients and its prognostic value.

Childhood obesity has become a global epidemic, with significant increases in prevalence over recent decades. While excessive calorie consumption and physical inactivity are known factors, emerging research highlights the role of Endocrine-Disrupting Chemicals (EDCs), particularly obesogens, in obesity's pathogenesis. This review explores the historical context of the environmental obesogens hypothesis, their sources, mechanism of action, impact on prenatal and postnatal development and epigenetics. Additionally, it discusses the long-term consequences of childhood obesity and proposes prevention strategies that will mitigate the negative health effects. Obesogens were found to disrupt hormonal balance and metabolic processes through various mechanisms such as altering gene expression, hormonal interference, and inflammation. Especially significant, was exposure during critical windows of development which correlates with increased risk of obesity in childhood or adolescence. Long-term effects of childhood obesity include chronic health conditions and psychosocial issues. A comprehensive approach is necessary to address childhood obesity, encompassing genetic, environmental, and lifestyle factors. Prevention strategies should focus on reducing obesogens exposure, promoting healthy lifestyles, and implementing regulatory policies. Future research should investigate obesogens-diet interactions, microbiome impacts, and combined obesogens effects. Long-term human studies are also crucial for validating findings from animal models and allow for inform decision-making to combat the obesity pandemic.

Cameroon introduced the malaria vaccine in its routine immunization programme on 22 January 2024, in the 42 districts out of 200, among the most at risk of malaria. A cross-sectional analysis of data on vaccine key events in the introduction roadmap and vaccine uptake during the first 30 days was conducted. In addition to available gray literature related to the introduction of the malaria vaccine, data on malaria vaccine uptake by vaccination session, collected through a digital platform, were analyzed. A total of 1,893 reports were received from 22 January 2024 to 21 February 2024 from 766 health facilities (85% of overall completeness). Two regions out of 10 recorded less than 80% of completeness. As of 21 February 2024, 13,811 children have received the first dose of the malaria vaccine, including 7,124 girls (51.6%) and 6,687 boys (48.4%). Thirty six percent of children were vaccinated through outreach sessions versus 61.5% through sessions in fixed posts. The overall monthly immunization coverage with the first dose was 37%. Early results have shown positive attitudes towards and acceptance of malaria vaccines. Suboptimal completeness of data reporting and low coverage highlight persistent gaps and challenges in vaccine rollout.

Sputum induction (SI) is a non-invasive technique to obtain lower airway samples from people who do not spontaneously produce sputum. Since its introduction in 1958, its use has significantly increased for various respiratory conditions, especially with the establishment of standardized techniques. It has been used in pediatric research since 2002, starting with asthma studies. It is a safe and repeatable procedure for non-expectorating children. The ability to analyze both cellular and fluid components of sputum provides valuable information about lung diseases. This work reviews the utility of sputum induction in pediatric respiratory research and its potential clinical applications. We also discuss the safety, tolerability, and side effects profile of the procedure, emphasizing its significance in pediatric respiratory research. Despite the valuable insights gained from SI studies, challenges remain for widespread clinical utilization, requiring further refinement of the technique and increased accessibility in clinical settings.

This study evaluates the preparedness of Siloam Hospital Bali for medical tourism using Actor-Network Theory (ANT) to analyze human and non-human interactions within social networks. The objective is to identify factors influencing the hospital's readiness. Data was collected through interviews with hospital administration, specialized physicians, local officials, and tourism organization members, supplemented by document and archival research. Network visualization with GraphCommons.com revealed interaction patterns, key actors, and potential impediments. The results show that effective hospital administration, professional care by doctors, and cooperation with tourism groups and local authorities significantly impact the hospital's readiness. However, dependencies on core nodes, lack of redundancy, and underutilization of peripheral nodes are vulnerabilities. Recommendations include enhancing integration with peripheral nodes, establishing network redundancy, involving educational institutions, and aligning with international insurance and immigration policies. This study contributes to a comprehensive understanding of medical tourism dynamics and offers strategies to enhance Siloam Hospital's readiness.

Taxonomic studies of dreams that continue to influence the dreamer’s thoughts and feelings after awakening have distinguished three types of impactful dreams: nightmares, existential dreams, and transcendent dreams. Of these, existential dreams and transcendent dreams are characterized by recurrent metacognitive appraisal of the epistemic tension between complementary (a) metaphoric (A “is” B) assertions and (b) literal (A “is not” B) assertions. Metacognitive appraisal of such complementary metaphoric and literal assertions is detectible as the felt sense of inexpressible realizations. The poesy of such inexpressible realizations depends upon the juxtaposition of a metaphoric topic and vehicle that are both “semantically dense” but at an abstract level “distant” from each other. The result is the “emergence” of attributes of the metaphoric vehicle that are sufficiently abstract to be attributes also of the metaphoric topic. The cumulative effect of successive metaphoric/literal categorical transformations produces a higher-level form of metacognition that is consistent with a neo-Kantian account of sublime feeling. Sublime feeling occurs as either sublime disquietude (existential dreams) or as sublime enthrallment (transcendent dreams). The aftereffects of these two dream types are thematically iterative “living metaphors” that have existential (but not totalizing) abstract ontological import.

Background/Objectives: Current guidelines recommend intravenous thrombolysis (IVT) followed by mechanical thrombectomy (MT) for patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO). This combined approach, known as bridging therapy (BT), is believed to increase the likelihood of a favorable functional outcome when administered within 4.5 hours of symptom onset. However, the benefits of BT over direct mechanical thrombectomy (d-MT) remain debated. This study aimed to compare the outcomes of AIS-LVO patients undergoing MT within 6 hours of symptom onset, with and without prior IVT. Methods: Within the prospective TINL STROKE-registry, AIS-LVO patients admitted to the Department of Neurology, University of Pécs, between February 2023 and June 2024 were investigated. The primary endpoint was the proportion of patients reaching functional independence at 90 days, defined as a modified Rankin Scale (mRS) score of 0-2. Secondary endpoints included clinical improvement at 72 hours (National Institute of Health Stroke Scale [NIHSS] score of ≤1 or a change from baseline [ΔNIHSS] of ≥4) and successful recanalization (modified Thrombolysis in Cerebral Infarction [mTICI] score ≥2). Safety outcomes were evaluated based on thrombus migration and intracranial hemorrhage (ICH). Results were compared using linear and logistic regression analyses adjusted for baseline variables. Results: Of 82 patients, 51 (62.2%) received BT, while 31 (37.8%) underwent d-MT. The BT group showed a significantly higher rate of functional independence (45.7% vs. 17.2%, p=0.014) and a lower 90-day mortality rate (13.7% vs. 35.5%, p=0.029). Multivariate analysis revealed that IVT was independently associated with favorable functional outcome (p=0.011) and reduced mortality (p=0.021). No significant differences were observed in terms of clinical improvement at 72 hours, successful recanalization, thrombus migration, or hemorrhagic transformation between the groups. Conclusions: This study supports current guidelines recommending BT for thrombectomy-eligible AIS-LVO patients, offering new insights into the ongoing clinical debate.

Antibiotic resistance is a global health problem. The human gut microbiome is implicated in the dynamics of antibiotic resistance acquisition and transmission, with the gut microbiota thought to play a crucial role. This study aimed to determine the potential influence of human gut bacteria microbiota on the gut resistome and the relationship between gut background microbiota and Escherichia coli resistome. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was used to systematically review studies that characterised gut microbiota and resistome using metagenomic analysis and/or those that reported gut E. coli resistome in healthy individuals. Changes in the diversity and abundance of bacterial gut microbiota and the resistome across different groups and the microbiota composition of the gut harbouring antibiotic-resistant E. coli were summarised. Findings suggest that lower bacterial microbiota diversity is likely associated with an increased abundance of the overall gut resistome. Age-related differences were observed, with younger infants exhibiting lower microbiota diversity and higher ARG abundance compared to older infants and adults. Studies that reported correlation revealed positive correlations between the compositional relative abundance of Proteobacteria and ARGs abundance, mainly driven by members within the Enterobacteriaceae family, particularly E. coli. This study also revealed that human gut microbiome studies that investigate gut resistome using metagenomic sequencing approaches in apparently healthy individuals are at least uncommon.

This study explores how the Household Dietary Diversity Score (HDDS) and spatial visualization can inform food governance in Chile, focusing on socio-demographic and geographical determinants affecting food consumption patterns. A national household database (n=4,407) provided by the “Family Support Program of Food Self-Sufficiency” (FSPFS) of the Ministry of Social Development and Family was analyzed. The findings revealed that Chilean vulnerable households were led mostly by women (86.6%), with an age average of 55.9 15.6 years old, versus 68.9 12.9 years in the case of men. The intake frequency analysis showed that dairy, fruits, and vegetables were below the recommended values in at least half of the households, and that fats and sugars were above recommended levels. Regarding the HDDS [0-189], the national average was of 91.4 ± 20.6 and was significantly influenced by the number of minors in the households, water access, food access issues, and residing in the Zona Sur. Finally, the spatial visualization showed that the Zona Central had higher consumption of fruits and vegetables, while the extreme zones Norte Grande and Zona Austral showed higher intakes of fats and sugars. These findings emphasize the importance of leveraging data insights like HDDS and spatial visualization to enhance food security and inform food governance strategies.

Cardiac autonomic neuropathy (CAN) is a severe complication of diabetes mellitus (DM) strongly linked to a nearly five-fold higher risk of cardiovascular mortality. Patients with Type 2 Diabetes Mellitus (T2DM) are a significant cohort in which these assessments have particular relevance to the increased cardiovascular risk inherent in the condition. This study aimed to explore the subtle correlation between the Ewing test, Sudoscan-cardiovascular autonomic neuropathy score, and cardiovascular risk calculated using SCORE 2 Diabetes in individuals with T2DM. The cohort consisted of 211 patients diagnosed with T2DM with overweight or obesity without established ASCVD, aged between 40 to 69 years. The prevalence of CAN in our group was 67.2%. In the study group, according SCORE2-Diabetes, four patients (1.9%) were classified with moderate cardiovascular risk, thirty-five (16.6%) with high risk, and one hundred seventy-two (81.5%) with very high cardiovascular risk. On multiple linear regression, the SCORE2-Diabetes algorithm remained significantly associated with Sudoscan CAN-score and Sudoscan Nephro-score and Ewing test score. Testing for the diagnosis of CAN in very high-risk patients should be performed because approximately 70% of them associate CAN. Increased cardiovascular risk is associated with sudomotor damage and that Sudoscan is an effective and non-invasive measure of identifying such risk.

The tailoring of the surface properties of cellulose nanocrystals (CNCs) to meet various requirements in environmental, food, and material areas has always been of great interest. In this study, the surface chemistry of CNCs was noncovalently modified by cetyltrimethylammonium bromide (CTAB), followed by characterizations and an application as a coating material for interfacial interaction investigation over various substrates. Due to the CTAB modification, the surface charge of the CNCs was neutralized, resulting in an increased size of each nanocrystal at the aqueous status and the aggregated microfibers when dried up. The CTAB modification not only decreased the crystallinity of the samples from 48.57% to 9.12% but also hydrophobized the CNCs and decreased their total surface energy. Finally, the adsorption behavior of the CNCs and CTAB-CNCs over nonionic, anionic, and cationic polymers was investigated by ellipsometry. Based on the thickness of the CNC and CTAB-CNC layers over 2-Hydroxyethyl cellulose (HEC), carboxymethyl cellulose (CMC), and polyethyleneimine (PEI), we proposed that the adsorption behavior was overall influenced by electrostatic interaction, hydrogen bonding, and van der Waals forces and the thickness of the adsorbed layers could be impacted by both the surface charge and the size of the crystals.

Background: The secretion of alarmin cytokines by epithelial cells, including thymic stromal lymphopoietin (TSLP), interleukin (IL)-25, and IL-33, heralds the onset of the inflammatory cascade and immune effector infiltration in asthma. However, alarmin cytokine expression in the upper airways in asthma remains largely unknown. Methods: We recruited 40 participants with asthma who were categorized into four severity groups as per the Global Initiative for Asthma (GINA) classifications (10 in each group of GINA-1/2, -3, -4, and -5). Cells were derived from buccal, nasal and throat brushings, and intracellular alarmin cytokine expression (TSLP, IL-25, and IL-33) was assessed in cytokeratin 8+ (Ck8+) epithelial cells immediately after collection using flow cytometry with fluorescence minus one (FMO) controls. We assessed differences in alarmin cytokine expressions across asthma severity using quantile regression adjusted for age and sex. Results: Of all patients, 24 (60%) were females with a mean (standard deviation [SD]) age of 41 (16) years. TSLP levels in Ck8+ epithelial cells in nasal samples of GINA-5 patients were significantly (p=0.03) higher than other GINA groups after adjusting for age and sex but did not differ between patients with and without nasal comorbidities. However, we did not find any significant changes in TSLP levels in Ck8+ epithelial cells in buccal and throat samples across GINA groups. IL-25 or IL-33 (obtained from nasal, buccal, and throat epithelial cell samples) were not significantly different across GINA groups. Conclusions: Our study demonstrates for the first time that Ck8+ nasal epithelial cells from GINA-5 asthmatics express elevated levels of TSLP.

Background: The Risk of Paradoxical Embolism (RoPE) score was developed to identify stroke-related patent foramen ovale (PFO) in patients with cryptogenic stroke. Methods: We conducted a retrospective analysis of the 2016 to 2020 National Inpatient Sample to determine the performance of modified RoPE score for PFO presence in patients with acute ischemic stroke (AIS). Results: A total of 3,338,805 hospital admissions for AIS were analysed and 3.0% had PFO. Patients with PFO were younger compared to those without PFO (median 63 years vs. 71 years, p&lt;0.001) and fewer were female (46.1% vs. 49.7%, p&lt;0.001). The patients with PFO had greater mean modified RoPE score (4.0 vs. 3.3, p&lt;0.001). The area under the curve for the RoPE score in predicting PFO was 0.625 (95%CI 0.620-0.629). The best diagnostic power of the RoPE score was achieved with a cut point of ≥4 where the sensitivity was 55% and the specificity was 64.2%. A cut point of ≥5 increased specificity (83.1%) at the expense of sensitivity (35.8%). The strongest predictor of PFO was deep vein thrombosis (OR 3.97, 95%CI 3.76-4.20). Conclusions: The modified RoPE score had modest predictive value in identifying patients with PFO among patients admitted with AIS.

Recent research emphasises the importance of Artificial Intelligence applications as supporting tools for students in higher education. Simultaneously, an intensive exchange of views has started in the public debate in the international educational community. However, for a more proper use of these applications, it is necessary to investigate the factors that explain their intention and actual use in the future. With the Unified Theory of Acceptance and Use of Technology (UTAUT2) model, this work analyses the factors influencing students' use and intention to use artificial intelligence technology. For this purpose, a sample of 199 Greek students at the School of Humanities and Social Sciences from the University of Patras participated in a survey. The findings highlight that expected performance, habit, and enjoyment of these Artificial Intelligence applications are key determinants influencing teachers' intentions to use them. Moreover, behavioural intention, habit, and facilitating conditions explain the usage of these Artificial Intelligence applications. The study did not reveal any moderating effects. The limitations, practical implications, and proposed directions for future research based on these results are discussed.

Health care in Canada is managed by provinces/territories. We investigated regional differences in survival among Canadians diagnosed with central nervous system (CNS) tumours. We identified 50,670 patients diagnosed with a first-ever primary CNS tumour between 2008 and 2017 with follow-up until December 31, 2017. We selected the four highest incidence histologies and used proportional hazards regression to estimate hazard ratios (HRs) for five regions (British Columbia, Prairie provinces, Ontario, Atlantic provinces and the Territories), adjusting for sex, tumour behaviour and patient age. Ontario had the best survival profile for all histologies investigated. The Atlantic provinces had the highest HR for glioblastoma (HR=1.26, 95% CI:1.18-1.35) and malignant glioma not otherwise specified (NOS) (Overall: HR=1.87, 95% CI:1.43-2.43; Pediatric population: HR=2.86, 95% CI:1.28-6.39). For meningioma, the Territories had the highest HR (HR=2.44, 95% CI:1.09-5.45) followed by the Prairie provinces (HR=1.52, 95% CI:1.38-1.67). For malignant unclassified tumours, the highest HRs were in British Columbia (HR=1.45, 95% CI:1.22-1.71) and the Atlantic provinces (HR=1.40, 95% CI:1.13-1.74). There are regional differences in the survival of CNS patients at the population level for all four specific histological types of CNS tumours investigated. Factors contributing to these observed regional survival differences are unknown and warrant further investigation.

Pulmonary artery stenosis represents a group of disorders involving main, branch or peripheral pulmonary arteries resulting either in pain, dyspnea, hemoptysis or even no symptoms. Early diagnosis and timely intervention are crucial for reducing mortality, while timely diagnosis is challenging due to the nonspecific symptoms. Computed tomography pulmonary angiography (CTPA) is useful in the diagnosis because it can provide more details about the abnormal changes in the lumen, vessel wall and adjacent mediastinal structures. Congenital and acquired pulmonary artery anomalies have some characteristics on CTPA, which can be useful for differential diagnosis. Awareness of these conditions and is important for the radiologists. This pictorial review provides an overview of CTPA imaging features of pulmonary artery stenosis.

Background and Aims: Stroke is a leading cause of seizures and epilepsy in adults, but current guidelines lack strong recommendations for treating post-stroke seizures (PSE). This study aims to demonstrate the safety and efficacy of lacosamide combined with non-vitamin K antagonist oral anticoagulants (NOACs) in patients with PSE and atrial fibrillation (AF). Methods: In this prospective longitudinal study, 53 patients with PSE and AF, admitted from 2022 to 2023, received NOACs for AF management and lacosamide for seizure control. A control group of 53 patients with cardioembolic stroke, receiving NOACs, was matched by age, sex, and NIHSS scores to ensure comparability. Results: Over 24 months, 16 patients in the study group and 15 in the control group experienced new embolic events, with no significant difference between groups. Seizure control improved significantly in the study group, with reduced frequency and severity. No severe adverse effects from lacosamide were observed. Conclusions: The combination of NOACs and lacosamide is a safe and effective treatment for patients with AF and PSE, not increasing the risk of recurrent ischemic or hemorrhagic events. Further studies with larger sample sizes and longer follow-ups are needed to confirm these findings and optimize treatment protocols.

Employing phonemic awareness in language development can lead to transformative educational outcomes. Having mastered this skill, students have a good foundation in language comprehension, writing, and reading, which increases their chances of academic achievement. This change can affect entire classrooms and schools, fostering a culture of literacy and academic performance, rather than just a select few students. The aim of the study is to gather literature that offers substantial information about this topic based on the facts presented. The overwhelming body of research points to the benefits of teaching phonemic awareness in early childhood education. The foundation of transformative education is phonemic awareness, which fosters fundamental language and reading skills. This profound effect emphasizes how crucial phonemic awareness is to the teaching process. Educators can use phonemic awareness to boost students' language development and create a transformative learning environment by putting these guidelines into practice.

The cortical motor system can be reorganized following a stroke, with an increasing recruitment of the contralesional hemisphere. However, it is unknown whether a similar hemispheric shift occurs in the somatosensory system to adapt to this motor change, and whether this is related to movement impairments.  This proof-of-concept study assessed somatosensory evoked potentials (SEPs), P50 and N100, in hemiparetic stroke participants and age-matched controls using high-density electroencephalograph (EEG) recordings during tactile finger stimulation. The laterality index was calculated to determine hemispheric dominance of the SEP and re-confirmed with source localization.  The study found that latencies of P50 and N100 were significantly delayed in stroke brains when stimulating the paretic hand. The amplitude of P50 was negatively correlated with Fügl-Meyer Upper Extremity Motor Score in stroke. Bilateral cortical responses were detected in stroke, while only contralateral cortical responses were shown in controls, resulting in a significant difference in the laterality index.  These results suggested that somatosensory reorganization after stroke involves increased recruitment of ipsilateral cortical regions. This reorganization delays the latency of somatosensory processing after a stroke.  This research provided new insights related to the somatosensory reorganization after stroke, which could enrich future hypothesis-driven therapeutic rehabilitation strategies from a sensory or sensory-motor perspective.

The ability to decode words accurately at an early age strongly predicts reading competence later on. Decoding-challenged children may find it difficult to understand texts, which might impede their overall academic development. Strong word decoding skills accelerate the process of learning vocabulary and grammar rules in a variety of languages. The paper aimed to collect relevant literature regarding word decoding ability in the world of the language acquisition process. Policymakers and educators will be greatly impacted by realizing how crucial word decoding is to language learning. Providing targeted interventions for struggling readers, encouraging a positive reading culture, and explicitly teaching phonological and orthographic abilities are all essential components of effective reading education. Promoting decoding proficiency also requires making sure that people have access to excellent reading materials and tools. In order to enable learners to become great readers and communicators across linguistic and cultural boundaries, educators and policymakers should prioritize phonemic awareness from an early age and use effective teaching methodologies.

Systemic AL amyloidosis is a challenging disease for which many patients are considered frail in daily clinical practice. However, no study has so far addressed frailty and its impact on the outcome of these patients. We built a simple score to predict mortality based on three frailty-associated variables: age, ECOG performance status (&lt;2 vs. 2) and NT-proBNP (&lt;8500 vs. 8500 ng/L). Four-hundred and sixteen consecutive newly diagnosed patients diagnosed at ten sites from the Spanish Myeloma Group were eligible for the study. The score was developed in a derivation cohort from a referral center, and it was externally validated in a multicenter cohort. On multivariate analysis the three variables were independent predictors of survival. The score was able to discriminate four groups of patients in terms of overall survival and early mortality in both cohorts. Comorbidity was also analyzed with the Charlson comorbidity index, but it did not reach statistical significance in the model. A nomogram was created to easily estimate the mortality risk of each patient at each time point. This score is a simple, robust, and efficient approach to dynamically assess frailty-dependent mortality both at diagnosis and throughout the follow-up. The optimal treatment for frail AL amyloidosis patients remains to be determined but we suggest that the estimation of frailty-associated risk could complement current staging systems, adding value in clinical decision-making in this complex scenario.

Keywords: spinal muscular atrophy (SMA); survival of motor neuron 1 (SMN1); SMN2; SMN protein; antisense oligonucleotide (ASO); nusinersen; gene therapy; onasemnogene; risdiplam; small molecule, combination therapy

Background: Individuals living in rural areas often face challenges in accessing healthcare, increasing their risk of poor health outcomes. Farmers, a sub-population in rural areas, are particularly vulnerable to mental health issues and suicide, yet exhibit low rates of help-seeking behavior. The aim of our study was to develop an in-depth understanding of the issues influencing mental help-seeking among farmers living in rural areas from the perspectives of healthcare providers, as well as to explore the strategies providers use to navigate through these issues to effectively engage with this vulnerable population. Methods: We used a descriptive phenomenological approach to understand healthcare providers’ perspectives, experiences, and approaches to providing mental healthcare to farmer clients in rural areas. Semi-structured interviews were conducted with 21 participants between March and May 2023. Results: Our analysis yielded five thematic areas: (1) ensuring accessibility, (2) establishing relatability, (3) addressing stoicism and stigma, (4) navigating dual roles, and (5) understanding community trauma. Conclusions: Healthcare service delivery for farmers is multifaceted. This study fills a gap in knowledge by translating these the data to inform an evidence-based model and a list of recommendations for implementing agriculturally-informed practices in rural areas.

Herein, we examined the effects of weather parameters and individual clinicodemographic risk factors on hemorrhagic stroke (HS) incidence, severity on admission, and disability at discharge in a harsh desert climate. In a retrospective design we studied patients admitted to a stroke unit in Arab Emirates in 2016-2019. With a distributed lag nonlinear model we explored immediate and delayed effects of weather on stroke incidence. Supervised machine learning was used to build models predictive of scores in NIHSS and mRS scales. We assessed model performance by calculating ROC AUC, F1 scores, specificity, and sensitivity. HS risk increased after a significant change in any weather parameter. The risk was reduced below baseline after 1-week adjustment to environmental changes. Climate input from the previous 3 days yielded reliable classification models. Humidex was a better predictor of severity than air temperature, whereas body mass index, age, and time of day at stroke onset were the strongest clinical predictors. Weather parameters before admission were stronger predictors of disease severity than individual clinical factors. We addressed limitations of previous studies by analyzing a full set of climate parameters: ambient temperature, relative humidity, humidex, atmospheric pressure, and wind speed. Predictive models may help to optimize patient management and develop preventative strategies.

Subcortical beetles interact with a wide range of semiochemicals released from different sources, including trees, fungi, and insect pheromones. While the attraction of bark beetles, their insect predators, and competitors to bark beetle pheromones is well-studied, the attraction of these beetle communities to other sources of semiochemicals remains poorly understood. We tested the attraction of bark and wood-boring beetles and their predators to host stress volatiles, fungal volatiles, and a mountain pine beetle lure in the field. Host stress volatiles were derived from lodgepole pine trees stressed by three fungal symbionts of mountain pine beetle and two common phytopathogens. Our results showed that bark beetles, particularly mountain pine beetles, show a preference for a combination of fungal volatiles, particularly 2-methyl-1-butanol and mountain pine beetle lures. Without the addition of lures, 2-methyl-1-butanol was also identified as a key fungal volatile in the attraction of mountain pine beetle competitors from the Cerambycidae and Buprestidae families. Predators in the Elateridae and Staphylinidae families showed attraction to host stress volatiles and the healthy tree volatile profile. These findings suggest that these chemicals warrant further field testing for potential use in monitoring and management of subcortical beetle populations.

This study investigated how different gamification elements in mobile apps influence users' basic psychological needs (autonomy, competence, relatedness) and subsequent engagement outcomes. Survey data was analyzed using PLS-SEM. Social gamification elements enhanced autonomy and competence needs, while immersive elements boosted autonomy and relatedness. Achievement/progression components increased competence and relatedness perceptions. Interestingly, personal traits did not significantly impact psychological needs. Crucially, satisfying autonomy and relatedness predicted higher user satisfaction and continued usage intentions, highlighting their importance for sustained engagement. Competence influenced satisfaction but not continuance intention. The findings demonstrate the motivational roles of distinct gamification features in fostering need-supportive experiences. Designers should incorporate varied social, immersive, and achievement components to address users' psychological requirements holistically. Prioritizing autonomy and relatedness support appears vital for achieving enjoyable, self-motivated, and persistent user engagement across gamified systems and domains. The study provides actionable insights for optimizing motivational affordances through psychologically-informed gamification implementations.

Mitochondrial DNA copy number (mtDNAcn) is associated with mitochondrial function contributing various diseases. Understanding of the association between mtDNAcn and infant neurodevelopment, as well as the role of racial disparities, remains unknown. A cohort study was conducted with 55 preterm infants and a single blood sample was collected from each infant during their NICU stay to measure mtDNAcn. NICU Network Neurobehavioral Scale (NNNS) and Bayley Scale of Infant Developmental testing Edition III was assessed during NICU until 2 years of corrected age (CA). Linear regression models were performed to investigate the relationship between the clinical characteristics, neurobehavioral outcomes and mtDNAcn. Majority of our subjects were male, White, non-Hispanic, had C-section, and without preterm premature rupture of membrane (PPROM). Increased mtDNAcn was found associated with younger birth gestational age (GA), nonoptimal neurodevelopment. However, the opposite associations between mtDNAcn and neurodevelopmental outcomes were observed between Black and White infants up to 1 year of CA. Adverse early life experience, together with increased mtDNAcn in White infants, and decreased mtDNAcn in Black infants may be considered as significant positive predictors of poor early life neurodevelopmental outcomes in infants.

The Atlantic Canada Together Enhancing Acute Stroke Treatment (ACTEAST) project is a Modified Quality Improvement Collaborative (mQIC) designed to improve ischemic stroke treatment rates and time-based efficiency in Atlantic Canada. This study specifically evaluates the implementation of the mQIC in Nova Scotia using qualitative methods. The mQIC spanned six months and included two Learning Sessions, multiple webinars, and a per-site virtual visit. Each session was followed by an action planning period to guide implementation efforts over the following 2-4 months. The Consolidated Framework for Implementation Research (CFIR) was utilized to develop a pre-tested, semi-structured interview guide, which aimed to uncover barriers and facilitators to mQIC implementation. Interviews were conducted with 14 healthcare professionals, generating 454 references that were coded into 28 CFIR constructs. Notably, 84% of these references were positively framed as facilitators. Despite this, significant barriers were identified, including resource availability, competing priorities, communication challenges, and difficulties engaging key stakeholders. Some barriers were particularly prominent during specific phases of implementation. The study findings offer valuable insights into the implementation of quality improvement initiatives in stroke care. They underscore the importance of recognizing and addressing context-specific barriers, while also leveraging identified facilitators to drive successful implementation and ultimately improve patient outcomes.

The Gulf of Mannar, a UNESCO World Biosphere Reserve, faces severe overfishing and habitat degradation threats. In this study, we investigate the pivotal role of ecosystem services in sustaining local livelihoods and overall well-being. By conducting a comprehensive survey of 480 respondents across two districts, we gathered extensive data on demographics, livelihoods, fishing practices, reliance on ecosystem services, and community management participation. The analysis reveals a critical dependence on the Gulf's resources (income, food security, traditions) with gender disparities (men fish, women in pre/post-harvest), but fishing is only allowed in the 10km buffer zone (not the core zone). The findings emphasize the promise of community-based strategies, such as Marine Protected Areas and reviving co-management committees, for achieving sustainable fisheries management. However, we also identify gaps, including the need for more nuanced well-being indicators and improved models for community management participation. To address these challenges, we advocate for sustainable fishing practices, tackling social inequities, especially gender disparities in resource access and decision-making, and investing in healthcare, education, and social safety nets for fishing communities. Promoting alternative livelihoods can alleviate pressure on fish stocks, and empowering local communities through capacity building and community-based management initiatives is crucial for ensuring the long-term sustainability of both the Gulf of Mannar ecosystem and the well-being of its dependent communities. This multifaceted approach holds significant promise for balancing ecological health with human prosperity.

In Africa, the urban population and informal settlements are increasing, resulting in additional public health and environmental risks and challenges related to the need of basic and sustainable infrastructures and services. In Maputo, the capital of Mozambique, at least 80% of the city is composed of informal settlements, and although some areas are regularized and have approved urbanization plans, the municipality has major deficiencies in meeting current demands in terms of basic infrastructures, such as water supply, sewerage, solid wastes, energy, roads and communications. Most of the peri-urban areas is occupied with small but overcrowding houses, mostly self-built, served by unpaved roads, and with access limitations. The water network is almost non-existent, and the same occurs for stormwater drainage, sanitation, waste collection and public illumination. Despite the improvements made in the last few years, some households still do not have safe sanitation, and in some neighborhoods, open defecation still prevails. In this study, the authors try to understand and explore the interdependences among the infrastructures of the different sectors and how they may jointly contribute for adequate services and a better life of the urban poor, and how to identify the combination of infrastructures to be implemented at short term in face of the limited budgets for investments.

3D-printed models with high anatomic fidelity are an increasingly viable tool in simulation-based medical education. One advantage of 3D models is they provide enhanced tactile and spatial understanding of complex anatomy to develop technical skills used in minimally invasive procedures. We propose that 3D anatomical models can improve the development of Interventional Radiology vascular access skills – first described in the 1950s as the Seldinger Technique – for pre-clerkship medical students. Early adoption of 3D-printed technology in pre-clinical medical education can lead to improved student engagement and satisfaction when learning procedural techniques. This study involved creating a 3D model of the upper extremity vasculature from an anonymized CT angiogram, using it as a medical education tool for 31 pre-clinical medical students practicing the Seldinger Technique on a prefabricated venipuncture arm, and assessing student satisfaction with this form of learning. Overall, attendees responded positively to the incorporation of the 3D model in medical education to improve their anatomic understanding and application to the Seldinger Technique. These results indicate that the use of 3D models in simulation-based medical education can provide benefits to acquiring technical skills and the potential to decrease training costs without harming a patient.

Gender-based violence (GBV) is an age-long issue plaguing societies all over the globe. Over the years, GBV perpetrated against women has been justified and legitimized by patriarchal and hegemonic masculine structures. This study explored the role of hegemonic masculinities and transnational cultural conflicts in creating a suitable environment for GBV against women to thrive amongst African immigrants in Canada, gathering perspectives of African immigrants and of the service providers working in immigrant-serving organizations. The paper adopts a qualita-tive approach and is hinged on the transnationalism framework. This framework argues that im-migrants maintain connections while transitioning to their countries of destinations. In such pro-cesses, immigrants carry with them their beliefs about cultural norms and hegemonic masculinity, of their country of origin. A total of 13 women immigrants and 20 service providers were pur-posively recruited to participate in the semi-structured interview. The interviews were recorded and transcribed verbatim. The data were analysed thematically and organized using the Nvivo version 12. Findings show that African immigrant women in Canada continue to disproportion-ately bear the burden of GBV due hegemonic masculinities. The construction of masculinity in immigrant population is heavily reliant on the communities of origin. As such, the prevailing sys-tems during and post migration such as – unstable residency status, fear of deportation, fear of social and family sanctions and stigmatization, economic dependence on their spouses, and fear of retaliation from their spouses creates an environment that supports toxic masculinity. The study recommends a comprehensive and culturally sensitive programs and services to support African immigrants affected by hegemonic masculinity and GBV.

Abstract: Giant Cell Arteritis (GCA) is an autoimmune/autoinflammatory disease affecting large vessels in patients over 50 years old. The disease presents as an acute inflammatory response with two phenotypes, cranial-GCA and Large Vessel Vasculitis (LV)-GCA, involving the thoracic aor-ta and its branches. 18F-fluorodeoxyglucose positron emission tomography-computed tomogra-phy (18F-FDG PET-CT) is among the imaging techniques contributing to diagnosis of patients with systemic disease. However, its association with soluble inflammatory markers is still elu-sive. This proof-of-concept study aims to identify novel soluble serum biomarkers in PET/CT pos-itive patients with LV-GCA and associate them with active (0 months) and inactive disease (6 months following treatment), in sequential samples. The Most-Disease-Segment Target-to-Background Ratio (TBRMDS) was calculated for 9 LV-GCA patients, while 12 cranial-GCA and 7 Polymyalgia Rheumatica patients with negative initial PET/CT served as disease controls. Serum macrophage-related cytokines were evaluated by Cytometric Bead Array (CBA). Finally, previously published NMR-metabolomics data acquired at the same blood sampling were associated with PET/CT findings. TBRMDS was significantly increased in active versus inactive disease (3.45 vs. 2.55, p=0.008). The analysis identified 6 serum metabolites, as more sensitive to change from the active to inactive state. Among them, choline levels were exclusively altered in the LV-GCA group, but not the disease controls. Cytokine levels were not associated with PET/CT activity. Combining with CRP, ESR, and TBRMDS a composite index was generated to depict well the differences between active and inactive systemic LV-GCA (25.45 vs 11.45, p=0.0039). These preliminary results could pave the way for more extensive studies integrating serum metabolomic parameters with PET/CT imaging data to extract sensitive composite disease indexes useful for the everyday clinical practice.

The recent mountain pine beetle outbreaks have caused widespread mortality among lodgepole pine trees in western North America, resulting in a reduced population of surviving trees. While previous studies have focused on the cascading impacts of these outbreaks on the physiology and growth of the surviving trees, there remains a need for a comprehensive study into the interactions among various physiological traits and the growth in post-outbreak stands. Specifically, the relationship between chemical (primarily terpenes) and anatomical (mainly resin ducts) defences, as well as the allocation of non-structural carbohydrates (NSCs) to support these defence modalities, is poorly understood. To address these gaps, we conducted a field survey of surviving lodgepole pine trees in post-mountain pine beetle outbreak stands in western Canada. Our retrospective analysis targeted to determine correlations between the post-outbreak concentrations of monoterpenes, diterpenes, and NSCs in the phloem, and the historical resin duct characteristics and growth traits before and after the outbreak. We detected strong correlations between post-outbreak concentrations of monoterpenes and historical resin duct characteristics, suggesting a possible link between these two defence modalities. Additionally, we found a positive relationship between NSCs and the total concentrations of monoterpenes and diterpenes, suggesting that NSCs likely influence the production of these terpenes in lodgepole pine. Furthermore, historical tree growth patterns showed strong positive correlations with many individual monoterpenes and diterpenes. Interestingly, while surviving trees had enhanced anatomical defences after the outbreak, their growth patterns did not vary before and after the outbreak conditions. The complexity of these relationships emphasizes the dynamics of post-outbreak stand dynamics and resource allocation in lodgepole pine forests, highlighting the need for further research. These findings contribute to a broader understanding of conifer defenses and their coordinated responses to forest insect outbreaks, with implications for forest management and conservation strategies.

The cognitive and affective impacts of video games are subjects of ongoing debate, with recent research recognizing their potential benefits. This study employs the Gaming Skill Questionnaire (GSQ) to evaluate participants' gaming skills across six genres and overall proficiency. Eighty-eight individuals aged 20-40 participated, completed assessments of empathy and six cognitive abilities: verbal short-term memory, verbal working memory, visuospatial short-term memory, visuospatial working memory, psychomotor speed (hand-eye coordination), and attention. Cognitive abilities were examined using the Digit Span Test, Corsi Block Test, and Deary-Liewald Reaction Time Task, while empathy was assessed using the Empathy Quotient Questionnaire. Findings indicate that high video game skill levels correlate with improvements in visuospatial short-term and working memory, psychomotor speed, and attention. Different genres enhanced specific skills: RPGs positively influenced verbal working and visuospatial short-term memory but negatively affected empathy; action games improved psychomotor speed and attention; and puzzle games benefited visuospatial working memory. These promising results contribute positively to ongoing research on the cognitive and affective effects of video games, highlighting the potential for video games to enhance certain cognitive functions while also underscoring the complexity of their impact on empathy. Future research should further investigate genre-specific effects and long-term outcomes.

Abstract: Objective: The aim of the study was to identify dietary patterns and its association with socio-economic, dietary and lifestyle practices among adolescents in Malaysia. Methods: A validated food frequency questionnaire was used to assess dietary patterns. Results: Multivariate analyses show that age and physical activity (PA) levels were emerged as positive determinants of healthy-based food pattern in Malay (All, p<0.001), whereas higher consumption of eating-out from home (EatOut) and fast food (All, p<0.05) were negative determinants. High weekly breakfast skipping (p<0.001) and EatOut (p<0.01) were positively associated with a western-based pattern, whereas age (p<0.001) and household income (p<0.05) were negative determinants. Higher frequency of daily snacking (p<0.05) was emerged as positive determinant of local-based food pattern. For Chinese adolescents, age (p<0.001), PA levels (p<0.001) and maternal education level (p<0.05) emerged as positive determinants for the healthy-based pattern, whereas high EatOut and fast food intakes (All, p<0.01) were negative determinants. Higher weekly consumption of EatOut (p<0.01), fast food (p<0.05) and carbonated beverages (p<0.05), and daily snacking practice (p<0.01) were positively associated with higher western-based food pattern, whereas age (p<0.01) was inversely associated. Conclusion: These findings suggest that unhealthy dietary and lifestyle practices could increase the risk of adherence to unhealthy western-based food pattern that is high in fat, sugar and salt contents, and consequently increase the risk of developing obesity and metabolic-related disorders during these critical years of growth.

Advances in gastric cancer screening and endoscopic technology have made it possible to detect and treat gastric cancer at an early stage. As a result, about 40% of all gastric cancers have now been resected by endoscopic treatment in Japan. In endoscopic diagnosis, magnifying endoscopic observation using band-limited light such as narrow band imaging (NBI) has significantly improved the accuracy of gastric cancer diagnosis. At the same time, in endoscopic treatment, endoscopic submucosal dissection (ESD) has contributed to increase explosively the number of gastric cancers which could be resected endoscopically. In recent years, the construction of algorism for endoscopic diagnosis and treatment with a view to personalized medicine has been explored, and endoscopic use for gastric cancer managements is expected to develop further in the future. Keywords (5 words):

As Alberta increases solar power generation, land use conflicts with agriculture increase. A solution that enables low-carbon electricity generation and continued (in some cases increased) agricultural output is the co-locating of solar photovoltaics and agriculture: agrivoltaics. This study reviews policies that impact the growth of agri-voltaics in Alberta. Solar PV-based electricity generation is governed by three regula-tions based on system capacity. In addition, agrivoltaics falls under various legisla-tions, frameworks, and guidelines for land utilization. These include Land Use Frame-work, Alberta Land Stewardship Act, Municipal Government Act, Special Areas Dis-position, Bill 22 and other laws/policies all of which are reviewed in the context of agrivoltaics. Several policies are recommended to support rapid diffusion of agrivolta-ics. First, open access research into agrivoltaics, which not only will help optimize agrivoltaic systems for the region, but also coupled with public education is expected to galvanize social acceptability of large-scale PV deployment. Clearly defining and categorizing agrivoltaic technology, developing agrivoltaic standards, making agri-voltaic technology-friendly regulations/frameworks and developing programs and pol-icies to incentivize agrivoltaic deployment over conventional PV will all accelerate dif-fusion. Through these measures, Alberta can achieve conservation and sustainability in food and energy sector while simultaneously addressing the renewable energy and climate-related goals.

The growing global population and limitations in fish catch production have led to a surge in the demand for aquaculture. Contaminants of emerging concern (CEC) are frequently being detected at low levels in surface water. These CECs, which include previously unidentified or unregulated pollutants, pose potential risks to health and the environment, though their impacts are not yet fully understood. Extensive research studies have been proposed and undertaken to address the issue of aquaculture wastewater, aiming to minimize its impact and implement effective treatment methods. This review provides an analysis of various technologies used for treating aquaculture wastewater using advanced oxidation processes (AOPs) focusing on photocatalysis and ozonation. It examines their advantages and disadvantages, as well as their respective treatment efficacies and discusses their potential applications in sustainable aquaculture practices complying with the Sustainable Development Goals of 1,2 and 6 and the Environmental Social and Governance (ESG) framework.

The steep decline in the price of wind and solar photovoltaics provides a possibility to decarbonize electricity deeply and affordably. This study uses HOMER Pro energy modeling tool to model an optimized grid-connected renewable energy system for a community in southern Alberta, Canada. The study's goal is to identify the best renewable energy technology combinations that can provide electricity at the lowest levelized cost of energy (LCOE) and has lesser greenhouse gas emission as compared to the electricity produced by traditional fossil fuel. Gleichen, is a small town in southern Alberta and is near to numerous commercial wind and solar projects given the region’s high quality renewable resources. “Tri-brid” systems consisting of wind turbines, solar photovoltaics, and battery energy storage systems (BESS) are considered and compared based on electricity prices, net present cost, and greenhouse gas emissions savings. This tri-brid system is connected to the grid to sell excess electricity generated or buying electricity when there is less or no availability of solar and wind. The tri-brid energy system has an estimated LCOE of 0.0705 CAD/kWh which is competitive with the price of electricity generated by natural gas and coal which is 0.127 CAD/kWh.

Motivation is essential in education, with highly motivated learners engaging more deeply with content and more ably transferring knowledge to new contexts. However, the validity of scales to measure motivation has been underexplored in pre-clerkship medical education. This study evaluates the validity of the Situational Motivation Scale (SIMS) for measuring motivation among pre-clerkship medical students in post-situational and short-term contexts. Using a sample of n = 156 students from the Frank H. Netter MD School of Medicine at Quinnipiac University, SIMS was tested for construct validity with attention paid to content, response process, internal structure, relationships to other variables, and consequences of use evidence. Small modifications from present to past tense in English were made for clarity following focus group feedback, and content validity was ensured via expert consultation. SIMS demonstrated strong internal consistency with a satisfactory Cronbach’s alpha for all subscales and anticipated patterns of correlations. Factor analysis confirmed appropriate factor loadings, with a stronger model fit for the short-term context, and no observed adverse effects on student engagement. These findings support the robustness of SIMS in capturing intrinsic, extrinsic, and amotivation in pre-clerkship medical students, highlighting its applicability for short-term and situational motivational assessment.

The development of multiple drug resistant (MDR) cancer all too often signals the need for alternative toxic therapy or palliative care. Our recent in vivo and in vitro studies using canine MDR lymphoma cancer cells demonstrated that the Anaphase Promoting Complex (APC) is impaired in MDR cells compared to normal canine control and drug sensitive cancer cells. Here, we sought to establish whether this phenomena is a generalizable mechanism independent of species, malignancy type or chemotherapy regime. To test the association of blunted APC activity with MDR cancer behavior, we used matched parental and MDR MCF7 human breast cancer cells, and a patient derived xenograft (PDX) model of human breast cancer. We show that APC activating mechanisms, such as APC subunit 1 (APC1) phosphorylation and CDC27/CDC20 protein associations, are reduced in MCF7 MDR cells when compared to chemosensitive matched cell lines. Consistent with impaired APC function in MDR cells, APC substrate proteins failed to be effectively degraded. Similar to our previous observations in canine MDR lymphoma cells, chemical activation of the APC using Mad2 Inhibitor-1 (M2I-1) in MCF7 MDR cells enhanced APC substrate degradation and resensitized MDR cells in vitro to the cytotoxic effects of the alkylating chemotherapeutic agent, Doxorubicin (DOX). Using cell cycle arrest/release experiments we show that chemo-sensitive and -resistant MCF7 cells progress through the cell cycle at similar rates, but mitosis is delayed in MDR cells with elevated substrate levels. When treated with M2I-1, MDR cells progress through mitosis at a faster rate that coincides with reduced levels of APC substrates. In our PDX model, mice growing a clinically-MDR human breast cancer tumor show significantly reduced tumor growth when treated with M2I-1, with evidence of increased DNA damage and apoptosis. Thus, our results strongly support the hypothesis that APC impairment is a driver of aggressive tumor development and that targeting the APC for activation has the potential for meaningful clinical benefits in treating recurrent cases of MDR malignancy.

Acute respiratory distress syndrome (ARDS) is caused by infectious insults, such as pneumonia from various pathogens or related to other noninfectious events. Clinical and histopathologic characteristics are similar across severely affected patients, suggesting that a common mode of immune reaction may be involved in the immunopathogenesis of ARDS. There may be etiologic substances that have an affinity for respiratory cells and induce lung cell injury in cases of ARDS. These substances originate not only from pathogens, but also from injured host cells. At the molecular level, these substances have various sizes and biochemical characteristics, classifying them as protein substances and non-protein substances. Immune cells and immune proteins may recognize and act on these substances, including pathogenic proteins and peptides, depending upon the size and biochemical properties of the substances (this theory is known as the protein-homeostasis-system hypothesis). The severity or chronicity of ARDS depends on the amount of etiologic substances with corresponding immune reactions, the duration of the appearance of specific immune cells, or the repertoire of specific immune cells that control the substances. Therefore, treatment with early systemic immune modulators (corticosteroids and/or intravenous immunoglobulin) as soon as possible may reduce aberrant immune responses in the potential stage of ARDS.

This is growing recognition of early onset gastrointestinal (GI) malignancies in young adults

Anastomotic Leakage (AL) remains the main cause of post-esophagectomy morbidity and mortality. Early detection can avoid sepsis and reduce morbidity and mortality. This study evaluates the diagnostic accuracy of the NUn-score and its components as early detectors of AL. This single centre observational cohort study included all esophagectomies from 2010-2020. C-reactive Protein (CRP), Albumin (Alb) and White cell count (WCC) were analyzed and Nun-scores calculated. Area under the curves (AUC) were used to assess their predictive accuracy. Seventy-four of the 668 patients (11%) developed an AL. CRP and the NUn-score proved to be good diagnostic accuracy tests on POD2 (CRP AUC:0,859; Nun-score AUC:0,869) and POD4 (CRP AUC:0,924; Nun-score AUC:0,948). A 182mg/L CRP cut-off on POD4 yielded a 87% sensitivity, 88% specificity, a negative predictive value (NPV) of 98% and a positive predictive value (PPV) of 47,7%. A Nun score cut-off&gt;10 resulted in 92% sensitivity, 95% specificity, 99% NPV and 68% PPV. Albumin and WCC have limited value in the detection of post-esophagectomy AL. Elevated CRP and a high NUn score on POD4 provide a high accuracy to predict AL after esophageal cancer surgery. Their high negative predictive value allows to select patients who can safely proceed with enhanced recovery protocols.

Accurate forecasting and efficient management of commodities are crucial for stakeholders in the industry, given the volatile nature of these markets. This study addresses these needs by leveraging advanced forecasting techniques and machine learning models to predict prices and enhance supply chain efficiency. TThe focus is on utilizing ARIMA, SARIMAX, and LSTM models to analyze historical trading data for commodities such as cocoa, coffee, and sugar sourced from Kaggle’s comprehensive dataset. The research applies ARIMA and SARIMAX models to forecast price trends, overcoming initial challenges related to data index frequency and seasonality. LSTM models are employed for more nuanced demand forecasting, particularly for random-length lumber, demonstrating the model's capability to predict future market trends accurately. The study highlights significant improvements in prediction accuracy and supply chain management through meticulous feature engineering and model optimization, offering valuable insights for strategic decision-making in the supply chain sector.

Aging causes various degenerative diseases in the older adult population. Senescence, a state of permanent cell-cycle arrest accompanied by the production of various pro-inflammatory factors known as senescence-associated secretory phenotype (SASP), is considered a significant contributor to the aging process and its chronic diseases. Ample evidence showed that various stressors could induce senescence, including DNA damage, telomere shortening and damage, activation of oncogenes, and mitochondrial dysfunction. Numerous credible findings indicate that environmental agents can induce senescence, including UV radiation, a high-fat diet, heavy metal exposure, and cigarette smoke. These findings posed the possibility that many more environmental agents may induce senescence and accelerate aging but remain unidentified. Senescence also becomes more intriguing due to its promising future as a pharmacological target to blunt the detrimental effects of aging and prevent aging-related diseases, either by eliminating the senescent cells or by controlling the SASP. On the other hand, investigating senescence has become more intricate due to the need for a multi-marker approach and translation in vivo analysis. This review will discuss senescence and its biomarkers, how to identify gerontogens in vivo, and also the development of senotherapy that targets senescent cells.

Adults’ with Intellectual Disabilities (ID) experiences on occupational participation were explored through the prism of Occupational Justice model (MOJ) aiming to shape and develop an occupation-centered model of Quality of Life (QoL). In this qualitative study participated thirteen adults with ID (N=13). A semi-structured interview based on MOJ was constructed and administered to explore perspectives on QoL, as well as injustices regarding occupational participation. The interviews were processed with QSR NVivo8 following content analysis research methodology. An Occupational – Quality of Life (O-QoL) model with an everyday occupations core component has been formed. This model includes three core O-QoL domains: (i) social well-being, (ii) emotional – physical well-being and (iii) material adequacy. Main indicators of O-QoL were the recreational occupations and social activities, while socio-environmental factors such as occupational deprivation have been identified as aggravating. In addition, specific occupations such as leisure activities, physical exercise / sports, art, video games and vocational training could also be beneficial for O-QoL. Moreover, the importance of promoting and supporting the rights of people with ID for employment, independent living and sexual expression was highlighted. The O-QoL could be a valuable conceptual framework in the field of ID, however further research for developing specialized assessment tools and Occupational Therapy interventions to promote O-QoL is needed.

Background: Pancreatic invasive ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer mortality in Japan. The early diagnosis of pancreatic cancer, which will increase the number of patients with resectable tumors, is urgently needed. The purpose of the present study was to examine the earliest signs of pancreatic abnormalities on CT in order to facilitate the diagnosis and treatment of PDAC. Methods: Forty-one patients with pancreatic cancer and their 154 CTs were selected for the present study. We used the images that were acquired prior to the diagnosis and examined the pancreas in these images to observe serial changes in the morphology of the pancreas after selecting CT images in which PDAC was suspected. We also confirmed whether the main pancreatic duct was observed around that area of the pancreas. Four thousand two hundred seventy-seven patients without pancreato-biliary disease with 4630 CTs were selected for the control group. Results: Two pancreas shapes were detected: localized constriction of the pancreatic parenchyma referred to as the K-shaped sign, and localized fatty changes. Twenty-four (58.5%) of 41 patients showed the K-shaped sign. The main pancreatic duct without dilatation was noted around the K-shaped sign in 9 of the 24 patients. Eight of 41 patients (19.5%) showed localized fatty changes. Nine of 41 patients (21.9%) showed no abnormality. In the control group, only seven of 4277 patients (0.16%) showed the K-shaped sign. Conclusions: The K-shaped sign including localized fatty changes is the earliest CT sign that presents with pancreatic abnormalities. The K-shaped sign does not indicate PDAC itself but may predict its future development.

It has been proven that in standard Einstein gravity, exotic matter (i.e. matter violating the point-wise and averaged weak and null energy conditions) is required to stabilize traversable wormholes. Quantum field theory permits these violations due to the quantum coherent effects found in any quantum field . Even reasonable classical scalar fields violate the energy conditions. In the case of the Casimir effect and squeezed vacuum states, these violations have been experimentally proven. It is advantageous to investigate methods of minimizing the use of exotic matter. One such area of interest is extended theories of Einstein gravity. It has been claimed that in some extended theories, stable traversable wormholes solutions can be found without the use of exotic matter. There are many extended theories of gravity and in this review paper we first explore f(R) theories and then explore some wormhole solutions in f(R) theories including Lovelock gravity.

AI tools provide individualized learning experiences tailored to specific language learners' requirements. Artificial intelligence-driven programs can customize lessons, exercises, and feedback by evaluating a learner's progress and determining strengths and shortcomings. This individualized method aids students in concentrating on their areas of weakness, thus improving their total language competency. This narrative literature review aims to gather relevant literature discussing AI tools as supplementary support in aiding a learner's language acquisition. Relevant studies stated that there are a lot of chances to improve learning outcomes when AI tools are used in language acquisition. Teachers who want to give their students more resources and help should consider including these tools in their lessons. To preserve the interpersonal and cultural components of language learning, it is imperative to strike a balance between the application of AI and conventional teaching techniques. AI tools are always accessible, providing assistance to learners whenever needed. This is especially helpful for individuals with unpredictable schedules or restricted access to conventional language learning materials.

Neuro-rehabilitation services are essential in reducing post-stroke impairments, enhancing independence, and improving recovery in hospital and post-discharge. However these services are therapist-dependent and resource intensive. Patients’ disengagement and boredom in stroke units are common which adversely affect functional and psychological outcomes. Novel techniques such as use of iPads™ are increasingly researched to overcome such challenges. The aim of this review is to determine the feasibility, effectiveness, acceptability, and barriers to the use of iPads™ in stroke neuro-rehabilitation. Four databases and manual literature search were used to identify published studies using the terms “iPad”, “Stroke”, and “neuro-rehabilitation”. Studies were included in accordance with the review selection criteria. A total of 16 articles were included in the review. The majority of the studies focused on iPads use in speech and language therapy. Although of small scale, the studies highlighted that iPads are feasible, have the potential to improve rehabilitation outcomes, and can improve patient’s social isolation. Patients’ stroke severity and financial limitations are some of the barriers highlighted in this review. This review presents preliminary data supportive for the use of iPad technology in stroke neuro-rehabilitation. However, further research is needed to determine impact on rehabilitation goals acquisition, clinical efficacy, and cost-efficiency.

53% of adults in the US acknowledge racial bias as a significant issue, 23% of Asian adults experience cultural and ethnic bias, and more than 60% conceal their cultural heritage after racial abuse. AI models like ChatGPT and Google Bard, trained on historically biased data, inadvertently amplify racial and ethnic bias and stereotypes. This paper addresses the issue of racial bias in AI models using scientific, evidence-based analysis and auditing processes to identify biased responses from AI models and develop a mitigation tool. The methodology involves creating a comprehensive database of racially biased questions, terms, and phrases from thousands of legal cases, Wikipedia, and surveys, and then testing them on AI Models and analyzing the responses through sentiment analysis and human evaluation, and eventually creation of an 'AI-BiasAudit,' tool having a racial-ethnic database for social science researchers and AI developers to identify and prevent racial bias in AI models.

The concept of vulnerable carotid plaques is pivotal in understanding the pathophysiology of is-chemic stroke secondary to large-artery atherosclerosis. At the macroscopic evaluation, vulnera-ble plaques are characterized by one or more of the following features: microcalcification, neo-vascularization, lipid-rich necrotic core (LRNC), intraplaque hemorrhage (IPH), thin fibrous caps, plaque surface ulceration, huge dimension determining stenosis, and plaque rupture. Recognizing these macroscopic characteristics is crucial to estimating the risk of cerebrovascular events, also in case of non-significant (less than 50%) stenosis. Inflammatory biomarkers, such as cytokines and adhesion molecules, lipid-related markers like oxidized low-density lipoprotein (LDL), and proteolytic enzymes capable of degrading extracellular matrix components are among the key molecules that will be scrutinized for their associative roles in plaque instability. Through their quantification and evaluation, these biomarkers reveal intricate molecular cross-talking govern-ing plaque inflammation, rupture potential, and thrombogenicity. Current evidence demonstrates that plaque vulnerability phenotypes are multiple and heterogeneous and are associated with as many highly complex molecular pathways that determine the activation of an immune-mediated cascade that culminates in thromboinflammation. This narrative review provides a comprehen-sive analysis of current knowledge on molecular biomarkers expressed by symptomatic carotid plaques. It explores the association of these biomarkers with the structural and compositional at-tributes that characterize vulnerable plaques

Technological advances in the last decades have led to the realization of the concept of a smart environment. A significant part of this development is decentralized ledger technology and its variant, a blockchain. The blockchain database is immutable, open to all stakeholders, secure by architecture and robust. Applying a blockchain in water supply sanitary control creates opportunities for optimization, higher quality of service, cost reduction, better sanitary standards and public control. Physical, chemical, and biological water supply contamination is a great source of public health hazards. Implementation of a blockchain for water supply IoT, from the source point to the consumption point, enables effective response to changing environments, possible cross-contamination, stormwater management or disaster and emergency action. The chapter encompasses all fundamental elements and principles of water collection, distribution and consumption, with a focus on the health hazards and sanitary requirements for potable water. The chapter listed the main contaminants, methods of their registration and elimination, and requirements for drinking water in accordance with WHO, EU Drinking Water Directive and EPA standards. Blockchain technology solutions are described for smart water supply, including smart supply management, smart contracts, tokenization, smart compliance systems, and, most importantly, effective utilization of distributed ledger technologies for sanitary monitoring of water sources, water treatment, and water distribution systems.

Background Olfactory perception is an important physiological function for the human well-being and health. Loss of olfaction, or anosmia, caused by viral infections such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) received a considerable attention especially in the persistent cases that take long time to recover. Objectives This review discusses the integration of different components of the olfactory epithelium to serve as a structural and functional unit, and explores how they are affected during viral infections, leading to the development of olfactory dysfunction. Methods The review mainly focused on the role of receptors mediating the disruption of olfactory signal transduction pathways such as ACE2, TMPRSS2 protease, neuropilin 1 (NRP1), basigin (CD147), olfactory, TRPV1, purinergic, and interferon gamma receptors. Furthermore, the compromised function of the epithelial sodium channel (ENaC) induced by SARS-CoV-2 infection and its contribution in olfactory dysfunction is also discussed. Results Collectively, this review provides fundamental information about the many types of receptors that may modulate olfaction and participate in olfactory dysfunction. It will help to understand the underlying pathophysiology of virus-induced anosmia which may help in finding and designing effective therapies targeting molecules involved in viral invasion and in olfaction. Conclusion This wide and complex spectrum of receptors that mediates the pathophysiology of olfactory dysfunction reflects the many ways by which anosmia can be therapeutically managed.

Human milk (HM) feedings are associated with reduced risks of neurodevelopmental and neurocognitive delays and systemic inflammatory diseases in infants born prematurely and/or at a low birth weight. Utilizing a neonatal piglet model, HM feedings were compared to bovine milk-derived infant formula (IF)-feedings with the aim of understanding the underlying mechanisms involved in reducing these risks. Six male piglets at postnatal-day (PD)2 were randomized into two feeding groups: HM-fed (n = 3) or IF-fed (n = 3) for 28 days. At 3- and 4-weeks-old, piglet memory and learning performance were assessed using novel object recognition (NOR). At PD30 piglets were euthanized, and whole brains were excised, weighed, and preserved for further analyses, and brain microglial morphology, and systemic inflammatory cytokines were quantified. During NOR, HM-fed piglets had significantly more non-novel revisits at both 3- and 4-weeks-old compared to IF-fed piglets. Microglia of HM-fed piglets had longer processes, more branch points, more endpoints, and a larger territorial volume compared to IF-fed piglets at PD30. In a neonatal piglet model, HM-feedings may improve cognition and reduce brain inflammatory response compared to IF-feedings.

There is an observed general low performance of Ethiopian Sport Governing Bodies (SGBs) in service delivery. Evidence shows that the trend can be corrected with proper understanding and insight into the process of organisational and management factors of these SGBs. This study aimed to investigate the contribution of organisational and management factors on effective sport service delivery in SGBs. For this study, a cross-sectional research design was employed. Purposive sampling was used to choose 350 samples. Pearson Product Moment Correlation Coefficient and multiple regression were used to analyse the data at the 0.05 significant level. The findings confirmed that organisational and management factor variables had a significant positive relationship with sport service delivery (organisational structure (r=0.515), organisational capabilities (r=0.701), communication (r=0.549), management practice (r=0.571), materials &amp; resources (r=0.527) and stakeholders satisfaction (r=0.742). In addition, Management factors were found to be significant contributors for predicting effective sport service delivery (F(3, 329)= 165.868, R2= 0.612). Furthermore, organisational factors had a joint significant contribution to effective sport service delivery (F(3, 329) = 148.743, R2= 0.576). In addition, organisational and management factor variables jointly best predicted effective sport service delivery in Ethiopian SGBs (F(6, 326) =130.81, R2= 0.707). Therefore, this study suggests organisational and management factor variables can be used to predict effective sport service delivery.

Accurate retroperitoneal lymph node metastasis (LNM) prediction in early-stage testicular germ cell tumours (TGCT) harbours the potential to significantly reduce over- or undertreatment and treatment-related morbidity in this group of young patients as an important survivorship imperative. We investigated the role of computed tomography (CT) radiomics models integrating clinical predictors for the individualized prediction of LNM in early-stage TGCT. Ninety-one patients with surgically proven testicular germ cell tumours and contrast-enhanced CT were included in this retrospective study. Dedicated radiomics software was used to segment 273 retroperitoneal lymph nodes and extract features. After feature selection, radiomics-based machine learning models were developed to predict LN metastasis. The robustness of the procedure was controlled by 10-fold cross-validation. Using multivariable logistic regression modelling, we developed three prediction models: A radiomics-only model, a clinical-only model and a combined radiomics-clinical model. The models' performance was evaluated using the area under the receiver operating characteristic curve (AUC). Finally, decision curve analysis was performed to estimate the clinical usefulness of the predictive model. The radiomics-only model for predicting lymph node metastasis reached a greater discrimination power than the clinical-only model, with an AUC of 0.84 (± 0.17; 95% CI ) vs 0.60 (± 0.22; 95% CI) in our study cohort. The combined model integrating clinical risk factors and selected radiomics features outperformed the clinical-only and the radiomics-only prediction models and showed good discrimination with an area under the curve of 0.94 ( ± 0.10; 95% CI). The decision curve analysis demonstrated the clinical usefulness of our proposed combined model. The presented combined CT-based radiomics-clinical model represents an exciting non-invasive prediction tool for individualized prediction of LN metastasis in testicular germ cell tumours. Multi-centre validation is required to generate high-quality evidence for its clinical application.

With the development of the energy sector based on renewable primary sources, structural changes are emerging for the entire national energy system. Initially, it was estimated that energy generation based on fossil fuels would decrease until its disappearance. However, the evolution of CO2 capture capacity leads to a possible coexistence for a certain period with the renewable energy sector. The paper develops this concept of coexistence of the two systems, with the positioning of green hydrogen not only within the renewable energy sector but also as a transformation vector for carbon dioxide captured in the form of synthetic fuels such as CH4 and CH3OH. The paper also analyzes the economic aspects related to price differences for energy produced in the two sectors, as well as their interconnection. The technical aspect, as well as the economic one, for storage through various other solutions besides hydrogen, has been highlighted. The development of the renewable energy sector and its demarcation from the fossil fuel energy sector, even with the transcendent vector represented by green hydrogen, leads to the deepening of dispersion aspects between the electricity sector and the thermal energy sector, a less mentioned aspect in current works but of great importance.

Objective: To analyze the clinical efficacy and safety of monotherapy and dual therapy in patients with early ischemic stroke. Methods: The study was conducted from August 2020 to August 2021, and 80 patients with early ischemic stroke who received treatment at our hospital during this period were selected as the study population. They were randomly divided into a control group and an observation group, with 40 patients in each group. The control group received conventional monotherapy, while the observation group received conventional dual therapy. The efficacy and safety indicators of the two groups were compared.Results: The treatment efficacy, functional recovery, blood indicators, and inflammation markers in the observation group were all superior to those in the control group (all, P<0.05); there was no significant difference in the drug safety profile between the two groups (P>0.05).Conclusion: The dual antiplatelet therapy is more ideal than monotherapy for treating patients with early ischemic stroke. It can further promote the recovery of neurological and cognitive function, improve hematological and inflammatory response indicators in patients, and the safety of this regimen is comparable to monotherapy.

Weight-bearing computed tomography (WBCT) enables acquisition of three dimensional bony structure images in a physiological weight-bearing position, which is fundamental in under-standing the pathologic lesions and deformities of the ankle joint. Over the past decade, re-searchers focused on validating and developing WBCT measurements, which has significantly enhanced our knowledge of common foot and ankle disease. Consequently, understanding the application of WBCT in clinical practice is becoming more important to produce improved out-comes in the treatment of disease around the ankle joint. This review will describe an overview of what is currently being evaluated in the foot and ankle surgery using WBCT and where the course of research will be heading in the future.

The article discusses early diagnosis and intervention for developmental delays in children, emphasizing the role of specialized services and personnel in supporting recovery and development. It presents findings from a pilot project initiated in Bucharest, aiming to assess the incidence of developmental delays in children aged 1-3 years in selected kindergartens, including ASD. The study involved children, parents, and specialists, utilizing systematic behavior observation (SBO) and semi-structured interviews. Results indicate that out of 613 evaluated children, 81 received specialized control recommendations, with 4 cases showing potential risk of ASD. Additionally, 8 children were diagnosed with autism. The incidence of autism in children aged 1-3 years was 1 in 51. Although exploratory, these findings suggest a model of good practice for future early diagnosis campaigns nationally. Conclusively, the study underscores the importance of early diagnosis and intervention for developmental delays, advocating for a responsive community and emphasizing the significance of national-level efforts to address these issues effectively.

High systolic blood pressure and increased blood pressure variability after the onset of ischemic stroke are associated with poor clinical outcomes. One of the key determinants of blood pressure is arteriolar size, determined by vascular smooth muscle tone and vasodilatory and vasoconstrictor substances that are released by the endothelium. The aim of this study is to outline alterations in vasomotor function in isolated peripheral arteries following ischemic stroke. The reactivity of thoracic aortic segments from male C57BL/6 mice to dilators and constrictors was quantified using wire myography. Acetylcholine induced endothelium-dependent vasodilation was impaired after ischemic stroke (LogIC50 Sham=-7.499, LogIC50 Stroke=-7.350, P=0.0132, n= 19, 31 respectively). Vasodilatory responses to SNP were identical in isolated aortas in sham and stroke groups. Phenylephrine induced vasoconstriction was impaired in aortas isolated from stroke animals in comparison to sham counterparts (Sham LogEC50= -6.652 vs Stroke LogEC50=-6.475, P< 0.001). Our study demonstrates that 24 hours post-ischemic stroke, peripheral vascular responses are impaired in remote arteries. Aortas from stroke animals exhibited reduced vasoconstrictor and endothelium-dependent vasodilator responses, while endothelium-independent vasodilatory responses were preserved. Since both vasodilatory and vasoconstrictor responses of peripheral arteries are impaired following ischemic stroke, our findings might explain increased blood pressure variability following ischemic stroke.

Stroke constitutes a significant public health concern due to its impact on mortality and morbidity. This study investigates the utility of machine learning algorithms in predicting stroke and identifying key risk factors using data from the Suita study, comprising 7,389 participants and 53 variables. Initially, unsupervised K-prototype clustering categorized participants into risk clusters, while five supervised models including Logistic Regression (LR), Random Forest (RF), Support Vector Machine (SVM), eXtreme Gradient Boosting (XGBoost), and Light Gradient Boosted Machine (Light-GBM) were employed to predict stroke outcomes. Stroke incidence disparities among identified risk clusters using the unsupervised K-prototype clustering method are substantial, according to the findings. Supervised learning, particularly RF was a preferable option because of the higher levels of performance metrics. The Shapley Additive Explanations (SHAP) method identified age, systolic blood pressure, hypertension, estimated glomerular filtration rate, metabolic syndrome, and blood glucose level as key predictors of stroke, aligning with findings from the unsupervised clustering approach in high-risk groups. Additionally, previously unidentified risk factors such as elbow joint thickness, fructosamine, hemoglobin, and calcium level demonstrate potential for stroke prediction. In conclusion, machine learning facilitated accurate stroke risk predictions and highlighted potential biomarkers, offering a data-driven framework for risk assessment and biomarker discovery.

The paper presents the findings of research on companies in the early stage of development based on the concept of ensuring their sustainability. The starting point is attributes shaping a sustainable model of start-ups. A solution has been proposed and examined that identifies the factors dynamising a business model, which give the company the ability to make fast changes in the configuration of the business model, and that applies stabilizing factors based on the concept of the Triple Bottom Line. The research problem is a response to the phenomena of the bankruptcy of many start-ups that cannot find a way to survive in the long term. The business models of companies in the early stage of development should be designed taking into account the possibility of their dynamic and iterative changes when the earlier assumptions do not work when implemented in practice. A cognitive gap has been observed as the relevant literature does not propose a systemic solution to the problem of instability of the startups viewed from the perspective of the business model concept. The research problem, therefore, is to identify potential new methods to ensure the sustainability of young companies trying to combine aspects dynamising changes in business models, taking into account economic, environmental and social aspects. The findings of research on companies in the early stage of development show that when the methods of increasing the flexibility of the business model are applied and attention is drawn to environmental and social activities and a strong emphasis is put on financial performance, reflecting the expectations of shareholders, the concept of ensuring the sustainability of young companies from the point of view of sustainable business model attributes emerges.

Ischemic stroke is a leading cause of mortality worldwide, and intravenous thrombo-lysis, while improving functional outcomes, still leaves a significant mortality rate. This study aimed to investigate the clinical and pathological data of thrombolysed stroke patients who subsequently died and underwent autopsy, focusing on hemorrhagic transformation (HT). Over a 10-year period, 1426 acute ischemic stroke patients re-ceived thrombolysis at our center, with an in-hospital mortality rate of 11.7%. Autop-sies were performed on 98 of the 167 deceased patients. HT was found in 47% of these cases, only less than half occurring within a day of thrombolysis. Significant inde-pendent predictors of HT included higher lactate dehydrogenase (LD) levels and higher INR values at admission. HT directly caused death in 30% of cases, often through herniation, while other complications (pulmonary embolism, pneumonia) were also common. These findings underscore the importance of postmortem investi-gations to accurately determine the incidence of HT and contributing factors. Our data indicate that in the vast majority of HT cases, the role of contributing factors other than rt-PA may be important. Of the routinely assessed clinical and laboratory parameters at admission only LD and INR were found to be independent predictors of HT in the autopsied studied cohort.

In this paper we investigate the differential topological properties of a subclass of singular space--subcarteisan spaces. First, we get further result on partition of unity for differential spaces. Second, we establish the tubular neighborhood theorem for subcartesian spaces with constant structural dimension. Third, we generalize the concept of Morse functions on smooth manifolds to differential spaces. For subcartesian space with constant structural dimension, we provide examples of Morse functions; With the assumption that the subcartesian space can be embedded as a bounded subset of an Euclidean space, we prove that smooth bounded functions on this space can be approximated by Morse functions; We study the infinitesimal stability of Morse functions on subcartesian spaces. Classical results on Morse functions on smooth manifolds can be treated directly as corollaries of our results here.

Recent discovery of triangular boron Nanotubes makes it a competitor of carbon in many respects. Closed forms of M-polynomial of nanotubes produce closed forms of many degree-based topological indices which are numerical parameters of the structure and, in combination, determine properties of the concerned nanotubes. In this report, we give M-polynomials of triangular boron nanotubes and recover many important topological degree-based indices of these nanotubes. We also plot surfaces associated to these nanotubes.

Long COVID-19 affects a significant percentage of survivors and is characterized by a wide range of symptoms, including weariness and mental fog as well as emotional symptoms like worry and sadness. COVID-19 is closely linked to the autoimmune disorders that are becoming more prevalent worldwide and are linked to the immune system hyperactivation, neutrophil extracellular trap (NET) development, and molecular mimicry pathways. Long-term COVID-related autoimmune responses include a watchful immune system, altered innate and adaptive immune cells, autoantigens secreted by living or dead neutrophils, and high concentrations of autoantibodies directed against different proteins. The microbiome, which consists of billions of bacteria living in the human body, is essential for controlling immune responses and supporting overall health. The microbiome can affect the course of long-term COVID-associated autoimmunity, including the degree of illness, the rate of recovery, and the onset of autoimmune reactions. Although the precise role of the microbiome in long COVID autoimmunity is still being investigated, new studies indicate that probiotics, prebiotics, and dietary changes—interventions that target the microbiome—may be able to reduce autoimmune reactions and enhance long-term outcomes for COVID-19 survivors. It is clear that more research is required to precisely understand how the microbiome affects COVID-19-related autoimmunity and to create tailored treatment plans.

We aimed to compare prognostic factors for overall survival (OS) following percutaneous radiofrequency ablation (PRFA) with or without chemolipiodolization (CL) for early-stage hepatocellular carcinoma (HCC) using propensity score-matched analysis. We enrolled 221 patients with early-stage HCC who received PRFA with (n = 76) or without (n = 145) CL in Saga Central Hospital between April 2004 and December 2020. No significant difference was observed in OS between PRFA with and without CL cohorts (median survival time [MST]: 5.4 vs. 4.5 years; p = 0.0806). To reduce confounding effects, 108 patients were selected using propensity score-matched analysis (n = 54 for each treatment). No significant difference was observed in OS between the cohorts (MST: 3.6 vs. 4.0 years; p = 0.5474). After stratification according to tumor size, no significant difference was observed in OS for patients with tumor size ≥20 mm between PRFA with and without CL cohorts (MST: 3.4 vs. 3.5 years; p = 0.8236). PRFA with CL was not a significant prognostic factor in both univariate and multivariate analyses (p = 0.5477 and 0.9600, respectively). Our findings suggest that PRFA with CL does not demonstrate longer prognostic effects than PRFA without CL in early-stage HCC, regardless of tumor size.

Rarely has a chemical elicited as much controversy as has dichloroacetate (DCA). DCA was initially considered a dangerous toxic industrial waste product. Then it was a potential treatment for lactic acidosis. However, the main controversies started in 2008 when DCA was found to have anti-cancer effects in experimental animals. These publications showed contradictory results in vivo and in vitro, so that a thorough consideration of this compound in cancer is merited. Despite 50 years of experimentation, DCA’s future in therapeutics is uncertain. Without adequate clinical trials and lack of health authorities’ approval, DCA has been introduced in off -label cancer treatments in alternative medicine clinics in Canada, Germany, and other European countries. The lack of well-planned clinical trials and its use by people without medical training has discouraged consideration by the scientific community. There are limited thorough clinical studies of DCA, and many publications are individual case reports. Case reports of DCA benefits against cancer have been increasing recently. Furthermore, it has been shown that DCA synergizes with conventional treatments and other repurposable drugs. Beyond the classic DCA target, pyruvate dehydrogenase kinase, new target molecules have also been recently discovered. These findings have renewed interest in DCA. This paper explores whether existing evidence justifies further research on DCA for cancer treatment and it explores the role DCA may play in oncology treatment.

This paper examines the correlation between numbers of computer cores in parallel genetic algorithms. The objective to determine the linear polynomial complementary equation in order represent the relation between number of parallel processing and optimum solutions. Model this relation as optimization function (f(x)) which able to produce many simulation results. F(x) performance is outperform genetic algorithms. Compression results between genetic algorithm and optimization function is done. Also the optimization function give model to speed up genetic algorithm. Optimization function is a complementary transformation which maps a TSP given to linear without changing the roots of the polynomials.

As hen body weight (BW) impacts egg weight (EW) and feed efficiency, egg producers prefer pullets of a specific size to enter the egg-laying cycle. Lighting and feeding programs were tested to achieve target pullet BW. Three feeding programs: Ad libitum (Ad lib); feeding to achieve breed standard weight for age (BSW); feeding to achieve 88% BSW (managed) were used with either control lighting, (CL: 10h light/d from 7 weeks of age (WOA)) or reduced lighting (RL: 9h light/d from 4 WOA). At 16 WOA pullets moved to cages and ad libitum feeding under a step-up photoperiod reaching 16h at 33 WOA. The age and weight of first egg, BW, feed intake (FI), egg production (EP) and EW were measured until 36 WOA. At 16 WOA, pullets reared with Ad lib feeding under CL had higher BW and cumulative FI (CFI) compared to Ad lib feeding under RL. The latter were the earliest and managed pullets under CL the latest, to lay. Control lighting and BSW independently generated the heaviest first eggs. At 36 WOA, BW, EW, CFI and CEP were highest following Ad lib feeding during rearing while CL generated higher BW and EW but lower CEP than RL. Hence lighting and feeding programs throughout rearing can regulate pullet growth and, hen performance throughout early lay.

This article uses strategy metaphors consisting of a plan, a home and a game to study government programme formation in Finland. The strategy approach both contradicts and complements the traditional political science approach to government formation. The government programme has been strategic in the sense of separating the formulation and implementation parts of the strategy. The most important function of the metaphor of plan is to hold coalition parties together. The adopted austerity policy provides a meagre contribution to the expansion of services and the increase in government spending. Consequently, the home metaphor in the government programme appears in the distant future and in combating external threats. The game metaphor is apparent in the goal of making contracts with social partners. The vocabulary change from politics to strategy alters the government programme’s position in terms of catering to the needs of civil servants, citizens and stakeholders. The strategy perspective might be instrumental in shifting open democratic debates to closed and secretive policy formations.

The issue of climate change represents a significant global risk that demands immediate attention. However, higher education frequently fails to incorporate global perspectives and intricate transdisciplinary matters. In order to integrate global and transdisciplinary aspects into the curriculum of a technical university with a focus on computer science, a Master's programme has been developed. The programme's objective is to situate global risk at the core of the curriculum, thereby encouraging scientists to work beyond the boundaries of their respective disciplines. The paper considers the challenges that science and higher education must address to facilitate pathways towards a peaceful and sustainable future. It argues for a shift in focus from short-term and localised issues to a more holistic approach, emphasising the importance of considering universal problems. The curriculum, as developed, may be regarded as a guide for future university efforts in the fields of global risk and climate change.

The Dph1•Dph2 heterodimer from yeast is a radical SAM (RS) enzyme that generates the 3-amino-3-carboxy-propyl (ACP) precursor for diphthamide, a clinically relevant modification on eukaryotic elongation factor 2 (eEF2). ACP formation requires SAM cleavage and atypical Cys-bound Fe-S clusters in each Dph1 and Dph2 subunit. Intriguingly, the first Cys residue in each motif locates next to another, ill-defined cysteine that we show in-here is conserved across eukaryotes. As judged from structural modeling, the orientation of these tandem cysteine motifs (TCM) suggests a candidate Fe-S cluster ligand role. Hence, we generated by site-directed DPH1 and DPH2 mutagenesis, Dph1•Dph2 variants with cysteines from each TCM replaced individually or in combination by serines. Assays diagnostic for diphthamide formation in vivo reveal that while single substitutions in the TCM of Dph2 cause mild defects, double mutations almost entirely inactivate the RS enzyme. Based on enhanced Dph1 and Dph2 subunit instability in response to cycloheximide chases, the variants with Cys substitutions in their cofactor motifs are particularly prone to protein degradation. In sum, we identify a fourth functionally cooperative Cys residue within the Fe-S motif of Dph2 and show that the Cys-based cofactor binding motifs in Dph1 and Dph2 are critical for the structural integrity of the dimeric RS enzyme in vivo.

Background: SARS-CoV-2 Omicron JN.1 has the highest number of amino acid mutations in its receptor binding domain (RBD) and has acquired a hallmark L455S mutation. The immune evasion capability of JN.1 is a subject of scientific investigation. The US CDC used RT-qPCR SGTF as the proxy indicator of JN.1 infections for evaluation of the effectiveness of updated monovalent XBB.1.5 COVID-19 vaccines against JN.1 and recommended that all persons aged ≥6 months should receive an updated COVID-19 vaccine dose. Objective: Recommend Sanger sequencing for diagnosis of JN.1 infections to generate the data based on which guidelines are made to direct vaccination policies. Methods: The RNA in nasopharyngeal swab specimens from patients with clinical respiratory infection was subjected to nested RT-PCR, targeting a 398-base segment of the N-gene and a 445-base segment of the RBD of SARS-CoV-2 for amplification. The DNA sequences were analyzed for amino acid mutations. Results: The N-gene sequence showed Q229K, usually associated with Omicron BA.2.86 (+JN.1). The RBD sequence showed 24 amino acid mutations, including the hallmark L455S mutation for JN.1 and the V483del for BA.2.86 lineage. Conclusions: The CDC should consider Sanger sequencing of the RBD to diagnose JN.1 infections for statistical analysis in making vaccination policies.

Controlling Nutritional Status (CONUT) Score is useful for the nutritional screening. We aimed to explore whether the CONUT score may predict a 3-month functional outcome in hemorrhagic stroke (AHS). Totally, 349 patients with incident AHS were consecutively recruited, and their malnutrition risks were determined using a high CONUT score of ≥ 2. Poor functional outcomes were defined as the modified Rankin Scale (mRS) score of ≥ 3 at 3 months. A total of 328 patients (mean age, 60.4 ± 12.83 years; 66.8% male) were included, 172 (52.40%) patients at malnutrition risk and 104 (31.7%) patients with a poor prognosis. High-CONUT patients had lower total lymphocyte counts and total cholesterol levels than low-CONUT patients (p &lt; 0.001 and p = 0.012). At 3-month post discharge, patients with malnutrition risk had higher hospitalization costs (p = 0.021), lower Barthel Index (p = 0.001), and more infectious complications (p = 0.002) than those without, and there was a greater risk for poor functional outcomes in the high-CONUT compared with the low-CONUT patients at admission (adjusted odds ratio: 2.32, 95% confidence interval: 1.28-4.17). High-CONUT scores predict a 3-month poor prognosis in AHS, which may help identify the AHS patients who need additional nutritional managements.

Objectives: Although the prevalence of metabolic syndrome (MetS) has increased among Koreans, the specific health benefits of the Korean Healthy Diet (KHD) score remain unexplored. This study aimed to evaluate the association between the KHD score and MetS, and to identify the optimal cutoff of the KHD score for reducing MetS prevalence. Methods: This cross-sectional study used data from 11,403 participants of the 7th and 8th Korea National Health and Nutrition Examination Survey. The KHD score was calculated based on adherence to 13 dietary components. Logistic regression analysis was used to determine the association between the KHD score and MetS, and to identify the optimal cutoff values for the KHD score. Results: The average KHD score was significantly lower in participants with MetS than in those without MetS (5.03 vs. 5.14, p=0.016). A one- and two-point increase in the KHD score was associated with reduction in MetS prevalence (one-point, odds ratio [OR]: 0.95, 95% confidence interval [CI]: 0.91–0.98; two-point, OR: 0.90, 95% CI: 0.84–0.97). The optimal cutoff for the KHD score was identified as &gt;7 points, which was related to lower odds of MetS (OR: 0.78, 95% CI: 0.65–0.93) compared to 1–4 points, particularly with hypertriglyceridemia (OR: 0.80, 95% CI: 0.69–0.94) and low high-density lipoprotein cholesterol (OR: 0.85, 95% CI: 0.74–0.98). Conclusions: The KHD score was inversely associated with MetS prevalence, and the identified optimal cutoff values can serve as a practical tool for public health interventions aimed at reducing the risk of MetS.

Background and Objectives: Fibrillinopathies have different phenotypic expression: Marfan- like skeleton features, MLSF; mitral valve prolapse syndrome, MVPS; MASS phenotype, M= mitral valve prolapse, MVP, A= aortic root dilation, S= skeletal features, and the second S= (cutaneous) striae; Marfan syndrome, MS. These are inherited connective tissue diseases, provoked by a mutation of the encoding gene for a protein(fibrillin 1, FBN1) which has major importance in the formation of elastic fibers.The study had the following main objectives: the correlation between disc displacement, DD( a major sign for temporomandibular joint dysfunction, TMD) on magnetic resonance imaging, MRI, and aortic Z score(a major sign for aortic root dilation) on echocardiography; the predictive value of DD towards aortic Z score. DD had 2 types of severity: DD with reduction(the mild type, DDwR) , and DD without reduction( the severe type, DDwoR). Materials and Methods: The type of fibrillinopathy was precised by clinical exam( systemic score), ophthalmic exam(for ectopia lentis), and echocardiography(aortic Z score, MVP). Medical treatment consisted in betablockers, BB(for patients with tachycardia), or angiotensin II receptor blockers, ARB. Surgical treatment was addressed to aortic root aneurysm, and severe MR. DD benefited by dental conservatory treatment, or surgical restoration.Results: DD- Z score had a powerful correlation in MASS(Rho= 0.787, p&lt; 0.01), and in MS patients(Rho=0.819, p&lt; 0.01). For the entire sample, both DDwR- Z score, and DDwoR- Z score had a moderate correlation(Rho= 0.469, and respectively 0.669). Muchmore, DD was an important predictor for Z score. DDwoR had a double power of prediction for Z score, comparative with DDwR(B coefficient= 1.661 for DDwR, and 3.281 for DDwoR). Conclusions: TMD had a powerful correlation with aortic root dilation, in MASS, and MS patients from the sample. Likewise, TMD was a major predictor for aortic root dilation, in the entire sample. We can utilize in clinical practice, an extracardiac finding, TMD, obtained by a non-invasive technique, MRI, for cardiac severity stratification of fibrillinopathies.

Abstract: Background: The optimal strategy for the microelimination of HCV within community settings remains ambiguous. We evaluated the percentage of participants who achieved linkage to care (LTC) following the conclusion of the screening campaign, and examined the diverse factors influencing LTC among these individuals. The effectiveness of recall intervention for the non-LTC population and its barriers were analyzed. Methods: We initiated an HCV patients recall program to identify the HCV participants who might not be treated after the HCV screening campaign. A program staff recalled HCV participants who lost to follow-up through the telephone from March 2019 to June 2019. They were informed of HCV treatment's importance, efficacy, availability, and safety. Result: Among 185 HCV-infected participants, 109 (58.9%) HCV-infected participants had obtained LTC. Compared with those who had LTC, those without LTC were older, lower education levels, were less aware of their HCV infection, less frequently lived in urban areas, and had less health insurance. At the end of the recall program, 125 (67.6 %) persons had liked to care. The proportion of LTC increased by 8.7 %. 119 persons had an HCV RNA test, and 82 (68.9%) had viremia. Of 82 patients with viremia, 78 (95.1%) received antiviral therapy. 76 (97.4 %) of them achieved a sustained virological response. Conclusion: After a community screening campaign, 59 % of participants with anti-HCV positive had LTC. The recall program can increase by 9 %. However, there were still 32% of HCV participants who couldn't be linked to care. Outreach care for non-LTC patients is a way worth trying to achieve micro-elimination of HCV in the rural community.

Esophageal cancer (EC) is one of the most common malignant tumors worldwide, and its two major types, esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC) present a severe global public health problem with an increasing incidence and mortality. Established risk factors include smoking, alcohol consumption, and dietary habits, but recent research highlights the substantial role of oral microbiota in EC pathogenesis. This review explores the intricate relationship between microbiome and esophageal carcinogenesis, focusing on eight significant mechanisms: chronic inflammation, microbial dysbiosis, production of carcinogenic metabolites, direct interaction with epithelial cells, epigenetic modifications, interaction with gastroesophageal reflux disease (GERD), metabolic changes, and angiogenesis. Certain harmful bacteria, such as Porphyromonas gingivalis and Fusobacterium nucleatum, are specifically implicated in sustaining irritation and tumor progression through pathways including NF-κB and NLRP3 inflammasome. Additionally, the review explores how microbial byproducts, including short-chain fatty acids (SCFAs) and reactive oxygen species (ROS), contribute to DNA harm and disease advancement. Furthermore, the impact of reflux on microbiota composition and its role in esophageal carcinogenesis is evaluated. By combining epidemiological data with mechanistic understanding, this review underscores the potential to target microbiota-immune system interplay for novel therapeutic and diagnostic strategies to prevent and treat esophageal cancer.

This review article is aimed at exploring the possibility of developing an integrated approach in the management of the different needs of endometrial cancer (EC) patients seeking to become pregnant. Life preservation of the woman, health preservation of the baby, a precocious and – as much as possible – minimally invasive characterization of the health and fertility parameters of the patient, together with the concerns regarding the obstetric, neonatal, and adult health risks of the children conceived via assisted reproduction techniques (ART) are all essential aspects of the problem to be taken into consideration, yet the possibility to harmonize such needs through a concerted integrated approach is still highly challenging. This article aims to illustrate the main features of EC and how it affects the normal physiology of pre-menopausal women. Then, we focus on the prospect for a miR-based, molecular evaluation of patient health status, including both EC early diagnosis and staging and, similarly, the receptivity of the woman, discussing the possible evaluation of both aspects using a single specific panel of circulating miR in the patient, thus allowing a relatively fast, non-invasive way to perform such testing with a significantly reduced margin of error. Finally, the ethical and legal/regulatory complexities arising from such innovative techniques require not only a risk-benefit analysis; respect for patient autonomy and equitable health care access allocation are fundamental issues as well.

Introduction Blunt carotid injuries (BCI) in pediatric trauma are quite rare. Due to the low number of cases, only a few reports and studies have been conducted on this topic. This review will discuss how frequent BCI/ BCVI on pediatric patients after blunt trauma is, what routine diagnostics look like, if a CT/ CTA scan on pediatric patients after blunt trauma is always necessary and if there are any negative health effects? Methods This literature review includes reviews, systematic reviews, case reports and original studies in english language between 1999 and 2020 that have dealt with pediatric blunt trauma and the diagnostics of BCI and BCVI. Furthermore, publications on the risk of radiation exposure on children were included in the study. For literature research, Medline (PubMed) and the Cochrane library were used. Results Pediatric BCI/ BCVI, shows an overall incidence between 0.03 – 0.5% of confirmed BCI/ BCVI cases due to pediatric blunt trauma. 1.1 – 3.5% of pediatric blunt trauma patients underwent CTA to detect BCI. Only 0.17 – 1.2% of all CTA scans shows a positive diagnosis for BCI. In children, the median volume CT dose index on a non-contrast head CT is 33 milligray, a computed tomography angiography needs at least 138 mGy. A cumulative doses of about 50 mGy almost triples the risk of leukemia, and doses of about 60 mGy triples the risk of brain cancer. Discussion Knowing that a BCI could have extensive neurologic consequences for children, it is necessary to evaluate routine pediatric diagnostics after blunt trauma. Computed tomography scans (CT) and computed tomography angiography (CTA) are mostly used in routine BCI diagnostics. However, since radiation exposure in children should be as low as reasonably achievable, it should be asked if other diagnostic methods could be used to identify risk groups. Trauma guidelines and clinical scores like the McGovern score are reflect established BCI screening options, as well as using duplex ultrasound.

The many limitations of implementing anticancer strategies under the term “precision oncology” have been extensively discussed. While some authors propose promising future directions, others are less optimistic and use phrases such as illusion, hype and false hypotheses. The reality is revealed by practicing clinicians and cancer patients in various online publications, one of which has stated that “in the quest for the next cancer cure, few researchers bother to look back at the graveyard of failed medicines to figure out what went wrong.” The message is clear: novel therapeutic strategies with catchy names (e.g., synthetic “lethality”) have not fulfilled their promises despite decades of extensive research and clinical trials. The main purpose of this review is to discuss key challenges in solid tumor therapy that surprisingly continue to be overlooked by the nomenclature committee on cell death and numerous other authors. These challenges include: the impact of chemotherapy-induced genome chaos (e.g., multinucleation) on resistance and relapse, oncogenic function of caspase 3, cancer cell anastasis (recovery from late stages of apoptosis), and pitfalls of ubiquitously used preclinical chemosensitivity assays (e.g., cell “viability” and tumor growth delay studies in live animals) that score such pro-survival responses as “lethal” events. Studies outline herein underscore the need for new direction in the management of solid tumors.

Stroke represents one of the neurological diseases most responsible for death and permanent disability in the world. Different factors, such as thrombus, emboli and atherosclerosis, take part in the intricate pathophysiology of stroke. Comprehending the molecular processes involved in this mechanism is crucial to developing new, specific and efficient treatments. Some common mechanisms are excitotoxicity and calcium overload, oxidative stress, and neuroinflammation. Furthermore, non-coding RNAs (ncRNAs) are critical in pathophysiology and recovery after cerebral ischaemia. ncRNAs, particularly microRNAs, and the long non-coding RNAs (lncRNAs) are essential for angiogenesis and neuroprotection, and they have been suggested to be therapeutic, diagnostic and prognostic tools in cerebrovascular diseases, including stroke. This review summarizes the intricate molecular mechanisms underlying ischemic and hemorrhagic stroke and delves into the function of miRNAs in the development of brain damage. Furthermore, we will analyze new perspectives on treatment based on molecular mechanisms in addition to traditional stroke therapies.