Bacteria can colonize and develop biofilm on a large variety of biotic and abiotic materials, it is accountable for nosocomial infections and chronic illness and consequently, it is a serious economic and public health problem. Staphylococcus epidermidis, thanks to its ability to form biofilm and colonize biomaterials, represents the most frequent causative agent involved in bio-film-associated infections of medical devices. Due to the biofilm presence, S. epidermidis infections are extremely difficult to treat and the research of new molecules able to interfere with its biofilm formation has a remarkable interest. In the present work, the attention was focused on Pseudomonas sp. TAE6080, an Antarctic marine bacterium able to produce and secrete an effective antibiofilm compound. The molecule responsible for this activity was purified by an activity-guided approach and it resulted to be a periplasmic protein, named Cold-Azurin. The Cold-Azurin was recombinantly produced in E. coli and purified. The recombinant protein was able to impair S. epidermidis attachment to the polystyrene surface and effectively prevent biofilm formation.

The extracellular matrix of most bacterial biofilms contains polysaccharides, proteins, and nucleic acids. These biopolymers have been shown to mediate fundamental biofilm-related phenotypes including surface attachment, intercellular adhesion, and biocide resistance. Enzymes that degrade polymeric biofilm matrix components, including glycoside hydrolases, proteases, and nucleases, are useful tools for studying the structure and function of biofilm matrix components and are also being investigated as potential antibiofilm agents for clinical use. Dispersin B is a well-studied, broad spectrum antibiofilm glycoside hydrolase produced by Aggregatibacter actinomycetemcomitans. Dispersin B degrades poly-N-acetylglucosamine, a biofilm matrix polysaccharide that mediates biofilm formation, stress tolerance, and biocide resistance in numerous Gram-negative and Gram-positive pathogens. Dispersin B has been shown to inhibit biofilm and pellicle formation; detach pre-formed biofilms; disaggregate bacterial flocs; sensitize pre-formed biofilms to detachment by enzymes, detergents, and metal chelators; and sensitize pre-formed biofilms to killing by antiseptics, antibiotics, bacteriophages, macrophages, and predatory bacteria. This review summarizes the results of nearly 100 in vitro and in vivo studies that have been carried out on dispersin B since it’s discovery 20 years ago. These include investigations into the biological function of the enzyme, it’s structure and mechanism of action, and its in vitro and in vivo antibiofilm activities against numerous bacterial species. Also discussed are potential clinical applications of dispersin B.

The occurrence and ability of Salmonella typhimurium to withstand the effects of various antibiotics has been extensively recorded. This highlights the necessity for alternative methods to combat Salmonella infections. The current investigation aimed to ascertain the impact of benzoic acid on the extent of surface coverage and biomass of S. typhimurium biofilm after 48 and 72 hours. The findings indicated that all the different doses of benzoic acid (ranging from 3.125% to 50%) resulted in a decrease in the extent of biofilm surface coverage. Benzoic acid exhibited a substantial inhibitory effect on the biofilm biomass at all concentrations. Higher concentrations of benzoic acid led to a decrease in biofilm biomass, suggesting a concentration-dependent response. This finding implies that benzoic acid is effective in managing Salmonella infections.

Nowadays the relationship between planning land use and actual land use is not so clear in general. A lot of efforts have been put in the failures of regulation for the expansion of construction land. However, it still lacks an integrated approach to study the effectiveness of land use regulation in terms of different land use types. Furthermore, the existing evaluation of land use plan mainly focuses on a general level, a detailed research on the regulation effectiveness of each construction land use type is absent. Therefore, this research tries to evaluate regulation effectiveness of land use plan, which takes Cangwu country, Guangxi Province as an example. The finding by analysis is that the total area of construction land expansion was about 3494.73 ha, nearly 1.1 times of the plan quota. Moreover, the effectiveness differs greatly in various construction land use types. Town, industrial/mining sites can be well regulated through the quota of land use plan. While, the quota regulation system is not as effective for other type of construction land. Thus, we suggest to improve the regulation effectiveness of construction land through different plan instruments.

Objective: To determine the effect of sandblasting before and after sintering on the surface roughness of zirconia and the micro-tensile bond strength of a pressable veneering ceramic to zirconia. Methods: Pre-sintered zirconia blocks (IPS e.max ZirCAD, Ivoclar Vivadent) were divided into a control group (CTR, no surface treatment) and four test groups of three specimens each: Pre-S-30, Pre-S-50, Pre-S-110 were sandblasted with 30µm SiO2, 50µm Al2O3 and 110µm Al2O3 particles respectively, before sintering, Post-S-30 was sandblasted with 30µm SiO2 after sintering. For each treatment, the surface roughness was measured (Ra, Perthometer M4P, Mahr Perthen). After sintering the zirconia blocks, a liner and a pressable ceramic (IPS e.max ZirPress, Ivoclar Vivadent) were fired. Sixteen micro-bars were obtained from each block and submitted to the micro-tensile bond strength (µTBS) test. Data were analyzed with one-way ANOVA. Any correlation between Ra and µTBS was evaluated (Sperman test). Results: Sandblasting before sintering with 110µm Al2O3 (Ra=3.44±0.44µm), 50µm Al2O3 (Ra=2.32±0.46µm), and 30µm SiO2 (Ra=1.22±0.22µm) resulted in significantly higher roughness than sandblasting after sintering with 30µm SiO2 (Ra=0.46±0.11µm). The highest µTBS was measured when the sintered zirconia was sandblasted with 30μm SiO2 (26.79±14.80 MPa), which was significantly different from that of specimens that were sandblasted before sintering (Pre-S-30=20.90±11.70; Pre-S-50=21.27±15.19; Pre-S-110=23.99±16.83) or were not treated (CTR=17.44±14.03). Conclusions: Sandblasting zirconia before sintering enhances the surface roughness proportionally to the particle size of the sand used. Sandblasting with 30µm SiO2 after sintering appeared to improve bonding between the veneering ceramic and zirconia. Clinical Significance: Sandblasting with 30µm SiO2 after sintering may improve bonding between veneering ceramics and zirconia, thus reducing ceramic fractures/chippings.

On using a 3D model to teach students a topic in astronomy, feedback was evaluated via a questionnaire. Analysis of students' responses to the questions revealed that user interface had a significant impact on their attitudes, which in turn could increase users' willingness to use immersive technology in e-learning. The results also showed that improving visual features through immersive technology and augmented reality tools were effective. The results confirm all hypotheses about positive relationships between facilitating conditions and usability of metaverse technology for students' attention and study motivation.

Lichenochemical composition and antimicrobial, antibiofilm and antioxidant effects of a newly described arctic lichen Placidium doesaiense growing in Pakistan were investigated. HPLC–DAD methods were used for identification of secondary metabolites in acetone and methanol extracts. The total polyphenol and the total flavonoid content was determined spectrophotometrically. The study examined the antioxidant (DPPH scavenging activity and reducing power), antibacterial (minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC)) and antibiofilm (inhibition of biofilm formation and reduction of mature biofilm) activities of extracts of the lichen P. doesaiense and isolated parietin. The chemical constituents olivetol, olivetolic acid, haematommic acid, fallacinol and parietin, were identified as major compounds in the tested extracts of the lichen. Parietin was isolated from the acetone extract on a separation column. The methanol extract had higher values of TPC (21.67 mg GA/g) and TFC (377.40 mg RE/g) than the acetone extract. Although the extracts showed the best antibacterial activity (especially against Proteus mirabilis ATCC 12453), parietin demonstrated superior antibiofilm activity (especially against Staphylococcus aureus ATCC 25923). Isolated parietin showed the best antioxidant activity measures according to DPPH scavenging activity (IC50= 51.616 μg/mL) and reducing power. This is the first report on the phytochemical composition of the lichen Placidium doesaiense and the first description of the chemical composition of some of the 28 species of the genus Placidia. This research will pave the way for further exploration of new activities of this lichen and its metabolites, which are important for medicine and pharmacy.

The work aims to develop an electromagnetic shielding measurement methodology and design an electromagnetic shielding effectiveness test setup for thin sheet material testing. In brief, multiple shielding effectiveness standards are described and analyzed in the thin sheet material testing framework. Two types of the developed shielding effectiveness test probe in high and low-frequency ranges are validated comprehensively. Extensive descriptions and data of developed testing methodology are also reported.

Background: Bacterial infections constantly have a large impact on public health, because of increased rates of resistance and reduced frequency of development of novel antibiotics. The utility of conventional antibiotics for treating bacterial infections has become increasingly challenging. The aim of the study was to assess the antibacterial effect of β -Lapachone, a novel synthetic compound. Methods: The antibacterial activity of the β -Lapachone compound was examined against laboratory strains by agar well diffusion method, minimal inhibitory concentration (MICs), and minimal bactericidal concentration (MBCs). Growth kinetics inhibition in presence of β -Lapachone on Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas aeruginosa (ATCC 27853) was assessed by MABA. Crystal violet blue assay was used for biofilm inhibition assays, biofilm eradication assay and for molecular modeling PyMOL was used. Results: β -Lapachone exhibited potent antimicrobial activity against laboratory strains of bacteria with MIC of 0.2 mM for S. saprophyticus and Staphylococcus aureus, and 0.04 mM for Staphylococcus epidermidis and Pseudomonas aeruginosa ATCC 27853. The inhibition of catalase enzyme was found to be the cause for its antibacterial activity. Molecular modeling predicted the binding of β -Lap at active site and heme binding site of catalase, KatA. The activity of some commercial antibiotics was enhanced in association with β -Lap. In addition, β -Lap inhibited the biofilm formation and eradicated the already formed and ultra-mature biofilms of aforesaid bacterial strains.

Background: Pediatric obesity treatment is based on high-intensity lifestyle counseling. However, high dropout rates and low effectiveness have been reported even in specialized centers. Mobile health technologies have been used in research settings to overcome these limits with contrasting results. This study aims to evaluate the effectiveness of a six-month intervention with a mobile app for the treatment of pediatric obesity at 6 and 12 months of follow-up. Methods: Patients were randomly assigned to standard care or standard care plus mobile app (2:1). The mobile app delivered high-intensity lifestyle counseling for diet and physical activity. Results: Seventy-five subjects were prospectively enrolled. At six months of follow-up, the m-app group showed significantly lower dropout rates compared to standard care(p=0.01). The risk of dropout was significantly higher in controls compared to the intervention group (OR 3.86,95%C.I. 1.39-10.42,p=0.01). After one year of follow-up, we observed lower albeit non statistically significant dropout rates in the m-app compared to the standard care group(p=0.24). No differences were observed in terms of z-score BMI and percentage of BMI reduction between the two groups. Conclusion: our findings suggest that mobile app might help in the clinical management of children and adolescents with obesity in terms of dropout reduction.

The increased emergence of multidrug-resistant Helicobacter pylori influences the prevention of stomach cancer. Zingiber officinale is a plant usually used in folk medicine to treat a variety of diseases involving infections, nausea, vomiting, peptic ulcer, dyspepsia, and inflammation. This study was conducted to evaluate the ability of Z. officinale extract to combat resistant H. pylori. The disc diffusion, microdilution, and microplate assays were performed to evaluate the susceptibility to antibiotics, and the antibacterial and antibiofilm activities of the Z. officinale extracts. Using the checkerboard method, the combined effects of the gentamicin and Z. officinale extract were investigated. In addition, anti-inflammatory activity and GC-MS analysis were determined by the modified protocol. According to the findings, H. pylori isolates exhibited resistance rates of 56.33, 50.0, and 45.85 for metronidazole, gentamicin, and tetracycline, respectively. The methanolic extract of Z. officinale had the strongest effectiveness against resistant H. pylori isolates with MIC of 20.0 to 50.0 µg/ml against both H. pylori isolates and the stranded strain NCTC 11637. Z. officinale extract suppress the biofilm formed by H. pylori isolates with a percentage of 92.96% at 50.0µg/ml, compared with 97.19% for gentamicin at the same concentration. According to FICI values, combination of methanolic Z. officinale extract to gentamicin increases bacterial sensitivity to such drugs. Moreover, the Z. officinale extract exhibits strong anti-inflammatory activity. The GC-MS analysis of Z. officinale extract exhibits 17 different chemical compounds. Conclusions: The Z. officinale extract contain the anti-inflammatory compound gingerol as the main constituent which inhibits the growth of H. pylori and its biofilm, are a promising natural therapeutic alternative or enhance antibiotics activity

Pyrolyzed organic matter – commonly referred to as biochar – generally has positive effects on plant growth and can enhance early seedling development. Biochar-based seed coatings may thus be beneficial, specifically under adverse soil conditions such as high soil salinity. We evaluated germination and early plant development in radish (Raphinus sativa) seeds coated with conifer-feedstock slow-pyrolysis biochar; following the precedent of prior studies, polyvinyl acetate (PVAc) was used as the binding agent. Biochar-based seed coatings reduced germination rates and radicle extension in Petri dish trials; however, leaching of coated seeds largely eliminated this effect. PVAc applied in solution inhibited seed germination to a similar extent, suggesting that toxicity of PVAc or chemical products derived from it is the main mechanism for germination inhibition; a meta-analysis of published literature also indicates negative effects of biochar-based seed coatings using PVAc. In greenhouse trials the same biochar seed coatings improved aspects of plant growth and physiological status relative to controls, specifically enhancing root development. We conclude that biochar-based seed coatings have promise in promoting early seedling growth, and in combating salinity stress in agronomic and restoration applications. However, our findings contraindicate PVAc use as a binding agent. Further research is needed to test non-phytotoxic, readily biodegradable binding agents and to optimize biochars and seed coating processes for specific applications in agronomy and ecological restoration.

Background: Bioaerosol can represent a danger to the health. During SARS-CoV-2 pandemic, portable devices were used in different environments and considered a valuable prevention tool. This study has evaluated the effectiveness of the air treatment device “AEROK 1.0” in reducing microbial, particulate and pollen airborne contamination indoors, during normal activity. Methods: In an administrative room, airborne microbial contamination was measured using active (DUOSAS 360 and MD8) and passive sampling; a particle counter was used to evaluate particle concentrations; a Hirst-type pollen trap was used to assess airborne pollen and Alternaria spores. Statistical analysis was performed using SPSS 26.0; p values <0.05 were considered statistically significant. Results: The airborne bacterial contamination assessed by the two different samplers decreased by 55.54% and 69.13%, respectively. The airborne bacterial contamination assessed by passive sampling decreased by 44.16%. For fungi, the reduction was 38.7% by active sampling. Airborne particles (diameters ≥ 1.0, 2.0 μm) and the ratio of indoor/outdoor concentrations of total pollen and Alternaria spp spores significantly decreased. Conclusions: The results highlight the effectiveness of AEROK 1.0 in reducing airborne contamination. The approach carried out represents a contribution to the definition of a standardized model for evaluating the effectiveness of this type of devices.

This work discusses seismic isolation technologies and analyses the concept of geotechnical seismic isolation (GSI) system, which is characterized by new principles of operation, using geomaterial with modified properties to reduce inertial seismic loads on buildings and structures. The aim of the study is to develop a geotechnical seismic isolation system in the form of vertical barriers, with different geometrical characteristics, using rubber-soil mixture (RSM). The novelty of the work consists in determination of effective constructive and technical solutions of vertical seismic barriers from RSM, which are characterized by reliability in providing seismic isolation of construction objects. Soil and superstructure interactions are modeled in Plaxis software, using the Northridge earthquake accelerogram. The results confirm the positive impact of using RSM as an effective material for GSI vertical barriers. The present numerical and experimental results show that the GSI system using RSM can significantly reduce the seismic hazard. The results of computational-experimental modeling will become a research, analytical and design basis for the development of new ways to ensure earthquake resistance of construction objects.

Introductory courses regarding radar technologies are very popular in undergraduate curriculum of many electrical and electronics engineering departments. Hands-on experience is an essential part for understanding the theoretical concepts given in lectures. In most cases, it is not affordable for universities to acquire experimental radar systems, especially those in developing countries. This paper presents a detailed description of a cost-effective easy-to-deploy radar system laboratory sessions and measures the educational effectiveness of the proposed material. The provided radar models can be used in teaching undergraduate students the working principles of frequency modulated continuous wave (FMCW) radar systems, as well as assisting graduate students in their research activities. The effectiveness of the laboratory sessions is measured thoroughly via qualitative and quantitative methods based on the proposed learning process and students’ success. The results show that the lab sessions have increased the students' understanding of the topics covered within the course, and the students' general perception is positive.

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

Background: The biofilm-forming bacteria Porphyromonas gingivalis (P. gingivalis) is primarily responsible for periodontal disorders, which continue to be a global health issue. Despite the widespread use of antibiotics like metronidazole, other potent therapeutic a crucial quorum sensing molecule implicated in the formation of P. gingivalis biofilm. Approaches are now being explored due to the growing challenge of antibiotic resistance. Objective: In particular, chemicals from Symphytum Officinale (S) and Panax Ginseng (G) plants will be examined in this study to assess if they have the ability to inhibit biofilm and to prevent the development of acylated homoserine lactones (AHLs), a quorum sensing molecule. Materials and Methods: With Metronidazole serving as a control, the antibacterial effects of these substances (Symphytum Officinale and Panax Ginseng) were examined against a standard strain and a clinical isolate of P. gingivalis. Dilutions of these plant extracts were used either alone (G+S) or in conjunction with metronidazole (G+S+F), to assess their antibacterial activity using antibacterial susceptibility test (inhibition zone), biofilm inhibition and disruption assay (optical density) and quorum sensing inhibition assay (AHL). Results: The combinations of Symphytum officinale, Panax Ginseng and metronidazole (S+G+F) showed the maximum effectiveness with highest zone of inhibition (25.000±0.001 mm) and biofilm inhibition (98.46%), and were comparable to G+S (inhibition zone of 24.341±0.593 mm and biofilm inhibition of 97.76%), and significantly different in the degree of biofilm inhibition with different treatment scenarios. Additionally, the plant's extracts and combinations are specific concentrations had a significant effect on the suppression of the generation of AHL (p &lt; 0.05). Conclusion: According to preliminary research, these plant-derived substances, especially when paired with metronidazole, significantly inhibited the growth of P. gingivalis biofilm providing valuable information for the development of innovative therapeutic approaches for periodontitis and other biofilm-associated illnesses.

This study aimed at testing the effectiveness of novel combinations of chemical and physical methods to control Prosopis juliflora, an invasive weed in the Moshi and Simanjiro districts of Nothern Tan-zania. Six different treatments including manual uprooting, glyphosate, bark chop with chemical application, two separate chemical mixtures and control were tested in a total of 32 plots, which represented two land use types (grazing land and farmland) found in the two districts. Each plot covered 20m×30m plot area. Two response variables (stem count and tree volume) were recorded to compare weed population density before and after treatment six months later. An analysis of the untreated control plots, showed that the inherent growth potential of P. juliflora was higher in Moshi than in Simanjiro district. The number of stems increased during the experiment for all six treatments showing that the P. juliflora population had not yet reached the local carrying capacity. For the manual control treatment, the increase was reduced compared to the untreated control. For all other treatments, the increase in stem count was on par with that in the untreated control or even higher. Thus, we conclude that only manual uprooting had a controlling effect but not to the extent that it eradicated P. juliflora. Thus, it is for P. juliflora as for weed control in general: weed control must be an ongoing effort.

There is a major problem with the rising occurrence of highly virulent and multiply-resistant strains, including methicillin-resistant Staphylococcus aureus (MRSA), because of their difficult treatment. This study aimed to evaluate the antibacterial and antibiofilm effect of new enterocins (Ent) against potential pathogenic MRSA strains isolated from rabbits. Staphylococci (n =110) were identified with PCR and screened for methicillin/oxacillin/cefoxitin resistance (MR) using the disk diffusion method and the PBP2' Latex Agglutination Test Kit. Enzyme production, hemolysis, DNase activity, slime production, and biofilm formation were tested in MRSA strains. The susceptibility of MRSA to eight partially-purified enterocins (Ent) produced by E. faecium and E. durans strains was checked using agar spot tests. The antibiofilm activity of Ents was tested using a quantitative plate assay. Out of 14 MRSA, PBP testing confirmed MR in 8 strains. The majority of MRSA showed DNase activity and β-hemolysis. Slime production and moderate biofilm formation were observed in all strains. MRSA were susceptible to tested Ents (100–12800 AU/mL; except Ent4231). The antibiofilm effect of Ents (except Ent4231) was noted in the high range (64.9-97.0%). These results indicate that enterocins offer a promising option for the prevention and treatment of bacterial infections caused by biofilm-forming MRSA.

To face the high tolerance of biofilms to antibiotics, it is urgent to develop new strategies to fight against these bacterial consortia. We describe here an innova-tive antibiofilm nano vector, consisting of a Dispersin B-permethylated-β-cyclodextrin/ciprofloxacin adamantly (DspB-β-CD/CIP-Ad). For this purpose, complexation assays between CIP-Ad and (i) unmodified β-CD and (ii) different derivatives of β-CD, that are 2,3-O-dimethyl-β-CD, 2,6-O-dimethyl-β-CD, and 2,3,6-O-trimethyl-β-CD were tested. A stoichiometry of 1/1 was obtained for the β -CD/CIP-Ad complex by NMR analysis. ITC experiments were carried out to determine Ka, ΔH, ΔS thermodynamic parameters of the complex between β-CD or its different derivatives in the presence of CIP-Ad. A stoichiometry 1/1 of β-CD/CIP-Ad complexes was confirmed with variable affinity according to the type of methylation. A phase solubility study showed increased CIP-Ad solubili-ty with CDs concentration, pointing out complex formation. The evaluation of the antibacterial activity of CIP-Ad and the 2,3-O-dimethyl-β-CD/CIP-Ad or 2,3,6-O-trimethyl-β-CD/CIP-Ad complexes was performed on S.epidermidis strains. MIC studies showed that the complex of CIP-Ad and 2,3-O-dimethyl-β-CD exhibited similar antimicrobial activity to CIP-Ad alone, while the interaction with 2,3,6-O-trimethyl-β-CD increased MIC values. Antimicrobial assays on S. epidermidis biofilms demonstrated that the synergistic effect observed with the DspB/CIP association was partly maintained with the 2,3-O-dimethyl-β-CDs/CIP-Ad complex. To obtain this "all in one" nano vector, able to destroy the biofilm matrix and release the antibiotic simultaneously, we covalently grafted DspB on three carboxylic permethylated CD derivatives with different length spacer arms. The strategy was validated by demonstrating that a DspB-permethylated-β-CD/ciprofloxacin-Ad nanovector exhibited efficient antibiofilm activity.

The current research work illustrates an economic and rapid approach towards biogenic synthesis of silver nanoparticles using aqueous Punica granatum leaves extract (PGL-AgNPs). The optimization of major parameters involved in the biosynthesis process was done using Box-Behnken Design (BBD). The effects of different independent variables (parameters) namely concentration of AgNO3, temperature and ratio of extract to AgNO3on response viz. particle size and polydispersity index were analyzed. As a result of experiment designing, 17 reactions were generated which were further validated experimentally. The statistical and mathematical approaches were employed on these reactions in order to interpret the relationship between the factors and responses. The biosynthesized nanoparticles were initially characterized by UV-vis spectrophotometry followed by physicochemical analysis for determination of particle size, polydispersity index and zeta potential via dynamic light scattering (DLS), SEM and EDX studies. Moreover, the determination of functional group present in the leaves extract and PGL-AgNPs was done by FTIR. Antibacterial and antibiofilm efficacies of PGL-AgNPs against Gram-positive and Gram-negative bacteria were further determined. The physicochemical studies suggested that PGL-AgNPs were round in shape and of ~ 37.5 nm in size with uniform distribution. Our studies suggested that PGL-AgNPs exhibit potent antibacterial, and antibiofilm properties.

AI-driven tools can identify nursing students' strengths and weaknesses, thus enabling the development of customized learning plans that target specific areas for improvement. This targeted approach can enhance knowledge retention and skill development, resulting in better prepared healthcare professionals. Nursing students are required to overcome their own psychological stress during their internship in order to understand sick children’s emotional reactions, as well as to be able to interact and communicate with such children. The application of AI picture-based teaching e-books helps nursing students to understand how to use therapeutic games to improve communication with sick children. A comparison of the differences between nursing teachers’ self-efficacy scores and nursing students’ application of AI picture-based teaching e-books (experimental group) and narrative handouts (control group) was achieved via therapeutic games to deal with sick children’s fear of medical examinations and treatments. In addition, a comparison was also conducted on the differences between the impact of the self-efficacy of the experimental group and that of the control group in dealing with sick children’s behavioral responses with respect to fears of medical examinations and treatments. This study is a quasi-experimental study, in which the self-efficacy scores of 30 nursing students were collected and analyzed in both the experimental group and the control group before and after intervention in dealing with sick children’s behavioral responses to fears of medical examinations and treatments. It was found that the self-efficacy score of the experimental group was higher than that of the control group (β coefficient is 0.356) when assessing the self-efficacy scores and behavior of the experimental and control groups in dealing with sick children’s fears of medical examinations and treatments through one-way analysis of covariance (one-way ANCOVA), moreover, a statistically significant difference (p < 0.05) was observed. The experimental group’s score of behavioral responses to the fears of sick children to examinations and treatments was lower than that of the control group (β coefficient was -1.540), wherein a statistically significant difference (p < 0.05) was shown. The self-efficacy of the experimental group in dealing with sick children’s fears of medical examinations and treatments had a statistically significant impact on the sick children’s behavioral responses to the fear of medical examinations and treatments (p < 0.05). In addition, the higher the self-efficacy scores of the experimental group in dealing with sick children’s fear of medical examinations and treatments, the lower the sick children’s behavioral responses to fears of medical examinations and treatments (the β coefficient was -0.914), the control group’s self-efficacy scores in dealing with sick children’s fears of medical examinations and treatments did not have a statistically significant impact on the sick children’s behavioral responses to fears of medical examinations and treatments (p > 0.05). This study proves that the application of AI picture-based teaching e-books by nursing teachers is more effective than narrative handouts in improving nursing students’ self-efficacy when using therapeutic games to deal with, as well as reduce, sick children’s fears of medical examinations and treatments.

Introduction: Bacterial resistance is a worldwide public health problem, requiring new therapeutic options. An alternative approach to this problem is the use of animal toxins, such as phospholipases (PLA₂) isolated from snake venom, which have important biological activities. Bothrops erythromelas is one of the snake species in the Northeast of Brazil that attracts great medical-scientific interest. Here we aimed to purify and characterize a PLA₂ from B. erythromelas, searching for heterologous activities against bacterial biofilm. Methods: Venom extraction and quantification were followed by RP-HPLC in C18 column, MALDI-ToF mass spectrometry and sequencing by Edman degradation. All experiments were monitored by specific activity using 4-nitro-3 (octanoyloxy) benzoic acid (4N₃OBA) substrate. In addition, hemolytic tests and anti-bacterial tests including action against Escherichia coli, Staphylococcus aureus and Acinetobacter baumannii, were carried out. Moreover, tests of antibiofilm action against A. baumannii were also performed. Results: PLA₂, after one purification step, presented 31 N-terminal amino acid residues, and molecular weight of 13656.4 Da with enzymatic activity confirmed in 0.06 µM concentration. Antibacterial activity against S. aureus (IC₅₀ = 30.2 µM) and antibiofilm activity against A. baumannii (IC₅₀ = 1.1 µM) were observed. Conclusions: This is the first time that PLA₂ purified from B. erythromelas venom has appeared as an alternative candidate in studies of new antibacterial medicines.

Seventy-seven percent of Irish primary school children do not meet recommended physical activity (PA) guidelines [1]. The Daily Mile (TDM) is a primary school initiative designed to increase children’s PA output. This study evaluates TDM’s perceived effect on Irish primary school children’s health-related metrics. A mixed-methods study, comprising two data collection phases, used the RE-AIM framework to evaluate TDM [2]. Phase one involved teachers, principals and classroom assistants (n = 191) from TDM-registered schools completing a questionnaire. Two TDM-registered schools participated in phase two where, (i) interviews were conducted with each principal, (ii) a teacher sub-sample (n = 4) participated in a focus group and (iii) a child sub-sample (n = 14) participated in separate focus groups. TDM was perceived to positively impact markers of children’s health, including their PA behaviour, physical fitness and social wellbeing. Inclement weather (66.5%) and a lack of time (56.5%) were reported as the top-ranked implementation barriers. Moreover, TDM’s repetitive nature often left children feeling disinterested and resulted in some teachers modifying the initiative to maintain engagement levels. Maintaining the long-term implementation of TDM and its health benefits in primary schools may require bespoke amendments to the original format to preserve children’s engagement.

Background Gingivitis can develop without mechanical cleaning within three weeks. The first clinical sign is bleeding on positive probing. The accumulation of dental biofilm generates an inflammatory gingival response. In the past decade, attention has focused mainly on the interproximal areas and the use of customsized interproximal toothbrushes.The aim of the study was to evaluate the effectiveness of individualized oral hygiene education and its role in dental prevention among patients with dental problems. Methods Before treatment, patients were clinically and radiologically examined, full mouth plaque score (FMPS), full mouth bleeding score (FMBS), and bleeding on brushing (BOB) were recorded, and matrix-metalloproteinase-8 (MMP-8) was measured by using a chair-side MMP-8 measuring system. Patients in group A had gingivitis, but no periodontal damage and patients in group B had periodontal damage. Patients in both groups A and B were identified in to four subgroups based on their toothbrushing habits and the oral health education they received. The three months after initial examination, each patient was examined three more times (2, 4 and 12 weeks later). Results It was concluded that subjects in groups A1 and B1 showed significant reduction in BOB, MMP-8, FMBS and FMPS levels after two weeks. Solo Prophylaxis (A1and B1) remained as a well-constructed protocol with hte complete resolution of interdental inflammation after two weeks. Other subgroups achieved significant reductions only after 12 weeks. Conclusions BOB and MMP-8 are valuable complements in preventive dentistry, and are able to detect potential pathological processes in interproximal spaces. The clinical relevance of BOB, in addition to FMBS, FMPS and gingival inflammation can be demonstrated to patients, which may increase compliance.

Long-term safety of a nutraceutical combination based on agnus castus and magnolia extracts combined with soy isoflavones (SI) and lactobacilli, and effectiveness on vasomotor symptoms and sleep disorders in postmenopausal women, were assessed. A controlled study was carried-out in menopausal women comparing this nutraceutical combination (ESP group) with formulation containing isoflavones alone (C group), at the dosage recommended. Kuppermann index, PSQI, and SF-36 were determined at baseline, 3, 6 and 12 months. Endometrial thickness, mammary density and liver function were evaluated at baseline and after 12 months. 180 women (100 in ESP group and 80 in C group, mean age 55.5 years, in menopause for about 36 months) were enrolled in the study. At the treatment end, mammary density, endometrial thickness, and hepatic function did not show substantial differences between groups. Kuppermann index, and particularly hot flushes, were progressively and significantly decreased in frequency and severity during ESP versus C treatment. No adverse events were observed. Agnus castus and magnolia, combined with SI + lactobacilli, can effectively and safely be used in symptomatic postmenopausal women, mainly when quality of sleep is the most disturbing complaint. Endometrium, mammary glands and liver function, were unaffected after 12 months treatment.

The wound management sector has attracted considerable attention due to the increasing challenge posed by antimicrobial resistance (AMR) and the specialized care required for chronic wounds. Effective wound care involves selecting appropriate dressings tailored with antimicrobial agents to prevent bacterial infection. Among various types of wound dressings, fibers and electrospun fibers, with their unique characteristics, have emerged as innovative new materials. However, the rise of AMR necessitates the exploration of new antimicrobial agents for wound dressings, particularly for addressing bacterial pathogens like methicillin-resistant Staphylococcus aureus (MRSA). Endophytic fungi, known for producing diverse bioactive compounds, including novel antibacterial agents, represent a promising source of such new agents. This study tested thirty-two endophytic fungi from thirteen distinct Australian native plants for their antibacterial activity against S. aureus, the most common wound-associated bacteria. Ethyl acetate (EtOAc) extracts from fungal culture filtrates exhibited inhibitory effects against both methicillin-sensitive S. aureus ATCC 25923 and MRSA strains M173525 and M180920. DNA sequence analysis was employed for fungal identification, with EtOAc extracts from the most active sample, EL 19 (Chaetomium globosum), selected for further bactericidal and antibiofilm testing against the chosen bacteria. Biofilm of S. aureus ATCC 25923 was reduced by 55% by EtOAc extracts of EL 19 at 1/2 × MIC. To demonstrate the potential application in wound dressing materials, three different concentrations of the extract were incorporated into Polycaprolactone fiber mats through electrospinning, with resultant inhibition of S. aureus ATCC 25923 being observed. This research underscores the potential of endophytic fungi from Australian plants as sources of substances effective against common wound pathogens. Further exploration of the responsible compounds and their mechanisms could facilitate the development of wound dressings effective against MRSA and innovative biofilm-resistant electrospun fibers, contributing to the global efforts to combat AMR.

Background: Dual function tail tubular proteins (TTP) belonging to the lytic bacteriophages are the interesting group of biologically active enzymes. Surprisingly, apart from their structural function, they are also polysaccharide hydrolyzes destroying bacterial extracellular components. One of the representatives of this group is TTPB from Klebsiella pneumoniae phage – KP32. TTPB hydrolyzes exopolysaccharide (EPS) of Klebsiella pneumoniae and Enterococcus faecalis strain. This depolymerizing feature was associated with the activity to prevent bacterial biofilm formation. TTPB can inhibit biofilm formation by K. pneumoniae, Enterobacter cloacae, Staphylococcus aureus, Enterococcus faecalis and Pseudomonas aeruginosa strains. Moreover, synergistic activity with antibiotic action has been observed, most likely due to depolymerases’ facilitation of contact of antibiotic with bacterial cells. Methods: TTPB was overexpressed in E coli system, purified and tested towards the bacterial strains using agar overlay method. The hydrolytic activity of TTPB was performed using EPSs of K. pneumoniae PCM2713 and E. cloacae ATCC 13047 as the substrates. Next, we determined the reducing sugar (RS) levels in the TTPB/EPS mixtures, regarding the RS amount obtained after acidic hydrolysis. The antibiofilm activity of TTPB has been set down on bacterial biofilm using a biochemical method. Finally, we have demonstrated the synergistic activity of TTPB with kanamycin. Results: For the first time, the hydrolytic activity of TTPB towards bacterial EPSs has been shown. TTPB releases about a half of the whole RS amount of EPSs belonging to K. pneumoniae PCM 2713 and E. cloacae ATCC 13047 strains. 1.12 µM of the phage protein reduces biofilm of both strains by over 60%. Destroying the bacterial biofilm the phage protein improves the antibiotic action increasing kanamycin effectiveness up to four times.

Weight loss solutions are on the rise, and there is growing interest in natural alternatives to the pharmaceuticals in the market, which are not devoid of relevant side effects. To this end, the objective of the current study is to assess the effects of a botanical-based blend comprised of lemon verbena and hibiscus extracts in weight management, body fat, appetite, lipid, and glucose profiles, in an overweight population, for 90 days. As a result, the volunteers presented significant weight loss in absence of diet, which coincided with decreased body fat. Body fat was assessed by anthropometry, electrical bioimpedance and DEXA scan. Cholesterol levels were also significantly decreased. Satiety assessment revealed that the product contributed to increased feeling of fullness and satisfaction after a meal, compared to the placebo group, which could contribute to the weight loss observed. Blood glucose and blood pressure levels remained unchanged, which was expected as the volunteers were normoglycemic and their blood pressure was in the healthy range. In conclusion, daily supplementation of a botanical-based blend contributes to weight loss in overweight individuals, in absence of diet, while not affecting other parameters that are in the healthy range. This product could be a candidate alternative or add-on to other weight loss products, as part of a healthy lifestyle.

Microbial biofilms cause several environmental and industrial issues, even on the human health. Although they have represented a threaten due to their resistance to antibiotics, there are currently no approved antibiofilm agents for clinical treatments. The multi-functionality of antimicrobial peptides (AMPs) including the antibiofilm activity and their potentialities to target multiple mi-crobes motivated the synthesis of AMP relatives for developing antibiofilm agents for clinical purposes. Antibiofilm peptides (ABFPs) have been organized in databases that allowed the building of prediction tools which have assisted in the discovery/design of new antibiofilm agents. However, the complex network approach has been explored yet as an assistant tool for this aim. Herein, a kind of similarity networks, called the Half-Space Proximal Network (HSPN) is applied to represent/analyse the chemical space of the ABFPs aimed to identify promising scaf-folds for the development of next generation antimicrobials, able to target both planktonic and biofilm microbial forms. Such analyses also considered the metadata associated to the ABFPs such as origin, other activities, targets, etc. in which the relationships were projected by multilayer networks called metadata networks (METNs). From the complex networks mining, a reduced but informative set of 66 ABFPs representing the original antibiofilm space was extracted. This subset retained from the most central to atypical ABFPs, having some of them, desired properties for developing next generation antimicrobials. So, this subset is advisable for assisting the search/design both new antibiofilm/antimicrobial agents. The provided ABFP motifs list, dis-covered within the HSPN communities, is also useful for the same purpose.

Staphylococcus aureus can develop resistance by mutation, tranfection or biofilm formation. Resistance was induced in S. aureus by growth in sub-inhibitory concentrations of ciprofloxacin for 30 days. The ability of the antimicrobials to disrupt biofilms was determined using crystal violet and live/dead staining. Effects on the cell membranes of biofilm cells was evaluated by measuring release of dyes and ATP and nucleic acids. S. aureus did not develop resistance to the AMPs but resistance increased to ciprofloxacin by 128 times after 30 passages. Only peptides reduced biofilms of ciprofloxacin resistant cells. The antibiofilm effect of melimine with ciprofloxacin was more (27%) than with melimine alone at 1X MIC (p < 0.001). Similarly, at 1X MIC the combination of Mel4 and ciprofloxacin produced more (48%) biofilm disruption than Mel4 alone (p < 0.001). Combinations of either of the peptides with ciprofloxacin at 2X MIC released  66 nM ATP, more than either peptide alone (p  0.005). At 2X MIC, only melimine in combination with ciprofloxacin released DNA/RNA which was 3 times more than released by melimine alone (p = 0.043). These results suggest the potential use of melimine and Mel4 with conventional antibiotics for the treatments of S. aureus biofilms.

Drug repurposing is an attractive strategy for developing new antibacterial molecules. Herein, we evaluated the in vitro antibacterial, antibiofilm, and antivirulence activities of eight FDA-approved “non-antibiotic” drugs, comparatively to tobramycin, against selected Pseudomonas aeruginosa strains from cystic fibrosis patients. MIC and MBC values were measured by broth microdilution methods. Time-kill kinetics was studied by the macro dilution method, and synergy studies were performed by checkerboard microdilution assay. The activity against preformed biofilm was measured by crystal violet and viable cell count assays. The effects on gene expression were studied by real-time quantitative PCR, while the cytotoxic potential was evaluated against IB3-1 bronchial CF cells. Ciclopirox, 5-fluorouracil, and actinomycin D showed the best activity against P. aeruginosa planktonic cells and, therefore, underwent further evaluation. Time-kill assays indicated actinomycin D and ciclopirox, contrarily to 5-fluorouracil and tobramycin, have the potential for bacterial eradication, although with strain-dependent efficacy. Ciclopirox was the most effective against the viability of the preformed biofilm. A similar activity was observed for other drugs, although they stimulate EPS production. Ribavirin showed a specific antibiofilm effect, not dependent on bacterial killing. Exposure to drugs and tobramycin generally caused hyperexpression of the virulence traits tested, except for actinomycin D, which downregulated the expression of alkaline protease and alginate polymerization. Ciclopirox and actinomycin D revealed high cytotoxic potential. Ciclopirox and ribavirin might provide chemical scaffolds for anti-P. aeruginosa drugs. Further studies are warranted to decrease ciclopirox cytotoxicity and evaluate the in vivo protective effects.

Pseudomonas aeruginosa is an opportunistic pathogen, especially dominant in people with cystic fibrosis; the drug resistance expressed by this pathogen and its capacity for adaptation generate a great challenge for its treatment and control, increasing morbidity and mortality rates globally. In this sense, the search for new treatment alternatives is imminent today, with products of plant origin being an excellent alternative to be used. The objective of this research was to evaluate the antibacterial and antibiofilm potential and to explore the possible effect of ethanolic extracts of wood and bark of Duguetia vallicola on the cell membrane. Microdilution assays showed inhibition of bacterial growth by more than 50%, with the lowest concentration evaluated (62.5μg/mL) of both extracts. Furthermore, we report the ability of both extracts to inhibit mature biofilms, with inhibition percentages between 48.4% and 93.7%. Intracellular material leakage experiments (260/280 nm), extracellular pH measurement, and fluorescence microscopy with acridine orange (AO) and ethidium bromide (EB) showed cell membrane damage. This indicates that the anti-bacterial action of ethanolic extracts of D. vallicola is associated with damage to the integrity of the cell membrane and consequent death of these pathogens. These results serve as a reference for future studies in establishing the mechanisms of action of these extracts.

A biofilm is any syntrophic consortium of microorganisms in which cells adhere to one another and, in some cases, to a surface. These adherent cells become encased in a slimy extracellular matrix made up of extracellular polymeric substances (EPSs). Until now, the use of commercial disinfectants remains the main strategy to control biofilm-mediated problems. This mini review summarizes common antibiofilm mode of actions taken by disinfectants and how water channels in microbial biofilms contribute to disinfectant resistance.

Essential oils (EOs) have gained economic importance due to their biological activities, and increasing amounts are demanded everywhere. However, substantial differences between the same essential oil samples from different suppliers are reported due to numerous companies involved in EOs production and the continuous development of online sales. The present study investigates the antibacterial and antibiofilm activities of 2-4 samples of five commercially available essential oils (Oregano, Eucalyptus, Rosemary, Clove, and Peppermint oils) from different manufacturers. Their effects were evaluated in vitro on Gram-positive and Gram-negative bacteria (Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa). The antibacterial efficacy (ABE%) and antibiofilm efficacy (ABfE%) were determined spectrophotometrically at 562 and 570 nm using microplate cultivation techniques. The essential oils' calculated parameters were compared with those of three standard broad-spectrum antibiotics: Amoxicillin/Clavulanic acid (AMC), Gentamycin (GEN), and Streptomycin (STR), active on tested bacteria. The results showed that at the first dilution (D1 = 2.5 mg/mL), all essential oils (EOs) exhibited antibacterial activity against Gram-positive and Gram-negative bacteria. On S. aureus and E. coli, EOs had considerable antibacterial effects (ABE = 79.70—92.80%, respectively, 71.30 ‒ 94.00%). The highest antibacterial effects of commercially available EOs were against P. aeruginosa because all exhibited a significant antibiofilm activity. Their antibiofilm efficacy intensively decreased on E. coli and S. aureus. Generally, the samples with different manufacturers of the same EO showed similar effects. Only Clove and Peppermint oils samples displayed a higher variability associated with active metabolites' different contents, maybe due to various zones of harvesting raw material, numerous technologies involved in EOs obtaining processes, and complex interactions between components.

Understanding the dynamics of land use and land cover (LULC) change in today's context of rapid urbanization is critical for sustainable urban planning and environmental conservation. Therefore, the research aim is to understand the LULC changes in Chattogram Metropolitan Area and to assess the policy implications of these changes for sustainable urban development. Through a comparative analysis of LULC maps for two periods (1997–2007; 2007–2017), we investigated the transformation of a detailed planning zone before and after detailed area plan (DAP) approval. Using a mixed-method approach integrating quantitative data with policy analysis, we elucidated the impacts of urbanization trends on local ecosystems—specifically the conversion of forest cover and waterscape use. The findings reveal a significant conversion of forested and waterscape areas to urban and peri-urban landscapes, highlighting the urgent need for sustainable planning interventions that focus on these peri-urban areas. The study further critiques the DAP's effectiveness, revealing a disconnect between regional policy implementation and local outcomes. This research proposes a validated, scalable framework for urban master plans that adapts to the complex socio-ecological contexts of rapidly urbanizing regions.

Onychomycosis is a common fungal nail infection for which new antibiotics are needed to overcome antifungal resistance and other limitations of conventional treatments. This study reports the development of antifungal nail lacquers containing oregano essential oil (OEO), rosemary essential oil (REO), and/or biogenic silver nanoparticles (bioAgNP). The formulations (F) were tested against dermatophytes by agar diffusion, ex vivo nail infection, and scanning electron microscopy techniques. They were evaluated pharmacotechnically and by FTIR-PAS to access permeation across the nail plate. F-OEO and F-OEO/Ag were promising for the final nail lacquer formulation, they permeated through the nail plate and showed antifungal efficacy against dermatophytes-contaminated nails after 5 days of treatment. The treated nails had decreased hyphae and spores compared to untreated control; the hyphae were atypically flattened which indicates loss of cytoplasmic content due to damage to cytoplasmic membrane. Formulations were stable after centrifugation and thermal stress, maintaining organoleptic and physicochemical characteristics. F-OEO and F-OEO/Ag had pH compatible with the nail, and drying time (59-90 s) within the reference for nail lacquer. For the first time, OEO and bioAgNP were incorporated in a nail lacquer, resulting in a natural and nanotechnological antifungal product for onychomycosis that may combat microbial resistance.

We analyze a time-delayed SIQR model that considers the transportation-related infections and entry-exit screening. This model aims to determine the measures for preventing and controlling major emergent infectious diseases and the associated costs. We calculate the basic reproduction number (R0), apply the linearization method, and construct an appropriate Lyapunov function to determine the stability of the disease-free equilibrium in the local and global. We collect COVID-19 infection data from two regions in the United States in 2020 for data fitting, obtain a set of optimal parameter values, and show that the model is suitable for simulating the outbreak and spread of emerging infectious diseases. We find that transportation-related infections increase the basic reproduction number, enhancing the impact on disease spread. Entry-exit screening effectively suppress the spread of disease by reducing the basic reproduction number. Furthermore, we investigate the influence of the incubation period on disease and find that a shorter incubation period results in a shorter duration but a larger scale of infection, and the peaks are reduced. We conduct a sensitivity analysis of the R0 and propose three measures to prevent the spread of new infectious diseases based on the most sensitive parameters: wearing masks, implementing urban closures, and administering medication to sick but not yet hospitalized patients promptly. In the case of COVID-19, we use Pontryagin’s minimum principle to get time-varying control measures to control the spread of the outbreak. Optimal control effectively controls the development and deterioration of the disease. Finally, several control measures are compared through cost-effectiveness analysis, and the results show that wearing masks is the most cost-effective measure. Our study provides some practical guidance for controlling the spread of major emerging infectious diseases.

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

Concrete cracks and local damage can affect the bond performance between concrete and steel bars, thereby reducing the durability of reinforced concrete structures. Compared with general concrete crack repair methods, biomineralization repair not only has effective bonding capabilities but is also particularly environmentally friendly. In view of this, this study aimed to apply biomineralization technology to repair damaged fiber-reinforced lightweight aggregate concrete (LWAC). Two groups of LWAC specimens were prepared. The control group used lightweight aggregates (LWAs) without bacterial spores and nutrient sources, and the experimental group used LWAs containing bacterial spores and nutrient sources. These specimens were first subjected to compression tests and pull-out tests, respectively, and thus were damaged. After the damaged specimen healed itself in different ways for 28 days, secondary compression and pull-out tests were conducted. The self-healing method of the control group involved placing the specimens in an incubator. The experimental group was further divided into experimental group I and experimental group II. The self-healing method of experimental group I was the same as that of the control group. The self-healing method of experimental group II involved soaking the specimen in a mixed solution of urea and calcium acetate for two days, and then taking it out and placing it in an incubator for two days, with a cycle of four days. The test results showed that, compared with the control group specimens, the relative bond strength ratio of the experimental group II specimens increased by 17.9%. Moreover, the EDS and XRD analysis results confirmed that the precipitate formed at the crack was calcium carbonate, which improved the compressive strength and bond strength after self-healing. This indicates that the biomineralization maintenance method used in experimental group II is more effective.

Background: Health insurance (HI) run by government is providing health care service to large population. Due to poor accountability, participation and sustainability, cooperative health insurance is becoming more popular and effective in low and middle income and some high-income countries too. In Nepal, there are public and cooperative HI is in practice. The aim of this study is to compare the effectiveness of public (government) and cooperative HI in relation to benefit packages, population coverage, inclusiveness, health care utilization, and promptness for treatment in these two health insurance models in Nepal. Method: This is an institution based concurrent mixed study consists of qualitative and quantitative variables from public and cooperative groups. We included all public HI operated by government hospitals and cooperatives groups those purchased hospital service in contract. Two separate study tools were applied to access the effectiveness of insurance models. The key questions were asked for the representatives of government and private health insurance. The numeric information consisted of in quantitative data and subjective response was included in qualitative approach. Descriptive statistics and Mean Whitney U test was applied in numeric data and qualitative information were analyzed by inductive approach Results: The study revealed that new enrolment was not increased, health care utilization rate was increased and the benefit package was almost same in both groups. The overall inclusiveness was higher for the government HI, but enrolment from the religious minority, proportion of negotiated amount during treatment were significantly higher (p<0.05). During illness, the response time to reach hospital was significantly faster in cooperative health insurance than government health insurance. Qualitative findings showed that level of participation, accountability, transparency and recording system was better in cooperative health insurance than public. Conclusion: Cooperative HI could be more sustainable and accountable to the community for all; low, middle and high-income countries.

Urinary tract infections (UTIs) are the second most common bacterial infection with high recurrence rates. A major causative agent of UTIs is uropathogenic Escherichia coli (UPEC), which can form persistent biofilms on urothelial surfaces and/or urinary catheters. Biofilms are inherently tolerant to antimicrobials, making them difficult to eradicate. Ciprofloxacin hybrids functionalised with nitroxides have previously shown enhanced biofilm eradication activity in vitro. Here, we evaluate a ciprofloxacin di-nitroxide hybrid (CDN11), previously reported to have antibiofilm activity against UPEC, as a potential UTI therapeutic in various infection models. We report potent CDN11 activity against mature biofilms formed by cystitis strain UTI89 inside polyethylene catheters. In infected human bladder cell monolayers, CDN11 afforded a 3-log reduction in UPEC colony forming units (CFU) compared to controls, including intracellular bacteria. Infected mouse bladders carrying biofilm-like intracellular UPEC reservoirs had reduced bacterial burdens following treatment with CDN11 ex vivo. Activity trends for CDN11 were comparable throughout all models, indicating that our testing pipeline was robust. New antimicrobial development is arduous and requires large investments of time and money. The pipeline described here could be readily used in testing new compounds, fast tracking the development of novel UTI therapeutics.

Microbiological risk associated to abiotic surfaces is one of the most important issue worldwide. Surface contaminations by pathogenic bacterial biofilms or adherent cell affect a number of sectors including medical services, food industries, human services, and the environment. There is a need to synthesize or to setup novel antimicrobials. Terpenes are usually found in essential oils and have potent antimicrobial activities. However, the direct use of these molecules is often inefficient due to their low water solubility, loss of volatile compounds, thermal degradation, oxidation and toxicity. The need for biosourced compounds with antimicrobial activity, low toxicity and low cost promote the search for new stable metal complexes based on terpene ligands. This will enable the manufacture of value-added products with a lower environmental impact, as well as the production of high value added commodities. The goal of this review is to discuss the development of novel antimicrobial complexes derived from terpenes. In addition, this review explored how to improve their bioactivities and characteristics by using a formulation based on microencapsulation.

Human Papillomavirus (HPV) self-sampling has the potential to increase cervical cancer screening (CCS) and reduce the cervical cancer burden in Medically Underserved Women (MUW). However, interventions promoting self-sampling are limited. We examined the effectiveness of an intervention study in increasing CCS among MUW. We conducted a quasi-experimental intervention study. Face-to-face verbal approach was to recruit MUW (n=85, mean age 48.57±11.02) living in a small city in the US. Behavioral intervention based on reframing, reprioritizing, and reforming (3R model) was used to educate the women about CCS in a group format. The women completed pre-and post-intervention assessments and followed-up interviews. The primary outcome was CCS uptake. Mixed methods analyses were conducted using a t-test for the primary outcome, PROCESS for mediation analysis, and NVivo for interview data. Majority of women (75%) completed self-testing. High-risk HPV prevalent among the women was 11%, and of those, 57% followed-up with physicians for care. We found that the significant increase in the women’s post-intervention screening behaviors was mediated by the increase in knowledge (Indirect Effect [IE] = .1314; 95% CI, .0104, .4079) and attitude (IE = .2167; 95% CI, .0291, .6050) scores, (p&lt;0.001). Interview analyses offered further explanations (see the explanations in parenthesis) why MUW found the intervention messages acceptable (encourages proactive behavior), feasible (simple and easy to understand), and appropriate (helpful and informative). Barriers including lack of trust and fear of results were identified. The findings suggest that an intervention that combines the 3R model and self-sampling may increase CCS among MUW.

Multidrug resistant organisms (MDROs) outbreaks have been steadilyincreasing in Intensive care units (ICUs). Still, healthcare institutions and workers (HCW) reached no unanimity on how and when implementing infection prevention and control (IPC) strategies. We aimed to provide a pragmatic, physician practice-oriented, resume of strategies towards different MRDOs outbreaks in ICU. We performed a narrative review on IPC in ICUs, investigating patient-to-staff ratios, education, isolation, decolonization, screening and hygiene practices, outbreak reporting, cost-effectiveness, reproduction-number(R0), and future perspectives. The most effective IPC strategy remains unknown. Most studies focus on a specific pathogen or disease, making the clinician losing the big picture. IPC strategies proved their cost-effectiveness regardless typology, country, or pathogen. A standardized, universal, pragmatic protocol for HCW education should be elaborated. Likewise, a rapid outbreak recognition tool elaboration (i.e., an easy-to-use mathematical model) would improve early diagnosis and spreading prevention. Further studies are needed to express in favor or against MDROs decolonization. New promising strategies are emerging and need to be tested in the field. The lack of IPC strategies application has made, and still makes ICUs a major MDROs reservoir into the community. In a not-too-distant future genetic engineering and phage therapies could represent a plot-twist in MDROs IPC strategies.

Immortal-time bias (ITB) is known to be common in cohort studies and distorts the association estimates between treated and untreated groups. We used data from the last of two large studies in an Italian province on COVID-19 vaccines safety and effectiveness incurred this bias, and aligned the entire population on a single index date, to correct the ITB. We considered the "all-cause deaths" outcome to compare the survival curves between the unvaccinated group and the various vaccination statuses. The all-cause deaths Hazard Ratios in univariate analysis for unvaccinated (reference) versus vaccinated with 1, 2, 3/4 doses were 0.88 (CI95: 0.78 –1.00; p-value 0.044), 1.23 (1.16–1.32; p-value ≤0.001) and 1.21 (1.14–1.29; p-value ≤0.001), respectively. The multivariate values were 2.40 (2.00–2.88; p-value <0.0001), 1.98 (1.75–2.24; p-value <0.0001), 0.99 (0.90–1.09; ns). The possible explanations of the trend of the Hazard Ratios as vaccinations increase could be a harvesting effect; a calendar-time bias, accounting for seasonality and pandemic waves; a case-counting windows bias; a healthy-vaccinee bias; or some their combination. With two and even with 3/4 doses the calculated Restricted Mean Survival Time and Restricted Mean Time Lost have shown a small but significant downside for the vaccinated populations.

This qualitative research explores the transformative impact of technological innovations on retail marketing effectiveness. Through thematic analysis of interviews with industry professionals, the study identifies key themes including enhanced customer engagement, personalized marketing strategies driven by AI and machine learning, data-driven decision-making leveraging big data and analytics, the rise of e-commerce platforms, integration of mobile technologies, adoption of augmented reality (AR) and virtual reality (VR), development of omnichannel strategies, and implementation of loyalty programs. These themes illustrate how technology has reshaped retail marketing by enabling real-time customer interactions, personalized shopping experiences, and targeted marketing campaigns that enhance customer satisfaction and loyalty. The findings highlight the critical role of digital platforms like social media in fostering community engagement and brand loyalty. AI and machine learning facilitate personalized marketing efforts, tailoring product recommendations and enhancing customer experiences. Data-driven strategies optimize marketing ROI by providing insights into consumer behavior and market trends. E-commerce platforms expand market reach and streamline transactions, while mobile technologies and AR/VR innovations create immersive shopping experiences that captivate consumers. Omnichannel strategies integrate physical and digital channels, delivering seamless brand experiences and enhancing customer retention through CRM systems and loyalty programs. Looking ahead, retailers must navigate challenges such as rapid technological change, the need for continuous adaptation, and concerns about data privacy. By embracing technological advancements strategically and maintaining ethical standards, retailers can sustain competitive advantage, meet evolving consumer expectations, and drive growth in the digital era.

This research focuses on developing a Student Performance Evaluation System to enhance effectiveness and oversight in higher education. The system aims to address challenges faced by instructors in evaluating student performance using a distributed system approach. Agile methodology is employed in development, and database replication techniques are applied for data synchronization. System features include registration, assessment form creation, assessment submission, statistical visualization, and access to assessment history. The system is designed to improve efficiency and transparency in the assessment process. Key features of the system include registration process, assessment form creation, assessment submission, statistical visualization, and access to assessment history. Its goal is to enhance efficiency and transparency throughout the assessment process. The article details the system workflow and the roles played by Admins, Instructors, and students in system usage. Additionally, it discusses the back-end development model and pathways, as well as the performance testing results. Performance testing indicates that the system achieves high throughput of up to 21.55 requests per second, with an average response time of only 34 milliseconds and an error rate of zero percent. These results affirm that the system efficiently handles user loads and nearly instantaneously responds to requests, providing an optimal user experience in the context of student performance evaluation in higher education.

Rapid haemostasis during surgery is essential when one wants to reduce the duration of opera-tions, reduce the need for transfusions, and above all when one wants to achieve better patient management. The use of haemostatic agents, sealants and adhesives improves the haemostatic process by offering several advantages, especially in vascular surgery. These agents vary widely in their mechanism of action, composition, ease of application, adhesion to wet or dry tissue, im-munogenicity and cost. The most used are cyanoacrylate-based glues (Glubran 2) or polysaccharide hydrogel-microsphere powder (AristaTMAH). This work is based on a retrospective study carried out on a sample of patients with different vascular diseases (FAV, pseudoaneurysm and PICC application) in which two different haemostatic sealants were used. The aim was to assess the safety, the advantages and the ability of both sealants to activate the haemostatic process at the affected site, also in relation to their chemical-physical characteristics. The obtained results showed that the application of Glubran 2 and AristaTMAH as surgical wound closure systems is effective and safe as the success achieved was ≥94% on anastomoses of FAV; 100% on stabilization of Picc catheters; ≤95% on pseudoaneurysms.

The effectiveness of combining strength-specific training with endurance training to enhance the performance of endurance runners remains uncertain. This study aimed to analyze effect of practising maximum-strength (MAX), explosive strength (EXP) or both combined (COMB) on seven runners’ performance-indicators: vertical jump (VJ), one-repetition-maximum-squat (1RM), peak-velocity/peak-running-speed (PV), lactate-threshold (over incremental-test-protocols, LT), middle-distance-time-trial (TT), maximum-oxygen-consumption (VO2max), running-economy (RE). Systematic-review (Scopus, Wed of Science, Sports Discuss, PubMed) with meta-analysis was conducted following PRISMA standards. Inclusion-criteria (PICOS) were: recreational or well-trained athletes aged 18-45 performing concurrent-training ≥five-week. Used search-terms were related to different types of strength/endurance, participants’ age, sport-modality. 20 manuscripts were selected, quality-assessed with PEDro. MAX training is more effective than EXP, COMB in improving VJ, 1RM, PV, while COMB is more effective than MAX, EXP to enhance TT. MAX is more effective than EXP in improving LT. Concurrent-workouts do not provide additional benefits to VO2max. It is unknown which strength-modality (MAX, EXP or COMB) is more effective in improving RE. Concurrent-training is more effective than single-mode-endurance-training for enhancing specific performance-variables in adult-endurance-runners. Middle-, long-distance-runners may consider incorporating MAX-training to target specific goals, e.g., improving VJ, 1RM, LT, PV while utilizing COMB-training to enhance TT. Certain variables may benefit from EXP. New randomized-controlled-trials are required to confirm these findings.

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

Deep inhalation breath hold (DIBH) has become a valuable technique in left breast cancer radiotherapy, offering the possibility to reduce radiation exposure to organs at risk (OARs) and minimize the risk of cardiac complications. The treatment method involves patients stopping breathing during irradiation to temporarily distance the heart from the radiation field, reducing potential cardiac and other complications. Research shows that DIBH reduces the radiation dose to the heart and lungs. However, the effectiveness of DIBH is determined by a variety of factors, including the patient's training, cooperation, anatomical features, age and choice of radiotherapy technique. Additionally, cardiovascular risk factors: diabetes, smoking, hypertension can affect the effectiveness and potential complications of DIBH. Moreover, lack of consent, fear, anxiety, depression and comorbid psychiatric disorders disqualify some patients from the DIBH treatment method. Careful patient selection, comprehensive training and optimization of treatment parameters are essential to maximize the benefits of DIBH while minimizing potential side effects. DIBH enhancement techniques, such as IMRT or VMAT, also have an important role to play. The purpose of this review article is to summarize the factors affecting the efficacy and side effects of DIBH in radiation therapy for left breast cancer, with the aim of optimizing its clinical application while minimizing side effects.

Colonoscopy, essential for diagnosing and treating colorectal cancer, relies on effective bowel preparation to inspect the colonic mucosa fully. Traditional education methods include printed instructions and verbal explanations, but these may not ensure clear patient understanding. Poor bowel preparation can obscure mucosal visibility, delaying cancer diagnosis and treatment. Using the outpatient’s Android mobile device, the mobile health care model is provided as a nursing guide to assist in bowel preparation for colonoscopy. This single-blinded, randomized trial en-rolled patients for colonoscopy at a Northern Taiwan gastroenterology center. Eligible patients were physically and mentally healthy and could communicate in Chinese. The study tested the ColonClean app during bowel preparation. After the procedure, endoscopists rated the prepara-tion quality using the Aronchick Scale. Data analysis with SPSS software (version 25.0) evaluated if the app significantly improved bowel preparation compared to those who did not use it. Forty patients were recruited for both the control (conventional method) and experimental (conven-tional method plus ColonClean app) groups. In the experimental group, endoscopists assessed bowel preparation quality; all achieved at least "Fair," with 75% receiving "Excellent" or "Good" ratings. The ColonClean App enhanced bowel preparation quality more effectively than tradi-tional nursing guidance.

Algorithmic systems used in healthcare contexts are primarily developed for the benefit of the public. It is therefore essential that these systems are trusted by the individuals for whose benefit they are deployed. Drawing inspiration from the principles embedded in the testing of the safety, efficacy and effectiveness of new medicinal products, concurrent design engineering and pro-fessional certification requirements, the authors propose, for the first time, a preliminary com-petency-based ‘Algorithmic Ethics’ Effectiveness Impact Assessment’ framework for developers of AI systems used in healthcare contexts. They concluded that this set of principles should en-compass the algorithmic systems ‘production lifecycle’, to guarantee the optimized use of the AI technologies, avoiding biases and discrimination while ensuring the best possible outcomes, simultaneously increasing decision-making capacity and the accuracy of the results. As AI is as good as those who program it and the system in which it operates, the robustness and trustworthiness of their ‘creators’ and ‘deployers’, should be fostered by a certification system guaranteeing the latter’s knowledge and understanding of ethical aspects as well as their com-petencies in integrating these aspects in trustworthy AI systems when used in healthcare con-texts.

A key step in the study of tree pathology is the identification of appropriate method for inoculating pathogens of diseases in branch and trunk. Pathogens of diseases in branch and trunk are commonly inoculated through punching, burning, and toothpick inoculation. However, there is a lack of comparative analysis of the inoculation outcomes of these three methods. In this work, Six‐year‐old P. alba var. pyramidalis were inoculated with V. sordida, using punching, burning, and toothpick techniques, respectively, to investigate the differences in the effectiveness of these inoculation methods. Results reveal that the incidence rate was 93.55% in the toothpick inoculation group, significantly higher than 80.65% in the burning inoculation group (p = 0.007), while punching inoculation exhibited significant pathological responses in the early stages, with spontaneous healing in the later stage. Addi-tionally, toothpick inoculation was more efficient in inducing Valsa canker when inoculating the pathogen at the bottom of the tree, with lower intra‐ and inter‐row spacing (stand density) providing better outcomes than higher intra‐ and inter‐row spacing. The results of this study demonstrate that toothpick inoculation is an optimal option for studying the artificial inoculation of V. sordida in six‐year‐old P. alba var. pyramidalis, providing technical support for research on poplar diseases and offering a theoretical basis for the inoculation of other diseases in branch and trunk.

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

Current research in the field of antimicrobials is focused on the development of novel antibiotics and antimicrobial agents to counteract the huge dilemma that the human population is mainly facing in regards to the rise of bacterial resistance and biofilm infections. Host Defense peptides (HDPs) are a promising group of molecules for antimicrobial development as they share unique characteristics suitable for antimicrobial activity including their broad spectrum of activity and potency against bacteria. AamAP1 is a novel HDP that was identified through molecular cloning from the venom of the North African scorpion Androctonus amoeruxi. In vitro antimicrobial assays revealed that the peptide displays moderate activity against different strains of Gram-positive and Gram-negative bacteria. Additionally, the peptide proved to be highly hemolytic and displaying significantly high toxicity against mammalian cells. In our study, a novel synthetic peptide analogue named A3 was designed from the naturally occurring scorpion venom host defense peptide. The design strategy depended on modifying the amino acid sequence of the parent peptide in order to increase its net positive charge, percentage helicity and optimize other physico-chemical parameters involved theoretically in HDPs activity. Accordingly, A3 was evaluated for its in vitro antimicrobial and anti-biofilm activity individually and in combination with four different types of conventional antibiotics against clinical isolates of multi-drug resistant (MDR) Gram-positive bacteria. A3 was also evaluated for its cytotoxicity against mammalian cells. A3 displayed potent and selective in vitro antimicrobial activities against a wide range of MDR Gram-positive bacteria. Our results also showed that combining A3 with conventional antibiotics displayed a synergistic mode of action which resulted in decreasing the MIC value for A3 peptide as low as 0.125 µM. These effective concentrations were associated with negligible toxicities on mammalian cells. In conclusion, A3 exhibits enhanced activity and selectivity when compared with the parent natural scorpion venom peptide. The combination of A3 with conventional antibiotics may be pursued as a potential novel treatment strategy against MDR and biofilm forming bacteria.

The advent of artificial intelligence (AI) has revolutionized digital marketing, offering unprecedented levels of personalization. AI-driven personalization leverages machine learning algorithms and data analytics to tailor content, advertisements, and recommendations to individual consumers based on their behavior, preferences, and demographics. This paper explores the effectiveness of AI-driven personalization in enhancing customer engagement, increasing conversion rates, and improving overall marketing efficiency. It also examines the ethical considerations associated with these technologies, including data privacy, consent, and the potential for manipulation or bias. While AI-driven personalization can lead to more relevant and engaging consumer experiences, it raises critical ethical questions that must be addressed to ensure responsible and fair use. The study concludes with recommendations for marketers and policymakers to balance the benefits of AI personalization with the need for ethical standards and consumer protection.

Knee osteoarthritis is the most popular type of osteoarthritis that causes extreme pain in elderly. Currently there is no cure for osteoarthritis. To lessen clinical symptoms, glucosamine was suggested. The primary goal of our study is to evaluate the efficacy and safety of glucosamine from recent studies. Electronic databases such as PubMed, Scopus, Cochrane were used to assess RCT. From the beginning through March 2023, the papers were checked, and if they fulfilled the inclusion criteria, they were then examined. WOMAC and VAS scales were considered as main outcome measure. A total of 15 studies were selected. Global pain was significantly decreased in comparison to placebo, as measured by the VAS index, with an overall effect size SMD of -7.41 ([95% CI] 14.31, 0.51). The WOMAC scale confirmed that pain, stiffness, and physical function had improved, however the effects were insufficient. A statistical update also revealed that there were no reports of serious medication interactions or significant adverse events. To summarize, glucosamine is more effective than a placebo at reducing pain in knee osteoarthritis patients. In long-term treatment, oral glucosamine sulfate 1500 mg/day is believed to be well tolerated.

The natural hosts regarding Orthohantaviruses are rodents, soricomorphs and bats, and it is well known they may cause serious or even fatal diseases among humans worldwide. The virus is persistent among animals and it is shed via urine, saliva and feces, throughout the entirety of their lives. We aim to identify the effectiveness regarding hantavirus detection from rodent tissue samples and urine originating from naturally infected rodents. Initially, animals were trapped at five distinct locations throughout the Transdanubian region in Hungary. Lung, liver, kidney and urine samples were obtained from 163 perished animals. All organs and urine were tested using nested reverse transcriptase-polymerase chain reaction (nRT-PCR). Furthermore, sera were examined for IgG antibodies against DOBV and PUUV viruses by Western Blot assay. IgG antibodies against hantaviruses and/or nucleic acid were detected in 25 (15.3%) cases. Among Apodemus, Myodes, and Microtus rodent species, DOBV, PUUV, TULV were all clearly identified. The virus nucleic acid was detected most effectively from the kidney (100%), while only 55% of screened lung tissues were positive. Interestingly, only 3 out of 20 rodent urine samples were positive regarding nRT-PCR. Moreover, five rodents were seropositive without detectable virus nucleic acid from any of the tested organs.

This study focuses on evaluating and improving the effectiveness of village fund management in Merauke Regency, South Papua. Village fund management faces unique challenges due to the region's geographical and socio-economic conditions. Organizational behavior transformation is critical, particularly in addressing weaknesses in organizational structure, communication, work culture, and monitoring systems, to achieve sustainable development outcomes. A qualitative case study approach was employed, with data collected through in-depth interviews, participant observation, and document analysis between May and August 2024. Merauke Regency was selected for its diversity in management practices. Thematic analysis and triangulation techniques were used to ensure the reliability and validity of findings. The findings reveal that transforming the organizational structure from hierarchical to flexible team-based models, improving communication, and fostering a positive work culture significantly enhanced village fund management. These changes led to better coordination, responsiveness, efficiency, and transparency. Increased community participation and strengthened monitoring and evaluation also contributed to more effective development outcomes.This study provides practical recommendations for policymakers to design more sustainable and inclusive village fund management strategies. Data-driven and participatory approaches are crucial for maximizing development impacts and ensuring socio-economic benefits at the village level.

Antiviral therapy such as Oseltamivir has been recommended for hospitalized children with suspected and confirmed influenza for almost 20 years. The therapy is officially authorized for newborns two weeks of age or older, however, questions about its safety and effectiveness still surround it. Our goal was to assess the epidemiological features of two consecutive seasonal in-fluenza cases in children following the COVID-19 pandemic and also to observe the clinical ef-fectiveness and tolerability of oseltamivir in hospitalized children who were not vaccinated against influenza and who had different influenza subtypes, including A (H1N1), A (H3N2), and influenza B, and to identify specific comorbidities associated with influenza in children. We performed an observational study on 1300 children, enrolled between 1st October 2022 and 30th May 2023 and 1st October 2023-4th of May 2024, to the IX Pediatric Infectious Diseases Clinical Section of the National Institute of Infectious Diseases "Prof. Dr. Matei Balș". During the 2022-2023 influenza sea-son, 791 pediatric patients tested positive for influenza and received Oseltamivir. Of these, 89% (704/791) had influenza A, with 86.4% subtypes A(H1N1) and 13.6% of cases had A(H3N2), and influ-enza B 11%(87/791) pediatric patients. Of the total group, 59% were male, and the median age was 2,4 years (1.02-9.28). For the 2023-2024 influenza season, 509 pediatric patients tested positive for influen-za, 56.9% were male gender and were treated with Oseltamivir. 81.6 % had Influenza A, and 18.4% had influenza B. Treatment with neuraminidase inhibitors like Oseltamivir, 2mg/kg/dose twice daily for 5 days, was well tolerated by the children, and we recorded no deaths. The duration of fever hospitaliza-tion after the Oseltamivir administration was significantly longer for patients with A(H1N1) infection than A(H3N2), during both seasons. We identified more complications in the 2022-2023 season and a decreasing number of Influenza B for the 2023-2024 season. Among children with comorbidities, the most common were asthma, gastrointestinal disorders, and metabolic and endocrine diseases. In terms of effectiveness, oseltamivir significantly reduced the intensity of influenza symptoms, thus reducing the number of days of hospitalization (p=0.001) as well as post-infection complications (p=0.005) in both groups. Oseltamivir was less effective in Influenza A (H1N1) than A(H3N2), (p=0.0035). In this study, we evaluated the clinical effectiveness of oseltamivir therapy for all influenza types/subtypes in children, and the length of hospitalization. We identified comorbidities associated with prolonged dura-tion of hospitalisation. Influenza vaccination should be the main tool in the prevention of influenza and its complications in children, especially with comorbidities.

Salmonella typhimurium is the predominant serovar identified in cases of salmonellosis. It is recognised for adhering to various surfaces and creating biofilm, leading to several foodborne outbreaks and antibiotic resistance. Actinomycetes are thought to possess a wide array of antibacterial characteristics that can combat different diseases. Currently, it is unclear whether it has antibiofilm properties against S. typhimurium. This study aimed to assess the antibiofilm efficacy of actinomycetes extracts against S. typhimurium ATCC 14028 by the Crystal Violet assay. Four actinomycetes isolates, EAS5, EAS7, EAA141, and EAA11, were obtained from BRIS soil in Terengganu. The actinomycetes isolates were extracted using ethyl acetate (EA). S. typhimurium was exposed to extracts for 6, 12, and 18 hours. The results showed that all EA extracts effectively prevented the S. typhimurium biofilm at 12 and 18 hours. EAAA11 was the most effective against the 12-hour biofilm, whereas EAS5 was the most effective against the 18-hour biofilm among these extracts. In conclusion, actinomycetes isolated from the BRIS soil in Terengganu show potential for controlling Salmonella infection.

The pollution of the bays in Abidjan is a major concern for the Ivorian policy makers. In fact, the pollution of the bays induce high costs to the society while impacting population health dramatically. As a result, pollution reduction management of production activities has been undertaken in the Cocody Bay area. To our knowledge, no study has yet proposed a model to evaluate the cost-effectiveness of these pollution management strategies. A cost-effectiveness model, based on Monte Carlo simulation, was developed to assess the economic and environmental impacts of various scenarios characterized by a set of production practices, both in the short term and in the long term. The authors discuss the steps and input parameters of the model presented. The proposed model may serve as the basis for identifying an optimal production scenario defined as the scenario with the best incremental cost-effectiveness ratio considering a willingness to pay (WTP) threshold. The WTP, to be estimated based on the gross domestic product of Côte d’Ivoire, represents the opportunity costs associated with selecting the optimal scenario. The current framework can also be applied to other settings facing similar challenge.

Context: As software industries, adopted different frameworks where Scrum is play a vital role in different software industries. Scrum basis the three main stakeholders i.e. Product Owner, Scrum Master and Development. Where Scrum Master is a very crucial role for any agile project. However, in the past Scrum Master Faces different challenges, which discovered in several studies. However, we need to measure the effectiveness of the Scrum master in Agile Projects, how presently Scrum Master are performing in Pakistani software industries. Objective: The main objective of this research to identify the effectiveness of the Scrum Master in agile projects in Pakistani software industries. Method: Research Method (Qualitative Research) For this purpose, we gathered the facts from Pakistani software industries by using the qualitative method. We conducted a survey from different software industries; almost 12 participants responded the survey as per their best knowledge as well as they agreed for face- to-face interviews. Results: The results indicated that, mostly organization compliance with the Scrum ceremonies. In addition, 65% Scrum Masters has a great effectiveness in any agile project. 21% of Scrum Master generates negative impact in agile project. Conclusion: The main highlights of this research, we have presented the compliance of the Scrum in different software organization. Further, we explore the both positive and negative impact of the Scrum master in Pakistani software organizations.

Dealing with randomness is a crucial aspect that cost-effectiveness analysis (CEA) tools need to address, but existing stochastic CEA tools have rarely examined risk and return from the perspective of global benefits. This paper proposes a stochastic CEA tool that supports medical decision-making from the perspective of global benefits of risk and return, the risk-adjusted incremental cost-effectiveness ratio (ICER). The tool has a traditional form of ICER but uses the risk-adjusted expected cost. Theoretically, we prove that the tool can provide marginal medical decisions that promote the risk-return level on global benefits within any intervention structure and can also serve as a discriminating condition for the optimal intervention structure. Numerical simulations within a framework of mean-variance support the conclusions in this paper.

Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2) is the virus that caused COVID-19 around the world. The disease starts off as a flu-like symptom and then eventually spreads in the human body.Infections are easily transmitted from human to human which makes it more severe among individuals. SARS-CoV-2 virus is in the same family of viruses SARS and MERS.As of today, there is no approved vaccine that can cure COVID-19. However, potential treatments showing promising improvement results among affected COVID-19 patients. In this review, the effectiveness of the current treatments for COVID-19 has been explored.

Our study aimed to identify predictors for the effectiveness of tumor regression in lung cancer patients undergoing neoadjuvant treatment and cancer resections. Patients admitted between 2016 and 2022 were included in the study. Based on the histology of the tumor, patients were categorized into lung adenocarcinoma group (LUAD), and squamous cell carcinoma group (SQCA). Ninety-five patients with non-small cell lung cancer were included in the study. Fifty-eight (61.1%) and 37 (38.9%) patients were included in the LUAD and SQCA groups, respectively. Nine (9.5%), 56 (58.9%), and 30 (31.6%) patients were categorized with a tumor regression score of I, II, and III respectively. In multivariable analyses, histology of the primary tumor (SQCA), lymph node size in the preoperative CT scan (>1.7cm) and absolute tumor size reduction after neoadjuvant treatment (>2.6 cm) independently predict effectiveness of tumor regression (OR, [95% Confidence interval, p-value] of 6.88 [2.40-19.77, p70 years, extended resection >one lobe, and tumor recurrence or metastasis were identified as significant independent predictors of reduced overall survival. Assessment of tumor size before and after neoadjuvant treatment might help to identify high-risk patients with decreased survival and to improve patient management and care.

Digital transformation is revolutionizing supply chain management, profoundly influencing marketing effectiveness across industries. This qualitative study explores the impact of digital transformation on supply chains and its implications for marketing strategies. Through in-depth interviews, case studies, and document analysis, the research elucidates how digital technologies such as IoT, blockchain, AI, and advanced analytics are reshaping supply chain dynamics. Key findings highlight enhanced supply chain visibility, improved decision-making capabilities, and strengthened collaboration among supply chain partners. These technological advancements empower organizations to optimize inventory management, anticipate market trends, and deliver personalized customer experiences, thereby enhancing operational efficiency and customer satisfaction. Furthermore, the study underscores the role of digital transformation in promoting sustainability and ethical practices within supply chains. Technologies like blockchain facilitate transparent and traceable supply chains, supporting initiatives for responsible sourcing and environmental stewardship. Despite the transformative benefits, the study identifies challenges including significant investment requirements, integration complexities, and data security concerns. Strategic approaches to technology adoption, robust cybersecurity measures, and employee training are essential for overcoming these challenges and maximizing the benefits of digital transformation. Overall, this study contributes to understanding how digital transformation drives innovation in supply chain management and enhances marketing effectiveness. By embracing digital technologies and aligning supply chain strategies with marketing objectives, organizations can navigate competitive landscapes, meet evolving consumer expectations, and achieve sustainable growth in the digital era.

Background: Advances in additive manufacturing and the development of antimicrobial biopolymers facilitate the production of critical medical devices with strong and safe biocidal properties. The purpose of this study was to assess the antimicrobial efficacy, safety, and longevity of a polylactic acid-based biopolymer supplemented with a copper-based composite additive. Methods: An antimicrobial polylactic acid-based biopolymer was tested against several inoculants including Staphylococcus Aureus, MRSA, E. coli, Listeria, HCoV-229E (a SARS-CoV-2 surrogate), and HIV-1. Material safety was evaluated according to international testing standards for in vitro cytotoxicity. Results: The main findings of the present investigation showed a strong and long-lasting biocidal effect of a polylactic acid-based biopolymer embedded with a copper-based composite additive against Staphylococcus Aureus, MRSA, E. coli, Listeria, HCoV-229E (a SARS-CoV-2 surrogate), and HIV-1. Furthermore, the cytotoxicity and safety assessment of the antimicrobial biopolymer was found to be “non-toxic” and safe for human skin contact. Conclusions: The present investigation showed that the antimicrobial biopolymer exhibits strong and long-lasting biocidal properties against an array of viral and bacterial inoculants.

Background: Although confirmed cases of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been declining since late 2020 due to general vaccination, little research has been done regarding the impact of vaccines against SARS-CoV-2 in Spain in terms of hospitalizations and deaths. Objective: Our aim was to identify the reduction in severity and mortality of coronavirus disease 2019 (COVID-19) at a nationwide level due to vaccination. Methods: We designed a retrospective, population-based study to define waves of infection and to describe the characteristics of the hospitalized population. We also studied the rollout of vaccination and its relationship with the decline in hospitalizations and deaths. Finally, we developed two mathematical models to estimate non-vaccination scenarios using machine learning modeling (with the ElasticNet and RandomForest algorithms). The vaccination and non-vaccination scenarios were eventually compared to estimate the number of averted hospitalizations and deaths. Results: In total, 498,789 patients were included, with a global mortality of 14.3%. We identified six waves or epidemic outbreaks during the observed period. We established a strong relationship between the beginning of vaccination and the decline in both hospitalizations and deaths due to COVID-19 in all age groups. We also estimated that vaccination prevented 170,959 hospitalizations (CI 95% 77,844–264,075) and 24,546 deaths (CI 95% 2,548–46,543) in Spain between March 2021 and December 2021. We estimated a global reduction of 9.19% in total deaths during the first year of COVID-19 vaccination. Conclusions: Demographic and clinical profiles changed over the first months of the pandemic. Patients over 80 years old and other age groups obtained clinical benefit from early vaccination. The severity of COVID-19, in terms of hospitalizations and deaths, decreased due to vaccination.

We aimed to directly compare the cost-effectiveness of the NELSON and NLST screening protocols, two trials influencing lung cancer screening implementation internationally. A decision-analytic model analyzing the cost-effectiveness of the NELSON protocols was manipulated to reflect the protocols of the NLST, while maintaining features specific to the Hungarian healthcare setting. In the NELSON protocol, there are three possible outcomes to the initial round of screening: positive, negative, or indeterminate, indicating an uncertain degree of suspicion for lung cancer. This pro-tocol differs from the NLST protocol, in which the only possible screening outcomes are positive or negative, with no indeterminate option. The NLST pathway for smokers aged 55-74 resulted in a 43 € increase in total average lifetime costs compared to the Hungarian screening pathway and re-sulted in a lifetime gain of 0.006 QALYs. The incremental costs and QALYs yield an ICER of 7875 €/QALY. Our results demonstrate that assigning any suspicious LDCT screen as a positive result (NLST protocol) rather than indeterminate (NELSON protocol) can yield a slight QALY gain that is worth the additional use of resources according to Hungary’s willingness to pay threshold. Our study provides insight on the cost-effectiveness, advantages, and disadvantages of various LDCT screening protocols for lung cancer and can assist other countries as they implement their screening programs.

A mathematical model that incorporates human attacks on dogs is presented to explore the dynamics of rabies transmission. The model divided the infection rate into two categories: dog-to-dog transmission rates during the prodromal phase (βdP) and the furious phase (βdF). It has been determined that the model is well-posed and that all of the solutions are positive, as well as the feasibility and positivity of the model's solutions. Both the basic reproduction number (R0) and the effective reproductive number (Re) are computed, and it is demonstrated that the model has a unique disease-free equilibrium that is globally asymptotically stable whenever Re < 1. To identify the model's most sensitive parameters and the ones that intervention efforts should focus on, sensitivity analysis of the effective reproduction number is carried out. We can construct an optimal control system using the state equations, the adjoint equations, and the optimality condition that determines the controls by applying Pontryagin's Maximum/Minimum principle. To help decision-makers in allocating funds for rabies interventions, cost-effectiveness analyses are conducted. To determine the degree to which the intervention strategies are advantageous and cost-effective, this study performs a cost-effective analysis of one or all possible combinations of the optimal rabies control strategies (pre-exposed and post-exposed vaccination for both dog and human populations) for the four different transmission settings. After arranging the techniques to increase effectiveness (total infections prevented), a cost-effective analysis using the Incremental Cost Effectiveness Ratio (ICER) was conducted. The result supports the function that the four intervention options are performing to either completely eradicate or significantly reduce rabies disease among the populations. The dynamical behavior of the system is studied through simulations using the ode45 numerical technique from MATLAB.

In the Emergency Department (ED), pain is one of the symptoms that is most frequently reported, making it one of the most significant issues for the emergency physician, but is frequently under treated. Intravenous (IV), oral (PO), and intramuscular (IM) delivery are the standard methods for administering acute pain relief. Firstly, we compared the safety and efficacy of IN analgesia to other conventional routes of analgesia to assess if IN analgesia may be an alternative for the management of acute pain in ED. Secondary, we analyzed the incidence and severity of adverse events (AEs) and rescue analgesia required. We performed a systematic review-based keywords in Pubmed/Medline, Scopus, EMBASE, the Cochrane Library and Controlled Trials Register finding only twenty randomized Clinical trials eligible in the timeline 1992-2022. A total of 2098 patients were analyzed and compared to intravenous analgesia showing no statistical difference in adverse effects. In addition, intranasal analgesia also has a rapid onset and quick absorption. Fentanyl and ketamine are two intranasal drugs that appear promising and may be taken simply and safely while providing effective pain relief. IN is simple to administer, non-invasive, rapid onset and quick absorption; it might be a viable choice in a variety of situations to reduce patient suffering or delays in pain management. Analgesia needs to be tailored to each patient's features and type of pain: IN Fentanyl and Ketamine look promising and may be administered easily and safely while providing effective pain relief.

Stormwater management is a key urban issue in the world, in line with the global issues of urban sprawl and climate change. It is urgent to investigate the effectiveness in managing stormwater with different strategies for maintain urban resilience. A method based on a storm water management model (SWMM) was developed for assessing the control of stormwater runoff volume and the percentage removal of suspended solids by implementing a Sponge City strategy. An interdisciplinary approach was adopted incorporating Low Impact Development (LID) with urban Green Infrastructure and Gray Infrastructure paradigms in a typical old residential community in Suzhou, China. Four types of sponge facilities for reducing stormwater runoff were bio-retention cells, permeable pavements, grassed pitches, and stormwater gardens. The simulation results indicate that the stormwater pipe system can meet the management standard for storms with a five-year recurrence interval. The volume capture ratio of annual runoff is 91% and the reduction rate of suspended solids is 56%. This study demonstrates that Sponge City strategy is an effective approach for managing stormwater, particularly in old and densely populated urban areas. Implementing spongy facilities with a LID strategy for stormwater management can significantly enhance urban water resilience and increase ecosystem services.

Medication non-adherence remains a substantial obstacle in asthma care, prompting the exploration of novel therapeutic modalities that prioritize rapid symptom relief, anti-inflammatory activity and facilitate patients’ compliance. This task is well served by a new form of therapy - inhaled triple-combination medications ICS/LABA/LAMA (inhaled glucocorticosteroid/long-acting beta2-agonist/long-acting muscarinic antagonist). The integration of three medications within a singular inhalation device culminates in the reduction of the effective dose of the principal therapeutic agent for asthma management, namely, ICS. This consolidation yields a dual benefit of minimizing the likelihood of adverse effects typically linked with ICS while concurrently optimizing bronchodilator efficacy. The accumulated evidence suggests that adding LAMA to a medium- or high-dose ICS/LABA results in a decrease of asthma exacerbations compared to medium- or high-dose ICS/LABA alone, accompanied by sustained enhancements in lung function parameters. We propose in adult patients experiencing suboptimal asthma control despite medium/high-dose ICS/LABA treatment - regardless of adherence to GINA-recommended strategies, such as MART therapy as a first-line approach or alternative second-line strategies - the preferred course for intensifying asthma therapy involves the addition of a LAMA, ideally in the form of SITT.

Varicella (chickenpox) is one of the most common infectious diseases in preschool children and can be prevented by immunization. While immunization program promotes higher vaccine coverage, there are still challenges with implementing vaccination programs particularly in low-income countries. Economic barriers can increase inequality in vaccination, which highlights the importance of distributing cost-effective varicella vaccines. Varicella vaccines have been developed with two main Varicella-Zoster Virus (VZV) strains globally: MAV/06 and Oka strains. Most of the vaccines are based on the Oka strain, while MAV/06 strain vaccines were exclusively developed by GC Biopharma. Although more than 30 million doses of MAV/06 vaccines as cost-effective vaccines have been distributed internationally, there is no comprehensive review on safety, immunogenicity, and effectiveness of MAV/06 vaccines in the literature. This paper aims to summarize and present more than 30 years of accumulated evidence from research on safety, immunogenicity, and effectiveness of MAV/06 vaccines. We expect that MAV/06 vaccines as cost-effective varicella vaccines make a significant contribution to improving global public health and health equality in children.

Background/Objectives: Population aging is rapidly increasing, and the importance of preventive medicine has been stressed. Health checkup, diet, and exercise are of paramount importance. This study aimed to evaluate the effectiveness of a personalized dual-task intervention that combined exercise with cognitive tasks in improving physical and cognitive functions among independently living elderly individuals. Methods: Participants were aged &gt;65 years who were mostly independent in their activities of daily living, divided into 2 groups. The group receiving the 20-min robot-assisted session was compared to the group receiving traditional functional restoration training. This randomized trial assessed the impact of this intervention on the 30-s chair stand test score and Montreal Cognitive Assessment-Japanese version score of the participants. Results: Both scores significantly improved in the intervention group, indicating enhanced lower-limb function and cognitive capabilities. Conclusions: These findings suggest that integrating cognitive tasks with physical exercise can be a potent strategy to improve overall well-being in the elderly, offering valuable insights for designing comprehensive preventive health programs tailored to this demographic.

Abstract: Using adjuvants to optimize and increase the efficacy of herbicides is an acceptable manner to reduce herbicides undesirable impact on the environment in sustainable agriculture. In this study, it was demonstrated that the application of 0.1% of the non-ionic surfactant (NIS, Contact) and 0.5 L ha-1 of a crop oil concentrate (COC, Renol) did not improve the efficacy of rimsulfuron on Amaranthus retroflexus. In contrast, the same treatments enhanced performance and rainfastnes of rimsulfuron in Chenopodium album in pot expriments. Increasing non-ionic surfactant concentration to 1 L ha-1 increased rimsulfuron performance around 11-fold for Amaranthus retroflexus compared to around 3-fold for Chenopodium album. The same treatment, also reduced the rainfastness of rimsulfuron on Amaranthus retroflexus while improving the rainfastness of rimsulfuron on Chenopodium album. Measured ED50 and ED90 values of rimsulfuron indicated that the addition of the 0.2 L ha-1 of NIS improved the recommended (60 g ai. ha-1) and the reduced (30 g ai. ha-1) of rimsulfurom in field. The highest potato yield measured (60 tons per ha) when 60 g ai. ha-1 rimsulfuron was applied at three stages (S1, S4, and S7) without using a NIS; not significant differences were measured when the same dose of rimsulfuron was applied at the three (S1, S4, and S7) and two (S1, S4) stages with NIS.

Background: In long-term care facilities, there are many residents who do not have the ability to seek shelter by themselves in the case of an emergency. Thus, it is extremely important that the staff of nursing homes are equipped with correct disaster prevention concepts, emergency survival responses, and hazard mitigation measures. Purpose: Discuss the intervention effectiveness of different fire prevention and emergency response trainings at nursing homes and the relationship and predictivity of awareness to self-efficacy. Method: Recruit staff from two nursing homes through purposive sampling, using a two-team pre-and post-test design to collect results from 41 individuals in the experiment group and 40 individuals in the control group. The research tool is the “Nursing Home Fire Prevention and Emergency Response Awareness and Self-Efficacy Scale,” to compare the effectiveness of advanced and general fire safety trainings. Result: After receiving improved advanced fire safety training, the total score and the result of the experiment group on fire prevention and emergency response awareness and self-efficacy had both performed better than the control group who received general fire safety training (p < .001); fire prevention and emergency response awareness has significant and positive correlation with self-efficacy (r=.601, p < .001), and awareness is a significant predictor variable to self-efficacy (p < .001). Conclusion/Practical Application: This study finds that the key to improving learning effectiveness includes adding fire science concept chapter when creating fire safety training material in order to strengthen basic awareness; fire safety training should comprehensively introduce all related duty responsibilities of staff fire defense formation, in turn enabling mutual responsive support for the needs of the site; also, to become familiarized with the knowledge requires appropriate frequency of training and enhancing the staff’s awareness to fire prevention and emergency response, which is the most important key of learning effectiveness.

Purpose: Melanoma’s incidence is increasing, and elderly people could be significantly impacted since the majority occurs in people over 65 years of age. Combined targeted therapies (TT) are current standard regimen for BRAF mutated metastatic melanoma (MM). Except for subgroups of pivotal trials, little data are available for TT in this population. Materials and Methods: Outcomes were explored in real life patients from MelBase, a French multicentric biobank dedicated to the prospective follow-up of unresectable stage III or IV melanoma. Patients treated by BRAF TT and/or MEK TT combined or not, were included from 2013 to 2017 in 2 groups: group 1 <65-year-old (yo), group 2 >65 yo, analyzed for tolerance and efficacy. Results: 353 patients were included: 231 in group 1, 122 in group 2. Median follow-up was 12 months (M). Median time of treatment was 6.9 M. A total of 80% had at least one Adverse Effect (AE). Most frequent AE (all grades) were mainly skin and subcutaneous, general, and gastrointestinal disorders. A total of 31% of AE were grade 3–4: 28% in group 1 and 39% in group 2 (p = 0.05). No differences were observed in all AE grades proportion, dose modifications, interruptions, and discontinuations. For each group, median overall survival was 20.3 M (CI 95%: 15.5–27.9) and 16.3 M (CI: 14.5–26.9), respectively (p = 0.8). Median progression free survival was 7.8 M (6.4–9.9) and 7.7 M (CI: 5.8–11.3) (p = 0.4). Objective response rate was 59% and 50% (p = 0.6). Conclusion: This study on a large multicentric cohort is the first to assess that TT is well tolerated in elderly BRAF-mutated patients such as in patients younger than 65. Efficacy was similar between groups with outcomes reaching those from pivotal studies. There is thus no argument against using TT in elderly people, although an onco-geriatric opinion is welcome for the most vulnerable.

Anthropogenic lead pollution is an environmental problem that threatens the quality of soils and waters and endangers living organisms in numerous surface and subsurface habitats. Lead coprecipitation on mineral surfaces through dissolution-recrystallization processes has long term effects on lead bioavailability. Gypsum and calcite are among the most abundant and reactive rock forming minerals present in numerous geological settings. In this work, we study the interaction of slightly acidic (pHi = 5.5) Pb-bearing aqueous solutions ([Pb]i = 1 mM and 10 mM) with crystals of gypsum and /or calcite under atmospheric conditions. This interaction results in a reduction of the concentration of lead in the liquid phase due to the precipitation of newly formed Pb-bearing solid phases. The extent of this Pb removal mainly depends on the nature of the primary mineral phase involved in the interaction. Thus, when gypsum is the only solid phase initially present in the system the Pb-bearing liquid-gypsum interaction results in Pb removals in the 98-99.8 % range, regardless of [Pb]i. In contrast, when the interaction takes place with calcite, Pb removal strongly depends on [Pb]i. It reaches 99% when [Pb]i = 1 mM while it is much more modest (⁓13%) when [Pb]i = 10 mM. Interestingly, Pb-removal is maximized for both [Pb]i (99.9 % for solutions with [Pb]i = 10 mM and 99.7% for solutions with [Pb]i = 1 mM) when Pb-polluted solutions simultaneously interact with gypsum and calcite crystals. Despite the large Pb removals found in most of the cases studied, the final Pb concentration ([Pb]f) in the liquid phase always is well above the maximum permitted in drinking water (0.1 ppm), with the minimum ([Pb]f = 0.7 ppm) being obtained for solutions with [Pb]i =1 mM after their interaction with mixtures of gypsum and calcite crystals. This result suggests that integrating the use of mixtures of gypsum-calcite crystals might help to develop more efficient strategies for in-situ decontaminating Pb-polluted waters through mineral coprecipitation processes.

On the eve of the Brexit process, in the context of a rising Euroscepticism that fuels the modest confidence of European citizens in their national and European institutions, the article assesses the efficiency and effectiveness of the European Parliament within the framework of the ordinary legislative procedure (co-decision). After defining and formulating the main indicators, the paper analyses the micro- and macro-performance of the European Parliament within the decision-making process from a quantitative-qualitative and a qualitative-quantitative perspective, highlighting the relativizing factors and the responsiveness of the European decision-making process to the Europeans’ needs.

Background/Objectives: High-intensity anaerobic physical training frequently results in muscle damage among boxers and kickboxers, which can impede performance and recovery. Vibrational therapy (VT) and passive rest (PR) have been employed as methods to enhance muscular recovery and performance. This study evaluates the effectiveness of these two recovery methods on upper limb muscle strength and lactate levels in plasma after high-intensity exertion. Methods: Eighteen elite boxers and kickboxers, aged 19-32 years, underwent tests employing VT and PR as recovery methods in a controlled, crossover study. Muscle performance was assessed via isokinetic dynamometry, and lactate levels were measured pre-exercise, post-exercise, and post-recovery. The study adhered to the Declaration of Helsinki guidelines and was approved by the relevant bioethics committee. Results: The results showed that VT led to a faster recruitment of muscle fibers and improved muscle endurance as indicated by decreased fatigue work indices compared to PR. However, no significant differences were observed in peak torque or lactate levels between the two recovery methods. The VT group exhibited quicker recovery times in torque generation and better performance in fatigue resistance. Conclusions: VT appears to provide superior muscular recovery compared to PR following intense anaerobic effort, particularly in terms of muscle strength endurance and activation speed. These findings support the potential of VT in sports recovery protocols, although similar lactate response suggests that metabolic recovery rates are not significantly affected.

Consumer trust in supply chain certifications plays a pivotal role in shaping contemporary consumer behavior and marketing effectiveness. This qualitative research investigates consumer perceptions of supply chain certifications and their impact on purchasing decisions and brand loyalty. Through semi-structured interviews and focus group discussions with 30 participants, the study explores themes such as credibility, transparency, perceived value, and the influence of certifications on consumer trust. Findings reveal that consumers value certifications that signal ethical sourcing practices and sustainability commitments, viewing them as assurances of product quality and social responsibility. Credibility and transparency in certification processes emerged as critical factors influencing consumer trust, while perceived benefits such as environmental sustainability and fair labor practices positively influenced purchase intentions. Moreover, certifications were found to enhance brand loyalty by aligning with consumers' ethical values and beliefs. However, the study identifies challenges including high certification costs, complexity in compliance, and consumer skepticism, which hinder broader adoption and effectiveness of certifications. The implications of these findings suggest that businesses can enhance consumer trust and market competitiveness by investing in rigorous certification standards, clear communication strategies, and sustainable practices. Addressing barriers through improved transparency and consumer education is crucial for maximizing the impact of certifications on ethical consumption. Future research directions include longitudinal studies on certification impacts and comparative analyses across industries and global markets to further enrich understanding of consumer behavior and certification influences.

(1) Background: Aim was to investigate real-world effectiveness (hypothesizing non-inferiority) and safety profile of risdiplam in paediatric and adult nusinersen-risdiplam spinal muscular atrophy (SMA) switch cohort. (2) Methods: A retrospective and anonymous collection of relevant demographic and clinical data for all Croatian SMA patients switched from nusinersen to risdiplam up to September 2023 (reimbursed by Croatian Health Insurance Fund – CHIF) was performed using CHIF database and associated reimbursement documentation. Patients were included in effectiveness and safety analysis if they met the following inclusion criteria: i) risdiplam reimbursed by CHIF; ii) patient received at least 6 doses of nusinersen before switch to risdiplam; iii) no relevant pause between the latter disease modifying drugs (DMDs); iv) availability of all prespecified studied data and parameters. (3) Results: 17 patients met inclusion criteria [58.9% female; median age 12.75 (3.0-44.5) yr.]. In our ‘switch’ cohort, we have demonstrated a non-inferiority of risdiplam to nusinersen, in SMA 1 (+1.0 in CHOP INTEND; p=0.067), SMA 3p (+0.7 in HFMSE; p=0.897) and SMA 3a (+0.8 in RHS; p=0.463) subpopulations, during a one-year follow-up period. There were no reports on respiratory function worsening, feeding worsening, and no lethal events. No new safety concerns were identified, except of the weight gain that arose as a new potential adverse drug reaction ‘signal’ in two patients. (4) Conclusions: We have reported a pivotal real-world findings on switching SMA patients from nusinersen to risdiplam and demonstrated its effectiveness (non-inferiority), safety and tolerability in a heterogenous paediatric and adult ‘switch’ cohort, which will further increase the quality and standards of care as well as safety of a notable portion of SMA patients; especially for those who demand switch from nusinersen to other DMDs from clinical or personal reasons.

Background. False memories tend to increase in healthy and pathological aging, and their reduction could be useful in improving cognitive functioning. The objective was to use an active-placebo method to verify whether the application of tDCS in improving true recognition and reducing false memories in healthy older people. Method. Participants were 29 healthy older adults (65-78 years old) assigned to active or placebo group; active group received anodal stimulation at 2mA for 20 min over F7. An experimental task was used to estimate true and false recognition. The procedure took place in two sessions on two consecutive days. Results. A mixed ANOVA of true recognition showed a significant main effect of session (p = .004), indicating an increase from before treatment to after it. False recognition showed a significant main effect (p = .004), indicating a decrease from before treatment to after it and a significant session x group interaction (p < .0001). Conclusions. Overall, our results show that tDCS is an effective tool for increasing true recognition and reducing false recognition in healthy older people, and suggest that stimulation improves recall by increasing the number of items a participant can recall and reducing the number of memory errors.

Evaluation of the effectiveness of protected areas is critical for forest conservation policies and priorities. To evaluate their effectiveness, we used 30-m resolution forest cover change data between 1990 and 2010 for ~4,000 protected areas and analyzed the relationships of the effectiveness of protected areas with socio-economic variables. Our results show that protected areas in the Tropics avoided 83,500 ± 21,200 km2 of deforestation during the 2000s. Brazil’s protected areas have the largest amount of avoided deforestation of 50,000 km2. We also show the amount of international aid received by tropical countries compared to the effectiveness of protected areas. International aid had major benefits in Latin America led by Brazil while tropical Asian countries used the resource ineffectively. Our results demonstrate that protected areas have been relatively more efficient in countries where deforestation pressures were increasing, and governance and forest change monitoring capacity are important factors for enhancing the efficacy of international aid.

This study assesses the effectiveness of HCV self-testing (HCVST) distribution models compared to provider-led HCV testing (PL-HCVT), including the standard of care facility-based HCVT (SOC-HCVT) and community-based organization HCVT (CBO-HCVT) among people who inject drugs (PWID) in Vietnam. A cross-sectional study was conducted as part of a larger implementation science study in Hanoi and Ho Chi Minh City from September 2023 to April 2024. We engaged 8 CBOs and 10 public and private clinics in offering choice of HCVST through community-based and facility-based distribution, and secondary distribution), or PL-HCVT via SOC-HCVT and CBO-HCVT. Among 1,165 PWID, 693 opted for HCVST and 472 for PL-HCVT. The proportion of first-time testers was significantly higher in HIVST community-based and secondary distribution as well as CBO-HCVT compared to SOC-HCVT and facility-based HCVST (87.1%, 93.3% and 82.7% vs. 41.9% and 35.7%, respectively; p < 0.001). Overall, HCV seropositivity rate was lower in HCVST than PL-HCVT, however, higher in HCVST facility-based and community-based distribution compared to HCVST secondary distribution (28.1% and 20.4% vs. 5.7%, respectively). Community-based HCVST was most effective, followed by facility-based HCVST and secondary distribution. Our findings indicate that HCVST effectively reaches first-time testers and results in more people diagnosed and treated among PWID.

After an earthquake, assessing the seismic vulnerability of buildings is essential for prioritizing emergency response, guiding reconstruction, and ensuring public safety. Accurate and timely evaluation of structural damage plays a vital role in mitigating further risks and facilitating in-formed decision-making during disaster recovery. This study investigates the performance of various Generative Artificial Intelligence (GAI) models, developed by different companies with diverse model sizes and context windows, in analysing post-earthquake images. The primary objective was to evaluate the models' effectiveness in classifying structural damage according to the EMS-98 scale (with 5 levels of damage), which ranges from minor damage to total destruction. For masonry buildings, the correct classification rates varied widely across models, from 28.6% to 64.3%, with mean damage grade errors ranging from 0.50 to 0.79. In the case of reinforced concrete buildings, correct classification rates ranged from 37.5% to 75.0%, with mean damage grade errors between 0.50 and 0.88. The use of fine-tuning could probably improve the results substantially. Improving the accuracy of GAI models could significantly reduce the time and resources needed to assess post-earthquake damage, namely when comparing with more traditional approaches. The results achieved thus far demonstrate the promise of GAI models for rapid, automated, and ac-curate damage evaluation, which is critical for expediting decision-making in disaster response scenarios.

This academic article examines the effectiveness of international humanitarian intervention in conflict zones. Humanitarian intervention refers to the use of military, diplomatic, or economic measures by external actors to protect civilians, promote human rights, and alleviate suffering in areas affected by armed conflict. The research employs a comprehensive approach, incorporating content analysis, case study, and historical analysis in its methodology. It explores the key challenges faced by international actors in implementing humanitarian interventions and evaluates their impact on conflict resolution and post-conflict reconstruction. Through this thorough analysis of case studies and scholarly literature, this article contributes to the ongoing debate surrounding the efficacy of international humanitarian intervention.

This paper aims to provide a systematic review of the literature on school effectiveness, with a focus on identifying the main factors that contribute to successful educational outcomes. The research question that this paper aims to address is: What are the main factors of school effectiveness? The research was interested in several descriptors such as school, effectiveness/efficiency theories, effectiveness/efficiency research, and factors. Studies were reviewed through two databases: JSTOR and ERIC (published within the 2016-2022 period). The paper defines several categories that are exposed within school effectiveness research. Within these categories, various factors that affect the students’ outcomes and the defined effectiveness at school are listed. As the results show, the issue of school effectiveness is a multifaced challenge as the effectiveness of schools is a complex concept that can be measured through various indicators such as academic achievement, student engagement and teacher satisfaction. The review of school effectiveness has revealed that several factors contribute to effective schools, such as strong leadership, effective teaching practices, a positive school culture and parental involvement. Additionally, school resources, such as funding and facilities, can impact school effectiveness, particularly in under-resourced communities.

Across the global construction industry, fatalities continue to occur from high-risk activities where the risk controls have been defined, however were unreliable. In the mining industry, Critical Control Risk Management has provided positive results in reducing major accidents, which raises the question, could the Critical Control approach reduce the fatality rate in the construction industry? This study analysed 10 years of serious and fatal incident investigation reports from four international construction companies to i) assess the reliability of their Critical Controls (CCs) and ii) assess the factors which affect the reliability of CCs. The results show the reliability of CCs, measured by implementation and effectiveness, averaged just 42%. Human performance factors including risk identification, decision-making and competency together with supervision, job planning, communication organisational factors were identified as affecting the reliability of CCs. The study used bow-tie diagrams with real event data to find the actual CC effectiveness. This gave actionable findings directly related to individual CCs enabling the participating organization to focus resources on improving specific verification processes. The results confirm the applicability of CCs for the Major Accident Event hazards analyzed and highlights further review is required of the factors which need to be considered when implementing a CC program. This paper details our methodology and results, to assist others apply CCs as a risk management tool.

(1) Background: Obstetric work requires good communication, which can be trained in interventions targeting health care providers and pregnant women/ patients. This systematic review aims to aggregate the current state of research on communication interventions in obstetrics. (2) Methods: Using the PICOS scheme, studies published in peer-reviewed journals in English or German between 2000 and 2020 were searched. Out of 7,018 results, 71 studies were included in this synthesis and evaluated using the Oxford Level of Evidence Scale. (3) Results: 63 studies, including a communication component, revealed a positive effect on different proximal outcomes (i.e., communication skills). Three studies evaluating the effect of communication training on distal performance indicators (i.e., patient safety) proved to be beneficial to some extent. Most studies included different groups at the same time; those addressing health care providers were more common than those with students (61 vs. 12). Expectant mothers were targeted only in 9 studies. Overall, the evidence level of studies was low (only 11 RCTs), with 24 studies evidence level of I-II, 35 of III, and 10 of IV. (4) Conclusions: Communication training should be applied more often to improve communication of staff, students, and pregnant women, and thereby improve patient safety.

Three-temperature heating systems consist of a heat engine and a heat pump, enabling thus maximum usage of the primary thermal source for the heating of buildings. This analysis has revealed obvious advantages and disadvantages that the combining of thermodynamic systems has in future development, also with respect to environmental and economic issues. It appears that the combination of a Stirling engine or a similar heat drive with a heat pump is especially suitable. In order to analyze the effectiveness of such a system, a comprehensive calculation procedure is used: its basis lies in accounting for all types of energy and their relationship to the original natural resource. The present paper aims to point out that the combination of Stirling engine and a heat pump is a useful solution thanks to the most favorable resultant economic impact if compared to the usage of a diesel, four-stroke gas, or, most commonly used, electric drive.

Light sources tend to affect images captured in any automatic optical inspection (AOI) system. In this study, the effectiveness of metal-halide lamps, quartz-halogen lamps, and LEDs as the light sources in AOI systems for the detection of the 3rd and 4th layers electrodes of thin-film-transistor liquid crystal displays (TFT-LCDs) is examined experimentally. The results show that the performance of LEDs is generally comparable or better than that of metal-halide and quartz-halogen lamps. The best optical performance is by the blue LED due to its spectrum compatibility with the time-delay-integration charged-coupled device (TDI CCD) sensor and its better spatial resolution. The images revealed by the blue LED are sharper and more distinctive. Since current LEDs are more energy efficient and environmentally friendly, using LEDs as the light source for AOI is very beneficial. As the blue LED performs the best, it should be adopted for AOI using TDI CCD sensors.

Cardiovascular disease is a major global health concern, with early detection being critical. This study assesses the effectiveness of the portable ECG device, based on Internet of Medical Things (IoMT) technology, for remote cardiovascular monitoring during daily activities. We conducted a clinical trial involving 2,000 participants who wore the HiCardi device while engaging in hiking activities. The device monitored their ECG, heart rate, respiration, and body temperature in real-time. If an abnormal signal was detected while a physician was remotely monitoring the ECG at the IoMT monitoring center, he notified the clinical research coordinator (CRC) at the empirical research site, and the CRC advised the participant to visit a hospital. Follow-up calls were made to determine compliance and outcomes. Of the 2,000 participants, 318 showed abnormal signals, and 182 were advised to visit a hospital. Follow-up revealed that 139 (76.37%) responded, and 30 (21.58% of those who responded) sought further medical examination. Most visits (80.00%) occurred within one month. Diagnostic approaches included ECG (56.67%), ECG and ultrasound (20.00%), ultrasound alone (16.67%), ECG and X-ray (3.33%), and general treatment (3.33%). Seven participants (23.33% of those who visited) were diagnosed with cardiovascular disease, including conditions such as arrhythmia, atrial fibrillation, and stent requirements. The portable ECG device using the patch-type electrocardiograph detected abnormal cardiovascular signals, leading to timely diagnoses and interventions, demonstrating its potential for broad application in preventative health care.

This qualitative study explores the transformative role of digital technologies in enhancing supply chain efficiency and marketing effectiveness across diverse industries. The integration of Internet of Things (IoT), artificial intelligence (AI), blockchain, and advanced analytics has reshaped organizational practices, enabling real-time data collection, analysis, and decision-making in supply chain management (SCM) and marketing. Through semi-structured interviews with 25 professionals, including supply chain managers, marketing executives, and IT specialists, insights were gathered into the adoption, integration, and impact of digital technologies within organizational contexts. Key findings highlight IoT's contribution to enhancing supply chain visibility, predictive maintenance, and operational efficiency through continuous monitoring and data-driven insights. AI technologies support demand forecasting, inventory optimization, and personalized marketing strategies, improving customer engagement and satisfaction. Blockchain enhances supply chain transparency, traceability, and security, reducing risks associated with fraud and ensuring compliance with regulatory standards. Advanced analytics provide organizations with actionable insights into consumer behavior and market trends, guiding strategic decision-making and optimizing marketing campaigns. Despite these benefits, organizations face challenges such as technological complexity, integration issues, data privacy concerns, and organizational resistance to change. Strategic planning, leadership support, and investment in digital infrastructure are essential for overcoming these challenges and maximizing the potential of digital technologies. Future research directions include exploring sustainability initiatives in digital SCM, advancing AI-driven analytics, and understanding digital transformation in emerging markets.

Pseudomonas aeruginosa infections are the focus of new treatment alternatives due to their frequent development of resistance to antibiotics and formation of biofilms. Recently, emphasis has been placed on combinations of antibiotics with drugs used for different indications. In this study the combined effects of metformin with imipenem, ceftazidime, cefepime, ciprofloxacin and levofloxacin has been investigated. 50 P. aeruginosa isolates isolated from patients with cystic fibrosis come to Gaziantep University Microbiology Laboratory were included in the study. The susceptibilities of the isolates to antibiotics were investigated by the liquid microdilution method and the combined effect of metformin and antibiotics by the chequerboard synergy test. In our study, as a result of the chequerboard synergy test; synergy between ceftazidime and metformin 6%, partial synergistic 22% isolates; while no synergistic effect was detected between cefepime and metformin in any isolate, partially synergy 46%; synergy between imipenem and metformin 4%, partial synergy 10%; synergy between ciprofloxacin and metformin 6%, partial synergy 6%, antagonist effect 2%; synergy was detected between levofloxacin and metformin 2% and a partial synergy was detected 12%. This study shows that metformin could be a potential antibiotic in its current form or in different chemical forms to be produced synthetically.

Radon, a carcinogenic radioactive gas, is a leading cause of lung cancer according to the World Health Organization. European Member States are required to develop and implement National Radon Action Plans (RAPs) to address its dangerous health effects. However, assessing the effectiveness of these RAPs presents challenges for authorities. This study aims to explore the possibility for a systematic and standardised assessment method to evaluate the effectiveness of RAPs strategies and its implementation. The method involved analysing the strategies of 27 EU Member States and the UK, conducting legal document analysis and group interviews with responsible authorities. Additionally, four regional workshops and one final European workshop were held. The research took place from March 2021 to May 2023. Findings indicate that evaluating RAP effectiveness is challenging due to limited existing common criteria or indicators. To address this, the study proposes guiding questions for each element required by the EU Directive, as well as additional questions related to education and training. This contribution benefits RAP owners and European regulatory authorities, supporting the development of effectiveness indicators for RAPs. BY improving assessment methods, we can enhance the effectiveness of strategies in mitigating the risks associated with radon exposure.