Multiple studies have shown that hospital settings are poorly cleaned during terminal cleaning. The adequacy of these cleaning methods has been undermined by presence of multi drug resistant bacteria on hospital surfaces. This case is even more serious in developing countries leading to health care- associated infections that pose a great threat to patients, visitors and health care providers in hospital settings.This study used various microbiological techniques to test for antibiotic susceptibility profiles of bacteria present at Thika Level 5 Hospital surfaces, Kenya. A simple random cross sectional study was performed, with a total of 85 samples being collected from five different sites. The sites included male and female wards, health care personnel offices, latrine, and kitchen surfaces. Samples were collected using sterile swabs, dipped in normal saline, and transported to the laboratory within 2Hours for processing.Of the 85 plates cultured, 47 plates showed bacterial growth (55%) on selective media with a significant P value of 0.0357. Seven different species of bacteria were identified biochemically from all sites, Escherichia coli was the most abundant species (28%), and the least was Salmonella typhii (5%). Multiple drug resistance was common in the different bacteria identified. All isolates were resistant to chloramphenical and susceptible to gentamycin. The most resistant microorganism was Staphylococcus aureus (50%), and the least resistant microorganism was Klebsiella pneumoniae (12.5%). The antimicrobial resistant bacterial species identified in this study have been documented to cause serious health care associated infections. These results present a significant public health concern because there is a possibility of patients, staff and visitors contacting nosocomial infections when they come into contact with surfaces at Thika Level 5 Hospital surfaces, Kenya.

Alzheimer's disease (AD) is the most prevalent form of dementia. With the global aging population, the incidence of AD and related dementias is projected to rise dramatically, posing significant public health challenges. Traditionally, the diagnosis of AD has relied on the detection of amyloid-beta (Aβ) plaques and neurofibrillary tangles of hyperphosphorylated tau in the brain, assessed through invasive cerebrospinal fluid (CSF) analysis and costly positron emission tomography scans. However, these methods are not feasible for widespread screening or use in low-resource settings. Recent advances in blood-based biomarkers offer a promising alternative for the early detection and monitoring of AD. These biomarkers provide a minimally invasive, cost-effective means of tracking the pathological progression of AD before the onset of clinical symptoms, potentially enabling earlier and more accurate diagnosis. Blood-based biomarkers, including those related to Aβ, phosphorylated tau, and neurofilament light polypeptide, have demonstrated significant potential in reflecting the underlying neuropathology of AD and correlating with traditional CSF and imaging biomarkers. This review synthesizes the latest research on blood-based biomarkers in AD, highlighting their role in the disease's etiopathogenesis, diagnostic accuracy, and prognostic value. We discuss the emerging evidence on proteinopathies, neuroinflammation, vascular pathology, and bioenergetic profiles, emphasizing the clinical applicability of these biomarkers. Furthermore, we explore the integration of blood-based biomarkers with advanced neuroimaging techniques and their potential to revolutionize the diagnostic landscape of AD, particularly in resource-limited settings. We have integrated protein-protein interaction (PPI) and miRNA network analyses to enhance the analysis. By incorporating these, we can explore the interactions and relationships between different proteomic, genomic, and epigenomic biomarkers, potentially unveiling new insights into the underlying biological mechanisms of AD. The continued development and validation of these biomarkers could lead to more accessible and equitable AD diagnostics, ultimately improving patient outcomes.

The study aimed to analyze thoracic and lumbar erector spinae muscle activations during 3D elongation exercises in individuals with adolescent idiopathic scoliosis (AIS). Participants included 24 adolescents, meeting specific criteria such as a Cobb angle between 10° and 20°, and not having undergone surgical or brace treatments. EMG data were collected to evaluate muscle activations. The study found no significant interaction between exercise type and the side of the curve, but a significant main effect of exercise type on muscle activation, irrespective of Cobb angle. Different exercise types significantly affected muscle activity, with the highest activations in the TheraBand exercise, followed by manual and without equipment conditions. This suggests that exercise type significantly impacts muscle engagement in AIS patients, providing valuable insights for targeted exercise program design. The study, however, focused on short-term muscle activation, not long-term Cobb angle progression, pointing to the need for further research in this area.

Background/Objectives: With the increasing prevalence of Crohn’s disease (CD), treatment op-tions for patients who fail conventional and advanced therapy are highly needed. Therefore, we explored the safety and efficacy of extracorporeal photopheresis (ECP) using 5-aminolevulinic acid (ALA) and blue light (405 nm). Methods: Patients with active CD who failed or were intolerant to biological therapy were eligi-ble. Mononuclear cells (90 mL) were collected from each patient using a Spectra Optia® apheresis system and diluted with 100 mL of 0.9% sodium chloride in a collection bag. The cells were in-cubated with ALA at a concentration of 3 millimolar (mM) for 60 minutes ex vivo and illumina-tion with a LED blue-light (405 nm) source (BLUE-PIT®) before reinfusion to the patient. Vital signs and adverse events were regularly performed. At week 13 we assessed the patients with colonoscopy, the Harvey Bradshaw Index (HBI), the Inflammatory Bowel disease Health Related Quality of Life Questionnaire, and measurement of serum C-reactive protein, and fecal calprotec-tin (FC) levels. Biopsies of the intestines were taken for immunohistochemistry. Results: Seven patients were included. Four patients completed, with in total 24 treatments. Three of the four achieved a response, including lower HBI, FC and/or endoscopic improvement. No significant adverse events were observed. The remaining three patients received only one, three or five treatments due to technical difficulties, medical reasons, or the withdrawal of informed con-sent. Conclusion: ALA-based ECP appears safe and seem to give some clinical improvement for the patients with active CD who failed to respond to conventional and advanced therapies.

There is little doubt that the efficacy of MnDPDP and its therapeutic improved counterpart Ca4Mn(DPDP)5 mainly depends on their MnSOD-mimetic activity when it comes to their potential use as rescue medicines, during e.g., acute myocardial infarction. However, pharmacokinetic considerations suggest that the efficacy of MnDPDP on Pt2+-associated neurotoxicity depends on another action of this drug. Electron Paramagnetic Resonance (EPR) studies have demonstrated that Pt2+ outcompetes Mn2+ and endogenous Zn2+ from binding to fodipir (DPDP), and hence suggest that the previously reported CIPN protective efficacy of MnDPDP is a result of chelation and elimination of Pt2+ by DPDP, which in turn suggests that Mn2+ is unnecessary for efficacy when it comes to oxaliplatin-associated CIPN.

Chronic kidney disease (CKD) affects approximately 12% of the global population posing a significant health threat. Inflammation plays a crucial role in the uremic phenotype of CKD contributing to elevated cardiovascular and overall mortality in affected individuals. This study aimed to explore novel metabolic pathways in non-dialysis dependent stage 5 CKD patients using semitargeted metabolomics. In a prospective observational design involving 50 patients, blood samples collected before the initial hemodialysis session underwent liquid chromatography and high resolution mass spectrometer analysis. Univariate (Mann-Whitney test) and multivariate (logistic regression with LASSO regularization) methods identified metabolomic variables associated with inflammation. Notably, adenosine-5’-phosphosulfate (APS), dimethylglycine, pyruvate, lactate, and 2-ketobutyric acid exhibited significant differences in the presence of inflammation. Cholic acid, homogentisic acid, and 2-phenylpropionic acid displayed opposing patterns. Multivariate analysis indicated increased inflammation risk with certain metabolites (N-Butyrylglycine, dimethylglycine, 2-Oxoisopentanoic acid, and pyruvate), while others (homogentisic acid, 2-Phenylpropionic acid, and 2-Methylglutaric acid) suggested decreased probability. These findings unveil potential inflammation-associated biomarkers related to defective mitochondrial fatty acid beta oxidation and branched-chain amino acid breakdown in CKD, shedding light on cellular energy production and offering insights for further clinical validation.

(1)Background：To date, no studies have epidemiologically examined whether the concentration of particulate matter (PM) 2.5 and its ionic components is related to the prevalence of skin symptoms. Therefore, this study aimed to clarify this association in patients with allergic diseases. (2)Methods: From February 1 to May 31, 2020, we evaluated the daily prevalence of skin symptoms in outpatients with allergic diseases being treated at Fukuoka Hospital, Fukuoka, Japan, and measured the concentration of PM2.5 and its ionic components. （3）Results: Univariate analysis showed a statistically significant association between skin symptoms and the concentration of PM2.5 and the ionic components SO42-, NH4+, K+, and Mg2+, and multivariate analysis showed a statistically significant association between the daily prevalence of skin symptoms and the concentration of the ionic components SO42- or Mg2+. (4)Conclusions: Our findings indicate that the concentration of some PM2.5 ionic components may affect skin symptoms in patients with allergic diseases.

Objective: The effect of long-term performance of one-bottle or two-bottle bonding agents on the shear bond strength to lithium disilicate ceramics (LDS) were to investigate, and the long-term performance of the bond strength of two-bottle bonding agent (Tokuyama Universal Bond II) was investigated under conditions without hydrofluoric acid solution (abbreviated as HF)-pretreatment of LDS. Methods: Nine resin cements (both self-adhesive and adhesive types) were used. It was investigated 1) the adhesion strength of various resin cements to LDS from the presence or absence of HF-treatment, 2) to determine the effect of the deterioration in three times [after one-day storage (abbreviated as Base), and after 5,000 & 20,000 thermocycles (abbreviated as TC 5k and TC 20k)] of one- and two-component bonding agents. And the difference in degradation between one- and two-component bonding gents consist of the silane coupling agent was performed by chemical analysis (High Performance Liquid Chromatography). Results: The trends of resin cements were statistically not very different for each cement 3 times with HF-conditions. Also ESTECEM II and Super-Bond Universal showed the significant greatest values in two conditions (TC 5k and TC 20k) without HF-condition. In TC 20k, ESTECEM II & Super-Bond Universal showed significantly better results than others when treated with the recommended bonding agents without HF-condition. In TC 20k, there was not much statistically significant difference if pretreated with Tokuyama Universal Bond II without HF-condition. Significance: When using LDS, it was found that long-term durability could be maintained by pretreating with Tokuyama Universal Bond II without pretreating with various hazardous HFs.

Second-level hospitals face peculiarities that hinder the implementation of the hearing rescreening protocol, which are not uncommon in other settings. This study analyzes the hearing rescreening process in this kind of hospital. A total of 1130 individuals were included. In this cohort, 61.07% were newborns in the hospital who failed their first otoemission test after birth (n=679) or were unable to have the test performed (n=11), then being referred to outpatient clinic. The remaining 38.93% were individuals who were born in another hospital with their first test conducted in the outpatient clinic (n=440). A high amount of rescreenings were made outside the recommended time frame, mainly in children referred from another hospital. There was a high rate of lost to follow-up especially with otolaryngologist referrals. Neonatal Hearing screening in second level hospitals is difficult because of the staffing and time constraints. This results in longer than recommended turnaround times and interferes with the timely detection of hearing loss. This is particularly serious in outpatients. Referral of children with impaired screening to out-of-town centers leads to unacceptable loss of follow-up. A legislative support for all these rescreening issues is necessary. We discuss these findings and propose some solutions.

Urinary infections are defined as the presence of microorganisms in any part of the urinary system, with the exception of the distal urethra. The majority are uncomplicated infections, resolved on an outpatient basis, with empirical therapy. The objectives of this work were to study the sociodemographic characteristics of patients, analyze associated strains and examine the response of the main microorganisms to antibiotics. A retrospective observational study of all positive urine cultures between 2018 and 2022 was carried out in an Institution (8340 samples). Sociodemographic data were also collected. 61.3% were women, with an average age of 63.4 years, 43.2% from the Emergency Department. 13.5% were fitted, 56% of whom were women. 95.9% were not taking any antibiotics and among the individuals who were taking antibiotics, 50% were injected. Escherichia coli (53.5%) and Klebsiella pneumoniae (13,8%) are identified as the most prevalent strains. In the time periods analyzed, Escherichia coli decreased its resistance to 11 antibiotics and increased to 5 antibiotics, while Klebsiella pneumoniae decreased to 7 and increased to 7, with emphasis on the presence of 3 antibiotics with a resistance rate of 100 % to all Klebsiella pneumoniae strains identified in 2022.

There are many uncertainties and risks in residential electricity consumption during the economic development. Knowledge of the relationship between residential electricity consumption and its key determinant—income—are important to the sustainable development of electric power industry. Using panel data from 30 provinces for the 1995-2012 period, this study investigates how residential electricity consumption changes as incomes increase in China. Previous studies typically used linear or quadratic double-logarithmic models imposing ex ante restrictions on the indistinct relationship between residential electricity consumption and income. Contrary to those models, we employed a reduced piecewise linear model that is self-adaptive and highly flexible and circumvents the problem of “prior restrictions.” Robust tests of different segment specifications and regression methods are performed to ensure the conservatism of the research. The results provide strong evidence that the income elasticity was approximately one, and it remained stable throughout the estimation period. The income threshold at which residential electricity consumption automatically remains stable or slows has not been reached. To ensure the sustainable development of the electric power industry, introducing higher energy efficiency standards for electrical appliances and improving income levels are vital. And government should emphasize electricity conservation in industrial sector rather than in residential sector.

Background/Objectives: Conventional surgery gland using the naked eye remains the standard for submandibular gland resection. Owing to its excellent automatic focus and high magnification, the ORBEYE 3D system introduces precise submandibular resection with less stress. Therefore, we examined the usefulness of the exoscope in submandibular gland resection for the first time. Methods: This retrospective study enrolled 12 patients who underwent submandibular gland resection using an ORBEYE exoscope at the Department of Head and Neck Surgery and Otorhinolaryngology at Kansai Medical University from April 2021 to March 2024. Surgical outcomes were retrospectively reviewed. Results: The mean age of the 12 patients (six females and six males) was 58.5 years (23–83 years). The final histopathology showed pleomorphic adenoma in eight cases, non-sebaceous-type lymphadenoma and carcinoma ex pleomorphic adenoma in one case each, and sialolithiasis with chronic inflammation in two cases. We performed facial artery and vein sparing in all cases except one in which level I neck dissection, including the submandibular gland, was performed. In all cases, we identified the marginal mandibular branches of the facial, hypoglossal, and lingual nerves, as well as the submandibular duct. No postoperative complications occurred in any patient. The mean operative time was 104 min (80–129 min). The mean blood volume lost was 20 mL (5–43 mL). Conclusions: Using ORBEYE in submandibular gland resection will contribute to preserving the mandibular marginal branch of the facial and lingual nerves and the facial artery and vein, and visualizing the submandibular duct, which are important structures surrounding the submandibular gland.

The reaction of 2-((diphenylmethylene)amino)acetonitrile with (E)-1-phenyl-3-(thiophen-2-yl)prop-2-en-1-one was performed by using 33% NaOH in CH3CN for 30 min at 0°C. The main product - rel-(2R,3S)-2-((diphenylmethylene)amino)-5-oxo-5-phenyl-3-(thiophen-2-yl)pentanenitrile was isolated and characterized by IR, 1H NMR, 13C NMR and high-resolution mass spectrometry (HRMS).

Snow cover products are primarily derived from the Moderate-resolution Imaging Spectrometer (MODIS) and Advanced Very High-Resolution Radiometer (AVHRR) datasets. MODIS achieves both snow/non-snow discrimination and snow cover fractional retrieval, while early AVHRR-based snow cover products only focused on snow/non-snow discrimination. The AVHRR Climate Data Record (AVHRR -CDR) provides a nearly 40-year global dataset that has a potential to fill a gap in long term snow cover fractional monitoring. Our study selects the Qinghai-Tibet Plateau as the experimental area, utilizing AVHRR-CDR surface reflectance data (AVH09C1) and calibrating with MODIS snow product MOD10A1. The snow cover percentage retrieval from the AVHRR dataset is performed using Surface reflectance at 0.64μm (SR1) and Surface reflectance at 0.86μm (SR2), along with a simulated Normalized Difference Snow Index (NDSI) model. Also, in order to detect the effects of land cover type and topography on snow inversion, we tested the accuracy of the algorithm with and without these influences, respectively (vanilla algorithm & improved algorithm). The accuracy of the AVHRR snow cover percentage data product is evaluated using MOD10A1、 ground snow-depth measurements and ERA5. Results indicate that the logic model based on NDSI has the best fitting effect, with R-square and RMSE values of 0.83 and 0.10, respectively. Meanwhile, the accuracy was improved after taking into account the effects of land cover type and topography. The model is validated using MOD10A1 snow-covered areas, showing snow cover area differences of less than 4% across 6 temporal phases. Improved algorithm results in better consistency with MOD10A1 than vanilla algorithm. Moreover, the RMSE reaches greater levels when the elevation is below 2,000 meters or above 6,000 meters, and is lower when the slope is between 16° and 20°. Using ground snow-depth measurements as ground truth, the multi-year recall rates are mostly above 0.7, with an average recall rate of 0.81. Results also show a high degree of consistency with ERA5. The validation results demonstrate that the AVHRR snow cover percentage remote sensing product proposed in this study exhibits high accuracy in the Tibetan Plateau region, also demonstrating that land cover type and topographic factors are important to the algorithm. Our study lays the foundation for the global snow cover percentage product based on AVHRR-CDR，furthermore lays a basic work for generating a long-term AVHRR-MODIS fractional snow cover dataset.

Lactoperoxidase (LP) is an important enzyme of the salivary and mammary glands. It has been proven to increase the shelf life of raw milk by inhibiting the growth of bacteria, especially Listeria monocytogenes, Escherichia coli, Staphylococcus aureus, and Pseudomonas spp. The aim of this work was to verify the use of LP to extend the shelf life of meat products. In vitro experiments showed inhibitory effects against selected bacteria (Listeria innocua (ATCC 33090), Staphylococcus saprophyticus (CP054440.1), and Pseudomonas fluorescens (ATCC 13525) due to prolongation of the lag phase of growth curves. A lower increase in viable counts (P < 0.05) was also found by testing the pork cubes surface treated with LP solution (5%) + L. innocua and stored for 7 days at 15 °C. LP has also been studied at concentrations of 0.25 and 0.50% in meat products (pork ham and pâté) during refrigerated storage (4 °C for 28 days). Lower viable counts were observed throughout the storage experiment, especially for 0.50% LP (P < 0.05). Meat products containing LP also showed lower levels of oxidation (MAD) (P < 0.05). According to these results, LP could extend the shelf life of a wider range of products.

Objectives: In this retrospective observational study, it is intended to establish how the implementation of the use of antimicrobial optimization programs at the hospital and ICU level in a Sincelejo Sucre Clinic has significantly impacted the improvement of the rational use of antibiotics1, due to the alarming situation of increasing antibiotic resistance. Materials and methods: The methodology used was to analyze the Excel database of the Clinic, in such a way that it would allow comparing the pre-PROA and post-PROA data of 4 antibiotics, ceftriaxone3, ciprofloxacin4, meropenem5 and vancomycin6, measured in Daily Dose. defined. Results: According to the DDD values obtained for the 4 antibiotics, a reduction in DDD was identified in the post-Proa period. On the other hand, considering the DDD reported by the WHO for each of the antibiotics, significant differences were verified compared to the DDD obtained in the clinic in the hospitalization and ICU services. Conclusions: In conclusion, in the clinic there was evidence of a reduction in DDD in the post-ASP2 period compared to the pre-PROA period, both in hospitalization and in the ICU, as well as a slight to large effect with Cohen's D.

Background: Ensemble tree-based models such as Xgboost are highly prognostic in cardiovascular medicine, as measured by the Clinical Effectiveness Metric (CEM). However, their ability to handle correlated data, such as hospital-level effects, are limited. Objectives: The aim of this work is to develop a binary outcome mixed effects Xgboost (BME) model that integrates random effects at the hospital level. To ascertain how well the model handles correlated data in cardiovascular outcomes, we aims to assess its performance and compare it to fixed effects Xgboost and traditional logistic regression models. Methods: A total of 227,087 patients over 17 years of age, undergoing cardiac surgery from 42 UK hospitals between 1 Jan 2012 and 31 Mar 2019 were included. The dataset was split into two cohorts: Training/Validation (n = 157196; 2012-2016) and Holdout (n = 69891; 2017-2019). The outcome variable was 30 days mortality with hospitals considered as clustering variable. The logistic regression, mixed effects logistic regression, Xgboost and binary outcome mixed effects Xgboost (BME) were fitted to both standardized and unstandardized datasets across a range of sample sizes and the estimated prediction power metrics were compared to identify the best approach. Results: The exploratory study found high variability in hospital-related mortality across datasets, which supported the adoption of mixed effects models. Unstandardized Xgboost BME demonstrated marked improvements in predictor power over the Xgboost model at small sample size ranges, but performance differences decreased as dataset sizes increased. Generalized linear models (glm) and generalized linear mixed-effects models (glmer) models followed similar results, with Xgboost models excelling also at greater sample sizes. Conclusions: These findings suggest that integrating mixed effects into machine learning models can enhance their applicability in clinical settings where sample size is small such as rare conditions.

Background: over the past 20 years, the treatment scenario of multiple sclerosis (MS) has radically changed and an ever-increasing number of disease-modifying treatments has emerged. Among high efficacy treatment agents, monoclonal antibodies (mAbs) have become a mainstay in the MS patient’s treatment due to their targeted mechanism, high efficacy and favorable risk profile. The latter varies from drug to drug and a skin cancer warning has emerged with sphingosine 1-phosphate receptors inhibitors. Several cases of skin malignancy in people with MS (pwMS) undergoing therapy with mAbs have also been described, but dermatological follow-up is not currently indicated. Objectives: the aim of this review is to investigate cases of cutaneous ma-lignancy during mAbs therapy and to explore possible pathophysiological mechanisms to evaluate the potential need for regular dermatological follow-up in pwMS treated with mAbs. Methods: literature search for original articles and review in PubMed. No date restrictions. Results: 1019 results were retrieved. Duplicates were removed using Endnote and manually. Only peer-reviewed studies published in English were considered for inclusion. At the end of these screening procedures, 54 studies published between 2001 and 2023 that met the objectives of this review were selected and reported. Conclusions: the available data do not show a clear link be-tween monoclonal antibody (mAb) treatment in pwMS and the risk of skin cancer. At present, these treatments remain contraindicated for people with cancer. Dermatological screening is ad-visable before starting mAb treatment in pwMS, and subsequent follow-up should be individual-ised according to each patient's risk profile.

Image stitching is a crucial aspect of image processing. However, factors like perspective and environment often lead to irregular shapes in stitched images. Cropping or completion methods typically result in substantial loss of information. This paper proposes a method for rectifying irregularly images into rectangles using deformable meshes and residual networks. The method utilizes a convolutional neural network to quantify rigid structures of images. Choosing the most suitable mesh structure based on the extraction results, offering options such as triangular, rectangular, and hexagonal. Subsequently, the irregularly image, predefined mesh structure, and predicted mesh structure are input into a wide residual neural network for regression. The loss function comprises local and global, aimed at minimizing the loss of image information within the mesh and global target. This method not only significantly reduces information loss during rectification but also adapting to different images with various rigid structures. Validation on the DIR-D dataset shows this method outperforms state-of-the-art methods in image rectification.

The article presents several innovative systems developed through student laboratory projects, including two autonomous vehicles, a four-legged walking robot, an active ankle-foot orthosis, a ball on beam balancing mechanism, a ball on plate system, and a manipulator arm—all powered by pneumatic artificial muscles (PAMs). Fluidic muscles offer significant potential in various mechatronic systems, robots, and manipulators due to their flexible, lightweight nature and compliance. Their ability to produce smooth and adaptable motions is particularly beneficial in applications requiring natural and human-like movement, such as rehabilitation and assistive devices. Although PAMs powered control systems face challenges with nonlinear phenomena, their biologically inspired design holds promise for future applications across various industries. These may include innovative applicability in industrial, automotive, and aerospace sectors, as well as use in sports, medical aids, entertainment, and animatronics. Incorporating self-made laboratory systems actuated by PAMs into control systems education offers a comprehensive learning opportunity that combines theoretical concepts with hands-on experience. This approach develops the necessary skills of future engineers, expanding their understanding of technical principles and preparing them for future challenges in engineering practice.

This study investigates the energy profile of a regional hospital in North America using an ASHRAE Level 2 Energy Audit. The audit aimed to assess the efficiency of existing systems, identify areas for improvement, and recommend cost-effective measures to reduce energy consumption and environmental impact. The analysis revealed a well-maintained heating system with efficient boilers. However, a critical concern emerged regarding operational risks due to the lack of redundancy in the cooling system. To address this vulnerability, the study recommends installing an air-cooled chiller for increased operational resilience. The economic feasibility of proposed improvements was evaluated, highlighting the balance between initial investment and long-term savings in energy costs and reduced greenhouse gas emissions. The findings contribute to the discourse on sustainable healthcare practices, emphasizing the importance of energy audits, strategic planning, and redundancy measures for optimized performance and environmental responsibility in hospitals.

Background: Surgical complications are devastating both for patients and treating surgeons. When these complications occur after bariatric procedures, due to specific characteristics of this population, management, although multidisciplinary should always be led by a surgical team. Methods: We present major complications treated at our general surgery service over a seven -year period. Case series: we present 5 cases that were treated at our service after a bariatric procedure was performed. Two patients were operated at another country and one of them at another service. Three of patients showed perforation and leak related complications. One patient died due to refeeding syndrome complications after revisional surgery. Conclusions: Optimal preoperative evaluations and surgical planning are mandatory for any type of surgery including bariatric procedures, attempting to adequate and well-established surgical techniques extensively described in medical literature is associated with better outcomes. Also is our understanding that easy channels of communication between patients and treating surgeons could avoid delay in detecting and treating life-threatening conditions.

Estimating Forest growing stock volume (GSV) is crucial for forest growth and resource management, as it reflects forest productivity. National measurements are laborious and costly, however integrating satellite data such as optical, Synthetic Aperture Radar (SAR), and Airborne Laser Scanning (ALS) with National Forest Inventory (NFI) data and machine learning (ML) methods has transformed forest management. In this study, Random Forest (RF), Support Vector Regression (SVR), and Extreme Gradient Boosting (XGBoost) were used to predict GSV using Estonian NFI data, Sentinel-2 imagery, and ALS point cloud data. Four variable combinations were tested: CO1 (vegetation indices and LiDAR), CO2 (vegetation indices and individual band reflectance), CO3 (LiDAR and individual band reflectance), and CO4 (a combination of vegetation indices, individual band reflectance, and LiDAR). Across Estonia's geographical regions, RF consistently delivered the best performance. In the northwest (NW), RF achieved an R² of 0.63 and an RMSE of 125.39 m³/plot. In the southwest (SW), it achieved an R² of 0.73 and an RMSE of 128.86 m³/plot. In the northeast (NE), RF achieved an R² of 0.64 and an RMSE of 133.77 m³/plot, and an R² of 0.70 and an RMSE of 120.72 m³/plot was achieved in the southeast (SE). These results underscore RF's precision in predicting GSV across diverse environments, though refining variable selection and improving tree species data could further enhance accuracy.

Rhodiola rosea, a perennial herb from the Crassulaceae family, contains the bioactive compound salidroside, recognized as an adaptogen with significant therapeutic potential for bone metabolism. Salidroside promotes osteoblast proliferation and differentiation by activating critical signaling pathways, including bone morphogenetic protein-2 and adenosine monophosphate-activated protein kinase, essential for bone formation and growth. It enhances osteogenic activity by increasing alkaline phosphatase activity and mineralization markers, while upregulating key transcription factors such as runt-related transcription factor 2 and osterix. Additionally, salidroside facilitates angiogenesis via the hypoxia-inducible factor 1-alpha and vascular endothelial growth factor pathway, crucial for coupling bone formation with vascular support. Its antioxidant properties offer protection against bone loss by reducing oxidative stress and promoting osteogenic differentiation through the nuclear factor erythroid 2–related factor 2 pathway. Salidroside's ability to counteract the negative effects of glucocorticoids on bone cells and prevent steroid-induced osteonecrosis, along with its anti-inflammatory properties, enhances its potential in treating conditions like osteoarthritis. These attributes underscore its multifaceted role in bone metabolism. This article reviews the literature, including in vitro and in vivo studies primarily on rodent models, demonstrating salidroside's efficacy in mitigating bone loss, preserving bone microarchitecture, and accelerating fracture healing. Future research directions to explore salidroside’s applications in bone-related diseases are also highlighted.

COVID-19 infection in high-risk populations is fatal and has a poor prognosis, necessitating a test to determine the protectiveness of immune response. Antibody testing is necessary to determine the body's immune response to COVID-19 infection and also vaccination strategies. Among the various methods available, chemiluminescent immunoassay (CLIA) test is more widely used and accessible to determine antibody levels. This study aimed to determine the protection level of S-RBD SARS-CoV-2 IgG using CLIA compared to Surrogate Virus Neutralization Test (SVNT). The population of this study comprised all healthcare professionals who experienced S-RBD SARS-CoV-2 IgG antibody level examinations. S-RBD SARS-CoV-2 IgG antibody levels were examined using CLIA and SVNT. The cut-off was determined using Receiver Operating Characteristic (ROC) curve and AUC (Area Under the Curve) measurements were evaluated. The result showed a strong positive correlation between S-RBD SARS-CoV-2 IgG CLIA and SVNT with a value of r=0.933 and p <0.001. The value ≥37.29 BAU/mL was determined as the cut-off based on SVNT 30% inhibition level with sensitivity, specificity, positive, and negative predictive values of 96.5%, 90.9%, 96.5%, and 90.9%, respectively. A titer of antibodies greater than or equal to 37.29 BAU/mL with CLIA showed the presence of protective antibodies compared to SVNT.

The purpose of this evaluation is to determine the effect of intensive, interactive training on hospital workers’ preparedness for special pathogen cases by utilizing the Frontline Facility Special Pathogens Training Course created by New York

Modification of electrode surface with a selective layer gives the possibility to detect target ana-lytes of forensic interest. 3-(4-trifluoromethyl)-phenyl)-thiophene (ThPhCF3) was deposited on a graphite (G) electrode by electrochemical oxidation and characterized as a receptor for the recognition of synthetic stimulants (2-aminoindane, buphedrone, naphyrone). First, the structural characterization of the polymeric layer were obtained from Raman spectroscopy. Second, the electrochemical profiles of selected synthetic stimulants and their affinity to ThPhCF3/G-modified electrodes were studied using square wave voltammetry and electrochemical impedance spec-troscopy. The values of the adsorption constant show the importance of – PhCF3 groups in the interaction with synthetic stimulants, namely recognition by the formation of hydrogen bonds (Kads (buphedrone) < Kads (2-AI)) and interaction with aromatic H atoms (Kads (buphedrone) < Kads (naphyrone)). It was demonstrated that the polymeric layer derived from thiophene with – PhCF3 group is capable to increase the intensity of the electrochemical signal.

Aquifer karstic structures, due to their complex nature, present significant challenges in accurately mapping their intricate features. Traditional methods often rely on invasive techniques or sophisticated equipment, limiting accessibility and feasibility. In this paper, we propose a new approach to non-invasive, low-cost 3D reconstruction using a camera that observes the light projection of a simple diving lamp. Our method capitalizes on the principles of structured light, leveraging the projection of light contours onto the karstic surfaces. By capturing the resultant light patterns with a camera, we reconstruct three-dimensional representations of the structures. The simplicity and portability of the equipment required make this method highly versatile, enabling deployment in diverse underwater environments. We validate our approach through extensive field experiments conducted in various aquifer karstic settings. The results demonstrate the efficacy of our method in accurately delineating intricate karstic features with remarkable detail and resolution. Furthermore, the non-destructive nature of this technique minimizes disturbance to delicate aquatic ecosystems while providing valuable insights into the subterranean landscape. This innovative methodology not only offers a cost-effective and non-invasive means of mapping aquifer karstic structures but also opens avenues for comprehensive environmental monitoring and resource management. Its potential applications span hydrogeological studies, environmental conservation efforts, and sustainable water resource management in karstic terrains worldwide.

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

Our previous studies demonstrated a tight connection between simvastatin (SIM) inhibition of B16.F10 murine melanoma cell proliferation in vivo and in vitro and strong suppression of the subunit α of hypoxia inducible factor 1 (HIF-1) (HIF-1 α) production in these cancer cells. Since the translation of HIF-1α is modulated by signaling pathways coordinated by Akt, SIM effects on the link between these two regulatory factors and cancer cell metabolism under normoxia was investigated, which to our knowledge have never been described before. To achieve the proposed aim, SIM effects on cell metabolism were analysed at mRNA (via RNA-seq and RT-qPCR) as well as protein level (via western blot and catalytic activity of the key enzymes) Our data suggested that SIM might orientate glucose transport and metabolism to ensure replenishment of tricarboxylic acid (TCA) cycle activity. Moreover, it seems that SIM enhanced biosynthetic role of TCA over its energy role to further support synthesis of lipid-derived signaling molecules. Thus, under normoxia SIM treatment orientated lipid metabolism to stimulate isoprenoid and prostaglandin synthesis which might favor melanoma cell survival and aggressiveness.

Tumid Lupus Erythematosus has been the subject of heated debate as to its correct nosographic classification. In particular, its definition has changed over time, depending on the different studies performed. In this review we address the initial definition of TLE, the changes that have taken place in the understanding and placement within the classification of Lupus Erythematosus (LE), and focus on clinical, histopathological, immunophenotypical and differential diagnosis aspects.

Background/Objectives Bowel endometriosis (BE) is defined as the presence of endometrial-like tissue in the muscular layer of the bowel wall. When BE does not cause severe obstruction to fecal transit, not leading to (sub)occlusive symptoms, the decision to operate becomes challenging as intestinal surgery is associated with higher complication rates and long-term bowel dysfunction. The aim of this cross-sectional study is to evaluate the quality of life (QoL) in patients with BE undergoing medical therapy or expectant management, investigating the impact of characteristics of BE nodules on QoL and intestinal function. Methods A retrospective cross-sectional analysis was conducted on 580 patients with BE who did not undergo surgery but were treated conservatively by medical therapy or expectant management between January 2017 and August 2022. The diagnosis of BE was done by transvaginal ultrasound and confirmed at double contrast barium enema. After at least one year of follow-up, QoL and intestinal function of patients were evaluated by the Endometriosis Health Profile-5 (EHP-5) questionnaire and Bowel Endometriosis Symptom score (BENS), whereas pain symptoms were assessed by the Visual Analogic Scale (VAS 0-10). Statistical analysis was performed to investigate possible associations between QoL and characteristics of bowel nodules (dimension, location, and evidence of stenosis) as well as type and length of eventual medical therapy. Results Patients with BE had a satisfying overall QoL with a mean EHP-5 score of 105.42 ± 99.98 points and VAS lower than 3 for all pain domains; additionally, they did not show a significant impartment of bowel function with mean BENS score of 4.89 ± 5.28 points. Notably, patients under medical therapy had a better QoL than patients without therapy (p

This paper presents the work done to transition the lab scale synthesis (1 g) to a large scale (400 g) synthesis of the 3-5-diamino-1H-Pyrazole Disperazol; a new pharmaceutical for treatment of antibiotic resistant Pseudomonas aeruginosa biofilm infections. The potentially hazardous diazotisation step in the lab scale synthesis was transformed to a safe and easy to handle flow chemistry step. Additionally, the paper presents an OSHA recommended safety assessment of the active compound E, performed by Fauske and Associates, LLC.

The structure verification of 5'-oxospiro-(fluorene-9,4'-imidazolidine)-2'-thione by NMR was reported. For the aim, 2D NMR techniques including 1H-1H COSY, HMQC and HMBC experiments were used to assist the assignment of the 1H and 13C chemical shifts for the corresponding structure. The mutual interpretation of the 1D and 2D NMR spectra ensured a complete and an accurate 1H and 13C NMR data assignment for 5'-oxospiro-(fluorene-9,4'-imidazolidine)-2'-thione.

Background: An aberrant cellular microenvironment characterized by pathological cells or inflammation represents an added risk factor across various cancer types. While the significance of chronic inflammation in the development of most diffuse tumors has been extensively studied, an exception to this analysis exists in the context of Chondrosarcomas. Chondrosarcomas represent 20–30% of all skeletal sarcomas and have an estimated incidence of 1 in 100,000 worldwide. The mean age of presentation is 50, with over 70% of patients over the age of 40 at the time of diagnosis. The aim of this retrospective study was to analyze the role of C-reactive protein (CRP) as a prognostic factor in relation to the histopathological findings for Chondrosarcoma. Methods: This retrospective study included 73 patients with confirmed Chondrosarcoma diagnosis treated between 2004 and 2019. Preoperative CRP determination was assessed in mg/dL with a non-pathological value below 0.5 mg/dL. Disease-free survival time was calculated as the time between the initial diagnosis and an event like local recurrence or metastasis. Follow-up status was described in death of disease, no evidence of disease and alive with disease. The exclusion criteria of this study included insufficient laboratory values, lack of information regarding the follow-up status and incomplete histopathological report. Results: The calculate risk estimation of a reduced follow-up time was 2,25 time higher in the patients with an CRP level &gt;0.5 mg/dL (HR 2,25 and 95% CI 1,13-4,45) and 3 times higher in patients with a tumour size &gt;pT2 (HR 3 and 95% CI 1,59-5,92). We can easily confirm that the most elevated risk for a reduce follow-up time relies in chondrosarcomas high grading, preoperative pathological CRP- level and a size &gt;8 cm. Conclusions: In Chondrosarcoma cases, we can consider CRP pretreatment value &gt;0.5 mg/dL a sensitive prognostic and sensitive risk factor for distant metastasis.

Dopaminergic replacement therapy remains the mainstay of symptomatic treatment for Parkinson’s disease (PD), but many unmet needs and gaps remain. Device based treatments or device-aided non-oral therapies are typically used in the advanced stages of PD, ranging from stereotactic deep brain stimulation to levodopa or apomorphine infusion therapies but there are concerns due to a number of procedural, hardware, or long-term treatment-related side effects of these treatments, and limited nonmotor benefit in PD. Therefore, there is an urgent unmet need for low risk adjuvants or standalone therapies which can address the range of burdensome motor and nonmotor symptoms that occur in PD. Recent studies suggest that non-invasive neurostimulation of the vestibular system may be able to address these gaps with stimulation of the vestibular brainstem sensory network which extensively innervates brain regions regulating both motor and a range of nonmotor functions. Therapeutic non-invasive vestibular stimulation is a relatively modern concept that may potentially improve a broad range of motor and nonmotor symptoms of PD, even at early stages of the disease. Here we review previous studies supporting the therapeutic potential of vestibular stimulation for the treatment of PD and discuss ongoing clinical trials and potential areas for future investigations.

Achieving the thermal conductivity required for efficient heat management in semiconductors and other devices requires the integration of thermally conductive ceramic fillers at concentrations of 60 vol% or higher. However, the increased filler content often negatively affects the mechanical properties of the composite matrix, limiting its practical applicability. To address this issue, in this paper, we present a new strategy to reduce the required ceramic filler content: the use of a thermally conductive ceramic composite filler with carbon nanotubes (CNT) grown on aluminum nitride (AlN). We have combined catalyst coating technology with vacuum filtration to ensure that the catalyst is uniformly applied to micrometer-sized AlN particles, followed by efficient and uniform synthesis of CNTs using a water-assisted process in a vertical furnace. By carefully controlling the number of vacuum filtration cycles and the growth time of the CNTs, we demonstrate precise control over the number and length of the CNT layers, thereby adjusting the properties of the composite to the intended specifications. When AlN/CNT hybrid fillers are incorporated into silicone rubber, while maintaining the mechanical properties of rubber, the thermal diffusivity achieved at reduced filler levels exceeds that of composites using AlN-only or simultaneous AlN and CNTs formulations. This demonstrates the critical role of CNTs on AlN surfaces. Our study represents a significant advancement in the design of thermally conductive materials with potential implications for a wide range of applications.

Although migraine belongs to the main causes of disability worldwide the mechanisms of its pathogenesis are poorly known, which is among the reasons that this disease is underdiagnosed and undertreated. As migraine diagnosis is based on the subjective assessment of symptoms, there is a need to establish objective markers of its occurrence and severity. Tryptophan (TRP) metabolism has been associated with the pathogenesis of neurological and psychiatric disorders. In the present work, we investigated an association between migraine and the urine concentration of TRP and its metabolites 5-hydroxyindoleacetic acid (5-HIAA), kynurenine (KYN), kynurenic acid (KYNA) and quinolinic acid (QA) in 21 low-frequency episodic migraine patients and 32 controls. Migraine patients displayed lower urinary levels of 5-HIAA and KYNA, but KYN and QA were enhanced as compared with the controls. Consequently, the patients were characterized by different values of the 5-HIAA/TRP, KYN/TRP, KYNA/KYN, and KYNA/QA ratios. Furthermore, urinary concentration of 5-HIAA was negatively correlated with Migraine Disability Assessment score, monthly migraine, and monthly headache days. A negative correlation between Patient Health Questionnaire 9 scores assessing depression. In conclusion, the urinary 5-HIAA level may be an easy-to-determine marker of migraine occurrence and severity and may contribute to the identification of migraine patients with depression.

Bipolar disorder is a debilitating psychiatric condition characterized by recurrent episodes of mania and depression, affecting millions worldwide. While pharmacotherapy remains the cornerstone of treatment, a significant proportion of patients exhibit inadequate response or intolerable side effects to conventional medications. In recent years, neuromodulation techniques have emerged as promising adjunctive or alternative treatments for bipolar disorder. We performed a narrative review to provide a comprehensive overview of the current literature on neuromodulation interventions in bipolar disorder across the course of lifespan. Specifically, it examines the efficacy, safety, and mechanisms of action of various neuromodulation strategies, including, among others, transcranial magnetic stimulation (TMS), electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), deep brain stimulation (DBS), and it describes the therapeutic experiences across the different ages of illness. Additionally, this review discusses the clinical implications, challenges, and future directions of the integration, in the clinical practice, of neuromodulation into the management of bipolar disorder. By synthesizing evidence from different studies, this review aims to inform clinicians, researchers, and stakeholders about the evolving landscape of neuromodulation treatments and their potential role in improving outcomes for individuals with bipolar disorder.

Levels of trace element pollution in surface soil can be estimated using soil analyses and leaching tests. These methods may reveal different results due to the effect of soil properties, such as grain size and mineral composition, on elemental availability. Therefore, this study advocates an alternative method for monitoring and assessment of trace element pollution in surface soil using terricolous fruticose lichens. Lichens growing at abandoned mine sites and unpolluted areas in southwest Japan and their substrata were analyzed using inductively coupled plasma-mass spectrometry and X-ray fluorescence spectrometry to clarify the relationships between Cu, Zn, As, and Pb concentrations in lichens and soils, including their absorption properties. Concentrations of these elements in the lichens were positively correlated with those in the soils regardless of lichen species, location, habitat, or conditions of soils. The analyzed lichens had neither competitive nor antagonistic properties in their elemental absorption, which made them good biomonitors of trace element pollution in surface soil. The distribution maps of average Cu, Zn, As, and Pb concentrations at each sampling region detected almost all of the Cu, Zn, and As pollution of the soils. Therefore, lichens could be used in practical applications to monitor Cu, Zn, and As pollution in surface soils.

Background: Histone deacetylases (HDACs) are implicated in carcinogenesis, and HDAC inhibitors (HDACis) are explored as a therapeutic tool in several tumors. The aim of this study was to evaluate the clinical significance of HDAC -2, -4, and -5 expression in epithelial ovarian carcinoma (EOC). Methods: HDAC-2, -4, and -5 immunohistochemical expression was examined in 92 EOC tissue specimens and was correlated with clinicopathological characteristics. Results: HDAC-2 was the most frequently (94.4%) expressed isoform, being marginally higher in serous tumors compared with other types (p=0,08). HDAC-5 was the less frequently expressed (28.1%), being positively associated with HDAC-4. HDAC-4 positivity was associated with lower FIGO-stage (p=0,045) and T-category (p=0.,043) and the absence of lymph node (p=0,05) or distant metastasis (p=0,09) in serous carcinomas. HDAC-2 positivity was correlated with absence of lymph node metastasis in serous tumors (p=0,045). On the contrary, HDAC-5 nuclear positivity was correlated with lymph node metastasis in the entire cohort (p=0,048). HDAC-4 positivity was marginally associated with favorable prognosis in serous carcinomas in univariate survival analysis (p=0,086), a correlation which was not significant in multivariate analysis. Conclusion: These findings suggest a differential expression of HDAC-2, -4 and -5, providing evidence for a potential role in the pathobiology of EOC.

Introduction: Anemia and undernutrition are severe public health concerns in Ethiopia. These are the two most common nutritional disorders in pregnant women and frequently co-exist. However, to the best of our knowledge, the evidence is lacking on the co-existence of anemia and undernutrition among pregnant women. Therefore, this study aimed to examine the prevalence of co-existing anemia and undernutrition (CAU) and associated factors among pregnant women. Methods: A community-based cross-sectional study was conducted from June 1–25, 2024, on a sample of 515 pregnant women in the Hawela Lida district of Sidama region, Ethiopia. We utilized a multi-stage sampling method to choose eligible study participants. A pre-tested and structured questionnaire was used to collect data via the online Open Data Kit mobile tool. We controlled the effect of confounders and clustering by using a multi-level mixed-effect modified Poisson regression analysis model. Result: The prevalence of CAU among pregnant women was 25.4% (95% CI: 21.9–28.9). The prevalence of CAU was associated with household food insecurity (adjusted prevalence ratio [APR]: 2.17; 95% CI: 1.43–3.28), training on model family (APR: 0.66; 95% CI: 0.45-0.96), inadequate dietary diversity (APR: 1.51; 95% CI: 1.18–1.95), and having poor knowledge of nutrition (APR: 1.55; 95% CI: 1.06-2.26) at individual levels. Low community-level women’s autonomy (APR: 6.19; 95% CI: 3.42-11.22) and community-level road accessibility (APR: 0.65; 95% CI: 0.43-0.98) were the identified determinants of CAU at the community level. Conclusion: One in four pregnant women was CAU in the study area. Household food insecurity, receiving model family training, inadequate dietary diversity, having poor knowledge of nutrition, low community-level women’s autonomy, and community-level road accessibility were the significant determinants of CAU. Therefore, inter-sectorial collaboration should be required to comprehensively address the determinants of CAU at different levels. Besides, any CAU prevention and intervention programs should provide model family training specifically targeting women who have poor nutritional knowledge and a low level of autonomy in health care decision-making.

Rheumatoid arthritis (RA) is a chronic inflammatory disease. Despite new methods of diagnostics and treatment as well as extensive biological and immunosuppressive treatment, the etiology of RA is not fully understood. Moreover, the problem of diagnosis and treatment of RA patients is still current and affects a large group of patients. It is suggested that these ER-related features may impair adaptation to chronic stress, inferring the risk of rheumatoid arthritis. The main goal in this study was evaluation of changes in mRNA translation to determine chronic ER stress conditions in rheumatoid arthritis patients. The study group consist of 86 individuals including total 56 rheumatoid arthritis patients and 30 healthy controls. The expression level of mRNA form blood samples of RA patients as well as controls of the PERK-UPR associated genes: p-eIF2, BCL-2, PERK, ATF4, BAX were investigated by Real-Time qPCR. GAPDH expression was used as a standard control. Considering the median, the expression of PERK, BCL-2, p-eIF2, ATF4, BAX was found to be significantly increased in the blood of RA patients compared with the control group. The p-value for the PERK gene was 0.0000000036, the p-value for the BCL-2 gene was 0.000000014, the p-value for the p-eIF2 gene was 0.006948, the p-value for the ATF4 gene was 0.0000056 and the p-value for the BAX gene was 0.00019, respectively. Thus, it can be concluded that targeting of the components of the PERK-dependent UPR signaling pathway via small-molecule PERK inhibitors, may contribute to the development of novel, innovative treatment strategies against rheumatoid arthritis.

Colorectal cancer is one of the most common causes of cancer mortality worldwide, and innovative drugs for the treatment of colorectal cancer are continually being revealed. 5-Fluorouracil (5-FU) is a common clinical chemotherapeutic drug. Acquired resistance to 5-FU is a clinical challenge in colorectal cancer. Parecoxib is a selective COX-2-specific inhibitor, which has been demonstrated to inhibit metastasis in colorectal cancers in our previous study. This study aimed to investigate the synergistic antimetastatic activities of parecoxib to 5-FU in human colorectal cancer cells and determine the underlying mechanism. parecoxib and 5-FU synergistically suppressed metastasis in colorectal cancer cells. Treatment with the parecoxib /5-FU combination induced an increase in E-cadherin and decrease in β-catenin. The parecoxib/5-FU combination could inhibit MMP-9 and MMP-2 expression and MMP-9 activity, and the NF-κB pathway might be suppressed as well. Mechanistic analysis denoted that the parecoxib/5-FU combination hindered the essential molecules of the PI3K/Akt route to obstruct metastatic colorectal cancer. Furthermore, the parecoxib/5-FU combination could inhibit reactive oxygen species. Our work showed the antimetastatic capacity of the parecoxib/5-FU combination for colorectal cancers via targeting the PI3K/Akt /NF-κB pathway.

Synaptopodin 2-like protein (SYNPO2L) is localized in the sarcomere of cardiomyocytes and is involved in heart morphogenesis. However, the molecular function of SYNPO2L in the heart is not fully understood. We investigated the interaction of SYNPO2L with sarcomeric alpha-actinin and actin filaments in cultured mouse cardiomyocytes. Immunofluorescence studies showed that SYNPO2L colocalized with alpha-actinin and actin filaments at the Z-discs of the sarcomere. Recombinant SYNPO2La or SYNPO2Lb caused bundling of actin filaments in the absence of alpha-actinin and enhanced alpha-actinin-dependent formation of actin bundles. In addition, high-speed atomic force microscopy revealed that SYNPO2La directly bound to alpha-actinin via its globular ends. The interaction between alpha-actinin and SYNPO2La stabilized the two proteins on actin filaments. These results strongly suggest that SYNPO2L cooperates with alpha-actinin during actin bundle formation to facilitate sarcomere formation and maintenance.

Our study optimized MET ex14 skipping mutation detection by analyzing 223 Oncomine Focus Assay (OFA)-positive cases using Pan Lung Cancer PCR Panel (AmoyDx) and reverse transcription (RT)-PCR. Among the 11 MET ex14 skipping mutation-positive cases (average read counts: 1,390), two with OFA read counts of 2540 and 10177 were positive on all platforms. Those with OFA read counts ranging from 179–612 tested negative elsewhere. Specimens with low ratios (average ratio: 0.12% for nine cases) may yield false-positive results. Our results suggested monitoring read counts and ratios, and validating results with RT-PCR, is crucial to prevent false positives.

Introduction: In Ethiopia, maternal undernutrition is a major public health concern. However, comprehensive evidence is lacking in the southern part of Ethiopia, specifically the household and community-level related determinants of undernutrition. Besides, the evidence about the prevalence and determinants of undernutrition is not yet documented in the current study setting. Thus, this study aimed to determine the prevalence of undernutrition and identify its determinants among pregnant women in Hawela Lida district of the Sidama region, Ethiopia.Methods: A community-based cross-sectional study was conducted on a sample of 515 pregnant women from June 1–25, 2024. A multi-stage sampling method was utilized to select eligible pregnant women. We collected data using the Open Data Kit smart phone device and exported it to Stata version 17 for further processing and analysis. A multi-level mixed-effects modified Poisson regression analysis with robust variance was used to account for between and with cluster effects.Result: The prevalence of undernutrition among pregnant women was 41.7% (95% CI: 37.3–45.6). The prevalence of undernutrition was associated with planned pregnancy (adjusted prevalence ratio [APR]: 0.80; 95% CI: 0.66-0.98), household food insecurity (APR: 1.64; 95% CI: 1.26-2.13), inadequate dietary diversity (APR: 1.79; 95% CI: 1.43-2.25), and women’s poor knowledge of nutrition (APR: 1.68; 95% CI: 1.32-2.12) at individual levels. The identified determinants of undernutrition at the community level were low community literacy rates (APR: 4.62; 95% CI: 1.13–18.79) and low community wealth status (APR: 1.91; 95% CI: 1.10–3.31).Conclusion: Two in five pregnant women had an undernutrition problem in the study setting. Individual and community-level determinants contributed to the high prevalence of undernutrition. Thus, any prevention and control approaches to undernutrition should consider inter-sectorial collaboration to account for determinants at various levels. Besides, any program must emphasize the delivery of nutrition education about dietary diversity, particularly targeting pregnant mothers who have poor knowledge of nutrition and unplanned pregnancy at the individual level. Moreover, creating a small business reform for the community with low wealth status using agricultural extension workers must be considered.

Background: The management of erectile dysfunction (ED) shows several grey zones and new treatments for reduce the percentage of patients who discontinued the treatment are required. Here, we aim to evaluate the role of a natural mixture of named Icarifil (L-Citrulline, L-Carnitine, Eruca vesicaria, Panax ginseng, Tribulus terrestris, Turnera diffusa, Taurine, Vitamin E, Zinc) in the management of patients with ED. Methods: From September 2022 to March 2023, all patients attending 3 urological institutions due to ED were randomized to receive: Icarifil 1 sachet every 24 h (Group 1) or Icarifil 1 sachet + tadalafil 5 mg 1 tablet every 24 h (Group 2) or tadalafil 5 mg 1 tablet daily (Group 3), for 3 months. All patients underwent urologic visit and dedicated questionnaires (IIEF-5, SEP-2, SEP-3) at the enrollment and at the follow-up evaluation (3 months). Patient Reported Outcomes (PROs) at the follow-up evaluation were used. Primary endpoint was the difference in the questionnaires at the follow-up visit when compared with enrollment among the study groups. Results: In the per-protocol analysis, 52 patients in the Group 1, 55 in the Group 2 and 57 in Group 3 have been analyzed. At the follow-up evaluation, IIEF-5 have been improved in all the 3 Groups between enrollment and follow-up evaluation, but a statistically significant difference has been reported between Group 2 (+7.4) versus Group 1 (+4.1) or 3 (+5.1), (p&lt;0.001; p&lt;0.001). Moreover, 47 patients (94.0%) in the Group 2 showed an improvement in the SEP questionnaires, when compared with the baseline, while 29 in the Group 1 (56.9%) and 42 in the Group 3 (82.3%) with a statistically significant difference (p=0.004; p=0.003) among the Groups. The PROs analysis reported a better efficacy and patients’ satisfaction in Group 2 when compared with Group 1 or 3. Conclusions: In conclusion, Icarifil is able to improve penile erectile function in mild–moderate ED and it is able to significantly improve the clinical efficacy of tadalafil 5 mg daily use. Icarifil could be represent an interesting alternative treatment in patients experiencing adverse effects or with contraindications for chronic treatment with PDE5-is.

The Mediterranean Diet, characterized by high intake of plant foods and unsaturated fats, has been suggested to improve assisted reproductive technology (ART) outcomes. This literature review aimed to summarize the evidence from observational studies on the associations between preconception Mediterranean Diet and ART outcomes. PubMed/MEDLINE, Embase, ScienceDirect, and Google Scholar databases were searched to identify relevant studies. Seven observational studies (n=2,321 women on ART) were included. Adherence to the Mediterranean Diet was assessed by food frequency questionnaires with 6-195 items. Three studies found that higher Mediterranean Diet scores improved Clinical Pregnancy or Live Birth rates, while two studies showed a positive effect on ART eggs and embryos. However, two studies reported no significant associations with ultimate ART success, and four studies found no effects on oocyte and embryo number or quality. Evidence for the effects of greater adherence to the Mediterranean Diet on ART outcomes is limited but promising. Additional rigorous research is needed to clarify and weigh the degree of association between the Mediterranean Diet and ART success.

(1) Background: A simple approach to map irrigated landcover has been introduced by using measures derived from optical spectral range as an alternative to thermal range. It has been demonstrated that substituting surface temperature (Ts, ‘thermal approach’) with SWIR transformed reflectance (STR, ‘optical approach’) to detect surface moisture is feasible with comparable results. (2) Methods: Using an iterative thresholding procedure to minimize within-class variance, the bilevel segmentation of variables derived from Landsat-8 representing surface moisture and vegetation cover was achieved for the 2020-21 summer for a key irrigation district in Australia. (3) Results: The results of irrigated landcover by optical approach found to be comparable with those by thermal approach. The classification accuracy was assessed using water delivery records at farm level. Though the overall accuracy is high in both cases, the optical approach (97.6%) performed slightly better than the thermal approach (93.9%). (4) Conclusions: The feasibility of using STR to map irrigated landcover has been confirmed by a high-level overall accuracy assessment. This has broader implications in terms of irrigated landcover assessment, as the use of satellite imagery in these applications may not necessarily be limited to microwave or thermal sensors.

Background: Hypoalbuminemia is known to be associated with adverse outcome in critical illness. In this study, we attempted to identify if hypoalbuminemia on emergency department (ED) arrival a reliable predictor for in-hospital mortality in necrotizing fasciitis (NF). patients. Method: A retrospective cohort study of hospitalized patients with NF was conducted in a tertiary teaching hospital in Taiwan between March 2010 and March 2018. Blood samples were collected in the ED upon arrival, and serum albumin levels were determined. we evaluated the predictive value of serum albumin level at ED presentation for in-hospital mortality. All collected data were statistically analyzed. Result: Of the 707 NF patients, 40 (5.66%) died in the hospital. The mean serum albumin level was 3.1 ± 0.9 g/dL and serum albumin levels were significantly lower in the non-survivor group than in the survivor group (2.8± 0.7 g/dL vs. 3.5 ± 0.8 g/dL). In the multivariable logistic regression model, albumin was associated with in-hospital mortality significantly (odds ratio[OR] 0.92, 95% confidential interval (CI) 0.88–0.96, P <0.001). The area under-the-receiver-operating-characteristic curve (AUC) for in-hospital survival was 0.77 (95% CI 0.72–0.82) and corresponding sensitivity, specificity, positive predictive value, negative predictive value, positive and negative likelihood ratio were 66%, 74%, 33%, 88%, 2.25 and 0.48, respectively. High sensitivity (96%) was shown at albumin level of 4.0 g/dL and high specificity (91%) was shown at level of 2.5 g/dL. Conclusion: Initial serum albumin levels were independently associated with in-hospital mortality among adult patients with necrotizing fasciitis and demonstrated fair discriminative performance in the prediction of in-hospital mortality. NF patients with hypoalbuminemia on ED arrival should be closely monitored for signs of deterioration and consider early and aggressive intervention to prevent mortality.

The Simultaneous Localization And Mapping (SLAM) scanner is an easy and portable Light Detection And Ranging (LiDAR) data acquisition device. Its main output is a 3D point cloud covering the scanned scene. Regarding the importance of accuracy in the survey domain, this paper aims to assess the accuracy of two SLAM scanners: the NavVis VLX and the BLK2GO Scanner. This assessment is conducted for both outdoor and indoor environments. In this context, two types of reference data are used: the Total Station (TS) and the static scanner Z+F Imager 5016. To carry out the assessment, four comparisons are tested: cloud to cloud, cloud to mesh, mesh to mesh, and edge detection board assessment. However, the results of the assessments confirm that the accuracy of indoor SLAM scanner measurements (5 mm) is greater than that of outdoor ones (between 10 mm and 60 mm). Moreover, the comparison of cloud to cloud provides the best accuracy regarding direct accuracy measurement without manipulations. Finally, based on the high accuracy, scanning speed, flexibility, and the accuracy differences between tested cases, it is confirmed that SLAM scanners are effective tools for data acquisition.

Abstract Background: Occipital neuralgia is a debilitating condition and traditional treatments often provide limited or temporary relief. Recently, ultrasound-guided hydrodissection of the greater occipital nerve (GON) has emerged as a promising minimally invasive approach. Objectives: To describe two novel ultrasound-guided hydrodissection with 5% dextrose for GON and discuss their advantages, disadvantages, and considerations. Methods: Two case reports are presented. Case 1 describes a lateral decubitus approach for hydrodissecting the GON between the semispinalis capitis (SSC) and obliquus capitis inferior (OCI) muscles. Case 2 details a cranial-to-caudal approach for hydrodissecting the GON within the SSC and upper trapezius (UT) muscles when the GON pass through these two muscles. Results: Both patients experienced significant and sustained pain relief with improvements in function and quality of life. Conclusions: Ultrasound-guided GON hydrodissection using 5% dextrose is a promising treatment for occipital neuralgia. The lateral decubitus and cranial to caudal approaches provide additional options to address patient-specific anatomical considerations and preferences.

Introduction: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection may cause acute respiratory failure but also remains responsible for many other pathologies, including electrolyte disorders. SARS-CoV-2 infection can cause dysfunction of the renin-angiotensin-aldosterone system and disrupt water hemostasis with thirst and appetite abnormalities. Dysnatremia affects prognosis and may be associated with mortality in patients admitted to SARS-CoV2 intensive care. Patients and Methods: The study included 209 patients admitted to the Intensive Care Unit between April 12, 2021, and March 1, 2022 who were over 18 years old and diagnosed with SARS-CoV-2 infection by clinical and thoracic tomography findings or with a positive reverse transcription polymerase chain reaction (RT-PCR) test result. The laboratory markers, treatment modalities, nutritional, and respiratory support also for outcome evaluation, length of stay in the ICU, total hospitalization duration, and mortality in ICU were recorded.The laboratory marker comparison was made admission with the final assessment performed before the time of mortality in ICU or discharge. Results: Inotropic requirements among patients were high which was reflected in the first-month mortality. Hypernatremia presence was associated with an increase in enteral support and inotropic support requirement and mortality. Hypernatremia was correlated with diabetes mellitus, chronic renal failure, and a longer duration under mechanical ventilation. Discussion: Hypernatremia was an important risk factor in ICU patients hospitalized for SARS-CoV-2 infection, which was also affected by the treatment regimens given itself. This complex relationship underlies the importance of proper electrolyte management, especially in patients who were under severe stress and organ failure.

The chemotactic cytokine fractalkine (FKN, chemokine CX3CL1) has unique properties resulting from the combination of chemoattractants and adhesion molecules. The soluble form (sFKN) has chemotactic properties and potently attracts T cells and monocytes. The membrane-bound form (mFKN) facilitates diapedesis and is responsible for cell-to-cell adhesion, especially by promoting the strong adhesion of leukocytes (monocytes) to activated endothelial cells with the subsequent formation of an extracellular matrix and angiogenesis. FKN signaling occurs via CX3CR1, which is the only known member of the CX3C chemokine receptor subfamily. Signaling within the FKN-CX3CR1 axis plays an important role in many processes related to inflammation and the immune response, which often occur simultaneously and overlap. FKN is strongly upregulated by hypoxia and/or inflammation-induced inflammatory cytokine secretion, and it may act locally as a key angiogenic factor in the highly hypoxic tumor microenvironment. The importance of the FKN/CX3CR1 signaling pathway in tumorigenesis and cancer metastasis results from its influence on cell adhesion, apoptosis and cell migration. This review presents the role of the FKN signaling pathway in the context of angiogenesis in inflammation and cancer. The mechanisms determining the pro- or anti-tumor effects are presented, which are the cause of the seemingly contradictory results that create confusion regarding the therapeutic goals.

This paper presents geometric analyses of welded frames after free relaxing and vibratory stress relief (VSR). Respected frames were tested components of a prototype packaging machine. Two types of relaxation were carried out to remove stresses introduced as a result of welding process. One of the frame was subjected to free relaxing, while the other one to accelerated vibration relaxing. Detection of the frame geometry changes was performed using a photogrammetric system. In addition, an evaluation of the geometry change was conducted for fifteen variants of steel frame support. A comparative analysis of the geometric deviations of the frames after free and vibratory stress relief confirmed the assumption that the frame after vibration stress relief better reproduces the nominal dimensions. Nevertheless, it should be emphasized that after vibratory stress relief the frame is not subject to further deformation, which is a desirable effect. In the case of free relaxing, the frame undergoes dimensional changes in a random manner. In summary, carrying out accelerated vibratory stress relief allows control of spontaneous dimensional changes in the designed frame of a packaging machine resulting from spontaneous relaxation of stresses arising from the welding process. The shortening of the relaxation process of the welded frame is also an unquestionable advantage.

A field experiment was conducted for 2 years in Green Tea Laboratory of Saitama Prefectural Agriculture and Forestry Research Center, Iruma, Saitama, Japan from March 2014 to December 2015. Controlled release fertilizers (CRF) or organic fertilizers (ORG) which is the mixture of chicken manure and oil cakewere applied with the amount of 450 kg N ha^-1 yr^-1 in 2014 and 397 kg N ha^-1 yr^-1 in 2015. Nitrous oxide (N₂O) emissionsfrom soil in green tea fields were measured by closed chamber method. The results showed that CRF has significantly lower N₂O compared to ORG. The cumulative N₂O emissions from CRF accounted for 51% of N₂O emissions from ORG fields and 138% of control with no fertilizer treatment. The N₂O flux from the row was higher than that of under the canopy, since fertilizer were applied on the row. However the total emission from the area between the rows was lower than that under the canopy because of the area ratio of row and canopy was 1:5.

Breast cancer remains a significant health concern worldwide, necessitating early detection and treatment. The rapid appearance or a change in the shape of skin lesion on the breast or just of the nipple-areola complex(NAC), especially if it is unilateral needs to be evaluated. Several primary or secondary tumours such as inflammatory skin lesions can affect this body area. Ultrasound, mammography, or magnetic resonance imaging (MRI) are the most used non-invasive diagnostic techniques for breast cancer, but in recent years reflectance confocal microscopy (RCM) and optical coherence tomography have emerged as additional tools to diagnose cases characterized by cutaneous changes.The introduction of new techniques such as reflectance confocal microscopy (RCM), may open new perspectives in the non-invasive diagnosis of mammary paget disease (MPD). RCM is a non-invasive diagnostic technique that allows high-resolution images of the skin at microscopic level in real time. It is non-invasive, painless and repeatable, making it a valuable tool in the early diagnosis and monitoring of skin diseases. We describe an atypical clinical presentation of mammary paget disease early diagnosed by reflectance confocal microscopy evaluation.

Background/Objectives: Nail technicians frequently have musculoskeletal pain, which impairs their job performance. A high-risk profession linked to back discomfort that causes morbidity is nail technician. QEC is a tool used for observing and assessing risks in a work environment. The goal of this research is to assess the ergonomic risks, pain, and their relationship with posture among manicurists. Methods: The 35 nail technicians filled the assessment form which consists of occupational information, pain, European Community Respiratory Health Survey, Nordic Musculoskeletal Questionnaire and QEC worker part. Physicians assessed nail technicians’ workspace and QEC outcomes. Results: It was stated that they worked an average of 61.92±11.09 hours per week, served an average of 11±5 customers per day, and their condition lasted 53.96±36.51 months. There is a strong significant correlation between discomforts, time spent in occupation (p=0,000) and working hours. Manicure, pedicure, unwanted hair removal, correction of eyebrow were considered for ergonomic risk evaluation. Each occupation accompanied repeated bad postures. Most of them were scored in very high risk categorization for back static positions (more than 29 point). Conclusions: This study may be useful for nail technicians seeking ergonomic improvements in the areas of engineering, administration, behavior, or personal.

Human footprint is having a unique set of ridges unmatched by any other human being, and therefore it can be used in different identity documents for example birth certificate, Indian biometric identification system AADHAR card, driving license, PAN card, and passport. There are many instances of the crime scene where an accused must walk around and left the footwear impressions as well as barefoot prints and therefore it is very crucial to recovering the footprints to identify the criminals. Footprint-based biometric is a considerably newer technique for personal identification. Fingerprints, retina, iris and face recognition are the methods most useful for attendance record of the person. This time world is facing the problem of global terrorism. It is challenging to identify the terrorist because they are living as regular as the citizens do. Their soft target includes the industries of special interests such as defense, silicon and nanotechnology chip manufacturing units, pharmacy sectors. They pretend themselves as religious persons, so temples and other holy places, even in markets is in their targets. These are the places where one can obtain their footprints easily. The gait itself is sufficient to predict the behaviour of the suspects. The present research is driven to identify the usefulness of footprint and gait as an alternative to personal identification.

Background. National surveys reported on variable prevalence of chronic kidney disease (CKD) due to differences in characteristics of population, design, equations used to estimate glomerular filtration rate (eGFR) and definitions. The EH-UH 2 survey is the first study evaluating CKD prevalence, characteristics and awareness in Croatia. Methods. This was a cross-sectional nationwide observational study designed to assess the prevalence and cardio-kidney-metabolic risk factors in Croatia which included 1765 randomly selected subjects. We estimated the prevalence of CKD by means of albumin-to-creatinine ratio (ACR) and eGFR (CKD EPI equation). Comorbidities, anthropometric and social factors related to the prevalence of CKD were analyzed, and CV risk profile was evaluated. Results. The weighted prevalence of CKD (any stage), CKD stage ≥ G3A A2, and CKD defined only as eGFR < 60 ml/min/1.73 m2 were estimated at 17.1%, 9.8% and 7.9%, respectively. The prevalence was higher in men than in women (11.8% vs. 7.9%; p 30 mg/g was 15.1%. Older age, male gender, diabetes, ePWV, and uric acid were independently associated with CKD prevalence. The awareness of CKD of 9.5%. Unaware were older with lower income, less educated, having more frequently diabetes, hypertension (less frequently controlled) and milder renal impairment. Conclusion. In Croatia, the estimated prevalence of CKD is high, being more frequently presented in men than in women. CKD patients have unfavorable CV risk profile. The awareness of CKD is very low reflecting poor health literacy in general population but also in health care workers.

AbstractBackground: In Ethiopia, 8.6% of maternal deaths are attributed to abortion. Despite the legalization of abortion and improved accessibility of safe abortion services, almost six in 10 abortions in Ethiopia are performed outside of the health facility. Abortion considered as an indicator for various aspects of reproductive health and healthcare access within a particular region or country. Despite the significance of the problem, there is a limited understanding of the magnitude of abortion and the contributing factors in the study area. Therefore, this study aimed to assess the prevalence of abortion and determinant factors among reproductive-age women in the Sidama regional state of Ethiopia.Methods: A community-based cross-sectional study was conducted from October to November 11, 2022, among 1,130 women of reproductive age. We utilized a multi-stage sampling method to select eligible women. A structured and pretested questionnaire was utilized to collect the data using Open Data Kit (ODK) mobile application. Due to the hierarchical nature of the data, a multilevel logistic regression model was applied. Variables with p-values < 0.25 on bi-variable analysis were included in a multivariable regression model. In the multivariable regression model, variables with a p-value < 0.05 were declared as statistically significant factors of abortion. Results: Nearly one-fifth (19.5%) of the women had a history of abortion. From the individual level determinates; women with formal education (AOR=0.44; 95% CI: 0.24-0.79), and planned pregnancy (AOR=0.41; 95% CI: 0.28-0.61) had lower odds of abortion. While from the community related factors; urban residence increased the odds of abortion (AOR=2.25; 95% CI: 1.20-4.20) as compared to the rural residence.Conclusion: the prevalence of abortion among reproductive age women of Northern Zone of Sidama Region was high. Education and a planned pregnancy serve as protective factors for abortion, while the risk of abortion increased among women reside in urban area. Therefore, to lower the abortion rate, it is better to implement a comprehensive approach, focusing on education, family planning, and urban-specific intervention.

Obesity is a risk factor for the development of gestational diabetes mellitus (GDM). However, the most optimal type of nutritional intervention to prevent GDM in high-risk women is not clearly defined. This study investigates if nutritional treatment based on the Mediterranean diet (MedDiet) before 12th gestational week (GW) in women at high risk due to a body mass index (BMI)≥25kg/m2, reduces the rate of GDM and metabolic syndrome (MetS) at 3 years postpartum. We performed a post-hoc analysis of the San Carlos Gestational Prevention Study. A total of 735 women with BMI≥25kg/m2 were evaluated between 2015-2018, 246 in standard diet control group (CG) and 489 in MedDiet intervention group (IG). The rate of GDM was significantly lower in IG compared to CG (25.1%vs31.7%;p=0.037). Postnatal follow-up was completed by 141 women in CG (57%) and 312 women in IG (64%). At 3 years postpartum, we observed a reduction (relative risk 95% confidence interval) in the rates of impaired fasting glucose (IFG) (0.51 (0.28-0.92);p=0.019), obesity (0.51 (0.28-0.92),p=0.041), waist circumference (WC)≥89.5cm (0.54 (0.31-0.94);p=0.022) and MetS (0.56 (0.33-0.94);p=0.003). MedDiet reduces the rate of GDM and postpartum MetS in women with BMI)≥25kg/m2, suggesting that its implementation should be routinely recommended from the first GWs.

The construction industry has a notable negative impact on the environment; thus, the promotion of the use of timber structures is an alternative to mitigate its effects. The research develops an artificial intelligence-based decision approach in the calculation of timber structures focused on the enhancement of the sustainability of roof structures. Based on the optimization carried out through genetic algorithms and the framework established in Eurocode 5, a general set of equations has been proposed for a laminated timber roof structure. The tool, which determines the most suitable roof structure for each strength class of laminated timber, allows for the determination of the dimensions of beams and purlins and their respective separations in order to minimize wood consumption. The ultimate goal is to offer multiple solutions regarding strength classes and structural designs in order to foster informed sustainable choices that promote efficient use of resources in construction.

In the field of Natural Language Processing (NLP), Large Language Models (LLMs) have shown great potential in document-level event extraction tasks, but existing methods face challenges in the design of prompts. To address this issue, we propose an optimization strategy called "Definition-driven Document-level Event Extraction (DDEE)." By adjusting the length of the prompt and enhancing the clarity of heuristics, we have significantly improved the event extraction performance of LLMs. We used data balancing techniques to solve the long-tail effect problem, enhancing the model's generalization ability for event types. At the same time, we refined the prompt to ensure it is both concise and comprehensive, adapting to the sensitivity of LLMs to the style of prompts. In addition, the introduction of structured heuristic methods and strict limiting conditions has improved the precision of event and argument role extraction. These strategies not only solve the prompt engineering problems of LLMs in document-level event extraction but also promote the development of event extraction technology, providing new research perspectives for other tasks in the NLP field.

Background: Tuberculosis (TB) continues to be a serious public health threat that affects the most vulnerable population. Patients who are LTFU after TB diagnosis still represent one of the biggest challenges to TB control. Method: In this prospective observational study, we aimed to identify and analyse the risk factors associated with LTFU among TB patients who started first-line TB treatment in the Sanatorium Hospital in Luanda. Result: A total of 113 patients with TB were included between August 2018 and September 2019. Seventy-six (67.3%) patients were cured, 27 (23.9%) were LTFU, 5 (4.4%) died, 4 (3.5%) were transferred and 1 (0.9%) presented a treatment failure. After excluding those dead, transferred or who failed to treatment, we observed that severe TB at the time of diagnosis (OR 9.24, 95% CI 2.18-39.04) and food insecurity were significantly associated with LTFU (OR 5.96, 95% CI 1.66-21.41). Conclusion: The findings of our study are of enormous value to understand the reasons for the LTFU of patients with TB and can guide polices and facilitate designing measures to allow better adherence, and therefore, greater treatment success

Background: Bariatric surgery (BS) has a significant impact on body composition (BC) and con-sequently may affect established sarcopenic obesity (SO) in candidate patients. The aim of this study is to assess the utility of muscle ultrasound (MUS) of rectus femoris thickness (RFT) for the evalua-tion of BC and skeletal muscle function in patients undergoing BS compared to bioimpedance analysis (BIA), dual-energy X-ray absorptiometry (DEXA) and dynamometry. On the other hand, we aim to demonstrate how MUS of RFT correlates better with the quality of life (Qol) in this population, likely because it enables the detection of regional quadriceps muscle sarcopenia, in comparison to the other mentioned methods. Methods: This is a prospective pilot study including 77 subjects (64.9% female, mean age: 53.2 ± 8.67 years) who underwent BS. Handgrip strength was measured using a dynamometer, fat-free mass index (iFFM) was assessed by BIA, appendicular muscle index (AMI) was calculated using DEXA and RFT was measured by MUS. Moreover, Homeostasis Model Assessment of Insulin Resintance (HOMA-IR) was calculated. All these measurements were conducted 1 month prior to BS and at the 12-month follow-up. QoL was as-sessed using the Moorehead-Ardelt questionnaire. Results: The mean BMI decreased by 12.95 ± 3.56 kg/m2 (p=0.001). Firstly, we observed positive correlation pre-surgery between HOMA and: RFT (r=0.27, p=0.02), iFFM (r=0.36, p=0.001), AMI (r=0.31, p=0.01) and dynamometer (r=0.26, p=0.02). In addition, we found correlation between RFT and iFFM (pre-surgical: r=0.31, p=0.01; post-surgical: r=0.25, p=0.05) and between RFT and lower extremities AMI post-surgical (r=0.27, p=0.04). Secondly, we observed significant reductions in iFFM, AMI and RFT (p=0.001), but not with dynamometer (p=0.94). Finally, a tendency to a positive correlation between QoL question-naire and RFT post-surgery (r=0.23, p=0.079) was observed. Conclusions: Our results suggest that RFT measured by MUS for the evaluation of SO and the follow-up after BS of these patients. Moreover, RFT can provide relevant information about regional sarcopenia and probably has an accurate correlation with QoL in comparison with the other methods.

EUS–TA in unresectable pancreatic cancer requires not only a tissue diagnosis but also tissue collection in anticipation of comprehensive genomic profiling. However, the optimal puncture target remains controversial. Therefore, the Primary and Metastatic Lesions in Pancreatic Cancer (PRIMATE) study was designed to clarify the optimal target by comparing the success rates for meeting OncoGuide NCC Oncopanel (NOP) analysis criteria on pre-check primary and metastatic lesion specimens obtained during the same EUS–TA session in patients with invasive pancreatic ductal adenocarcinoma. In this ongoing prospective study, two specimens, each from primary and metastatic lesions, are obtained by EUS–TA (typically using a 19G fine-needle biopsy needle) in patients with invasive pancreatic ductal adenocarcinoma. The primary endpoint is the proportion of EUS–TA specimens that meet NOP analysis criteria during pre-check (i.e., tumor cellularity ≥ 20% and tissue area ≥ 4 mm2), which are then compared between primary and metastatic lesions. This study has been approved by the National Cancer Center Institutional Review Board (Research No. 2022-168). The results of this study will be reported at an international conference and published in an international peer-reviewed journal. The trial registration number is UMIN 000048966.

This study employed High-Performance Liquid Chromatography coupled with Diode Array De-tector and Mass Spectrometry (HPLC-DAD-MS) to characterize bioactive compounds in olive leaf extracts. The analysis revealed a diverse metabolic profile, predominantly composed of tyrosol, flavonoids, and hydroxycinnamic acid. The antioxidant activity of the extracts demonstrated their efficacy, with variations observed between neutral and acidic pH conditions. Encapsulation was explored as a preservation method, successfully maintaining the integrity of phenolic compounds in both liquid and powdered forms. All four extracts have an undeniable antimicrobial effect. Moreover, the antibacterial activity tested on E. coli ATCC 25922 and S. aureus ATCC 25923 strains significantly improved post-encapsulation, particularly for the acidic pH extract. The findings suggest that encapsulation can potentially conserve and/or enhance the antimicrobial activity of olive leaf extract, paving the way for developing functional products with improved shelf life and nutritional properties. Further investigations are recommended to elucidate underlying mecha-nisms and optimize encapsulation processes to maximize the benefits of olive leaf extract in di-verse applications.

Background/Aim: Stool gluten immunogenic peptides (GIP) determination is now considered a valuable tool for detecting dietary lapses in treated celiac disease (CeD) patients. Our study aims to explore the diagnostic performance of a qualitative lateral flow immunoassay point-of-care test (LFIA/PoCT) compared with a qualitative enzyme-linked immunosorbent assay (ELISA) for detection of stool GIP. Methods: The study is a post hoc analysis of stool samples collected in the real-life conditions from a cohort of gluten-free diet-treated CeD patients. Stool GIP was measured in µg/g of stool using an ELISA kit (iVYLISA GIP S®, Biomedal SL). For the qualitative evaluation of stool GIP, a LFIA/PoCT test (GlutenDetect®; Biomedal S.L) was employed, which reported results as positive or negative. The LFIA/PoCT performance was evaluated against ELISA, considered as the gold standard. GIP concentrations

Gestational diabetes mellitus (GDM) pathophysiology comprises clinical and genetic factors. In fact, GDM has been associated with several single nucleotide polymorphisms (SNPs). This study aimed to build a prediction model of GDM combining clinical and genetic risk factors. A total of 1588 pregnant women from the San Carlos Cohort participated in the present study, 1069 (67.3%) Caucasian (CAU) and 519 (32.7%) Latin American (LAT), 255 (16.1%) with GDM. The incidence of GDM was similar in both groups (16.1% CAU and 16.0% LAT). Genotyping was performed by IPLEX Mass ARRAY PCR selecting 110 SNPs based on literature references. The SNPs showing the strongest likelihood of GDM development were the rs10830963, rs7651090 and rs1371614 in CAU and rs1387153 and the rs9368222 in LAT. Clinical variables including age, pre-pregnancy body mass index and fasting plasma glucose (FPG) at 12 gestational weeks predicted the risk of GDM (AUC 0.648, 95%CI 0.601-0.695 in CAU; AUC 0.688, 95%CI 0.628-9.748 in LAT) and adding the SNPs modestly improved prediction (AUC 0.722, 95%CI 0.680-0.764 in CAU; AUC 0.769, 95%CI 0.711-0.826 in LAT). In conclusion, adding genetic variants enhanced the prediction model of GDM risk in CAU and LAT pregnant women. An RCT is underway to demonstrate its usefulness

Background: In response to inflammation, the absorption of nutritional iron is restricted. Multiple inflammation-related signaling pathways can lead to ferroptosis, an iron-dependent mechanism of programmed cell death. Since the pathophysiological significance of the presence and uptake of iron in chronic inflammation is still unknown, we tested the effect of a low iron diet on the clinical course of arthritis in the mouse model of collagen-induced arthritis (CIA). Methods: Six- to eight-week-old male DBA/1 mice were fed either a normal or a low iron diet starting three weeks before arthritis induction. From day four after the collagen-booster made on day 25, the development of arthritis was regularly monitored until the end of the experiment (day 34), using a standard clinical arthritis score. The complete blood count was determined as well as Fe2+, Fe3+, oxidized and reduced glutathione (GSH and GSSG) and malondialdehyde (MDA) in whole paw tissue by ELISA. Quantitative PCR was performed from whole paw tissue for glutathione peroxidase 4 and other key regulator genes of iron metabolism and ferroptosis. We used nonparametric tests to com-pare markers of iron metabolism and ferroptosis as well as nonlinear regression models for longitu-dinal data for signs of arthritis. Results: Mice fed a low iron diet showed a significantly less severe course of arthritis compared to mice fed a normal iron diet (p

Background/Objectives:The first attempts of posterior lumbar interbody fusion can be traced back to the 1940s, where their performance was marked by animosity due to high rates of failure. Nowadays, the use of interbody fusion involves a much more complicated consideration of factors such as global alignment, disc height, fusion rates, and operative risk, all combined at once.Our study aims to examine all these effects using Flarehawk 9 as a means of interbody fusion.Materials and methods: A total of 58 patients underwent open posterior lumbar surgery using Flarehawk 9 between September 2021 and February 2023 with a mean follow up of 1 year.The mean age was 59.8 years old ( range between 33 and 79 years old), 36 of them are males while 22 of them are females. The diagnostic groups included spinal canal stenosis (n=40), failed back surgery syndrome-revision surgery (n=5),spondylolisthesis with slip percentage 25% (n=4),recurrent herniated disc (n=7) and adjacent segment disease (n=2). Results: The majority of patients demonstrated remarkable improvement based on ODI scores.The rate of union varied based on the fused levels and whether the patients had previous surgery or not.The amount of lordosis postoperatively is increased by 2±0.4 degrees.Conclusions: Even though anterior approaches become more and more popular and advanced nowadays, posterior fusion with interbody cage still remains a safe and effective method to treat various spine surgical pathologies with optimal results.

The recent increase in global consumption of rice has led to increased demand for sustainable water management in paddy cultivation. In this study, we propose an enhanced paddy simulation module to be introduced to Soil and Water Assessment Tool (SWAT) to evaluate the sustainability of paddy cultivation. The enhancements added to SWAT include: (1) modification of water balance calculation for impounded fields, (2) addition of an irrigation management option for paddy fields that are characterized by flood irrigation with target water depth, and (3) addition of a puddling operation that influences the water quality and infiltration rate of the top soil layer. In a case study, the enhanced model, entitled SWAT-Paddy, was applied to an agricultural watershed in Japan. The results showed that the SWAT-Paddy successfully represented paddy cultivation, water management, and discharge processes. Simulated daily discharge rates with SWAT-Paddy (R² = 0.8) were superior to the SWAT result (R² = 0.002). SWAT-Paddy allows the simulation of paddy management processes realistically, and thus can enhance model accuracy in paddy-dominant agricultural watersheds.

Until recently, no disease-specific health-related quality of life (HRQoL) instrument existed for pediatric traumatic brain injury (TBI). In this revalidation study, the psychometric properties and the validity of the final German version of the 35-item QOLIBRI-KID/ADO questionnaire were examined in 300 children and adolescents. It is the first self-reported TBI-specific instrument for measuring pediatric HRQoL in individuals aged 8–17 years. The six-factor model fits the data adequately. Internal consistencies were excellent for the total score and satisfactory to excellent for the scale scores. Intraclass correlations indicated good test-retest reliability. Construct validity was supported by overlaps between the QOLBRI-KID/ADO and the PedsQL, which measures generic HRQoL. Discriminant validity indicated that HRQoL was significantly lower in older children and girls, and in those with anxiety, depression, and post-concussion symptoms than in comparison groups, replicating the results of the questionnaire’s first development study. Our results suggest that the QOLIBRI-KID/ADO is a valid and reliable multidimensional instrument for assessing disease-specific HRQoL after pediatric TBI in clinical and research settings, which can additionally be used across the lifespan in combination with the adult version. This may help to improve care, treatment, daily functioning and HRQoL after TBI.

The presence of antibiotic residues in honey has recently become a growing public health concern due to the overuse of these products in beekeeping and their transfer to the food industry. The aim of this study was to develop and validate a simple, selective and sensitive method for the simultaneous identification and quantification of residues of twenty-two sulfonamides, trimethoprim and dapsone in honey using a rapid and reliable liquid chromatography–tandem mass spectrometry (LC–MS/MS) method. The developed method showed good linearity, specificity, precision (repeatability and intra-laboratory reproducibility) and recovery. The decision limit (CCalpha) ranged between 2.16-22.12 µg/kg for CCα, while the detection capability (CCbeta) was between 2.16- 2.67-27.36 µg/kg. The method proved to be rapid, reliable and effective for the determination of sulfonamides, trimethoprim and dapsone from honey samples. The average recoveries were estimated to be between 70 and 106%. The relative standard deviations (RSDs) were between 6-18%. In practice, the method is essential to check the honey sold on the market and ensure its safety before it reaches the consumer.

Despite Low Power Wide Area Networks’ ability to offer an extended range, it might still encounter challenges with coverage blind spots in the network. This article proposes an innovative energy-efficient nature-inspired relay selection algorithm for LoRa-based LPWAN networks, serving as a solution for challenges related to poor signal range in areas with limited coverage. A behavior swarm-inspired approach has been utilized to select the relays’ localization in the network, providing network energy efficiency and radio signal extension. These relays help bridge communication gaps, significantly reducing the impact of coverage blind spots by forwarding signals from devices with poor direct connectivity with the gateway. The proposed algorithm considers critical factors for the LoRa standard, such as the Spreading Factor or device energy budget analysis. The simulation experiments validate the proposed scheme’s effectiveness in terms of energy efficiency under diverse multi-gateway topology scenarios involving thousands of devices. Specifically, it has been verified that the proposed approach outperforms the reference method in preventing the battery depletion of relays, which is vital for battery-powered IoT devices. Furthermore, for some large-scale problems, the proposed heuristic method achieves over twice the speed of the exact method with a negligible accuracy loss of less than 2%.

This study aimed to identify whether gyrate atrophy of the choroid and retina (GACR) heterozygous individuals have possible clinical manifestations and to explore the potential pathogenic mechanism. In this retrospective study, we surveyed a two-generation pedigree of an individual diagnosed with GACR. Two family members underwent ophthalmological, hematologic, and genetic tests. An arginine-restricted diet with vitamin B6 supplementation was implemented; clinical assessments were repeated every 3 months during follow-up. Relative OAT mRNA expression was determined using real-time quantitative polymerase chain reaction. The 19-year-old compound heterozygous daughter (OAT: c.1186C&gt;T; c.748C&gt;T), had bilateral high myopia, posterior staphyloma, chorioretinal atrophy, macular abnormalities, and elevated hematologic ornithine. The 54-year-old heterozygous mother (OAT: c.1186C&gt;T), presented with bilateral severe myopia, asymmetric posterior staphyloma, retina and choroidal capillary layer atrophy, retinal pigment epithelium abnormalities, and mildly elevated hematologic ornithine. Compared to normal individuals, the daughter and mother had 29% and 46% relative OAT mRNA expression, respectively (P&lt;0.001). We believe that this is the first report of a carrier of one OAT variant allele with mild phenotypes, suggesting that family members should be aware of the possible involvement of autosomal recessive conditions. Additional data suggests nonsense mediated decay-initiated mRNA degradation may cause GACR.

Background: Ankle fractures, comprising about 10% of musculoskeletal injuries, pose a significant healthcare burden with an increasing incidence, particularly among an aging population. This study focuses on isolated Danis-Weber type B fractures. Recent trends lean towards surgical intervention for anatomical restoration, quicker recovery, albeit with associated complications. This report aims to assess the safety and efficacy of NewClip narrow locking plate system with early weight bearing in treating isolated fibular fractures. Methods: The study includes patients with Danis-Weber type B fractures surgically treated with NewClip narrow locking plate system. Exclusions involved nondisplaced fractures, open fractures, or those requiring additional fixation.Results: Fifteen patients were enrolled in this study. Minor complications, including wound swelling, were observed in two cases. The Visual Analogue Scale (VAS) for pain exhibited a steady decline postoperatively, with almost complete resolution by the third month. At three months, the FAOS demonstrated excellent results, and final follow-up at twelve months revealed complete osseous healing without complications.Conclusions: The use of this type of plates in treating isolated fibular fractures with early weight bearing shows promising results in terms of fracture healing, pain resolution, and functional outcomes warranting further investigation with larger cohorts.

This paper introduces a class of symmetric ciphering systems with a finite secret key, which provides ideal secrecy, autonomy in key generation and distribution, and robustness against the probabilistic structure of messages (Ideally Secret Autonomous Robust – ISAR system). The ISAR system is based on wiretap polar codes constructed over an artificial wiretap channel with a maximum secrecy capacity of 0.5. The system autonomously maintains a minimum level of key equivocation by continuously refreshing secret keys without needing additional key generation and distribution infrastructure. Thus, this class of systems generalizes Shannon's ideal and strongly ideal ciphering systems. Additionally, it can transform any stream ciphering system with a finite secret key of known length into an ISAR system without the necessity of knowing and/or changing its algorithm. Therefore, this class of system strongly supports privacy, a critical requirement for contemporary security systems. The ISAR system's reliance on wiretap polar coding for strong secrecy ensures resistance to passive attacks with known plaintext messages. Furthermore, resistance to passive attacks on generated keys follows directly from ideal secrecy and autonomy. The results presented offer an efficient methodology for synthesizing this class of systems with predetermined security margins and a complexity of the order of nlogn, where n is the block length of the applied polar code.

Exogenous melatonin, a nutraceutical for maintaining a healthy sleep-wake cycle and managing sleep disorders, requires large, repeated doses due to low bioavailability and short half-life. This necessitates the development of a sustained-release formulation with a longer half-life and sustained plasma concentration. Therefore, exogenous novel 5 mg sustained-release melatonin capsules (Melatonin-SR, test product) were formulated. This open-label cross-over study compared the pharmacokinetics (maximum concentration [Cmax], time to reach Cmax [Tmax], area under the curve [AUC] and elimination half-life [t1/2]) and safety of Melatonin-SR with 5 mg immediate-release melatonin capsules (Melatonin-IR, reference product) after single-dose oral administration in healthy fasting adults. Sixteen participants (aged 18-45 years) were randomized (1:1) to receive either Melatonin-SR or Melatonin-IR in two periods with a 7-day washout period. Melatonin-SR reported lower Cmax (11446.87 pg/mL) compared to Melatonin-IR (22786.30 pg/mL). The mean Tmax of Melatonin-SR and Melatonin-IR was 1.26 h and 0.87 h, respectively. The mean t1/2 of Melatonin-SR (5.10 h) was prolonged by five-fold compared to Melatonin-IR (1.01 h). One adverse event (vomiting) was reported following administration of the Melatonin-IR. Melatonin-SR resulted in higher and sustained plasma melatonin concentrations for an extended period and was well-tolerated. Hence, Melatonin-SR may be a promising nutraceutical for maintaining healthy sleep.

Smith-Magenis syndrome is a complex neurobehavioral genetic disorder. The spectrum of SMS phenotype is broad but commonly includes craniofacial, neurobehavioral, and otolaryngologic features. While the etiology of SMS is commonly attributed to one copy interstitial deletion in the 17p11.2 region (90-95% of cases), variants identified by sequence analysis in RAI1 have also been reported in 5-10% of cases. The phenotypic spectrum of patients with RAI1 sequence alterations is not clear. In this study, we report a 9-year-old male with global cognitive and psychomotor developmental delay, musculoskeletal and cardiovascular abnormalities, and dysmorphic craniofacial features. Whole genome quad analysis of the proband, unaffected parent, and unaffected brother identified a novel de novo RAI1:c.2736delC variant. This is the first report of this variant in the literature. This report also highlights the details of the genome analysis and this patient's phenotypic spectrum.

Background: Chronic kidney disease (CKD) is a significant cardiovascular (CV) risk factor, with dialysis-dependent CKD (DD-CKD) patients facing high mortality rates. Hypercholesterolemia is another crucial CV risk factor, typically managed with lipid-lowering therapy, though its efficacy in DD-CKD remains uncertain. Evidence shows mixed results regarding the benefits of statins in these patients. Citrate-based dialysates are known to reduce inflammatory biomarkers compared to acetate-based ones, potentially impacting lipid profiles and immune responses. This study aimed to determine the effects of citrate versus acetate dialysate on lipid profiles and immunophenotypes in DD-CKD patients. Methods: This unicentric, cross-over, prospective study included 21 hemodialysis patients (10 males, 11 females, average age 62.25 years). Each patient underwent 24 dialysis sessions (12 with each dialysate) and acted as their own control. Lipid profiles, immunological parameters, and nutritional and inflammatory markers were measured before the last session with each dialysate. Results: Compared to acetate dialysate (AD), citrate dialysate (CD) resulted in significantly higher LDL (75.71 vs. 67.05 mg/dL, p=0.042) and HDL (51.19 vs. 47.14 mg/dL, p=0.013), and lower TG (97.86 vs. 110.38 mg/dL, p=0.046). CD also led to higher NK cells (19.24 vs. 16.95%, p=0.035), higher complement C3 levels (115.14 vs. 107.81 mg/dL, p=0.009) and lower CD3+ CD8+ and CD16+56+ lymphocytes. Finally, total lymphocytes were lower with AD than with CD. We found no difference in predialysis nutritional nor inflammatory parameters (IL-6 and hs-CRP) except for ESR, which was higher when subjects used CD than AD. Conclusion: There are significant differences in lipid and immunophenotypic profiles that should increase the CV risk of patients who use CD. However, numerous studies have shown no differences, or even a benefit in mortality in certain HD subpopulations that use CD. Further studies are needed to understand if the observed changes may be counterbalanced by other mechanisms potentially provided by citrate (e.g., reducing vascular calcification).

Sustainable food consumption has attracted a widespread attention during last decades by scholars, policy makers and consumers. In line with this, farmers’ markets (FMs) have the potential to encourage sustainable agricultural production and consumption. By reducing the number of actors and distances along the food chain, these alternative food systems foster the reconnection between farmers and consumers and contribute to different social, economic and environmental sustainable goals. This paper provides insights on the role of consumers' sustainability concerns related to their motivation for shopping at FMs. By means of a choice experiment, we analyze the determinants of consumers’ WTP for buying apples at FMs. We are particularly interested in understanding how attitudes towards the three sustainability dimensions are related to consumer preferences in this context. We find that consumer attitudes towards direct contact with producers, contributing to farmers’ income, and environmental benefits can be directly related to product characteristics that are specific to FMs.

This paper investigates the impact of price and real exchange rate volatility on Foreign Direct Investment (FDI) inflows in a panel of 10 Latin American and Caribbean countries, observed between 1990 and 2012. Both price and exchange rate volatility series are estimated through the Generalized Autoregressive Conditional Heteroscedasticity model (GARCH). Our results, obtained employing the Fixed Effects estimator, confirm the theory of hysteresis and option value, in so far it is found a statistically significant negative effect of exchange rate volatility on FDI. Price volatility, instead, turns out to be positive but insignificant. Moreover, we show that human capital and trade openness are key for attracting foreign capital. From the policy perspective, our analysis suggests the importance of stabilization policies as well as the one of government credibility in promoting trade openness and human capital formation.

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

A useful perioperative nutritional therapy for highly invasive esophageal cancer surgical cases needs to be developed. We clarified the usefulness of amino acid-enriched nutritional therapy using glutamine (Gln)/arginine (Arg)/calcium β-hydroxy-β-methylbutyrate (HMB) products on the short-term postoperative outcomes of minimally invasive esophagectomy for esophageal cancer. Altogether, 114 patients (Gln/Arg/HMB group) received perioperative nutritional therapy with Gln/Arg/HMB products, and we retrospectively investigated the change in nutritional parameters including skeletal muscle mass, occurrence of postoperative complications, and short-term postoperative outcomes in this group. The results were compared between the Gln/Arg/HMB and control groups (79 patients not receiving the Gln/Arg/HMB products). The incidence of all postoperative complications, sputum expectoration disorder, and pleural effusion of grade ≥III was significantly lower in the Gln/Arg/HMB group (62.0% vs. 38.6%, p = 0.001; 44.3% vs. 28.1%, p = 0.020; 27.8% vs. 13.2%, p = 0.011, respectively). The psoas muscle area and postoperative body weight was significantly higher at 1 month and 1 year after surgery in the Gln/Arg/HMB group than in the control group (93.5% vs. 99.9%, p &lt; 0.001; 92.0% vs. 95.4%, p = 0.006). Perioperative amino acid-enriched nutritional therapy may improve the short-term postoperative outcomes, nutritional status, and skeletal muscle mass of esophageal cancer surgical patients.

Introduction: The aim is to investigate the possibility of altering the delusional perceptions of psychotic patients by exposing them to a cognitively flexible virtual environment. A flexible vir-tual reality (VR) environment could challenge and enhance the ability to adapt to changing situa-tions and generate novel solutions to core psychotic symptoms. Materials and methods: A systematic review was conducted using different combinations of keywords in different databases. This study was conducted using the PRISMA statement. Results: There is a growing literature on the use of VR to manipulate and normalise perceptual distortions in psychosis. Over the last decade, the number of published studies on VR in mental health has increased 14-fold. Conclusions: A cognitive flexibility virtual environment can alter delusional perception by ex-posing the person to different scenarios that require them to question their assumptions, test their hypotheses, and revise their beliefs. Commonly used biosensors measure heart rate, skin con-ductance and body temperature in relation to different emotional states. Recently, there has been a major shift towards the use of neuroimaging techniques to better understand the pathophysiology of mental disorders. This is where the new wave of biosensor-integrated virtual reality (VR) sys-tems comes in.

This study proposes a flexible and adaptable protocol for the establishment of agricultural management zones that utilises remote sensing, ground truthing (apparent electrical conductivity and soil sampling), the IRRIGOPTIMAL® system and machine learning. This protocol could contribute significantly to the rational use of inputs (water, fertilizers and pesticides) and to the further efficient development of an optimal irrigation system with variable irrigation rates. The methodology to develop this protocol was applied to olive and alfalfa plots in Heraklion (Crete, Greece) to monitor soil and crop responses for the period 2022-2024. Spatial and temporal assessment of selected soil and plant parameters (moisture, photosynthetic activity) using ground and vegetation reflectance mapping by satellites and unmanned aerial systems provides important information in both the pre- and main phases of the management zone delineation. Geophysical methods such as electromagnetic induction, applied in the main phase of management zone delineation, provide a robust technique to determine the spatial and temporal distribution of apparent electrical conductivity. The Random Forest machine learning model was found to be most suitable for predicting soil electrical conductivity based on satellite-derived salinity indices and ground electromagnetic induction. Finally, the IRRIGOPTIMAL® system provides real-time monitoring of a variety of weather and soil parameters to determine the optimal cultivation of crops based on the creation of agricultural management zones.

Cartilage degeneration is a characteristic of osteoarthritis (OA) which is often observed in aging populations. This degeneration is due to the breakdown of articular cartilage (AC) mechanical and tribological properties, primarily attributed to lubrication failure. Understanding the reasons behind these failures and identifying potential solutions could have significant economic and societal implications, ultimately enhancing the quality of life. This review provides an overview of developments in the field of AC, focusing on its mechanical and tribological properties. The emphasis is on the role of lubrication in degraded AC, offering insights into its structure and function relationship. Further it explores the fundamental connection between AC mechano-tribological properties and the advancement of its degradation and puts forth recommendations for strategies to boost its lubrication efficiency.

Introduction: Parkinson’s disease (PD) patients harboring recessive gene variants exhibit a distinct clinical phenotype with an early disease onset and relatively mild symptoms. Data concerning individualized therapy for autosomal recessive PD forms are still scarce. Methods: Demographic and treatment data of a cohort of PD carriers of recessive genes (9 homozygous or compound heterozygous PRKN carriers, 4 Heterozygous PRKN carriers and 3 biallelic PINK1 carriers) were evaluated. Results: The average Levodopa Equivalent daily dose (LEDD) was 806.8±453.5 (range 152-1810) in PRKN carriers and 765±96.6 (range 660-850) in PINK1 carriers. The majority responded to low/moderate doses of Levodopa. The response to Dopamine Agonists (DA) was often favorable both as initial and longitudinal therapy. 8/13 PRKN and 1/3 PINK1 carriers were treated with amantadine successfully, and this also applied to patients who could not tolerate Levodopa or DA. Conclusions: In the era of personalized treatment, the therapeutic approach in recessive PD gene carriers might differ as compared to idiopathic PD. Lower LEDD doses were efficient even in patients with a very long disease duration, while a few patients were doing well without any Levodopa treatment decades after disease initiation. DA or amantadine could be used as a first and main line treatment regimen if well tolerated. Literature data on therapeutic strategies in carriers of pathogenic mutations in recessive PD genes, including device-aided treatments will be further discussed.

Objectives: Stress urinary incontinence (SUI) negatively affects the quality of life and sexual function in women. This study aimed to evaluate the efficacy of radiofrequency (RF) therapy in reducing SUI symptoms and its impact on sexual function. Methods: Thirty-four women with SUI were enrolled and underwent a single RF treatment session using the Viveve® System (Viveve Medical Inc., USA) with parameters of 90 J/cm² and 220 pulses per hour. Assessments at baseline and 6 months post-treatment included perineal ultrasound and personal interviews to evaluate lower urinary tract symptoms and sexual function. Urodynamic studies, voiding diaries, and questionnaires such as the Female Sexual Function Index (FSFI), Overactive Bladder Symp-tom Score (OABSS), Urogenital Distress Inventory-6 (UDI-6), Incontinence Impact Question-naire-7 (IIQ-7), and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) measured outcomes. Results: RF therapy significantly improved sexual function, with higher FSFI scores in all domains except pain at 6 months. SUI symptoms were significantly re-duced, as indicated by improved scores on OABSS, UDI-6, IIQ-7, and ICIQ-SF, alongside better voiding diary results. Anatomical changes included reduced bladder neck mobility, decreased vaginal width, and a reduced rotation angle of the proximal urethra. Conclusions: RF therapy is effective and safe for treating mild to moderate SUI and enhances sexual function, potentially due to changes in vaginal topography. These results suggest RF therapy as a viable non-surgical op-tion for managing SUI and improving sexual health.

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.

Assembly theory provides a promising framework to explain the complexity of systems such as molecular structures and the origins of life, with broad applicability across various disciplines. In this study, we explore and consolidate different aspects of assembly theory by introducing a simplified toy model to simulate the autocatalytic formation of complex structures. This model abstracts the molecular formation process, focusing on the probabilistic control of catalysis rather than the intricate interactions found in organic chemistry. We establish a connection between probabilistic catalysis events and key principles of assembly theory, particularly the probability of a possible construction path in the formation of a complex object, and examine how the assembly of complex objects is impacted by the presence of autocatalysis. Our findings suggest that autocatalysis tends to favor longer consecutive construction sequences in environments with low catalysis probability, while this bias diminishes in environments with higher catalysis probabilities, highlighting the significant influence of environmental factors on the assembly of complex structures.

Multifunctional landscapes are complex systems that integrate biophysical, cultural-historical and socio-economic components into unique territorial structures and regional ensembles. Facing increasing pressures generated by urbanization, climate change and overexploitation of natural resources, assessing the sustainability of these landscapes has become an urgent priority. The present research is based on the development and parametrization of a new tool for evaluating the sustainability of multifunctional landscapes that aims to measure the level of biocultural resilience of a landscape, integrating biological, cultural and socio-economic indicators in a single analytical framework. This index, called the biocultural resilience index (BRI), provides a holistic perspective on the dynamics of landscapes, allowing the identification of vulnerability areas and the development of conservation and sustainable management strategies. The evaluation of the of multifunctional landscapes sustainability requires a comprehensive approach that has to integrate both biological aspects, such as biodiversity and ecosystem health, as well as identity and cultural aspects, such as cultural value and the relationship of the local communities with the environment. In this context, this study highlights the fact that the development of appropriate tools and methods for assessing and monitoring the sustainability of multifunctional landscapes becomes essential for their sustainable management and for protecting the benefits they offer to society. Our findings show that the biocultural resilience index (BRI) can be used in a variety of contexts and fields, including spatial planning, biodiversity conservation, sustainable rural development and ecotourism. In the meanwhile, this index offers a robust and flexible analytical framework, adaptable to the needs and particularities of different regions and communities.

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

Introduction: One of the key strategies to achieve sustainable development goal by reduce preventable maternal deaths below 70 per 100,000 is increasing awareness about major obstetrics danger sign. Mother's awareness of obstetric danger signs in developing country is relatively low regardless of attempts trough many local and national program. It is crucial to increase women’s knowledge of obstetric danger signs through education and awareness-raising efforts. Despite its importance to reduce maternal deaths, Studies are limited only to the Northern Ethiopia. Objective: This study aimed to assess prevalence of knowledge of obstetric danger signs and associated factors among women who delivered in the last 12 months in Sidama region, Ethiopia. Methods: We conducted a community-based cross-sectional study from October to November, 2022. A multi-stage sampling procedure was utilized to select study participants. A structured and pretested questionnaire was utilized to collect data. A multilevel mixed-effects negative binomial regression model was used to control effects of clusters and confounders.Results: Out of 1,140 study participants, only 1,130 study participants took part in the study making a response rate of 99.12%. The overall prevalence of knowledge of obstetrics danger sign was estimated as 22.3% (95%CI: 18.7, 25.9). Government employed women (AIRR = 1.37; 95% CI: 1.2, 1.6), women who had access to mass media (AIRR = 1.16; 95% CI: 1.08, 1.25), women who had received model family training (AIRR = 1.15; 95% CI: 1.1, 1.25), autonomous women (AIRR = 1.15; 95% CI: 1.04, 1.25), women who had faced health problems during pregnancy (APR = 1.21; 95% CI: 1.11, 1.32) and urban women (APR = 1.22; 95% CI: 1.09, 1.62) were factors associated positively with knowledge of obstetrics danger sign. Conclusion: The prevalence of knowledge of obstetrics danger sign is found to be lower compared with the national average. Residence, mass-media exposure, model family planning, problem faced during pregnancy and women autonomy are the main predictors of knowledge of obstetrics danger sign. Public health policy makers should enhance health literacy at for focused on rural community. Awareness creation should be improved through mass media. Health providers should educate women during maternity health services to empower women for decision making process.

Heart failure (HF) is a growing issue in developed countries and most patients present with a reduced ejection fraction. This condition significantly impairs quality of life and represents a threat not only for patients, but also for the entire healthcare system due to its high management cost. In the last decade, new medical treatments and devices have been developed to reduce HF hospitalizations and improve prognosis, while reducing the overall mortality rate. Medical therapy does not achieve the same results in all patients and, whenever it fails, technology comes in handy: novel devices for the management of HF have reduced symptoms. They have also improved the treatment of fluid retention and life threatening arrhythmias. The present review article gives to the readers a comprehensive overview of the most recent and important findings that need to be considered in HF with reduced ejection fraction patients. Both novel medical treatments and devices have been presented and discussed.

(max 200 words): The contamination of groundwater is a serious concern for ecosystems and human health. In this regard, biochar represents a promising low-cost and sustainable material for in-situ groundwater remediation. Herein, biochar waste of biomass energy production process derived from pine wood gasification at 950°C was used as active carbonaceous material in combination with different biopolymers: chitosan (CS), alginate (ALG), potato starch (PST), and carboxymethylcellulose (CMC) to produce BC@biopolymer composite materials. Different concentrations of biochar (0.3–1.0 g·L-1) and biopolymers (0.2–20.0 g·L-1) were tested and blending mode was used as simple and straightforward strategy to obtain BC composites. Scanning electron microscopy (FE-SEM), UV-Visible, infrared (FT-IR) spectroscopy, specific surface area (BET method), pore volume, and pore size distribution (textural parameters), dynamic light scattering (DLS), and ζ-potential were used to investigate the composite chemical structure, stability, and to assess the interaction among counterparts. On optimized formulations, breakthrough tests and batch adsorption isotherms on trichloroethylene (TCE) as a model contaminant were performed to evaluate the capability of composites to be delivered through a porous medium determining the transport properties, (hydrodynamic dispersion retention percentage, and adsorption capacity). This biopolymer-modified biochar holds significant promise as a sustainable and effective solution to address various groundwater pollution challenges.

Patients with inflammatory bowel diseases (IBD), including both ulcerative colitis (UC) and Crohn's disease (CD), are at a higher risk of developing colorectal cancer (CRC). However, advancements in endoscopic imaging techniques, integrated surveillance programs, and improved medical therapies have led to a decrease in the incidence of CRC among IBD patients. Currently, the management of patients with IBD who have a history of or ongoing active malignancy is an unmet need. This involves balancing the risk of cancer recurrence/progression with the potential exacerbation of IBD if the medications are discontinued. The objective of this review is to provide an updated summary of the epidemiology, causes, risk factors, and surveillance approaches for CRC in individuals with IBD, and to offer practical guidance on managing IBD patients with history of previous or active cancer.