Financial fraud poses a severe threat to the integrity of corporate financial statements and market efficiency. While auditors play a crucial role in detecting and preventing such fraud, the unique characteristics of this domain, including class imbalance, high misclassification costs, and am-biguous attributes, pose significant challenges. Traditional classification algorithms may not be optimally suited for this task. This paper proposes a novel stacking ensemble learning approach to enhanced detecting of Financial Statement Scam. By combining the strengths of multiple base learners, including Random Forest, XGBoost, and Gradient Boosting Decision Trees, our model leverages their diverse predictions to improve overall performance. A Logistic Regression me-ta-learner is employed to integrate the outputs of the base learners, capturing their collective wisdom while mitigating individual weaknesses. Extensive experimentation using a real-world dataset shown the superiority of our approach, achieving remarkable recall, precision, accuracy, and area under the curve metrics. The proposed model outperforms individual base learners, under-scoring the efficacy of ensemble learning in tackling the intricate problem of financial fraud detection. This research contributes to the creation of substantial and robust fraud detection systems, fostering trust and transparency in financial markets.

In recent years, the implementation of artificial intelligence (AI) in accounting has grown in many domains, including auditing. AI permits auditors to evaluate large data sets and rapidly identify discrepancies and sequences in audit. This means auditors can review all of a client's transactions via a low time and effort. This entails auditing firms investing heavily in technological infrastructure as well as training their human resources to use cutting-edge AI technologies. Thus, this research sought to investigate the impact of the use of AI techniques by Jordanian external auditors in fraud risk assessment, the moderating effect of auditor size. The descriptive analytical method was used by distributing 280 questionnaires electronically to auditors employed in auditing firms operating in Jordan, The result reveals that AI techniques are extremely beneficial in fraud risk assessment at all levels, and the relationship between the use of AI techniques and the assessment of fraud risk has improved as auditor size has increased.

Introduction: intraocular pressure (IOP) measurement is an essential part glaucoma’s diagnosis and follow-up. Goldmann applanation tonometry (GAT) is the gold standard for IOP measurement but it’s affected by many factors like central corneal thickness (CCT). Racial differences in CCT are reported but the Syrian population was never studied. Research design and methods: 57 subjects with 114 eyes visiting Damascus hospital were examined and 100 eyes were included. IOP was measured using GAT and CCT was measured using OCULUS Pentacam AXL Corneal Topography, demographic data and history of ocular surgery, systemic co-morbidities and history of medications were collected. IOP values were corrected for CCT. Results: 56% were males, the mean age was 48.1. 24% of subjects had hypertension. Males had higher CCT with 557.23± 25.33 compared with 531.34 ± 41.88 for females. There was a moderately positive correlation between CCT and IOP (r=0.232, p-0.02), CCT and IOP values were linearly correlated (ANOVA, p=0.02). Conclusions: This study showed that the correlation between CCT and IOP is present in the Syrian population. Males had a slightly thicker corneas than females and CCT didn’t significantly change with age.

The COVID-19 pandemic had a wide-ranging impact, resulting in a global recession due to weakened purchasing power. This circumstance necessitates business organizations adapting to developments and being more conscious of the risk of financial statement fraud. The intention of this research is to investigate the way corporate governance affected financial statement fraud during the COVID-19 pandemic. To acquire empirical data for examining corporate governance variables on financial statement fraud, the research was examined using quantitative methods. The study takes advantage of secondary data acquired from annual reports of companies under special monitoring listed on the Indonesia Stock Exchange of 2020-2021. The logistic regression method was used to evaluate 134 data sets, and financial statement fraud was measured using the Z-Score and F-Score models. The results indicate that using the Z-score, only the board size has a negative effect on financial statement fraud during the COVID- 19 pandemic. Meanwhile, using the F-Score, the corporate governance variables studied are not proven to have an influence on financial statement fraud during the COVID 19 pandemic.

Purpose –This study examines the effect of ESG performance on auditor choice and audit opinion for Egyptian-listed firms. Design/methodology/approach – We use univariate and multivariate analyses of 612 firm-year observations for a sample of 68 firms listed on EGX100 over 2012-2022 using binary logistic regression models. Findings – Consistent with the ethical perspective of corporate social responsibility, we found that firms listed in the ESG index are more likely to assign one of the Big4 auditors, and less likely to receive a qualified opinion. In addition, we find that COVID-19 moderates the relationship between ESG performance, auditor choice, and audit opinion. Originality/value – Our results contribute to the growing interest in the implications of ESG performance for audit practices in emerging economies. Implications: This research has important implications for investors, the audit profession, firms, and regulators in Egypt. It provides substantial evidence that ESG performance can enhance financial reporting quality. Further, it indicates that binding guidelines and regulations are crucial to oversee corporate ESG performance, especially during crisis time to enhance investors’ protection and firms’ sustainability.

Nuclear magnetic resonance (NMR) is a technique used for many years by chemists for elucidation of molecular structure. Technological progress over the years has enabled this technique, making it easier to use. Thus, the LF-NMR (low-field NMR) was introduced as side technique, characterized by low man-agement costs and shorter analysis time than its main counterpart. The application of 1H LF-NMR for the quantification of ethyl alcohol in different alcoholic matrices is herein described, comparing results ob-tained with this technique with those determined by a reference gascromatographic method.

Among the knowledge areas in which process mining has had an impact, the audit domain is particularly striking. Traditionally, audits seek evidence in a data sample that allows to make inferences about a population. Mistakes are usually committed when generalizing the results and anomalies, therefore, appear in unprocessed sets. However, there are some efforts to address these limitations using process mining-based approaches for fraud detection. To the best of our knowledge, no fraud audit method exists that combines process mining techniques and visual analytics to identify relevant patterns. This paper presents a fraud audit approach based on the combination of process mining techniques and visual analytics. The main advantages are: (i) a method is included that guides the use of the visual capabilities of process mining to detect fraud data patterns during an audit; (ii) the approach can be generalized to any business domain; (iii) well-known process mining techniques are used (Dotted Chart, Trace Alignment, Fuzzy Miner…). The techniques were selected by a group of experts and were extended to enable filtering for contextual analysis, to handle levels of process abstraction, and to facilitate implementation in the area of fraud audits. Based on the proposed approach, we developed a software solution that is currently being used in the financial sector as well as in the telecommunications and hospitality sector. Finally, for demonstration purposes, we present a real hotel management use case in which we detected suspected fraud behaviors, thus validating the effectiveness of the approach.

The corporate strategic planning of businesses in sub-Saharan Africa (SSA) largely focuses on immediate financial performances with minimal credence to social sustainability. Thus, studies on the linkage between corporate governance and sustainability reporting have focused on developed economies. This study therefore investigated the role of institutional ownership in the impact of board committee characteristics on social sustainability reporting. The study involved strongly balanced panel data with 1,969 observations of 275 publicly listed non-financial firms in SSA within the timeframe of 2012 to 2021. Data was analyzed using STATA 14.1. The hypotheses were tested using the two-step system of the generalized method of moment (GMM) using the Arellano-Bond dynamic panel-data estimation method. The rate of social sustainability reporting was 39.4%. Relatively, Mauritius and South African firms had the most effective board committee characteristics and higher levels of social sustainability reporting. Institutional ownership had no significant effect on social sustainability reporting. Institutional ownership moderated the effect of sustainability committee independence and sustainability committee gender diversity on social sustainability reporting negatively. The paper presents a new perspective on corporate governance and social sustainability literature by examining the effect of institutional ownership on board committee characteristics and social sustainability reporting in SSA.

This research aims to determine the influence of the independent commissioners, audit committee, institutional ownership, firm size and leverage against the integrity of the financial reporting information. This research is quantitative research with the causal approach. This study uses secondary data and panel data regression analysis method. The research results prove that audit committee, institutional ownership and leverage effect on the integrity of the financial reporting information. But it does not prove that the independent commissioner and firm size effect on the integrity of the financial reporting information.

Volunteering has many social, emotional and health benefits and could be an option for people with younger/early onset dementia to engage in stage/age-appropriate, personally meaningful activity within their local community. Audio data of people with young onset dementia discussing their volunteering experiences were taken from the Dementia Diaries and co-analysed. This study explored how people with dementia volunteer in the UK, the benefits and barriers, and how we can improve access to volunteering opportunities. The findings suggest that stigma is the overarching concept (or net) which influences people’s experiences of volunteering with dementia. Within the stigma net, three themes were developed that employed a lifespan approach to challenging said stigma: 1) Valuing the past, 2) Valuing the present and 3) Valuing the future, each with additional subthemes. This research contributes to the limited pool of literature that highlights the clear benefits of volunteering for people with young onset dementia, while also considering how dementia stigma can create practical and institutional barriers to accessing volunteering. Guidance is provided for how to deliver meaningful and accessible volunteering opportunities.

This study examines the impact of executives implicated in fraud on firms' investment decisions using AAERs in the US, aiming to address the underexplored aspect of rationalization within the fraud triangle. Executives implicated in fraud often display abnormal attitudes to justify accounting irregularities, prompting an investigation into how abnormal investment decisions are used for rationalizing fraud, given their critical role in a firm's long-term sustainability. Analysis of AAERs spanning from 1981 to 2013 reveals that implicated executives, particularly CEOs and CFOs, tend to make abnormal investment decisions, and that collusive fraud exacerbates this behavior. Notably, such executives lean towards overinvestment, particularly in R&D expenditures, to hide or justify fraud; the duration of fraud amplifies its impact on investment decisions. By shedding light on the rationalization aspect of the fraud triangle, this research contributes valuable insights for investors, regulators, and academia emphasizing the significance of public disclosure of fraud to enhance transparency in capital markets and the importance of ethics-focused education in accounting to prevent corporate fraud.

In this study, we explored the application of deep learning techniques for credit card fraud detection, aiming to improve the performance and reliability of anomaly detection methods in financial transactions. We first utilized the Isolation Forest algorithm, achieving a detection accuracy of 26% for the top 1000 transactions. Subsequently, we experimented with the Autoencoder algorithm, an unsupervised deep neural network model, which enhanced the detection accuracy to 33.6% in the best case despite some fluctuations. The results demonstrate deep learning models' strong feature extraction capability and adaptability, highlighting their potential to surpass traditional methods. However, the high imbalance in the dataset, with only 0.17% of transactions being fraudulent, poses a significant challenge. This study underscores the necessity for further experimentation and optimization of network structures and hyperparameters to achieve more stable and efficient fraud detection. The findings provide valuable insights and reference points for future research in financial fraud detection using deep learning methodologies.

This study investigates the moderating effect of corporate governance on the associations of internal audit and quality of internal audit with quality of financial reporting among commercial banks in the Republic of Yemen. The final sample includes 210 internal auditors, heads of internal auditors, chairpersons, and members of audit committees. Using a survey-based methodology, the results of the Smart-PL4 analysis showed a positive association between internal audit and quality of internal audit and quality of financial reporting. Interestingly, the results showed an insignificant association between internal audit, quality of internal audit, and quality of financial reporting when considering the moderating effect of corporate governance. The findings of this study contributes valuable insights to the existing literature on the influence of internal audit, quality of internal audit, and corporate governance on quality of financial reporting in developing countries, specifically in Yemen.

Corporate governance is widely suggested by economists and regulators as a solution to reduce agency problems and improve firm performance. However previous studies have failed to generate consistent results. Using a dynamic panel system GMM estimator to alleviate endogeneity concerns we determine the effect of corporate board structure on the performance of a panel of 1265 Chinese firms listed on the Shanghai and Shenzhen stock exchanges from 2010 to 2016. We compare the dynamic system GMM estimator to some commonly used estimators; ordinary least squares (OLS), fixed effects (FE) and the dynamic OLS, and show that these estimates are biased due to endogeneity. The dynamic system GMM estimator incorporates the dynamic nature of internal governance choices to provide valid and powerful instruments that address unobserved heterogeneity and simultaneity. Our results show support for the board model corporate governance mechanism. We find that board size is positive and significantly related to both return on assets and total net profit margin. In addition board independence is positive and significantly related to return on assets but insignificantly related to total net profit margin. Duality was found to have a negative but statistically insignificant relation with firm performance.

Corporate governance has received increasing attention from practitioners and politicians after the collapse of large companies due to accounting errors and failure to disclose information that reflects the true financial condition of companies. Voluntary risk disclosure includes several aspects, including financial risks, including risks of interest rate, exchange rate, liquidity as well as risks of operations. In Jordan, the most common type of business is family businesses, where boards of directors usually serve the interests of the family that owns the majority stake in the company.This study identifies the moderate effect of family in the link joining the audit committee with the voluntary risk disclosure of financial institutions in Jordan. It's population is the Jordanian commercial banks registered and operating in Jordan during the period extending from 2017 to 2023.Significantly, it concluded with revealing that the characteristics of the audit committee; namely, independence, experience, and committee size, obviously impact disclosure of voluntary risk in the selected banks. However, the results made it obvious that the number of audit committee meetings did not affect the degree of voluntary risk disclosure. In addition, the results view family ownership as moderately affecting the relationship joining some audit committee characteristics with voluntary risk disclosure.

The objectives of the research are to investigate the characteristics of the board of directors on the financial performance of the enterprise. Using a sample data from 52 construction and real estate enterprises listed on Vietnam stock exchange in the period 2006-2020. Using typical regression methods such as pooled OLS, FEM, REM and assessing the defects of the research model, the FGLS method is selected. At the same time, due to the existence of endogenous phenomena and the nature of interdependence among enterprises in Vietnam, research using the instrumental variables two-step generalized method of moments (IV-GMM) in order to correct for cross-sectional dependence, autocorrelation, endogeneity, and heteroskedasticity in the analysis. Research results suggest that board size, female board members, meeting frequency, and board members' education have a positive influence on financial performance. Moreover, the independence of the Board of Directors increases, the business efficiency decreases. The research also found a positive relationship of tangible fixed assets, and a negative relationship between capital structure choice, firm size and corporate financial performance.

Prior research has extensively examined the relationship between religion and accrual-based earnings management. However, there is currently little research in the relationship between religion and real (non-accrual) earnings management, especially in Europe. This paper aims to fill this research gap and examines whether and how the effect of religion could be linked with firms’ real earnings management activities. Four hypotheses are developed and tested with our results providing indications that the degree of overall religiosity is negatively and significantly associated with real earnings management. Furthermore, when investigating the effects of different religions in Europe, Christianity and Islam have the opposite impact on firms’ real earnings management activities. Overall, our paper indicates that in European countries, the religious environment can mitigate firms’ manipulations on earnings.

Background: Despite tremendous advances in medicine, infective endocarditis (IE) continues to be a challenge for physicians due to increasing morbidity and unchanged high mortality. Objectives: Our aim was to evaluate clinical outcomes in patients with IE and to identify predictors of in-hospital mortality. Material and methods: The study was retrospective, single-centered, and included 270 patients diagnosed with IE, for the period 2005-2021 (median age 65 (51–74), man 177 (65.6%). Results: Native IE (NVIE) was found in 180 (66.7%), prosthetic IE (PVIE) in 88 (33.6%) and cardiac device-related IE (CDRIE) in 2 (0.7%), significantly more in the non-survivors group. Healthcare associated IE (HAIE) was 72 (26.7%), the most common pathogen were Staphylococci and the proportion of Gram-negative bacteria (GNB) non-HACEK were significantly higher in non-survivor’s vs survivors (11 (15%) vs 9 (4.5%), p=0.004). Overall, early surgery was performed in 54 (20%) patients, with a significant difference between deceased/alive (3 (4.5%) vs 51 (25.1%, p=0.000). The all-cause in-hospital mortality rate was 24.8% (67). The risk factors identified that increased the risk of death were septic shock (OR – 83 1; 95% CI (17.0-405.2), p=0.000) and acute heart failure (OR –24.6; 95% CI (9.2-65.0), p=0.000). Early surgery (OR – 0.03, 95% CI (0.01-0.16), p=0.000) and low Charlson comorbidity index (OR – 0.85, 95% CI (0.74-0.98, p=0.026) in turn reduce this risk. Conclusion: We found that acute heart failure and septic shock are independent predictors of in-hospital mortality. Low Charlson comorbidity index and early surgery increased survival. Knowing the predictors of death would change the therapeutic approach to a more aggressive one and improve the near and long-term prognosis of patients with IE.

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.

This paper analyzes if the Financial Fair Play (FFP) regulations set by UEFA have influenced the auditing fees charged to the football clubs. In addition, it explores the determinants of audit fees. We use a two-sample t test with equal variances to determine whether differences are present. After this, we carry out a panel data regression with clubs fix effect to estimate the determinants of audit fees in football clubs. Our findings reveal an increase of audit fees after the implementation of FFP regulations. On top of that, audit fees are explained by the presence of foreign investors if the audit firm is one of the Big4 and if the auditor is a woman. The regulation change has an impact on the audit fees charged by auditors for their services. However, this increase can be compensated across future years given the improving financial situation of clubs; therefore, the auditors’ risk diminishes and subsequent audit fees may be reduced. UEFA should monitor audit fees as well as the quality of the audit reports, which have become crucial to obtaining the license to participate in UEFA competitions.

The anti-money laundering (AML) process has failed both in identifying suspicious cases in due time as in assisting the AML analysts in decision making. Starting from a new generic anti-fraud approach, this article presents the main aspects related to the development of a multi-agent system that goes beyond the capture of suspicious transactions, seeking to assist the human expert in the analysis of suspicious behaviour. First, a transactional behavioural profile of clients is obtained in a data mining process. A set of rules, obtained through data mining over a real database, in conjunction with specific rules based on legal aspects and in the expertise of the AML analysts make up the agents' knowledge base. The cases for which the system was unable to suggest a decision are flagged as requiring more detailed analysis. The system analysed 6 months of real transactions and indicated several suspicious profiles, a set of these suspects was investigated by the AML analysts who proved the suspicion of several cases, including some that had not been identified by the systems in execution.

Climate change complies firms to introduce various measures to enhance both their competitiveness and sustainability, particularly energy efficiency measures (EEMs). Energy efficiency is particularly important in energy-intensive sectors such as the industrial sector. However, EEMs within the industrial firms are hindered by several internal barriers such as competing interests within firms, the lack of information regarding energy efficiency opportunities, and the low technical competence. In this regard, energy audit aims to improve energy efficiency in facilities and to tackle internal barriers to energy efficiency. We construct a model which aims to explore the importance of energy audit in implementing EEMs and reducing the intensity of internal barriers to energy efficiency. Our research model was empirically tested through survey data gathered from 193 industrial firms in Morocco. Results show that competing interests, the lack of information and the low technical competence hinder the adoption of EEMs within industrial firms. In addition, energy audits enhance EEMs, and mitigate the negative effect of the lack of information and the low technical competence on the adoption of EEMs. However, energy audits do not attenuate the negative effect of competing interests on EEMs. This study reinforces previous studies with additional confirmation regarding the importance of energy audits for tackling the lack of information, and the low technical competence within firms. Furthermore, our study extends prior research as we found that energy audits do not reduce the intensity of competing interests within firms regarding EMMs’ implementation.

This paper examines the relationship between the ratio of independent board member to the financial performance of the company under the mediation of the three pillars of environment, society, and governance (ESG) in Taiwan. The study addresses a research gap between independent directors and corporate financial performance, an issue that is rarely discussed today. The author develops the hypotheses and tests them by applying panel data regression to the data tables taken from the Thomson Reuters Eikon database to analyze data on 173 Taiwanese companies that reported ESG from 2009 to 2021. The results show that the relationship between the ratio of independent directors and financial performance has a positive relationship. At the same time, the 3 pillars of ESG also clearly show the intermediary role in this relationship. Finally, this study provides additional insights into the relationship between the ratio of independent directors and financial performance in the Taiwan context.

In this study, the effects of grain size and gradation of riprap, overtopping flow depth and downstream slope of embankment on scouring and deposition characteristics at the downstream toe of the embankment was investigated. For the experiment, three different downstream slopes (1:2, 1:3, and 1:4), three different overflow depths (1, 2, and 3 cm), and three different sizes (d₅₀ of 16.41 mm, 8.48 mm, and 3.39 mm herein referred as No.5, 6 and 7 respectively) of riprap particles, respectively, were used in the laboratory. The experimental results demonstrated that the scour depth and deposition height increased with increasing energy head for each downstream slope condition. Among the three particle sizes, for No. 5 size particle shows the lowest scour depth and highest deposition height. For the 1:2 slope, the No. 5 particle size could resist scour 62% and 75% less than that of the No. 6 and No. 7 particles, respectively. For the 1:3 slope case, this was 31% and 46%, and for the 1:4 slope case, this was 39% and 49% less than the No. 6 and No. 7 size particles, respectively.

Taiwan’s auditors have suffered from processing excessive audit data, including drawing audit evidence. This study advances sampling techniques by integrating machine learning with sampling. This machine learning integration helps avoid sampling bias, keep randomness and variability, and target the risker samples. We first apply a Naive Bayes classifier to classify data into some classes. Next, a user-based, item-based, or hybrid approach is employed to draw audit evidence. The representativeness index is the primary metric for measuring the representativeness of audit evidence. The user-based approach denotes the selection of samples between two percentiles in a class as audit evidence. It may be equivalent to a combination of monetary and variable sampling methods. The item-based approach represents the choice of risky samples as audit evidence. It may be identical to a combination of non-statistical and monetary sampling methods. Auditors can hybridize those user-based and item-based approaches to balance representativeness and riskiness in selecting audit evidence. Three experiments show that sampling using machine learning integration has the benefits of drawing unbiased samples, handling complex patterns, correlations, and unstructured data, and improving efficiency in sampling big data. However, the limitations are the classification accuracy output by machine learning algorithms and the range of prior probabilities.

Background: Infective endocarditis (IE) remains a difficult disease to diagnose and treat, with a persistently high mortality rate. There is a lack of recent data on IE in Bulgaria over the last decades. Methods: The study is retrospective, single centered, includes 270 patients diagnosed with IE, for the period 2005 - 2021. We compared the two periods 2005-2015 (n=119) and 2016-2021 (n=151) to find the characteristics changes. Results: The median age was 65 (23) years and 65.5% (177) were male. In the second period, there is a significant increase in age from 62 (29) to 67 (22), (p=0.023); Charlson comorbidities index (CCI) from 3 (3) to 4 (4), (p=0.000); cases with chronic kidney diseases (CKD) from 12.6% (15) to 36.9% (55), (p=0.001); coronary arterial diseases (CAD) from16.85% (20) to 29.1% (44), (p=0.018); atrial fibrillation (AF) from 10.9% (13) to 23.8% (36), (p=0.006). Injection fraction decreased significantly in the second period from 63 (14) to 59 (15), (p=0.000). Almost half of the patients 45.6% (123) had no known predisposing cardiac condition and 46.3 (125) had an unknown port of entry. IE was community-acquired in 173 (64.1%), healthcare-associated in 26.7% (72), and injection drug use related IE in 9.3% (25).The study population included 67.8% (183) native valve IE, 31.5% (85) prosthetic IE, and 0.74% (2) intracardiac device­related IE. The hemoculture were positive in 59.6%, and the most frequent pathogenic agent was Staphylococcus - 33.3 % ( aureus – 16.5 % and coagulase negative - 16.8 %). Only 20% of patients underwent early surgery. The all­cause 30 days mortality rate was 24.8%. There is no significant difference between the two periods in terms of the characteristics listed above. Conclusion: The profile of IE in Bulgaria has changed with increasing age and comorbidity, changing predisposing cardiac conditions and entry door. The most common pathogen was the Staphylococcus group. The 30 day mortality rate remains high.

This review explores the nuanced decision-making surrounding postoperative radiotherapy for diffuse low-grade glioma (DLGG) patients, emphasizing the need for personalized treatment to balance the benefits of tumor control with the risks of long-term side effects. Radiotherapy is a cornerstone of DLGG treatment, offering significant improvements in progression-free survival, but its potential for cognitive decline and vascular lesions necessitates careful consideration of individual patient factors. The review delves into the complexities of radiotherapy timing, revealing that while early radiotherapy enhances progression-free survival, it does not significantly impact overall survival and may lead to earlier onset of cognitive decline. Conversely, delayed radiotherapy may mitigate cognitive decline but may result in shorter progression-free survival and the onset of neurological symptoms. The review advocates for a patient-centered approach, emphasizing the importance of weighing individual risks and benefits, and highlights the potential of artificial intelligence in predicting cognitive decline and the need to revisit previous research findings in light of the 2021 WHO (World Health Organization) classification update, underscoring the evolving nature of DLGG treatment and the ongoing quest for optimal therapeutic strategies.

The changing of banking customer preferences after Covid-19 pandemic encourages banking transformation. Neobanks emerges as innovation in banking that enter the market to compete with the incumbent banks by offering new digital experience for customer. This paper analyzes the neobanks which transformed from traditional bank, specifically its efficiency after they implement digital transformation. Efficiency is measured by using Stochastic Frontier Analysis (SFA). This study also uses Pooled Mean Group (PMG) of Panel ARDL (Autoregressive Distributed Lagged) to investigate digital transformation as one of determinants neobank’s efficiency, as well as to examine the existence of short-term and long-term relationship between digital transformation and efficiency. The SFA results show that the efficiency of the neobanks increase after they carry out digital transformation. Furthermore, from PMG Panel ARDL, it can be concluded that digital transformation is one of determinant of efficiency and there is longevity relationship between digital transformation and efficiency. In the short run, digital transformation has a significant and negative correlation with efficiency and in the long run, it has a significant positive relationship because initially digital transformation cost for operational and risk management innovation decreases the profit efficiency, but afterwards it increases the profit efficiency.

Managing a portfolio whose value closely tracks an index by trading only in a subset of the index constituents involves an NP-hard optimisation problem. In the prior literature, it has been suggested to solve this problem using sequential Monte Carlo (SMC, a.k.a. particle filter) methods. However, this literature does not take transaction costs into account, although transaction costs are the primary motivation for attempting to replicate the index by trading in a subset, rather than the full set of index constituents. This paper extends the SMC approach to index tracking to allow for proportional transaction costs and implements this extended method on empirical data for a variety stock indices. In addition to providing a more practically useful tracking strategy by allowing for transaction costs, we find that including a penalty for transaction costs in the optimisation objective can actually lead to better tracking performance.

Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the gastrointestinal tract and encompasses two main subtypes, Crohn’s disease (CD) and ulcerative colitis (UC). IBD is frequently accompanied by extraintestinal manifestations (EIMs), with axial and peripheral spondyloarthritis (SpA) being the most common. Enthesitis, an inflammation of the bone insertions of capsules, ligaments, and tendons, represents an initial lesion in SpA. However, enthesitis remains an underestimated and often obscured EIM. The early detection of subclinical enthesial involvement in IBD patients using ultrasound (US) could provide an opportunity for timely intervention. While previous meta-analyses have reported on the incidence and prevalence of SpA in IBD, specific attention to enthesitis has been lacking. Therefore, this narrative review aims to resume the current knowledge on existing IBD-SpA cohorts, focusing specifically on enthesitis.

Mortality in children accounts for 15% of all AIDS-related deaths globally, with a higher burden among Cameroonian children (25%), likely due to poor virological response. We sought to evaluate viral suppression (VS) and its determinants in a nationally representative paediatric and young adult population receiving antiretroviral therapy (ART). A cross-sectional and multicentric study was conducted among Cameroonian children (

Financial statement analysis is an analysis that uses analytical procedures to evaluate a company's financial health, risks, performance, and future growth potential. This article aims to find out the application of analysis of financial statements of PT. Astra Internasional, Tbk towards the decision-making of novice investors in the Indonesian capital market. This article is qualitative descriptive with literature studies. The results of this article can be concluded that the analysis of the financial statements of PT. Astra Internasional, Tbk can help novice investors in the Indonesian capital market in making investment decisions.

Incorrect sitting posture, characterized by asymmetrical or uneven positioning of the body, often leads to spinal misalignment and muscle tone imbalance. Prolonged maintenance of such postures can adversely impact well-being and contribute to the development of spinal deformities and musculoskeletal disorders. In response, smart-sensing chairs equipped with cutting-edge sensor technologies have been introduced as a viable solution for real-time detection, classification, and monitoring of sitting postures, aiming to mitigate the risk of musculoskeletal disorders and promote overall health. This comprehensive literature review evaluates the current body of research on smart-sensing chairs, with a specific focus on the strategies used for posture detection and classification, as well as the effectiveness of different sensor technologies. A meticulous search across MDPI, IEEE, and Google Scholar databases yielded 34 pertinent studies that utilize non-invasive methods for posture monitoring. The analysis reveals that Force Sensing Resistors (FSR) are the predominant sensors utilized for posture detection, whereas Convolutional Neural Networks (CNN) and Artificial Neural Networks (ANN) are the leading machine learning models for posture classification. However, it was observed that CNNs and ANNs do not outperform traditional statistical models in terms of classification accuracy, due to constrained size and lack of diversity within training datasets. These datasets often fail to comprehensively represent the array of human body shapes and musculoskeletal configurations. Moreover, this review identifies a significant gap in the evaluation of user feedback mechanisms, essential for alerting users to their sitting posture and facilitating corrective adjustments.

The Solvency II regulatory framework specifies procedures and parameters for determining solvency capital requirements (SCRs) for insurance companies. The proposed standard SCR calculations involve two steps. The Value–at–Risk (VaR) of each risk driver is measured and, in a second step, all components are aggregated to the company’s overall SCR, using the Standard Formula. This formula has two inputs: the VaRs of the individual risk drivers and their correlations. The appropriate calibration of these input parameters has been the purpose of various Quantitative Impact Studies that have been conducted during recent years. This paper demonstrates that the parameter calibration for the equity–risk module—overall, with about 25%, the most significant risk component—is seriously flawed, giving rise to spurious and highly erratic parameter values. As a consequence, an implementation of the Standard Formula with the currently proposed calibration settings for equity–risk is likely to produce inaccurate, biased and, over time, highly erratic capital requirements.

Background/Objectives: interpretation of evidence on de-escalation of triple therapy with with-drawal of inhaled corticosteroids (ICS) to dual bronchodilator therapy with a long-acting musca-rinic antagonist (LAMA) and a long-acting beta-agonist (LABA) in patients with chronic obstruc-tive pulmonary disease (COPD) is conflicting. We evaluated the efficacy and safety of ICS discon-tinuation from LABA-LAMA-ICS triple therapy compared to its continuation. Methods: we searched PubMed, Embase, Scopus, Web Of Science, clinicaltrial.gov and CENTRAL for RCTs and observational studies from inception to March 22, 2024, investigating the effect of triple therapy de-escalation with withdrawal of ICS to dual therapy on the risk of COPD exacerbation, pneumonia and lung function. This study was registered with PROSPERO, CRD42024527942. Results: 3335 studies were screened; three RCTs and three real-world non-interventional studies were ultimately identified as eligible. Analysis of the time to the first moderate or severe exacerbation showed a pooled HR of 0.96 (95% CI, 0.80 to 1.15; I²=77%) for ICS withdrawal compared with triple therapy continuation. Analysis according eosinophil levels showed that COPD subjects with ≥300 eosino-phils/µL had a significant increase in the incidence of moderate or severe exacerbations when de-escalated from ICS/LABA/LAMA to LABA/LAMA (pooled HR: 1.35, 95% CI 1.00-1.82; I2: 56%). The ICS withdrawal in favour of LABA/LAMA did not significantly affect the risk of mortality and pneumonia. Conclusions: the main findings of this meta-analysis are consistent with current recommendations and suggest that the use of eosinophil counts may be of help in guiding maintenance therapy. However, methodological heterogeneity between the included studies is evident.

The nucleosome is a major modulator of DNA accessibility to other cellular factors. Nucleosome positioning has a critical importance in regulating cell processes such as transcription, replication, recombination or DNA repair. The DNA sequence is a major factor influencing the position of nucleosomes on genomes. Different sequence motifs can promote or inhibit the nucleosome formation, thus influencing the accessibility to the DNA. Sequence-encoded nucleosome positioning having functional consequences on cell processes can then be selected or counter-selected during evolution. We review the interplay between sequence evolution and nucleosome positioning evolution. We first focus on the different ways to encode nucleosome positions in the DNA sequence, and to which extent these mechanisms are responsible of genome-wide nucleosome positioning in vivo. Then, we discuss the findings about selection of sequences for their nucleosomal properties. Finally, we illustrate how the nucleosome can directly influence sequence evolution through its interactions with DNA damage and repair mechanisms. This review aims to provide an overview of the mutual influence of sequence evolution and nucleosome positioning evolution, possibly leading to complex evolutionary dynamics.

Self-report measurement is frequently used in human sports to assess training adaptations [1, 2]. This is a technique novel to the equestrian sport. The aim of this study was to describe how elite event riders of Germany evaluate their own fitness as well as that of their horses for the entire duration of an eventing season. Additionally, correlations with possible influencing external factors such as type of training or duration of grazing were also investigated. Short online questionnaires were used to allow eight riders to describe the training of their horses. Five criteria (general performance, ability to concentrate, general state of mind, general muscular condition and emotional wellbeing) were used to assess both, their horse's, as well as their own wellbeing. A 1-10 rating scale was used to score each criterion resulting in an average of 38 points out of 50 (maximum wellbeing) for horse (Std. dev. 0.55) and rider (Std. dev. 0.65) respectively. A total of 120 questionnaires were analysed. A correlation could be demonstrated (Spearman's correlation coefficient = 0.5) between rider and horse score, whereby it only became a linear correlation above 30 points. In addition, the horse score correlates positively with its success at competitions. While the horses were rated similarly throughout the season, the riders’ perceived welfare was higher in the middle of the season compared with the beginning and end of the season. Regularly turned-out horses resulted in higher horse scores (Linear mixed model, p=0,04, n=120). It can be concluded that the self-report measurement of fatigue and wellbeing can be a useful tool for trainers and riders to better determine the horse’s fatigue and recovery. It should be noted that external factors influence both, rider and horse assessment.

Occupational accidents, despite continuous safety updates, are still a scourge in the occupational and forensic spheres, constituting, among other things, the subject of a large share of litigation. Demographic data can help to understand the areas where the application of health surveillance is lacking. This meta-analysis sets out to analyze data from studies on accidents at work, focusing on the correlation between the areas in which accidents occur and whether or not personal safety equipment is used, about the different regulations in force. For the selection of the data, a systematic review was carried out according to the PRISMA guidelines, with the primary objective of identifying the trend of occupational accidents in specific geographical areas, which differ in terms of the attention paid to preventive aspects. The data we highlighted showed, regarding the type of accident, substantial differences between low-income countries and industrialized countries (stratified according to the Human Development Index) and, an overall indifference as to whether or not individual safety devices were used, revealing that, despite the continuous normative evolution in the field of safety at work, even today, the investigative data on the actual application of the regulations, during accidents at work, is underestimated and little researched.

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

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

Inflammation is implicated in the etiology of obesity-related diseases. Thromboxane-prostanoid receptor (TPR) is known to play a role in mediating an inflammatory response in a variety of cells. Gut-derived lipopolysaccharide (LPS), a TLR4 agonist, is elevated in obesity. Moreover, free fatty acids (FFAs) are important mediators of obesity-related inflammation. However, the role and mechanisms by which TPR regulates the inflammatory response in human immune cells remain unclear. We sought to determine the link between TPR and obesity and the role/mechanisms by which TPR alters LPS or stearic acid (SA)-induced inflammatory response in PBMCs. Cells were pre-treated with agents blocking TPR signaling, followed by treatment with LPS or stearic acid (SA). Our findings showed that TPR mRNA levels are higher in PBMCs from individuals with obesity. Blockade of TPR as well as ROCK which acts downstream of TPR, attenuated LPS and/or SA-induced pro-inflammatory response. On the other hand, TPR activation using its agonist enhanced the pro-inflammatory effects of LPS and/or SA. Of note, TPR agonist by itself elicits an inflammatory response which was attenuated by blocking TPR or ROCK. Our data suggest that TPR plays a key role in promoting an inflammatory response in human PBMCs and this effect is mediated via TLR4 and/or ROCK signaling.

The seed habit is the most complex and successful method of sexual reproduction in vascular plants. It represents a remarkable moment in the evolution of plants that afterwards spread on land. In particular, seed size had a pivotal role as for evolutionary success and agronomic trait, especially in the field of crop domestication. Given that crop seeds constitute one of the primary products for consumption, it follows that seed size represents a fundamental determinant of crop yield. This adaptative feature is strictly controlled by genetic traits from both maternal and zygotic tissues, although seed development and growth are also affected by environmental cues. Despite being a highly exploited topic for both basic and applied research, there are still many issues to be elucidated as for developmental biology as well as for agronomic science. This review addresses a number of open questions related to cues that influence seed growth and size, and how developmental processes are influenced by them. Besides, new insights on the genetic-molecular control of this adaptive trait are presented.

Hydrogen storage in general is an indispensable prerequisite for the introduction of a hydrogen energy based infrastructure. In this respect, high-pressure metal hydride (MH) tank systems appear to be one of the most promising hydrogen storage techniques for automotive applications using proton exchange membrane (PEM) fuel cells. These systems bear the potential of achieving a beneficial compromise of comparably large volumetric storage density, a wide working temperature range, comparably low liberation of heat, and increased safety. The debatable term unstable metal hydride stands in the literature short for metal hydrides with high dissociation pressure at comparably low temperature. Such compounds may help to improve the merit of high-pressure MH tank systems. Consequently, in the last few years, some materials for possible on-board applications in such tank systems have been developed. This review summarizes the state-of-the-art developments of these metal hydrides, mainly including intermetallic compounds and complex hydrides and gives some guidelines for future developments. Since typical laboratory hydrogen uptake measurements are limited to 200 bar, a possible threshold for defining unstable hydrides could be a value of their equilibrium pressure of peq > 200 bar for T < 100°C. However, these values would mark a technological future target and most current materials, and those reported in this review, do not fulfill these requirements and need to be seen as current stages of development towards the intended target. For each of the aforementioned categories in the review, special care was taken not only to covers the pioneering and classical research, but also to portrait the current status and latest advances. For intermetallic compounds, key aspects focus on the influence of partial substitution on absorption/desorption plateau pressure, hydrogen storage capacity and hysteresis properties. For complex hydrides, the preparation procedures, thermodynamics and theoretical calculation are presented. Besides, challenges, perspectives, and development tendency of this field are also discussed.

This paper presents a comprehensive study on applying machine learning (ML) techniques for real-time credit card fraud detection. With the increasing prevalence of credit card fraud, financial institutions face the challenge of detecting fraudulent transactions promptly and accurately. This research evaluates various ML models, including Logistic Regression, Decision Trees, Random Forests, XGBoost, and Deep Convolutional Neural Networks, for their effectiveness in identifying fraudulent activities. Utilizing PySpark for processing large-scale transaction data, the study highlights the importance of real-time analysis, adaptive learning, and handling imbalanced datasets. Key findings reveal that XgBoost, with its balance of accuracy and complexity, emerged as the most promising model, achieving an accuracy rate of 98% in detecting fraudulent transactions. The paper further discusses the potential of ensemble methods, graph-powered systems, and intelligent sampling in enhancing fraud detection capabilities. Challenges such as overfitting, data access, and the need for real-time analysis are addressed. Future research directions include implementing models in live transaction environments, expanding model applicability across financial platforms, and developing advanced anomaly detection methodologies. This study underscores the pivotal role of machine learning in safeguarding financial transactions against fraud, offering significant implications for consumers, financial institutions, and the broader financial ecosystem.

The rural population in the Dry Zone of Sri Lanka is largely affected by Chronic Kidney Disease of Unknown etiology (CKDu). According to the multidisciplinary research carried out so far, quality of groundwater was considered one of the possible causative factors for CKDu. Therefore, the assessment of water quality variations and evolution mechanism of water quality parameters of drinking water sources is important for identifying any relationships between CKDu and the drinking water quality. The current study aimed to perform a detailed hydrogeochemical investigation using isotopic and chemical methods on selected groundwater sources in the CKDu-endemic, non-endemic and control areas. TDS, hardness, Mg2+, Na+ and F- are the main parameters that cause water quality deterioration but, their derived mechanism in these three regions are completely different. The excess concentrations of F- and Mg2+ in the CKDu endemic area, low F- and high Mg2+in the CKDu non-endemic sedimentary formation, and either combinations of low F- and low Mg2+, high F- and low Mg2+ or low F- with high Mg2+ in the control area are the distinct features. The primary processes that regulate the evolution of groundwater types in CKDu endemic and control area is the weathering of silicates. Similarly, in the CKDu endemic area, carbonate dissolution and reverse ion exchange are prominent. Cation exchange and evaporite dissolution are more pronounced in the control area. Shallow groundwaters are evapo-concentrated hence it further deteriorates quality when compared to the deep groundwater with non-mixed, non-evaporated, and higher elevation recharge effect (from 100 m altitude) in the CKDu endemic area. Dilution decreases the ion content in the CKDu endemic area while evaporite dissolution further increase it in the control area after the rainy season. Evaporation, and seawater mixing affected the quality of groundwater in the non-endemic sedimentary formation. A statistically significant difference of F- ionic ratio with Na+, Mg2+, Ca2+ in the endemic and control areas. Intense rock weathering combined with the desorption added excess F- to the groundwater in the CKDu endemic area while the cation exchange and fluorite dissolution is contributing factor in CKDu control area. All the groundwater samples analyzed have exceeded the moderate hardness threshold. However, prominent Mg hardness proportion together with excess F- in the CKDu endemic area may produce nephrotoxic MgF2 complexes that may trigger renal damage. In contrast, produced NaF complexes in the CKDu control area leads to reduction of F- toxicity in the human body. Therefore, increased levels of magnesium, fluoride and TDS in the shallow groundwater, along with geochemical, hydrogeological and climatic factors, may contribute to the CKDu in the Dry Zone of Sri Lanka.

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

With the increased global attention to environmental protection, social responsibility and corporate governance (ESG) standards, integrating ESG into supply chain management (SCM) is becoming a strategic requirement for companies to achieve competitiveness and sustainable development. This study reviews the impact factors of ESG practices on supply chain competitiveness, and empirically examines the mechanism of ESG performance on supply chains through a questionnaire survey with a sample of Chinese SMEs. It was found that normative pressure, coercive pressure and imitative pressure in SMEs have a significant positive effect on cognition and attitude and perceived behavioral control; good corporate cognition and attitude, perceived behavioral control and corporate pressure also enhance the level of ESG practices. Further analysis shows that cognition and attitude and perceived behavioral control play a mediating role in the impact of ESG practices, and ESG performance promotes sustainable development of SMEs. The article puts forward the following suggestions: (1) close supply chain partnerships to enhance green innovation; (2) the government should give more resource support to ESG-invested enterprises and support the development of advantageous enterprises; (3) improve the corporate disclosure mechanism and strengthen the supervision; and (4) strengthen the training of professionals in supply chain ESG management.

The article presents the case of a 27-year-old female patient with idiopathic congenital complete heart block who was referred by her primary care physician for cardiological evaluation. The conduction disturbance was recognized at the age of 6 years and was asymptomatic. The disqualification from pacemaker implantation included detailed history of a patient’s symptoms, echocardiographic assessment of the heart, exercise testing and ECG Holter monitoring. The aid of salbutamol administered orally was also useful.

As the demand of heating and air conditioning is increasing day by day due to getting a comfortable life, for that reason, the market for heat pump and air conditioning systems or both, is seeing a steady increase in low global warming potential. All researchers on heat pump and air conditioning systems are searching for environmentally friendly refrigerants. However, a significant number of contemporary refrigerants (HCFCs) have the potential to cause global warming and ozone depletion, such as those found in heat pump air conditioning systems. Using more environmentally friendly refrigerants, including hydrocarbon and blend refrigerant mixtures, is one way to lower GWP and Ozone depletion potential. This study examines the performance of several alternative refrigerants, including R32, R134A, R410A, R22, and R290. In order to examine the performance of R290, theoretical and simulation results are compared on various refrigerants while taking into account a number of performance parameters, including the refrigerant energy efficiency ratio, mass flow rate, coefficient of performance, cooling capacity, and compressor work for one ton of refrigeration (1TR) air conditioners. One player with a very low GWP is R290. However, the only drawback is that it can catch fire and is hazardous to use in split-type commercial heat pump air conditioning applications. The environmental and thermo physical properties of HC-290 are significantly better than those of other materials, according to theoretical and simulation studies utilizing Cool Pack software, hence it is a viable replacement.

This study uses machine learning to identify key factors influencing the cost-effectiveness of over-the-counter (OTC) medications. By developing a novel cost-effectiveness rating (CER) from user ratings and prices, we analyzed data from Amazon. The findings indicate that FSA/HSA eligibility, symptom treatment range, safety warnings, special effects, active ingredients, and packaging size significantly impact cost-effectiveness across cold, allergy, digestion, and pain relief medications. Medications eligible for FSA or HSA funds, treating a broader range of symptoms, and having smaller packaging are perceived as more cost-effective. Cold medicines with safety warnings were found to be cost-effective due to their lower average price and effective ingredients like phenylephrine and acetaminophen. Allergy medications with kid-friendly features showed higher cost-effectiveness, and ingredients like calcium, famotidine, and magnesium boosted the cost-effectiveness of digestion medicines. These insights help consumers make informed purchasing decisions and assist manufacturers and retailers in enhancing product competitiveness. Overall, this research supports better decision-making in the pharmaceutical industry by highlighting factors that drive cost-effective medication purchases.

Background/aims: Prior research identified a significant association between heart disease and metabolic dysfunction-associated liver steatohepatitis (MASLD), but the mechanisms are unclear. This study aims to search predictive biomarkers for grade I left ventricular diastolic dysfunction (LVDD), an early stage of heart failure (HF), in type 2 diabetes mellitus (T2DM) patients. Methods: This single-center, prospective observational study screened 73 T2DM patients for grade 1 LVDD and MASLD using 2D echocardiography, tissue analysis, spectral color Doppler, and Fibromax. Results: The study analyzed 50 patients (mean age 58±11.3 years) with a median diabetes duration of 7 years, abdominal obesity (mean BMI 34.4±5.9 kg/m2), and a mean HbA1c of 7.9±1.5%. The prevalence of grade I LVDD, fibrosis, mild steatosis, moderate to severe liver steatosis, mild MASLD, and moderate MASLD was 54%, 44%, 14%, 80%, 43%, and 34%, respectively. Regression analysis revealed that grade 1 LVDD was positively associated with age, Fibrotest, ɑ2-macroglobulin, epicardiac adipose tissue (EAT), and negatively associated with lateral s`, E wave, E/e`, E/A, medium E`, and septal e` (p&lt; 0.05 for all). ɑ2-macroglobulin &gt; 1.92 g/L (AUROC= 0.782, sensitivity 70.4%, specificity 81.2%) and fibrotest score &gt; 0.11 (AUROC 0.766, sensitivity 92.6%, specificity 56.2%) were significant predictors of grade I LVDD. Conclusion: HF is a multifaceted disorder associated with multisystem organ damage, including nonalcoholic MASLD. Although the underlying mechanisms remain unclear, innovative non-invasive biomarkers, such as ɑ2-macroglobulin or fibrotest, could concurrently indicate liver stiffness and the likelihood of grade I LVDD, an early, asymptomatic HF stage in T2DM patients.

Mechanical ventilation (MV), used in patients with acute lung injury (ALI), induces diaphragmatic myofiber atrophy and contractile inactivity, termed ventilator-induced diaphragm dysfunction. Phosphoinositide 3-kinase- (PI3K-) is crucial in modulating fibrogenesis during the reparative phase of ALI; however, the mechanisms regulating the interactions among MV, myofiber fibrosis, and PI3K- remain unclear. We hypothesized MV with or without bleomycin treatment would increase diaphragm muscle fibrosis through the PI3K- pathway. Five days after receiving a single bolus of 0.075 units bleomycin intratracheally, C57BL/6 mice were exposed to 6 or 10 mL/kg MV for 8 h after receiving 5 mg/kg of AS605240 intraperitoneally. In wild-type mice, bleomycin exposure followed by MV 10 mL/kg prompted significant increases in disruptions of diaphragmatic myofibrillar organization, transforming growth factor-1, oxidative loads, Masson’s trichrome staining, extracellular collagen levels, positive staining of -smooth muscle actin, PI3K- expression, and myonuclear apoptosis (P &lt; 0.05). Decreased diaphragm contractility and peroxisome proliferator activated receptor- coactivator-1 levels were also observed (P &lt; 0.05). MV-augmented bleomycin-induced diaphragm fibrosis and myonuclear apoptosis were attenuated in PI3K-γ-deficient mice and through AS605240-induced inhibition of PI3K- activity (P &lt; 0.05). MV-augmented diaphragm fibrosis after bleomycin-induced ALI is partially mediated through PI3K-γ. Therapy targeting PI3K-γ may ameliorate MV-associated diaphragm fibrosis.

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

Code summarization plays a vital role in aiding developers with program comprehension by generating corresponding textual descriptions for code snippets. While recent approaches have concentrated on encoding the textual and structural characteristics of source code, they often neglect the global hierarchical features causing limited code representation. Addressing this gap, our paper introduces the Statement-grained Hierarchy enhanced Transformer model (SHT), a novel framework that integrates global hierarchy, syntax, and token sequences to automatically generate summaries for code snippets. SHT is distinctively designed with two encoders to learn both hierarchical and sequential features of code. One relational attention encoder processes the statement-grained hierarchical graph, producing hierarchical embeddings. Subsequently, another sequence encoder integrates these hierarchical structures with token sequences. The resulting enriched representation is then fed into a vanilla Transformer decoder, which effectively generates concise and informative summarizations. Our extensive experiments demonstrate that SHT significantly outperforms state-of-the-art approaches on two widely used Java benchmarks. This underscores the effectiveness of incorporating global hierarchical information in enhancing the quality of code summarizations.

This article aims to analyze the relationship between non-obstructive coronary artery disease (NOCAD) and atrial fibrillation (AF), exploring the underlying pathophysiological mechanisms and implications for clinical management. NOCAD and AF are prevalent cardiovascular conditions that often coexist, yet their interrelation is not well understood. NOCAD, characterized by the presence of atherosclerotic plaques without significant luminal stenosis, can lead to ischemic necrosis of cardiomyocytes and their replacement with fibrous tissue, in this way sustaining the focal ectopic activity in atrial myocardium. Atrial fibrillation, on the other hand, is the most common sustained cardiac arrhythmia, associated with an increased risk of stroke and heart failure, which may accelerate atherosclerosis and may increase oxygen consumption in the myocardium, creating a mismatch between supply and demand, thus promoting the development or worsening of coronary ischemia. Therefore, NOCAD and AF seems to be a complex Interplay with one begets another.

The existence of multiple copies of genes is a well-known phenomenon. A gene family is a set of sufficiently similar genes, formed by gene duplication. In earlier works conducted on limited number of completely sequenced and annotated genomes it was found that size of gene family and size of genome are positively correlated. Additionally, it was found that several atypical microbes deviated from the observed general trend. In this study, we reexamined these associations on a larger dataset consisting of 1484 prokaryotic genomes and using several ranking approaches. We applied ranking methods in such a way that genomes with lower number of paralogs would have lower rank. Until now only simple ranking methods were used; we applied the Kemeny optimal aggregation approach as well. Regression and correlation analysis were utilized in order to accurately quantify and characterize the relationships between measures of paralog indices and genome size. In addition, boxplot analysis was employed as a method for outlier detection. We found that, in general, all paralog indexes positively correlate with an increase of genome size. As expected, different groups of atypical prokaryotic genomes were found for different types of paralog quantities.

Background: Cardiovascular (CV) morbidity and mortality are many times higher in chronic kidney disease (CKD), as well as IgA nephropathy (IgAN), than in the general population. The occurrence of metabolic syndrome (MetS) and metabolic risk factors are independent risk factors for CV disease and renal progression. The study aimed to determine the prognostic role of metabolic profiles in a homogenous group of CKD patients. Methods: One hundred and forty-five IgA nephropathy patients (92 male, 53 female, age 54.7 ± 13 years) with CKD stage 1-4 were investigated and followed for a median of 190 months. The composite (CV and renal) endpoints included all-cause mortality and any CV event such as stroke, myocardial infarction, revascularization (CV), end-stage renal disease, and renal replacement therapy (renal). Results: Patients with MetS had significantly more endpoint events (16/27 patients vs. 15/98 patients, p = 0.001) compared to the nonMetS group. Of the secondary endpoints (CV or renal separately), the rate of the renal and CV endpoints was significantly higher in the MetS group (p = 0.001 and p = 0.029). The primary endpoint independent predictors of survival were dyslipidemia, eGFR, hemoglobin, urine albuminuria, and diabetes mellitus, as determined by Cox regression analysis. Independent predictors of secondary renal endpoint were dyslipidemia, hemoglobin, urine albumin, and eGFR. Predictors of secondary cardiovascular endpoints were gender, BMI, and diabetes. Kaplan-Meier curves showed significant differences in MetS and non-MetS when examined at the combined endpoints (CV and renal) or at each endpoint separately. The primary endpoint rate increased significantly with the increased number of MetS components (MetS comp. 0 vs. MetS comp. 2+, primary endpoints, p = 0.012). Conclusion: Our results showed that the metabolic profile has a prognostic role not only for renal endpoints but also for CV endpoints in IgAN. BMI, hyperuricemia, hypertension, and diabetes have a predictive value for the prognosis of IgA nephropathy.

The climate change constitutes nowadays an enormous global threat for human health and environmental sustainability. The expanding world population and the increased global needs for food production have an important negative impact upon environment. Diet can link human health with environmental sustainability. Food production systems are closely related to anthropogenic greenhouse gas emissions and the aggravation of climate change, and current western type, animal-based, dietary patterns may lead to adverse environmental footprints. In the present narrative review, we address the interconnection of the Mediterranean diet (MD) with climate change and sustainability. MD is a highly recommended dietary intervention for the prevention and management of various endocrine and cardiometabolic diseases. Beyond its evidence-based, health-promoting effects, it also has beneficial environmental impact, reducing greenhouse gas emissions and enhancing biodiversity, food security and sustainability. Based on the evidence reviewed herein, MD should be incorporated within the framework of a “One Health” model, which involves the improvement not only of human health but also of planetary health and food system sustainability. Our review aims to provide a stimulus for health pro-fessionals to strongly recommend the implementation of MD under the current pressure of climate change, despite all barriers, targeting both human health preservation and the planetary well-being.

In recent decades, a number of high-profile cases involving fraud as research misconduct have been in the media and resulted in severe consequences for those convicted. According to the increased cases of allegations and coverage in the media, this reflects a heightened awareness that fraudulent actions exist. Nonetheless, the Office of Research Integrity data suggests that despite the growth in the number of the cases of allegation there has not been a commensurate increase in findings of misconduct. The purpose of this paper is to explore misconduct to better understand what it entails. An analysis of misconduct from the perspective of the definitions of allegations and fraud of is conducted and potential frameworks for understanding both are considered. The paper considers serial-positioning effects of primacy and recency on allegation phenomena, as well as supervenience theory and contextualism as a lens for understanding fraud. Discussion of the relational semantics of the core aspects of fraud and de facto grouping of forms of misconduct. It is concluded that the interrogative pronouns of “what” and “when” could be used to categorize forms of misconduct laying the foundation for the next paper that deconstructs the definition of falsification according to the Public Health Service.

Chronic Myeloid Leukemia (CML) is one of the most commonly found types of myeloproliferative neoplasms, characterized by increased proliferation of granulocytic cells without losing their differentiation ability. Imatinib, a Tyrosine Kinase Inhibitor (TKI), can be effectively used as therapy for CML. However, imatinib can affect bone turnover, thus having clinical implications on the bones of CML patients undergoing long-term imatinib therapy. However, parameters that can accurately describe the bone condition in CML patients receiving imatinib still need further study. A combination of imaging techniques such as Bone Mineral Density (BMD) and bone turnover activity markers such as C-terminal telopeptide of type I collagen (CTX-1) and Osteocalcin has the potential to be used as monitoring parameters for bone density abnormalities in CML patients receiving imatinib. This article explains the rationale for using BMD, CTX-1, and Osteocalcin as monitoring parameters of bone remodeling in CML patients receiving imatinib. First, the physiological process of bone turnover will be explained. Then, we describe the role of tyrosine kinase in bone metabolism. Next, the impact of imatinib on BMD, CTX-1, and Osteocalcin will be explained. In conclusion, the assessment of bone health of CML patients on Imatinib should include both BMD tests and bone turnover marker assays such as CTX-1 and Osteocalcin.

Cloud computing has become a prominent technology due to its important utility service; this service concentrates on outsourcing data to organizations and individual consumers. Cloud computing has considerably changed the manner in which individuals or organizations store, retrieve, and organize their personal information. Despite the manifest development in cloud computing, there are still some concerns regarding the level of security and issues related to adopting cloud computing that prevent users from fully trusting this useful technology. Hence, for the sake of reinforcing the trust between Cloud Clients (CC) and Cloud Service Providers (CSP), as well as safeguarding the CC’s data in the cloud, several security paradigms of cloud computing based on a Third-Party Auditor (TPA) have been introduced. The TPA, as a trusted party, is responsible for checking the integrity of the CC’s data and all the critical information associated with it. However, the TPA could become an adversary and could aim to deteriorate the privacy of the CC’s data by playing a malicious role. In this paper, we present the state-of-art of cloud computing’s privacy-preserving models (PPM) based on a TPA. Three TPA factors of paramount significance have been discussed: TPA involvement, security requirements, and security threats caused by vulnerabilities. Moreover, TPA’s privacy preserving models have been comprehensively analyzed and categorized into different classes with an emphasis on their dynamicity. Finally, we discuss the limitations of the models and present our recommendations for their improvement.

Audit&amp;Feedback (A&amp;F) consists of multidimensional quality improvement activities, but its optimal design is still debated. Our study aims to outline how interventions of the Italian EASY-NET research program were designed, to explore whether desirable characteristics of an "ideal" A&amp;F were adopted. A&amp;F design included description of the working group, targeted clinical behaviors, selected indicators, sources, feedback procedures, corrective actions expected. Information was classified into four topics: nature of the desired action, type of data available, feedback display and delivery. Out of 9 projects, 3/9 aimed at changing a focused clinical behavior, 6/9 were generic; all projects identified clinicians as recipients, 8 explicitly considered managers. It was planned to develop an average of 27 indicators from administrative databases, as needed supplemented by ad hoc data collection. Five projects included outcome measures. Comparators derived from scientific literature or from territorial real-life data. Feedback was scheduled every 12, 6 or 3 months, or upon request, delivered as aggregate data (graphs and tables) via web platforms, e-mail, workshops, and individual meetings. In conclusion, at an early stage the projects were mostly “wide focused”, but improvements in A&amp;F design and delivery have been introduced, and projects, still ongoing, will offer interesting insights on A&amp;F effectiveness.

Landslides are a global and frequent natural hazard, affecting many communities and infrastructure networks. Technological solutions are needed for long-term, large-scale condition monitoring of infrastructure earthworks, or natural slopes. However, current instruments for slope stability monitoring are often costly, require a complex installation process and/or data processing schemes, or have poor resolution. Wireless sensor networks comprising low-power, low-cost sensors have been shown to be a crucial part of landslide early warning systems. Here, we present the development of a novel sensing approach that uses linear arrays of three-axis accelerometers, used for monitoring soil deformation. By combining these deformation measurements with depth-resolved temperature measurements, we can link our data to subsurface thermal-hydrological regimes where relevant. In this research, we present a configuration of cascaded I2C sensors that (i) have ultra-low power consumption and (ii) enable an adjustable probe length. From an electromechanical perspective, we developed a novel board-to-board connection method that enables narrow, semi-flexible sensor arrays and a streamlined assembly process. The low-cost connection method relies on a specific FR4 printed circuit board design that allows board-to-board press-fitting without using electromechanical components or solder connections. The sensor assembly is placed in a thin, semi-flexible tube (inner diameter 6.35 mm) that is filled with an epoxy compound. The resulting sensor probe is connected to a AA battery powered data logger with wireless connectivity. We characterize the system's electromechanical properties and investigate the accuracy of deformation measurements. Our experiments performed with probes up to 1.8 m long demonstrate long-term connector stability, as well as probe mechanical flexibility. Furthermore, our accuracy analysis indicates that deformation measurements can be performed with a 0.390 mm resolution and a 95% confidence interval of ±0.73 mm per meter of probe length. This research shows the suitability of low-cost accelerometer arrays for distributed soil stability monitoring. In comparison to emerging low-cost measurements of surface displacement, our approach provides depth-resolved deformation, which can inform about shallow sliding surfaces.

Introduction: Although aging is a natural phenomenon, in recent years it has accelerated. One key factor implicated in the aging process is oxidative stress. Oxidative stress play also role in frailty (frail) and metabolic syndrome (MetS). Methods: 66 elderly persons (65 years old and older) with no acute or severe chronic disorders were assessed: waist circumference (WC), arterial blood pressure, glycemia, glycated hemoglobin (HbA1c), plasma lipids and activity of erythrocyte superoxide dismutase (SOD-1). Patients were classified as NonMetS-Nonfrail (n=19), NonMetS-frail (n=20), MetS-Nonfrail (n=17), and MetS-frail (n=10). Results: There were no significant differences in superoxide dismutase activity among investigated elderly groups. However, the data suggests that MetS individuals, both frail and nonfrail, have higher risk factors for cardiovascular disease compared to NonMetS individuals. The correlations analyses of SOD-1 and other metabolic indices suggest that SOD-1 levels may be influenced by age, total cholesterol, HDL cholesterol, and fasting glucose levels in certain groups of seniors. Conclusions: Aging is associated with decreased antioxidant enzyme SOD-1 activity with glucose alteration in frailty syndrome as well as with lipids disturbances in metabolic syndrome.

In the wake of increasing digital fraud, this paper introduces an innovative application of Artificial Intelligence (AI) in detecting fraudulent activities across finance, healthcare, and e-commerce sectors. It presents a detailed analysis of machine learning methodologies, specifically focusing on the advantages of supervised, unsupervised, and deep learning techniques. The paper addresses the challenges such as data imbalance, model interpretability, and ethical implications in AI-based fraud detection. It also discusses the necessity of high-quality datasets and advocates for the integration of traditional and advanced machine learning methods to enhance accuracy and adaptability in fraud identification. However, it acknowledges the limitations including computational demands and overfitting risks. The study underscores the importance of collaborative efforts between AI experts and industry professionals to develop ethical, efficient, and reliable AI solutions for fraud detection.

The integration of deep learning models into financial risk prediction and analysis has significantly transformed traditional approaches. While conventional quantitative methods often rely on simplistic metrics like maximum drawdown, the advent of deep learning necessitates a more nuanced evaluation, emphasizing the model's generalization ability, especially during market crises such as stock market crashes. This paper explores the critical aspects of evaluating deep learning models' risk control capabilities in finance, underscoring the importance of understanding both statistical metrics and generalization abilities, particularly in adverse market conditions. By examining deep learning models' performance in scenarios like stock market crashes and highlighting the significance of cross-validation techniques, this study aims to offer practitioners insights into constructing robust risk management systems. It advocates for a comprehensive approach integrating quantitative analysis with macroeconomic factors to enhance financial risk prediction and analysis in volatile markets. The experimentation reveals that different deep generative models excel in various aspects of financial time series analysis, with generative adversarial networks (GANs) demonstrating superior performance in predicting Value at Risk (VaR) and variational autoencoders (VAEs) excelling in return rate prediction. Moreover, integrating multiple models further enhances predictive performance, leveraging the strengths of each model to compensate for individual weaknesses. Overall, this paper underscores the potential and significance of deep generative models in financial time series analysis, offering a roadmap for improved risk management and decision-making in financial markets.

Frequent and excessive consumption of alcohol, be it episodic or sustained misuse, ranks among the top causes of mortality globally. This comprehensive analysis seeks to elucidate how alcohol misuse precipitates death, with a particular focus on associated cardiac anomalies. Notably, the phenomenon of "Holiday Heart Syndrome," linked to binge drinking, is recognized for inducing potentially fatal cardiac arrhythmias. Moreover, persistent alcohol consumption is implicated in the development of alcoholic cardiomyopathy, a condition that underlies heart failure and arrhythmic disturbances of the heart. Additionally, individuals undergoing withdrawal from alcohol frequently exhibit disruptions in normal heart rhythm, posing a risk of death. This review further delves into additional alcohol-related mortality factors, including the heightened likelihood of hypertension, cerebrovascular accidents (strokes), and the connection between excessive alcohol use and Takotsubo syndrome.

This study investigates the impact of specimen size on the mechanical properties of wood, specifically focusing on compression strength, elastic modulus, and Poisson's ratio. Compression tests were conducted using three different specimen sizes (20mm×20mm×30mm, 40mm×40mm×60mm, 60mm×90mm×90mm) in the longitudinal, radial, and tangential directions. Mechanical parameters, failure mechanisms, load-displacement curves, and stress-strain relationships were systematically analyzed for each size. The study also evaluated the influence of specimen size on the accuracy of finite element numerical simulations by utilizing the obtained mechanical parameters. The results reveal a significant correlation between compressive strength and specimen size, indicating a decrease in compressive strength with increasing specimen size. Conversely, elastic modulus and Poisson's ratio exhibit less sensitivity to variations in specimen size. Notably, parameters derived from small-sized specimens (20mm×20mm×30mm) exhibited substantial errors, while those obtained from medium-sized (40mm×40mm×60mm) and large-sized specimens (60mm×90mm×90mm) demonstrated greater reliability, providing precise results in finite element numerical simulations.

Oil-Gan, also known as emblica, is the fruit of the genus Phyllanthus emblica L. The fruits of these trees are high in nutrients and have excellent effects on health care and development values. There are many methods for the management of diabetic nephropathy (DN). However, there is a lack of effective drugs for treating DN from throughout the disease course. The primary aim of this study was to examine the protective effects (including urine analyses, the measurement of inflammatory cytokine levels, and histological examination) and mechanisms of action of an ethyl acetate extract of P. emblica (EPE) on db/db mice, an animal model of diabetic nephropathy, as well as a secondary aim of examining the expression levels of protein kinase Cα (PKCα) in the kidney and its downregulation of vascular endothelial growth factor (VEGF) and fibrosis gene transforming growth factor-β1 (TGF-β1) by Western blot analyses. Eight db/m C57BLKS/J mice were used as the control group. Forty db/db mice were randomly divided into five groups. Treatments included vehicle, EPE1, EPE2, EPE3 (at doses of 100, 200, or 400 mg/kg EPE), or the comparative drug aminoguanidine for 8 weeks. After 8 weeks of treatment, blood samples were collected for analyses of blood glucose, insulin, and HbA1c levels, and pancreatic and kidney tissues were dissected for histological analyses. The present study indicated that the administration of EPE to db/db mice effectively controlled hyperglycemia and hyperinsulinemia by markedly lowering blood glucose, insulin, and glycosylated HbA1c levels. Administration of EPE to db/db mice decreased the levels of BUN and creatinine both in blood and urine and reduced urinary albumin excretion and the albumin creatine ratio (UACR) in urine. Moreover, EPE treatment decreased the blood levels of inflammatory cytokines, including kidney injury molecule-1 (KIM-1), C-reactive protein (CRP), and NLR family pyrin domain containing (NLRP3). Our findings showed that EPE not only had antihyperglycemic effects but also improved renal function in db/db mice. Histological examination of the kidney by immunohistochemistry indicated that EPE can improve kidney function by ameliorating glomerular morphological damage following glomerular injury; alleviating proteinuria by upregulating the expression of nephrin, a biomarker of early glomerular damage; and inhibiting glomerular expansion and tubular fibrosis. Moreover, the administration of EPE to db/db mice increased the expression levels of p- PKCα/t-PKCα but decreased the expression levels of VEGF and renal fibrosis biomarkers (TGF-β1, collagen IV, p-Smad2, p-Smad3, and Smad4), as shown by Western blot analyses. These results implied that EPE as a supplement has a protective effect against renal dysfunction through the amelioration of insulin resistance as well as the suppression of nephritis and fibrosis in a DN model.

Many types of banana (Musa spp.)—one of the most economically important horticultural crops—exist, and their ploidy (diploid, triploid, and tetraploid, usually) and genome types (containing A or/and B genome in most cases) differ. At present, observation and genome type detection are commonly used to identify banana germplasm resources. However, the former is tedious, while the latter cannot distinguish categories below genome types. It is therefore urgent that a simple and effective method for identifying banana germplasm resources is established. We sequenced and analyzed the ribosomal DNA internal transcribed spacer (ITS) sequences of 62 banana germplasm and found that the sequencing peaks, especially the 20 bp region near the 420 bp position (referred to as the “420 bp region”), exhibited relatively recognizable and repeatable polymorphism characteristics. Using the “420 bp region” as a marker, we were able to quickly distinguish bananas belonging to different genome type groups (comprising the AA, AB, AAA, ABB, AAB, ABBB, AAAB, and AAAA groups) or different subgroups in the same genome type group (for example, the Cavendish, Gros Michel, Red, Lakatan, and Ibota Bota subgroups in the AAA group; and the Pisang Raja, Plantain, Pome and Silk subgroups in the AAB group). Moreover, it appeared that Sanger sequencing of ITS could be used for identifying banana hybrid offspring. These results demonstrated that the banana ITS region contains rich genetic information that is useful for genotyping. In general, ITS sequencing simplifies the classification of banana germplasm resources and has potential application in several areas of Musa improvement.

In this work model of mirror elements equilibrium of the micromechanical components is developed, the behavior analysis of the mirror element of micromechanical mirrors in case changing of control voltages of electrostatic actuators is carried out, an expression for determining the maximum value of deflection voltage at which the snap-down effect will take the following form is obtained in case of the influence of the coefficient of the electrostatic rigidity of electrostatic actuators. The developed equilibrium model of mirror elements and the obtained results of modeling can be used at design of micromechanical mirrors with internal suspensions.

Nocardia is an emerging bacterial disease that often affects patients with compromised immune systems. As survival increases, more and more patients are receiving solid organ transplantations, and more patients are cancer survivors and receiving long-term immune system modifying agents or corticotherapy and immunosuppressive agents, organisms that are not harmful in usual circumstances become a public health problem. Carbapenems are usually a second-line therapy in the setting of Nocardia infections. We present the case of a patient who had an immunocompromised status and was diagnosed with Nocardia farcinica, which showed in vitro resistance to carbapenems. The symptoms were non-specific and had a common presentation, although the infection was disseminated and had severe CNS and ocular involvement. The clinical course was more severe when the carbapenem was withdrawn based on the provided antibiogram and markedly improved when clinical judgment considered it might be beneficial. The first case in our region to describe an „in vitro” carbapenem-resistant Nocardia species, that responded „in vivo” differently and we believe it is important to remind clinicians of this potentially severe disease in difficult cases.

Fraudulent transactions pose a significant threat to financial institutions and e-commerce platforms.Machine learning models, trained on historical labeled data (fraudulent vs. legitimate transactions), are often employed to identify and prevent fraud. However, real-world datasets frequently exhibit class imbalance, where fraudulent transactions (minority class) are significantly outnumbered by legitimate transactions (majority class). Machine learning models may perform poorly as a result of this imbalance, underestimating fraud and favouring the majority class. This paper proposes a novel approach to address class imbalance and improve fraud detection accuracy. We explore the implementation of FROST (Feature space RObust Synthetic saTuration) oversampling, a technique specifically designed to generate synthetic samples for the minority class. The FROST function leverages the k-nearest neighbors (KNN) algorithm and a user-defined amplification factor (m) to create synthetic data points that closely resemble existing minority class instances. We integrate the FROST-enhanced oversampling technique into the machine learning pipeline for fraud detection. The paper evaluates the effectiveness of this approach compared to traditional oversampling methods and analyzes its impact on classification accuracy metrics.

M184V is a single-base mutation in the YMDD domain of reverse transcriptase (RT). The M184V resistance-associated mutation is related to virological unresponsiveness to lamivudine (3TC) and emtricitabine (FTC) and induces high-level resistance to these two antiretroviral agents. M184V is rapidly selected in the setting of non-suppressive antiretroviral therapy (ART) and accumulates in the HIV reservoir. There were continuous efforts to evaluate the impact of M184V mutation on the treatment outcomes in people with HIV (PWH). Since lamivudine remains an extensively used part of recommended antiretroviral combinations, M184V is commonly detected in patients with virological failure. ART guidelines do not recommend the use of drugs impacted by resistance-associated mutations as they have been confirmed to comprise a risk factor for virological failure. However, previous authors suggest that 3TC/FTC can remain active even in the presence of M184V. Obtaining the viral resistance profile for each individual both treated or ART-naïve is a key challenge for lifelong treatment management.Given the potential benefits of lamivudine in the ART combinations, the investigation of M184V remains of high interest for clinicians and researchers. This is a review of literature for the challenges in treating both naïve and experienced individuals carrying the M184V resistance mutation, including virological failure, virological suppression, and resistance to ART.

Osteoarthritis is a painful, disabling condition which is increasing in prevalence as a result of an ageing population. With no recognised disease limiting therapeutics, arthroplasty of the hip and knee is the most common and effective treatment for lower limb osteoarthritis, however lower limb arthroplasty has a finite life-span and a proportion of patients will require revision arthroplasty. With increasing life expectancy and an increasing proportion of younger (<65 years) patients undergoing arthroplasty, the demand for revision arthroplasty after implant failure is also set to increase. Statins are cholesterol modulating drugs widely used for cardiovascular risk reduction which have been noted to have pleiotropic effects including potentially influencing arthroplasty survival. In vitro studies have demonstrated pleiotropic effects in human bone cells, including enhancement of osteoblastogenesis following simvastatin exposure, and in vivo studies have demonstrated that intraperitoneal simvastatin can increase peri-implant bone growth in rats following titanium tibial implant insertion. There is evidence also that statins may also influence osseointegration, enhancing bone growth at the bone-implant interface, subsequently improving the functional survival of implants. Data from the Danish Hip Arthroplasty Registry and Clinical Practice Research Datalink in the UK suggest a reduction in the risk of lower limb revision arthroplasty in statin ever-users vs never users, and a time dependent effect of statin administration on reduction in risk of revision. In this article we review the clinical and scientific evidence linking statins and risk of revision arthroplasty.

Introduction: Patients with chronic lymphocytic leukemia (CLL) and multiple myeloma (MM) are susceptible to viral infections, including varicella-zoster virus (VZV) reactivation due to both disease-related and treatment-induced immunosuppression. The recombinant adjuvanted herpes zoster vaccine (RZV) has shown high efficacy in immunocompetent adults, but immunogenicity data in CLL and MM patients is limited. This study evaluates the immunogenicity and safety of RZV in this population. Methods: Patients with CLL and MM vaccinated with RZV (administered in two doses at least one month apart) were included in the study. Pre- and post-vaccination anti-VZV IgM and IgG antibody levels were measured to assess immunogenicity, and adverse events (AEs) were captured for safety evaluation. Results: Seventy-eight patients received both vaccine doses, and 71 had post-vaccination samples. Most of the patients were IgM seronegative and IgG seropositive before vaccination. Pre-vaccination IgG levels were higher in CLL compared to MM patients (p=0.001), while post-vaccination IgG levels significantly increased in both CLL (p<0.0001) and MM (p<0.0001) patients. In actively treated CLL patients, the pre-vaccination IgG levels were significantly lower than in not actively treated patients (p=0.002). Post-vaccination IgG levels were lower in MM patients receiving antiviral prophylaxis concurrently with the vaccination (p=0.013). AEs were reported in 49.4% after the first dose and 48.7% after the second dose, mostly mild (local or low-grade systemic). One case of immune thrombocytopenia was noted. Conclusion: RZV demonstrated strong immunogenicity and acceptable safety in CLL and MM patients, significantly boosting IgG levels, even in actively treated or heavily pretreated patients.

A study analyzed financial statements in the beer sectors of Italy and Spain during 2019-2021 using compositional data analysis (CoDa) to gauge pre- and post-pandemic financial health and aid sector-level decision-making. Geometric averages were employed to mitigate statistical issues, offering more accurate insights than arithmetic averages. The exploratory, quantitative methodology calculated key financial ratios and profitability metrics. Results indicated satisfactory short-term solvency. Returns and margins remained subpar despite pandemic policies. Geometric averages proved essential in portraying sector health accurately, underscoring the need for their use in classic brewing sector ratios. The study also showcased CoDa's efficacy in diagnosing sectoral financial health for informed decision-making. Furthermore, a web analysis revealed varying transparency levels in communicating non-financial indicators, with Spain excelling in waste, water, and energy disclosures, while Italy prioritized energy and waste with less transparency.

The implementation of sentinel lymph node (SLN) biopsy is changing the scenario in the surgical treatment of early-stage cervical cancer and the oncologic safety of replacing bilateral pelvic lymphadenectomy with SLN biopsy is currently under investigation. One of the undisputed values of SLN biopsy is its diagnostic accuracy in detecting low-volume metastases (LVM) via pathologic ultrastaging. In early-stage cervical cancer, the reported incidence of LVM ranges from 4 to 20%. The prognostic impact and the role of adjuvant treatment in patients with LVM is still unclear. Some non-prespecified analyses in prospective studies showed no impact on the oncologic outcomes compared to node-negative disease. However, the heterogeneity of the studies, the differences in the disease stage and the use of adjuvant treatment, and the concomitant pelvic lymphadenectomy (PLND) make any conclusion on this topic hard. Current guidelines suggest considering micrometastasis (MIC) as a node-positive disease, while isolated tumor cells (ITC) as a node-negative disease, with a low level of evidence. This review aims to highlight the unanswered questions about the definition, identification, prognostic and therapeutic role of LVM and underline the present and future challenges we are facing. We hope this review will guide further research, giving robust evidence on LVM and their impact on clinical practice.

MicroRNAs (miRNAs), particularly miR-16 and miR-21, play a crucial role in mul-tiple myeloma (MM) pathogenesis by regulating gene expression. This study evalu-ated the prognostic significance of circulating miR-16 and miR-21 expression levels in 48 patients with MM at diagnosis treated with lenalidomide/dexamethasone (LD) compared with 15 healthy individuals (HI). All patients were treated with LD, 13 at first line and 35 at relapse, of whom 21 were tested twice at diagnosis and before LD initiation. The results revealed significantly lower levels of miR-16 and miR-21 in patients than in HIs, both at diagnosis and relapse, with decreased miR-16 levels at diagnosis, indicating improved overall survival (OS) (p value 0.024). Furthermore, miR-16 and miR-21 levels were associated with disease markers, while both corre-lated with the depth of response and mir-16 with sustained response to LD treatment. The ratios of both miR-16 and miR-21 expression levels (prior to LD treat-ment/diagnosis) below 2 predicted a shorter time to response (P = 0.027) and a longer time to next treatment (P = 0.042), respectively. These findings suggested a prognostic value for serum miR-16 and miR-21 levels in MM, as their expression levels corre-lated with disease variables and treatment outcomes.

BACKGROUND Detecting total cholesterol in dried blood spots could aid in identifying individuals with a high likelihood of familial hypercholesterolemia and could be used as a screening measure. This study aims to assess the diagnostic accuracy of dried blood spots on Whatman 903 paper cards using a manual enzymatic technique. METHODS A total of 394 samples collected as serum and dried blood spots were compared. Cholesterol was determined in serum using the automated reference method, while cholesterol on paper was measured using a manual enzymatic method. Within- and between-day diagnostic variability were analyzed. The correlation between both methods was assessed using Passing-Bablok regression and Bland-Altman plot. Internal validation of our correlation formula was performed on 149 samples, along with external validation of the formula proposed by Corso et al. RESULTS The within- and between-day coefficient of variation was found to be lower than 10.14% and 14.09%, respectively. Method comparison yielded an area under the curve of 0.976, with a standard error of 0.009. Passing-Bablok regression indicated a precision of 0.803 and an accuracy of 0.96. Internal validation precision was measured at 0.716. Regarding internal validation, calculated cholesterol with our regression line did not differ from serum cholesterol analysis, while significant differences were observed in calculated cholesterol levels using the external formula. CONCLUSIONS Total cholesterol analysis in dot blood spots demonstrates high precision and reproducibility. This method reliably enables the incorporation of this biological marker into neonatal screening for familial hypercholesterolemia detection.

With the continuous advancement of digital transformation, digital payments are playing an increasingly important role in the financial industry. This study aims to utilize machine learning models to predict and analyze digital payment behavior. Initially, the background and significance of digital payments in the financial sector are introduced. Subsequently, the current status and trends of traditional digital payment distribution are reviewed, alongside related work on digital payment behavior prediction. Methodologically, principles and applications of machine learning models such as logistic regression, decision trees, and random forests are elaborated, along with experimental design and data preprocessing methods. The experimental results and discussion section illustrates the performance of each model in digital payment prediction and explores their impact on credit decisions. This exploration equips financial institutions with more effective user behavior analysis and risk management tools, thereby fostering future development and application of digital payment technologies.

With the continuous advancement of digital transformation, digital payments are playing an increasingly important role in the financial industry. This study aims to utilize machine learning models to predict and analyze digital payment behavior. Initially, the background and significance of digital payments in the financial sector are introduced. Subsequently, the current status and trends of traditional digital payment distribution are reviewed, alongside related work on digital payment behavior prediction. Methodologically, principles and applications of machine learning models such as logistic regression, decision trees, and random forests are elaborated, along with experimental design and data preprocessing methods. The experimental results and discussion section illustrates the performance of each model in digital payment prediction and explores their impact on credit decisions. This exploration equips financial institutions with more effective user behavior analysis and risk management tools, thereby fostering future development and application of digital payment technologies.

The automobile industry is undergoing technological advancement, which includes breakthroughs such as hybrid cars, electric vehicles (EVs), and self-driving capabilities. However, despite these advances, issues remain, notably in recall management efficiency, security and risk of fraud. To solve these difficulties, the idea of Industry 4.0 has been adopted, which uses technologies such as sensors, IOT’s, and machine learning. Even this technology still has loopholes in the area of security which has been exploited negatively over time. In other to mitigate these loopholes we introduce Blockchain technology as a viable alternative, providing a safe and transparent environment. This study investigates and proposed the use of blockchain to create an enhanced Vehicle Tracking System (VTS) intended at enhancing recall management and reducing fraud in the automobile sector. The proposed solution was discussed in detail and a mock smart contract was also written, which was deployed on the Ethereum Virtual Machine (EVM).

Background Sarcopenia is a state with progressive and generalized loss of skeletal muscle mass and strength. It is a serious complication occurring in chronic kidney disease (CKD) patients which increases morbidity and mortality rate. Sarcopenia is diagnosed when loss of both compartments - muscle strength and skeletal muscle quality or quantity are present. However, there are still numerous patients, also with CKD, diagnosed as pre-sarcopenic individuals with low muscle strength and normal skeletal muscle quality or quantity and conversely, with correct muscle strength and decreased skeletal muscle mass, who are prone to develop sarcopenia in future life. It is crucial to examine numerous variables possibly associated with changes of skeletal muscle mass and muscle strength in terms of preventing the development of sarcopenia. The aim of the study was to investigate anthropometric and clinical correlates and sources of variation in both skeletal muscle mass and muscle strength in advanced stages of CKD. Methods The study sample consisted of 84 non-dialysis dependent patients of both sexes (including 45.2% of women) with eGFR < 45 ml/min/1.73m²: 26.2% with eGFR 30-44 mL/min/1.73 m², 65.5% with eGFR 15-29 mL/min/1.73 m² and 8.3% with eGFR < 15 mL/min/1.73 m². Muscle strength was estimated by measuring hand grip strength (HGS) with the use of handheld hydraulic dynamometer. Muscle quantity was measured by bioimpedance spectroscopy using Body Composition Monitor. Appendicular skeletal muscle mass (ASM) was calculated according to Lin’s formula. Serum creatinine, urea, uric acid and albumin were measured. Results In bivariate analysis we found that ASM significantly and positively correlated with anthropometric variables such as body mass (r=0.903, p<0.001), NH weight (r=0.882, p<0.001), height (r=0.694, p<0.001), body mass index (BMI) (r=0.701, p<0.001), lean tissue mass (LTM) (r=0.664, p<0.001), lean tissue index (LTI) (r=0.433, p<0.001), fat mass (r=0.614, p<0.001) and fat tissue index (FTI) (r=0.449, p<0.001), and was negatively associated with clinical variable such as hydration status (p<0.001). HGS significantly and positively correlated with anthropometric parameters such as body mass (r=0.319, p=0.003), NH weight (r=0.315, p=0.004), height (r=0.666, p<0.001), LTM (r=0.490, p<0.001), LTI (r=0.238, p=0.029), and ASM (r=0.501, p<0.001), and was negatively associated with clinical variables like uric acid (p=0.039) and urea (p<0.001). After adjustment for age, sex and height, HGS remained significantly and negatively related with uric acid (β=-1.078, p=0.041) and hydration status (β=-0.805, p=0.042). Conclusions In CKD patients, ASM is determined mainly by anthropometric parameters but HGS - both by anthropometric and clinical variables specific for CKD.

This paper draws upon the theory of turbulence in physics to explore the similarities and differences between volatility in financial markets and turbulent phenomena at a statistical physics level. By analogizing the dynamics of financial markets with fluid turbulence, we have developed an innovative analytical framework aimed at deepening the understanding of the complexity inherent in financial markets. Our research methodology includes a comparative analysis of simulated time series data for the Standard & Poor's 500 Index and fully developed turbulent velocity time series. We focus on the similarities in key statistical physical properties, including probability distributions, correlation structures, and power spectral densities. Furthermore, we have established a model of capital flow in financial markets and proposed corresponding solutions. Through computational simulations and data analysis, we find that while financial market volatility shares some statistical characteristics with turbulent phenomena, significant differences exist in the shapes of probability distributions and the temporal scales of correlations. This suggests that although financial markets exhibit patterns akin to turbulence, the behavior of this complex, multi-variable driven system does not completely correspond to natural turbulence, highlighting the limitations of directly applying turbulence theory to financial market analysis. Our study offers a new perspective for the theories of financial markets and the field of econophysics, providing fresh insights into the complexity of financial markets and contributing to the prevention and management of financial risk.

With the digital transformation of the logistics industry, smart logistics algorithms have become a core technology to improve efficiency and reduce costs. This paper reviews the development history of traditional logistics technology and discusses the key role of technologies such as the Internet of Things, big data analysis, artificial intelligence, and automation in logistics technology innovation. It focuses on the application of intelligent logistics algorithms in path optimization, intelligent scheduling, data mining and prediction, and intelligent warehousing. To solve the problem of inconsistency between training and testing objectives, this paper proposes DRL4Route, a deep reinforcement learning-based path optimization framework, and designs the DRL4Route-GAE model. Validated through extensive offline experiments and online deployments, the model significantly outperforms existing optimal benchmark methods on real datasets, improving the location deviation squared metrics and the top-three location prediction accuracy metrics. These research results provide important support to further promote the intelligent development of the logistics industry.

Ultrasound (US) scans of the inferior vena cava (IVC) provide useful information on the volume status of a patient. However, their investigation is user-dependent and prone to measurement errors. An important technical problem is the objective difficulty in studying a very compliant blood vessel like IVC, which makes large respirophasic movements and shows a complicated three dimensional geometry. Using bi-dimensional (2D) B-mode views either in long or short axis has improved the characterization of IVC dynamics compared to a measurement along a single direction (M-mode). However, specific movements of the IVC can challenge also the information provided by these 2D sections. Thus, these two orthogonal views, provided by an US system in X-plane, are here integrated by an innovative method. It is tested on simulated videos of the IVC performing complicated movements, that are compensated by the new method, overcoming the biased measurements provided by 2D scans. The method is then applied on example experimental data.

Taiwan’s Chi Mei Medical Center has a vision of becoming a sustainable organization. They found they violated the sustainable development goal (SDG) 13 (“Climate Action”) since its workflows consume excessive tangible resources and waste much operation time. To fulfill the vision, the Chi Mei Medical Center first introduced electronic invoicing. Implementing this electronic invoicing included adopting cloud E-invoice data and creating a software robot for auditing them. This study presents this software robot and its contributions. The software robot replaces an internal auditor to log into Taiwan’s E-invoice platform, download cloud E-invoice data, and detect the inconsistency between these cloud and on-premise data. Internal auditors of the Chi Mei Medical Center only needed to confirm the detection results. They welcome this software robot since it significantly reduces their work burdens. They approved more software robots for assisting other workflows. Besides, the Chi Mei Medical Center earned profits after eliminating paper invoices. This elimination helped release less carbon. This study concludes that chasing a sustainable organization is unnecessarily equivalent to the requirement of more costs. A software robot represents the last puzzle for constructing a paperless workflow since it can resolve the resistance of existing workers to a new workflow.

In wireless sensor networks (WSNs), each sensor node can estimate the global parameter from the local data in distributed manner. This paper proposed a robust diffusion estimation algorithm based on minimum error entropy criterion with self-adjusting step-size, which are referred to as diffusion MEE-SAS (DMEE-SAS) algorithm. The DMEE-SAS algorithm has fast speed of convergence and is robust against non-Gaussian noise in the measurements. The detailed performance analysis of the DMEE-SAS algorithm is performed. By combining the DMEE-SAS with diffusion minimum error entropy (DMEE) algorithms, an Improving DMEE-SAS algorithm is proposed, in non-stationary environment where tracking is very important. The Improving DMEE-SAS algorithm can avoid insensitivity of the DMEE-SAS algorithm due to the small effective step-size near the optimal estimator, and obtain a fast convergence speed. Numerical simulations are given to verify the effectiveness and advantages of these proposed algorithms.

As companies increasingly undergo digital transformation, the role of talent management pro-cesses becomes pivotal in enhancing overall organizational performance. The research addresses the significance of talent management in corporate digital transformation, examining whether variations in the digitalization of these processes can be attributed to company size. A qualitative approach was employed, utilizing a questionnaire, collecting responses from 202 organizations across diverse sectors. Findings reveal disparities in digitalization throughout the talent man-agement process, with pronounced presence in the attracting, selecting, and rewarding phases, but diminishing in deployment and development, further declining in planning. A positive cor-relation between company size and adoption of specific digital platforms was observed. Larger enterprises exhibit greater utilization of digital platforms in talent deployment and development. Moreover, corporate communication tools are consistently utilized in the rewarding phase, irre-spective of company size. These findings offer practical insights for organizations to optimize their digitalization strategies based on their scale, thereby contributing to more effective and tailored digitalization endeavors. The uniqueness of this research lies in its exploration of the in-fluence of company size on the digitalization of talent management processes and its potential to explain variations across different stages of these processes.

The Distributed eLearning Center (DeLC) is a portal, providing extensive support in the day-to-day work when it comes to e-learning content – it helps students and teachers organize their learning materials, fill the gaps in knowledge (for students) and educational approaches (for teachers), organize and conduct exams, and overall, with providing proactive and personalized e-learning environment. The scope of DeLC as a project involves many extensions, covering the aspects of learning, teaching, exams, and collecting statistical information. Such extension is an agent-oriented environment, which enriches the functionalities with intelligent components, that are reactive and proactive, referred to as agents or assistants. This paper is focused on presenting the latest step in the evolution of FraudDetector software agent, which started with base functionality for fraud detection, and now it aims at usage of AI to accomplish its tasks, taking advantage not only from its knowledgebase, but from a much larger one, used by ChatGPT – through integration with it, which is the main contribution of this research, although the real results from production environment are still pending. In this process, agent’s architecture should stay open for collaboration with another external AI provider if necessary, trying to decouple the components, responsible for integration. As of now, the experiments show that involving ChatGPT in FraudDetector’s functionality enriches it and the agent’s precision could be improved this way.

This study examines the moderating effect of trained human capital on the associations of accounting information systems, generalized auditing software, and technology adoption with the performance of external auditors among Saudi listed companies. This study used a survey-based methodology. The final sample consisted of 136 responses with an 8% response rate. Using Smart-PL4 analysis, the results showed that there is a positive correlation between accounting information systems and external auditors. Conversely, a negative relationship between generalized auditing software and external auditors has been documented. In addition, this study reported a negative association between technology adoption and external auditors. However, the results highlight the positive relationship between trained human capital and external auditors. Overall, this study provides valuable insights for accounting and auditing policymakers on how external auditors’ performance is influenced by several factors in the Saudi audit market.

Immune checkpoint inhibitors (ICI’s) are in the forefront of advanced Non Small Cell Lung Cancer (NSCLC) treatment. Still, only 27- 46% of patients respond to initial therapy with ICI’s and of those, up to 65% develop resistance within four years. After disease progression (PD), treatment options are limited, with 10% Objective Response Rate (ORR) to second or third-line chemotherapy. In this context, ICI rechallenge is an appealing option for NSCLC. Most data on the efficacy of ICI rechallenge are based on retrospective real-world studies of small, heavily pretreated, and heterogeneous patient groups. Despite these limitations, these studies suggest that ICI monotherapy rechallenge in unselected NSCLC patient populations who discontinued initial ICI due to PD is generally ineffective, with a median Progression-Free Survival (PFS) of 1.6-3.1 months and a Disease Control Rate (DCR) of 21.4%-41.6%. However, there is a subpopulation that benefits from this strategy, and further characterization of this subgroup is essential. Furthermore, immunotherapy rechallenge in patients who discontinued initial immunotherapy following treatment protocol completion and progressed after an immunotherapy-free interval showed promising efficacy, with a DCR of 75-81%, according to post-hoc analyses of several clinical trials. Future research of ICI rechallenge for NSCLC should focus on better patient stratification, to reflect the underlying biology of immunotherapy resistance more accurately.

This study evaluates literature on the wheel of audit partners in Chinese companies and institutions by examining the impact of relationships before and after the rotation between the input and output partners. We consider the partners in the rotation before the rotation, before the work relationship. We find two different results from the previous working relationships: (a) increasing the likelihood of the outgoing partners after the cooling period, and (b) reducing the quality of the audit and lower accounting after the rotation. These findings ask whether the rotational partners are truly independent of the working relationships.

This paper presents design and optimization of a small-size electromagnetic induction heating control system powered by a 3.7V-900mAh lithium battery and featuring an LC series resonant full bridge inverter circuit, which can be used in small size materials heating applications, such as micro medical devices. The effects of resonant capacitance, inductor wire diameter, heating tube material and wall thickness are studied to maximize the heating rate of the workpiece and meantime reduce the temperature rise of the NMOS transistor. The optimal circuit configuration meeting the design requirements was finally identified via comparing the operational parameters and NMOS transistor loss under different circuit conditions. The validation experiments were conducted on a designed electromagnetic induction smoking devices. The results indicate that under an output current of 4.6A, the heating tube can reach up to the temperature target of 250℃ within 11 seconds, and all NMOS transistors stay below 50°C in a 5 minutes heating process.

Design process can be divided into stages of analysis and synthesis. This paper presents the application of the object-oriented technique to the synthesis as well as theoretical considerations concerning to design of gear size ranges. The synthesis consists in composition (aggregation) of single details into units – according to the rule: “from details up to general view”. The basics of the object-oriented synthesis were formulated. Furthermore, the consecutive stages of synthesis were formulated. The interactions between these stages were discussed. Some aspects were described in details e.g.: creation of interfaces for performance of the embodiment phase the designed artefact via CAD system drawing with specification (dimensions are still parametrically set). The final step of the procedure is creation of so called substantial (concrete) form of artifacts i.e. final assignment of dimensions which stored in the special data base. The final stage of the design process is issuing of technical documentation (technical drawings) created automatically via CAD system. The considerations are terminated by the list of advantages connected with the object-oriented approach to design (in comparison to the traditional way).

World health is increasingly threatened by the growing number of spice-related food hazards. Further development of reliable methods for rapid, non-targeted identification of counterfeit ingredients within the supply chain is needed. ENEA has developed a portable, user-friendly photoacoustic laser system for food fraud detection, based on a quantum cascade laser and multivariate calibration. Following a study on the authenticity of saffron, the instrument was challenged with a more elusive adulterant, olive leaves in oregano. The results show that the reported method of laser sensing and chemometric analysis was able to detect adulterants at mass ratios of at least 20% in less than five minutes.

Infection with human immunodeficiency virus (HIV) and induced acquired immune deficiency syndrome (AIDS) represent one of the greatest health burdens worldwide. The complex pathophysiological pathways that link highly active antiretroviral therapy (HAART) and HIV infection per se with dyslipidemia make the management of lipid disorders and the subsequent increase in cardiovascular risk essential for the treatment of people living with HIV (PLHIV). Amongst the HAART regimens, darunavir and atazanavir in terms of protease inhibitors, tenofovir disoproxil fumarate, nevirapine or rilpivirine in terms of nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors respectively, and especially integrase inhibitors, have demonstrated the most favorable lipid profile emerging as sustainable options in HAART substitution. To this day, statins remain the cornerstone pharmacotherapy for dyslipidemia in PLHIV, although important drug-drug interactions with different HAART agents should be taken into account upon treatment initiation. For those intolerant or not meeting therapeutic goals, the addition of ezetimibe, PCSK9, bempedoic acid, fibrates or fish oils should also be considered. This review summarizes the current literature on the multifactorial etiology and intricate pathophysiology of hyperlipidemia in PLHIV, with an emphasis on the role of different HAART agents, while also providing valuable insights into potential switching strategies and therapeutic options.

The combined use of lasmiditan and triptan is unexplored in medical literature. This study aimed to investigate whether the intake of lasmiditan following triptan improves migraine pain. Following triptan intake, if headache relief was less than 50% at 1 hour, patients took 50 mg lasmiditan within 2 hours of migraine onset. Patients recorded headache intensity and adverse events(AEs) caused by lasmiditan at 1, 2, and 4 hours after intake of additional 50 mg of lasmiditan. A significant reduction in pain scale was observed post 50 mg lasmiditan intake (p &lt; 0.001, t-test). Pain relief was reported for 32 migraine attacks (80%) at 1 hour after additional lasmiditan intake. Although AEs were observed in 63% of the patients who took an additional lasmiditan, most were mild and resolved 1 hour after lasmiditan intake. Our study revealed the significant headache reliefs provided by an additional lasmiditan for patients who did not achieve satisfactory results following initial triptan intake for treating migraine. The AEs associated with this treatment strategy were mild and lasted for a short term. This study suggested that the combination of triptan and lasmiditan is promising for the treatment of migraine and should be studied in a randomized placebo-controlled trial.

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths. Classically, liver transplantation (LT) can be curable for HCC tumors within the Milan criteria. Bridging strategies to reduce the dropouts from LT waiting lists or/and to downstage patients who are beyond Milan criteria are widely utilized. We conducted a literature-based review to evaluate the role of systemic therapies as a bridging treatment to liver transplantation (LT) in HCC patients. Tyrosine Kinase Inhibitors (TKIs) can be used as a bridging systemic therapy to LT in patients with contraindication to locoregional liver-directed therapies. Immune Checkpoint Inhibitors (ICIs) treatment can be utilized either as a monotherapy or as a combination therapy with Bevacizumab or TKIs prior to LT. Acute rejection post liver transplantation is a concern in the context of ICIs treatment. Thus, a safe ICI washout period before LT and cautious post-LT immunosuppression strategies are required to reduce post-LT rejections and to optimize clinical outcomes. Nevertheless, prospective clinical trials are needed to establish definitive conclusions about the utility of systemic therapy as a bridging modality prior to LT in HCC patients.