Preserving and restoring biodiversity is becoming a great challenge as we face a world where planetary boundaries will likely be crossed over the following decades. Such challenge needs to consider multiple scales of complexity, both in space and time. A common thread in most cases is the presence of nonlinear phenomena generating shifts among alternative states. These breaking points imply a new perception of risk and different management strategies. A broad range of phenomena affect the preservation of healthy communities and constrain the ways to deal with conservation, from local features associated with habitat loss or facilitation to mesoscale or global network-level ecological complexity and the role played by extreme events. How are these scales connected? How can the emergent properties associated with ecosystem dynamics be exploited? Here a synthesis of ideas is presented, with a complex systems view of the different scales involved, the emergent phenomena separating them, and the universal properties that allow defining simple models on each scale.

Background: Escalating climate change concerns have prompted the healthcare sector, particularly anaesthesia, to reassess its practices to align with environmental sustainability. Anesthetic gases like desflurane, sevoflurane, and isoflurane significantly impact the environment due to their high Global Warming Potentials (GWPs) and prolonged atmospheric lifetimes. This manuscript investigates these impacts and advocates for strategies to reduce the carbon footprint of anesthetic care while maintaining patient safety. Methods: We reviewed the environmental impacts of anesthetic gases and explored various strategies for sustainable anaesthesia. These strategies include adopting anesthetics with lower GWPs, enhancing recycling and waste reduction techniques, transitioning to intravenous anaesthesia, and implementing low-flow anaesthesia methods. We also examined barriers to these strategies, such as educational gaps, technological challenges, resistance to change, and policy limitations. Results: Adopting anesthetics with lower GWPs, such as sevoflurane over desflurane, and implementing low-flow anaesthesia can significantly reduce greenhouse gas emissions. Recycling and waste reduction techniques, though challenging, offer additional environmental benefits. Transitioning to intravenous anaesthesia can eliminate the direct GWP contributions from volatile anesthetic gases. However, these strategies require comprehensive education, advocacy for research and innovation, strategic change management, and supportive policies. Conclusions: Continuous monitoring and evaluation are crucial to ensure the effectiveness of sustainable practices in anaesthesia. Establishing robust Key Performance Indicators (KPIs) and utilizing advanced analytical tools will enable the anaesthesia community to adapt and refine practices. Collaborative efforts among clinicians, policymakers, and stakeholders are essential to significantly reduce the environmental impact of anaesthesia and promote ecological responsibility within healthcare.

The aims of this paper are twofold. First, it is shown, for the first time, which types of nonsmooth functions are characterized by all vector critical points as being efficient or weakly efficient solutions of vector optimization problems in constrained and unconstrained scenarios on Hadamard manifolds. This implies the need to extend different concepts, such as the Karush--Kuhn--Tucker vector critical points and generalized invexity functions, to Hadamard manifolds. The relationships between these quantities are clarified through a great number of explanatory examples. Second, we present an economic application proving that Nash's critical and equilibrium points coincide in the case of invex payoff functions.

This study sought to investigate the problem of losses along the milk value chain in Nandi and Kakamega Counties in Kenya. Using semi structured questionnaire, quantitative data were collected from different stages of the value chain consisting of 400 dairy farmers proportionally and randomly selected in Chesumei and Ikolomani sub counties; 15 cooperatives, 40 transporters, 20 milk bars, 17 supermarkets. Additionally Key informant interviews and focus group discussions we held with extension staff and farmers, respectively.The results showed losses occurred at all stages of the value chain in Nandi and Kakamega Counties with the highest losses at Cooperative (50.6%), collection centres (33.7%) and milk bars (7.5%). Annual milk loss was estimated to be 260,000 litres and 20,000 litres in Nandi and Kakamega counties respectively. The economic value of losses per year was estimated at KES 13 million (USD 100 000). Significant factors (P<0.001) influencing milk losses at farm level were: type of cow housing, level of training of milker, mixing morning and evening milk and Lack of cooling facilities. In cooperatives, poor roads, poor preservation of milk and mastitis influenced post harvest losses (PHL) causing milk rejection due to spoilages; while transporters attributed PHL to storage during transportation. Inadequate storage facilities and milk handling practices influenced PHL in milk bars while supermarkets attributed PHL to poor packaging materials and short shelf life. The most important causes of milk PHL along the chain were spoilages, spillages, adulteration and physical dirt. Key interventions to minimize PHL should target improvement of rural road infrastructure connecting farmers to markets; milk storage facilities and capacity building on milk handling practices for all actors. A sustainable PHL reduction should entail policy dialogue on milk payment system based on quality rather than quantity.

The interband transitions of urania (UO2) are validated independently through cathode luminescence of UO2. A picture emerges consistent with density functional theory. While theory is generally consistent with experiment, it is evident that the choice of functional can significantly alter the band gap and some details of the band structure, in particular at the conduction band minimum. Strictly ab initio predictions of the optical properties of the actinide compounds, based on density functional theory alone continues to be somewhat elusive.

Introduction Sepsis-associated encephalopathy (SAE) is common in sepsis and is linked to high mortality and impaired neurologic outcome. Brain ultrasonography (US), including transcranial Doppler (TCD) and transcranial color-coded duplex sonography (TCCS), is a non-invasive tool for cerebral monitoring and might be useful in sepsis. The aims of this review are: 1) to explore whether brain perfusion is altered in sepsis, 2) to determine the role of brain US in guiding resuscitation, and 3) its ability to predict neurological outcomes in septic patients. Materials and methods This scoping review adhered to the PRISMA-ScR protocol and JBI methodology. A comprehensive literature search was conducted across MEDLINE, Scopus, and Web of Science. The review included studies on adults with sepsis or septic shock in the ICU. Randomised controlled trials, clinical trials, observational studies and systematic reviews were included. All the data related to the review's key questions were extracted and charted independently by two authors. Results 625 articles were screened, and 34 were ultimately included after application of exclusion criteria. 85% of the studies were observational 15% were systematic reviews with or without meta-analysis. The studies primarily focused on cerebral blood flow (CBF) alterations in sepsis, reporting variable results. Findings showed variable cerebral autoregulation (CAR) impairment, with higher incidence in the early stages of sepsis and associations with poor neurological outcomes. However, while alterations in CAR and CBF are common in septic patients, their impact on neurological outcomes and mortality is not clear. Regarding resuscitation, only a paucity of studies were found and no conclusions can be drawn. Conclusions The current body of evidence has a poor grade, but it is possible to say that brain US can identify cerebral perfusions alterations. Its usage during resuscitation is feasible and warrants further investigations. Use of brain US during resuscitation and for prediction of outcome is not currently supported by evidence. Further studies on brain perfusion, acquisition of 2D images of parenchyma (TCCS) and application of a multimodal brain monitoring might be useful in these contexts.

Introduction: Atrial fibrillation (AF) is a common cardiac arrhythmia whose prevalence rises with age and is linked to increased morbidity and mortality due to the risk of thromboembolism. Management typically involves anticoagulation and rhythm control, but the treatment of elderly patients with multiple comorbidities requires careful consideration of drug side effects and interactions. Cibenzoline, a Vaughan-Williams class IA antiarrhythmic, is effective against AF but has risks of toxicity, especially in older people and those with renal impairment, due to its renal excretion and prolonged half-life in these populations. Discussion: This paper presents a case of an 80-year-old woman with paroxysmal AF who suffered cardiac arrest due to cibenzoline toxicity despite receiving standard adjusted dosages. The patient's cibenzoline blood concentration was significantly higher than the therapeutic range, leading to cardiotoxicity, which was exacerbated by drug interactions with bisoprolol and edoxaban, both metabolized by the CYP3A4 enzyme. Venoarterial extracorporeal membrane oxygenation (V-A ECMO) and intra-aortic balloon pump (IABP) successfully managed the cardiac arrest. This case emphasizes the unpredictable pharmacokinetics of cibenzoline in elderly patients with renal impairment and the need for vigilant therapeutic drug monitoring to avoid adverse events. Conclusions: Cibenzoline can pose a significant risk of severe toxicity in elderly patients with renal impairment, and drug interactions may potentiate this risk. The paper underscores the importance of careful dose adjustment and monitoring of drug levels in this population. In cases of cibenzoline-induced cardiac arrest, V-A ECMO and IABP are effective treatment modalities. The case study serves as a critical reminder for clinicians to remain vigilant for drug-induced complications and to apply aggressive supportive treatments when necessary.

Acute Respiratory Distress Syndrome (ARDS) is a severe lung condition with a high mortality rate for which there are no effective therapeutics. The failure of the alveolar-capillary barrier, composed of lung endothelial (EC) and alveolar epithelial (AEC) cells, is a critical factor leading to excessive inflammation and edema characteristics of acute lung injury (ALI). Phosphodiesterases (PDE) are enzymes well-recognized for their roles in regulating endothelial permeability and inflammation. Although PDE inhibitors are used as therapeutics for inflammatory diseases like COPD (chronic obstructive pulmonary disease), their efficacy in treating ARDS has not yet been established. In this study, we investigate the effects of ensifentrine, an FDA-approved novel dual PDE 3/4 inhibitor, on lung endothelial and epithelial dysfunction caused by methicillin-resistant S. aureus (MRSA), a pathogen involved in bacterial ARDS. Human primary lung endothelial cells and alveolar epithelial cell lines (A549 and immortalized AEC) were treated with heat-killed MRSA, and their responses were assessed in the presence or absence of ensifentrine. Ensifentrine given either pre- or post exposure attenuated MRSA-induced increased lung endothelial permeability. VE-cadherin junctions, which serve to stabilize the EC barrier, were disrupted by MRSA; however, ensifentrine effectively prevented this disruption. Pre-treatment with ensifentrine protected against MRSA-induced EC pro-inflammatory signaling by inhibiting the expression of VCAM-1, ICAM-1, and by reducing the IL-6 release. In AEC, MRSA caused upregulation of ICAM-1, activation of NF-kB and production of IL-8, all of which were inhibited by ensifentrine. These results indicate that dual inhibition of phosphodiesterases 3 and 4 by ensifentrine is barrier protective and attenuates MRSA-induced inflammation in both lung endothelial and epithelial cells. The PDE3/4 inhibitor ensifentrine may represent a promising novel strategy for the treatment of ALI.

Enhancing traffic safety is one of the fundamental objectives of Intelligent Transport Systems (ITS), and it aligns closely with the principles of sustainable transport. Due to specific differences in infrastructure, vehicles, and users’ behaviour, places where different modes of traffic intersect are recognized as critical points of the traffic system, making them crucial aspects of Sustainable Urban Mobility Plans (SUMPs) implementation. The SUMPs aim to create urban mobility that is not only environmentally friendly and efficient but also safe for all users. The continuous development and widespread adoption of innovative ITS technologies have paved the way for a system that could provide drivers with real-time information about both immediate and potential dangers at these critical points. This paper provides an overview of previous research in the field, investigating the impact of information systems on drivers’ behaviour, various detection and communication solutions that can be effectively integrated into such a system, as well as a brief overview of models and solutions that have been developed to warn drivers in a similar context. The reviewed literature offered valuable insights on which a novel driver information system architecture framework is proposed. This framework can contribute to the ongoing safety improvement in multimodal transport networks within the context of sustainable transport.

Background/Objectives: The 28-day mortality rate for septic shock is high, necessitating rapid and effective empiric antimicrobial therapy. This study investigates whether the rate of catecholamine dose reduction in septic shock can indicate bacterial susceptibility to initial antimicrobial therapy. Methods: This retrospective observational study involved 108 adult patients with bacteraemia and septic shock admitted at the intensive care unit of Nihon University Itabashi Hospital between January 2017 and December 2023. They were classified into the Susceptible or Resistant group based on the bacteria’s susceptibility to the initial empiric antimicrobial therapy. Catecholamine dosages were converted to norepinephrine equivalent (NEE) scores, with the time course from peak to end of administration measured at NEE reductions. Results: Of the 108 patients, 94 were in the Susceptible group and 14 in the Resistant group. The Susceptible group showed faster reductions in catecholamine doses: time to reduce the dose from the maximum NEE to 25% was 19 vs. 49.5 hours (p = 0.0057); and 0%, 29 vs. 54 hours (p = 0.0475). Conclusions: In septic shock with bacteraemia, faster catecholamine dose reduction indicates bacterial susceptibility to initial empiric antibiotics. This reduction rate can serve as an early clinical indicator of appropriate initial empiric therapy.

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.

Fever control is essential in patients with severe traumatic brain injury (TBI). The efficacy of therapeutic hypothermia (TH) in severe TBI has been investigated over the last few decades; however, in contrast to experimental studies showing benefits, no evidence of efficacy has been demonstrated in clinical practice. In this review, the mechanisms and history of hypothermia were briefly outlined, while the results of major randomized controlled trials (RCTs) and meta-analyses investigating TH for adult TBI are introduced and discussed. The retrieved meta-analyses showed conflicting results, with a limited number of studies indicating benefits of TH. Some studies have shown benefits of long-term TH compared with short-term TH. Although TH is effective at lowering elevated intracranial pressure (ICP), reduced ICP does not lead to favorable outcomes. Low-quality RCTs overestimated the benefits of TH, while high-quality RCTs showed no difference or worse outcomes with TH. RCTs assessing standardized TH quality demonstrated the benefits of TH. As TBI has heterogeneous and complicated pathologies, applying a uniform treatment may not be ideal. A meta-analysis of young patients who underwent early cooling and hematoma removal showed better TH results. TH should not be abandoned, and its optimal should be advocated on an individual basis.

The Gaussian signaling strategy with power control for the Gaussian Z-interference channel with weak interference is reviewed in this paper. In particular, we study the various communication strategies that may arise at various points of the capacity region and identify the locations of the phase transitions between the various strategies. The Gaussian Z-interference channel with weak interference is known to have two critical points in its capacity region, where the slope of the region shows a sudden change. They occur at the points of the unconditional maximum rate for one of the users and the maximum rate that can be accommodated by the other user. In this paper, we discuss two additional critical points (locations of phase transitions) in the achievable region of this channel. At these points, we do not observe a discontinuous slope in the achievable rate region, but there is a discontinuity in the second derivative of the rate contour of the achievable region. This review paper is mainly based on some of our ITA (Information Theory and Applications Workshop, UCSD, San Diego, CA, USA) papers since 2011.

Merkel cell carcinoma (MCC) is a rare, highly aggressive skin cancer characterized by two etiologies: the first one, observed in most cases, is attributed to Merkel cell polyomavirus (MCPyV), a DNA tumor virus, while the second one is due to ultraviolet (UV) radiation exposure. Currently, there are limited diagnostic, prognostic, and therapeutic biomarkers available for MCC. MicroRNAs (miRNAs) are small RNA molecules that do not code for proteins but regulate various cellular processes, including cell cycle progression, proliferation, differentiation, and apoptosis. The dysregulation of miRNAs has been associated with a wide range of cancers since they can act as either tumor suppressors or oncogenes. This paper aims to collect, summarize and re-organize the recent discoveries concerning miRNAs, whose dysregulation in the pathogenesis and progression of MCC is slowly emerging. Furthermore, the potential clinical applications of miRNAs as diagnostic biomarkers, possible differentiation between MCPyV-related and unrelated MCC, predictors of response to therapy and prognostics are also discussed. From this review, it emerges that miRNAs may have, in the near future, the potential to become clinically significant in improving the diagnostic accuracy, prognostic evaluation, and therapeutic options of MCCs. Finally, the new perspectives on the poorly explored field of artificial intelligence in MCC are provided.

Pulmonary arterial hypertension (PAH) is a chronic disease characterized by a progressive in-crease in mean pulmonary arterial pressure. Mutations in the BMPR2 and AQP1 genes have been described in familial PAH. The bone morphogenetic proteins BMP9 and BMP10 bind with high affinity to BMPR2. Administration of BMP9 has been proposed as a potential therapeutic strategy against PAH, although recent conflicting evidence dispute the effect of such practice. Considering the involvement of the above molecules in PAH onset, progression, and therapeutic value, we ex-amined the effects of modulation of BMP9, BMPR2, and AQP1 on BMP9, BMP10, BMPR2, AQP1, and TGFB1 expression in human pulmonary microvascular endothelial cells in vitro. Our results demonstrated that silencing the BMPR2 gene resulted in increased expression of its two main ligands, namely BMP9 and BMP10. Exogenous administration of BMP9 caused return of BMP10 to basal levels, while restored the decreased AQP1 protein levels and the decreased TGFB1 mRNA and protein expression levels caused by BMPR2 silencing. Moreover, AQP1 gene silencing also resulted in increased expression of BMP9 and BMP10. Our results might possibly imply that the effect of exogenously administered BMP9 on molecules participating in the BMP-signaling pathway could depend on the expression levels of BMPR2. Taken together, these results may pro-vide insight into the highly complex interactions of the BMP-signaling pathway.

Potential permanent magnet (Fe0.7Co0.3)2B has large saturation magnetization and high Curie temperature but a moderate magnetocrystalline anisotropy (MCA) and displays relatively low coercivity. One way to improve coercivity is to combine the contribution from magnetocrystalline- and magnetic shape anisotropy by preparing (Fe0.7Co0.3)2B nanowires. We study the effect of size, morphology, and surface defect on the hard magnetic properties of nanowires using micromagnetic simulation. The hard magnetic properties of (Fe0.7Co0.3)2B nanowire bonded magnet have been estimated, including the role of inter-wire magnetostatic interaction. By considering the existence of local reduction of MCA energy up to 30% on the surface layer of nanowires, the anisotropic bonded magnet with 65% vol. of (Fe0.7Co0.3)2B nanowires displays typical magnetic properties of remanence Br=8.4 kG, coercivity Hci=9.9 kOe, and maximum energy product (BH)m=17.8 MGOe. Developing effective technology for synthesizing nanowires and fabricating corresponding bonded magnets is promising for manufacturing practical magnets based on magnetic phase with relatively low or moderate MCA, such as (Fe0.7Co0.3)2B.

Aim: The aim of this study is to evaluate the possibility of discriminating between the two sexes through the simultaneous use of cheiloscopy and palatine rugoscopy. Materials and methods: 80 palate and lip impressions (40 male and 40 female) were analyzed. The palate impressions were acquired using both analogue and digital methods. The lip impres-sions were first acquired analogically and then scanned. The morphology of the palatine rugae in the palate impressions was analyzed, with the exclusion of segmental rugae. The lip prints were analyzed in sextants and the morphology of the lip wrinkles was evaluated. Results: Palatine rugoscopy shows that women have more curvy rugae than men and that men have more rugae on the left side than on the right. Cheiloscopy gave no statistically significant re-sults. Discussion: Palatine rugoscopy showed some differences between the sexes, however, these re-sults were not solid enough for reliable sex discrimination. Differences between the results of dif-ferent studies can be attributed to ethnic and methodological variations. Cheiloscopy, on the other hand, did not provide statistically significant results for sex discrimination. Conclusions: Given the scant results obtained from palatine rugoscopy and the lack of statisti-cally relevant results in cheiloscopy, together with a lack of concordance among the data found in literature, it is believed that it is not possible to discriminate between the two sexes by using the two methods contemporarily. Further research is needed.

This case report demonstrates the rare but potentially serious complication of pulmonary vein stenosis (PVS) diagnosed several years after radiofrequency ablation for atrial fibrillation. Pulmonary vein stenosis can remain asymptomatic until significant occlusion occurs, after which it can present with a variety of symptoms, mimicking numerous cardiovascular and pulmonary pathologies. Early diagnosis and treatment rely on consistent follow-up using appropriate diagnostic imaging modalities, which are paramount in preventing severe complications.

Aortic stenosis continues to be still the most frequently valvular pathology in the elderly population of the Western countries. According to the latest guidelines, the therapeutic choice of aortic stenosis depends on the age of the patient (&lt;75 years or &gt;75 years) and the risk class (STS-Prom/ Euroscore II &lt; o &gt; 4%). Therefore, if the surgical indication is clear in young and low risk patients and percutaneous treatment is the gold standard in older and high-risk patients, the therapeutic choice is still debated in intermediate-risk patients. In this group of patients the aortic valve stenosis treatment depends on the patient's global evaluation, on the experience of the center and no less important on the patient's will. Two main therapeutic options are debated: surgical aortic valve replacement with sutureless prosthesis versus transcatheter aortic valve implantation. In addition, the progressive development of mininvasive techniques for aortic valve surgery (right -anterior minitoracotomy) has also reduced the peri and post -operative risk in this group of patients. The goal of our review is to analyze the literature evidence of the best therapeutic choice in intermediate risk patients with severe aortic stenosis.

The urbanization effects on land surface phenology (LSP) have been investigated by many studies, but few studies focused on the temporal variations of urbanization effects on LSP. In this study, we used the MODIS EVI, MODIS LST data and China’s Land Use/Cover Datasets (CLUDs) to investigate the temporal variations of urban heat island intensity and urbanization effects on LSP in Northeast China during 2001–2015. Land surface temperature (LST) and phenology differences between urban and rural areas represented the urban heat island intensity and urbanization effects on LSP, respectively. Mann-kendall nonparametric test and Sen's slope were used to evaluating the trends of urbanization effects on LSP and urban heat island intensity. The results indicated that the average land surface phenology (LSP) during 2001–2015 was characterized by high spatial heterogeneity. The start of the growing season (SOS) in old urban area had become earlier and earlier than rural area and the differences of SOS between urbanized area and the rural area changed greatly during 2001–2015 (−0.79 days/year, p < 0.01). Meanwhile, the length of the growing season (LOS) in urban and adjacent areas had become increasingly longer than rural area especially in urbanized area (0.92 days/year, p < 0.01), but the differences of the end of the growing season (EOS) between urban and adjacent areas did not change significantly. Next, the UHII increased in spring and autumn during the whole study period. Moreover, the correlation analysis indicated that the increasing urban heat island intensity in spring contributed greatly to the increases of urbanization effects on SOS, but the increasing urban heat island intensity in autumn did not lead to the increases of urbanization effects on EOS in Northeast China.

Background: The aim of this experimental work was to evaluate cheiloscopy potential: to confirm the individual uniqueness of lip prints, to verify the presence of recurrent patterns according to the Suzuki and Tsuchihashi classification and to search for characteristics that can be used in establishing the sex of a subject, with a focus on assessing the method's limitations. Methods: Lip prints were taken from a sample of 172 volunteers using liquid lipstick and transparent adhesive tape and were digitally analyzed. Results: 59 prints (35.3%) were not considered for Suzuki and Tsuchihashi classification due to quality errors and the impossibility of visualizing lip wrinkles in one or more sextants. All the digitized prints revealed themselves to be unique after having been analyzed using superimposition. Qualitatively valid prints indicated a prevalence of Type II in both male and female. A major problem was that the analysis of the same print by different operators often resulted in a different attribution of a Type. Conclusions: The potential of cheiloscopy lies mainly in the matching of prints, given their uniqueness, but the absence of a database greatly limits its use. Additionally, its use for sex identification does not seem to be reliable. It is necessary to establish an acquisition protocol for taking and analyzing prints that could reduce the errors committed by the operator.

Background: The aim of this experimental work was to confirm the individual uniqueness of lip prints, to verify the presence of recurrent patterns according to the Suzuki and Tsuchihashi classification and to search for characteristics that can be used in establishing the sex of a subject. Methods: Lip prints were taken from a sample of 172 volunteers using liquid lipstick and transparent adhesive tape and were digitally analyzed. Results: 59 prints (35.3%) were not considered for Suzuki and Tsuchihashi classification due to quality errors and the impossibility of visualizing lip wrinkles in one or more sextants, all the digitized prints revealed themselves to be unique after having been analyzed using superimposition. Qualitatively valid prints indicated a prevalence of Type II in both male and female and the presence of sex-linked features. A major problem was that the analysis of the same print by different operators often resulted in a different attribution of a Type. Conclusions: The potential of cheiloscopy lies mainly in the matching of prints, given their uniqueness, and can be a valid tool in gender determination but the absence of a database greatly limits its use. It is necessary to establish an acquisition protocol for taking and analyzing prints that could reduce the errors committed by the operator.

Background/Objectives: The purpose of this study was to evaluate the relationship between 1-year mortality and health insurance benefit extension policy items in severe pneumonia pa-tients requiring mechanical ventilation using a South Korean nationwide cohort. Methods: A nationwide population-based retrospective study was conducted using the Korean National Health Insurance database. A total of 1,099 patients (542 patients in the health insurance benefit item group and 557 patients in the control group) were included. The primary outcome was 1-year mortality. Results: Among patients with health insurance benefit extension policy items, 203 patients (37.5%) were diagnosed with hemato-oncological disease, who were categorized as group A, and 339 patients (62.5%) were diagnosed with cerebrovascular, cardiovascular, or rare diseases, who were categorized as group B. Group B had lower 1-year mortality (50.7% vs. 62.5%, P

Endothelin-1 (ET-1) is a potent vasoconstrictor produced by endothelial cells and cleared from circulating blood mainly in the pulmonary vasculature. In a healthy pulmonary circulation, the rate of local production of ET-1 is less than its rate of clearance. In the present study we aimed to investigate whether abnormal pulmonary circulatory handling of ET-1 relates to poor clinical outcomes in patients with COVID-19-induced ARDS. Plasma ET-1 levels were measured in 18 mechanically ventilated COVID-19-induced ARDS patients, with simultaneous central venous and systemic arterial blood sampling on Days 1 and 3 following ICU admission. Two age- and sex-matched non-COVID-19 control groups were also used [mechanically ventilated non-COVID-19 critically ill and ARDS patients]. On ICU admission, COVID-19-induced ARDS patients had higher systemic arterial and venous ET-1 levels compared to non-COVID-19 ARDS and critically ill patients (p< 0.05). The arterial:venous (A:V) ET-1 ratio was higher in the non-COVID-19 ARDS patients [1.06 (0.93-1.20)] compared to the other two groups (p< 0.05). The A:V ratio was 0.63 (0.49-1.02) in the COVID-19-induced ARDS patients and 0.79 (0.52-1.11) in the non-COVID-19 critically ill patients. On Day 3, the A:V ratio in all three groups was < 1. The COVID-19 patient group was then divided based on 28-day ICU mortality. Although arterial and venous levels did not differ, the A:V ratio was statistically significantly higher on ICU admission in the non-survivors [0.95 (0.78-1.34)] vs 0.57 (0.48-0.92), p= 0.027]. Measurement of ET-1 clearance via A:V plasma ET-1 levels on ICU admission may assist in predicting outcomes in COVID-19 critically ill patients.

Acute and chronic respiratory diseases impose a significant economic and health burden. Distal small airway assessment requires invasive procedures such as a bronchoscopy and bronchoalveolar lavage. The Particles in Exhaled Air (PExA) device provides a non-invasive means of assessing small airways; it captures distal airway particles sized around 0.5-7m and contains particles of respiratory tract lining fluid (RTLF) that originate during airway closure and opening. The PExA device can measure particle count and mass according to particle size. Subsequent capture of particles in a thin membrane enables application of various analytical methods to assess a broad range of biomolecules including phospholipids, proteins, inflammatory profile, and other metabolites to characterise inflammation and diseases processes such as asthma, chronic obstructive pulmonary disease, acute respiratory distress syndrome, lung cancer, and more recently acute infections such as COVID-19. PExA analysis provides a promising alternative to traditional investigative methods in the assessment, diagnosis, and management of respiratory conditions. By evaluating specific biomarkers in the RTLF associated with airway inflammation, PExA may offer a more accurate and comprehensive understanding of the molecular-level changes in the small airways of patients with acute and chronic lung diseases.

Abstract: Laryngoscopy for tracheal intubation has been developed for many decades. Among various conventional laryngoscopes, videolaryngoscopes (VL) have been applied in different patient populations, including difficult airways. The safety and effectiveness of VL have been repeatedly studied in both normal and difficult airways. The superiority of VL then has been observed and is advocated as the standard of care. In contrast to laryngoscopy, the development of video-assisted intubating stylet (VS, also named as styletubation) has been noticed two dec-ades ago. Since then, sporadic clinical experiences of use have appeared in literature. In this re-view article, we presented our vast use experiences of the styletubation (more than 55,000 pa-tients since 2016). We found this technique is swift (the time to intubate: from 3 s to 10 s), smooth (first-attempt success rate: 100%), safe (no airway complications), and easy (high subjective satis-faction and fast learning curve for the novice trainees) in both normal and difficult airway sce-narios. We therefore propose styletubation technique can be feasibly applied as universal rou-tine use for tracheal intubation.

Background: Bacterial/fungal coinfections (BFC) are associated with antibiotic overuse, poor outcomes such as prolonged ICU stay and increased mortality. Our aim was to develop machine learning-based predictive models to identify respiratory bacterial or fungal coinfections on ICU admission. Methods: Secondary analysis of two prospective multicenter cohort studies with confirmed influenza A(H1N1)pdm09 and COVID-19. Multiple logistic regression (MLR) and random forest (RF) were used to identify factors associated with BFC in the overall population and in each subgroup (influenza and COVID-19). Performance was assessed by area under the ROC curve (AUC) and out-of-bag (OOB) for MLR and RF, respectively. Results: Of the 8,902 patients, 41.6% had influenza and 58.4% had SARS-CoV-2 infection. The median age was 60 years, 66% were male and the crude ICU mortality was 25%. BFC was observed in 14.2% of patients. Overall predictive models showed modest performance with AUC of 0.68 (MLR) and OOB 36.9% (RF). Specific models did not show improved performance. However, age, procalcitonin, CRP, APACHE II, SOFA and shock were factors associated with BFC in most models. Conclusion: Machine learning models for predicting respiratory BFC in patients with pandemic viruses are not able to predict adequately. However, the presence of factors such as advanced age, elevated procalcitonin or CPR and high severity of illness should alert clinicians to the need to rule out this complication on admission to the ICU.

Some of neurodegenerative diseases may be characterized by continuing behavioral and cognitive dysfunction that contains memory loss and/or apathy. Alzheimer's disease is the most typical type of such neurodegenerative disease characterized by deficit of cognition and alteration of behavior. Despite the huge efforts against Alzheimer's disease, there has been yet no successful treatment for this disease. Interestingly, several possible risk genes to cognitive dysfunction are frequently expressed within brain cells, which may also be linked to cholesterol metabolism, lipid transport, exosomes and/or caveolae formation, suggesting that caveolae may be a therapeutic target to consider cognitive dysfunctions. Interestingly, modulation of autophagy/mitophagy with the alteration of glucagon-like peptide-1 (GLP-1) and N-methyl-d-aspartate (NMDA) receptors signaling may offer a novel approach to prevent and alleviate the cognitive dysfunction. A paradigm that both GLP-1 and NMDA receptors at caveolae sites is promising and crucial for the treatment of cognitive dysfunctions has been presented here, which might also be able to modify the progression of Alzheimer's disease. This research direction may open the potential to move a clinical care toward disease-modifying treatment strategies with maximal benefits for patients without detrimental adverse events for neurodegenerative diseases.

HIV infection is a nowadays pathology that affect persons from all of the world. Pathogenesis of the HIV-infection and cancer is a great problem, with a complexity directions in research. More important in HIV infection to patients, is also to take into consideration others things, such as prevention, diagnosis, monitoring, treatment, including control measures. This previously mentioned, should be supported by statistical studies that report on restricted or extended geographical areas, to the level of social class and age. In our written text we try to describe from our opinion, strategies in HIV, infection, status knowing as a social and as a healthcare problem.

Many people in the USA have lost their lives or become addicted to opioids via prescription opioids given for chronic pain. The chronic pain epidemic has emerged due to a convergence of factors, including the medicalization of pain as well as injuries happening in the workplace, in the home, or during recreation. Opioid prescriptions rose precipitously from the late 1990’s through to approximately 2020, and despite public awareness, still are increasing. This review examines literature on integrative approaches to chronic pain as delineated by pain type. The review is organized by the most common causes of chronic pain, and randomized controlled trials, meta-analyses and systematic reviews are extracted for each cause of chronic pain. Several promising interventions may alleviate chronic pain of some causes, and some interventions may work across pain causes. Lowering inflammation through dietary or lifestyle regimens may be a general way of reducing pain. Pain can be alleviated through several adjunctive and integrative treatment approaches, which may serve to lower the need for opioid medication.

This study aimed to determine shifts in microbial populations regarding richness and diversity from the daily use of a popular over-the-counter nasal spray. In addition, the finding of nasal commensal bacterial species that overlap with the oral microbiome may prove to be potential probiotics for the “gateway microbiomes.” Nasal swab samples were obtained before and after using the most popular over-the-counter (OTC) nasal spray in 10 participants aged 18–48. All participants were healthy volunteers with no significant medical histories. The participants were randomly assigned a number by randomizing software and consisted of five men and five women. The sampling consisted of placing a nasal swab atraumatically into the nasal cavity. The samples were preserved and sent to Northwestern University Sequencing Center for whole-genome deep sequencing. After 21 days of OTC nasal spray use twice daily, the participants returned for further nasal microbiome sampling. The microbial analysis included all bacteria, archaea, viruses, molds, and yeasts via deep sequencing for species analysis. The Northwestern University Sequencing Center utilized artificial intelligence analysis to determine shifts in species and strains following nasal spray use that resulted in changes in diversity and richness.

In this paper, we consider the Cauchy problem of a time fractional nonlinear diffusion equation. According to the Kaplan’s first eigenvalue method, we first prove the blow-up of the solutions in finite time for some sufficient conditions. We next give sufficient conditions for the existence of global solutions by using the result of Zhang and Sun. In conclusions, we find the second critical exponent for the existence of global and non-global solutions via the decay rates of the initial data at spatial infinity.

The critical systems, which the failure and malfunction may result in human, environment and financial severe damages, are essential components in various sectors and particularly in energy domains. Although unwished, integration error problems in supervision of critical systems occurs, incurring significant expenses because of operator’s subjective analysis and on hardware topology failures. In this work, a malleable model design approach is proposed to formulate and solve the integration error problem in the critical systems supervision in terms of reliability. A real Hybrid Power Plant (HPP) case is considered as a requirement for a study case with simulated data. A method framework with informal approach (C4 diagram) and formal approach (Hierarchical Coloured Petri Nets) in radial spectrum is applied to the HPP supervision design. Using formal methods, a formulation and solution to this problem through structured, scalable and compact mathematical representations are possible. This malleable model intends to guarantee functional correctness and then reliability of the plant supervision system based on system software architecture. Outcomes suggest corroboration that the malleable model is appropriate for energy domain, and can be used for other types of critical systems, bringing all the benefits of this methodology to the context in which it will be applied.

Introduction. Anesthesia is widely used in various fields of dentistry to reduce patient discomfort when the treatment would be painful. The dentist may need to infiltrate the anesthetic into multiple locations and this is usually done with the same needle which passes through the soft tissues several times to distribute the anesthetic solution over a larger area. The present study aims to evaluate, through a morphological analysis under a scanning electron microscope (SEM), how the beveled tip of a 30G needle, used to inject anesthetic several times into different areas of the vestibular mucosa, changes. Materials and methods. 30G needles with two different brands were tested, in vivo used for a variable number of sequential injections from 1 to 6 on 192 patients. The specimens were analyzed under SEM observation to evaluate any deformations induced by contact with the vestibular soft tissues. Results. The amount of deformation, measured along the axis parallel to the needle, was proportional to the number of injections. The protrusion of deformations, measured on an axis perpendicular to the needle, were maximum on the needles used 3 times. For the needles used 4,5 and 6 injections, no further increase in deformations was noted. Conclusion. From the data it seems that the tested needles are not produced to withstand multiple injections consequently after the first injection on soft tissues, they undergo a deformation which could increase the risk of injury to the mucosa itself or to nerves and vessels with which they come into contact. It would be advisable to use the single needle for a reduced number of injections.

Iron is an essential nutrient for humans and microbes, such as bacteria. Iron deficiency occurs commonly in critically ill patients, but iron replacement therapy is not considered during the acute phase of critical illness, since it increases iron availability for invading microbes and oxidative stress. However, persistent iron deficiency in the recovery phase is harmful with potential adverse outcomes such as cognitive dysfunction, fatigue and cardiopulmonary dysfunction. Therefore, it is important to treat iron deficiency timely and efficiently. This article reviews current knowledge about iron-related biomarkers in critically ill patients and provides possible criteria to guide decision-making for iron supplementation in the recovery phase of critical illness.

Quantitative determination of the critical size of inclined coal pillar in old goaf water affected area is of great significance for water damage prevention and safe mining. The critical size of inclined waterproof coal pillar is derived by using theoretical analysis, numerical calculation and field engineering practice for the stability of the waterproof coal pillar in old goaf water affected area of 1303 working face of Dananhu I mine in Xinjiang region. Firstly, a force model of inclined waterproof coal pillar was established to reveal the law that the critical size of the coal pillar increases with the increase of coal seam inclination under the action of asymmetric load. Then, numerical simulation was applied to reveal the dynamic evolution process of plastic deformation-destabilization-destruction of section coal pillar under the influence of mining and single-side water pressure, and the critical size of waterproof coal pillar in study area was determined to be 19.09m. Finally, measures such as pumping and pressure relief and slurry reinforcement were adopted to reduce the deformation rate of the roadway on side of waterproof coal pillar, which ensured the stability of the coal pillar and roadway and the safe recovery of the working face.

Our target point within this following steps, is prostate cancer. Prostate cancer is classified structurally, by its Gleason Score. Phosphatases are implicated in differents cell alterations, including proliferation, differentiation and carcinogenesis. In specific life circumstances, proteins are regulators with implications in intracellular signaling pathways. Alterations in phosphatases functionality represent a key point in malignancy development. We try within our description, to focus on an important process refering to dysregulation of phosphatase activity. More than, we will discuss therapeutic key points refering to compounds that inhibits phosphatase proteins with implications in carcinogenesis. Researchers try to investigate and to conclude on prostate cancer using also genomic analyses, clinically useful biomarkers and imagistic methods. So finally after folowing describtion steps, purposed aim is to conclude on prostate cancer and different key points abordation.

Background: Falls risk assessment tools are used in hospital inpatient settings to identify pa-tients at increased risk of falls (which may be related to muscle loss/sarcopenia) to guide and target interventions for falls prevention. In 2022, Western Health, Melbourne, Australia, intro-duced a new falls risk assessment tool, the Western Health St. Thomas’ Risk Assessment Tool (WH-STRATIFY), a modified version of The Northern Hospital’s risk tool (TNH-STRATIFY), which replaced the Peninsula Health Risk Screening Tool (PH-FRAT). Aims: To determine the predictive accuracy of three falls risk assessment tools (PH-FRAT, TNH-STRATIFY and WH-STRATIFY) on admission to Geriatric Evaluation Management (GEM) units. Method: A retrospective observational study was conducted on four GEM units. Data was col-lected on 54 consecutive patients who fell during admission and 62 randomly sampled patients who did not fall between December 2020 and June 2021. Participants were scored against three falls risk assessment tools. The event rate Youden (Youden IndexER) indices were calculated and compared using default and optimal cut points to determine which tool was most accurate for predicting falls. Results: Using default cut points to compare falls assessment tools, TNH-STRATIFY had the highest predictive accuracy (Youden IndexER = 0.20, 95% confidence interval CI = 0.07, 0.34). The PH-FRAT (Youden IndexER = 0.01 and 95% CI = -0.04, 0.05) and WH-STRATIFY (Youden IndexER = 0.00 and 95% CI = -0.04, 0.03) were statistically equivalent and not predictive of falls compared to TNH-STRATIFY. When calculated optimal cut points were applied, predictive accuracy im-proved for PH-FRAT (Cut point 17, Youden IndexER = 0.14 and 95% CI = 0.01, 0.29) and WH-STRATIFY (Cut point 7, Youden IndexER = 0.18 and 95% CI = 0.00, 0.35). Overall, all tools had low predictive accuracy for falls. Conclusion: TNH-STRATIFY had the highest predictive accuracy for falls. The predictive accu-racy of WH-STRATIFY improved and was significant when the calculated optimal cut point was applied. The optimal cut points of falls risk assessment tools should be determined and validated in different clinical settings to optimise local predictive accuracy, enabling targeted falls risk mitigation strategies and resource allocation.

The aging populations observed across numerous countries worldwide necessitate a thorough exploration of interventions aimed at promoting healthy aging. As individuals age, they undergo significant physiological changes that impact their functional capacity and often necessitate increased reliance on external support systems. Enhancing the autonomy and well-being of elderly individuals emerges as a critical imperative, serving not only individual interests but also broader societal goals. This review investigates various interventions designed to optimize the health and independence of aging populations, offering insights into effective strategies for promoting healthy aging and mitigating the societal burdens associated with an aging demographic.

The features of a class of cubic curves with a shape factor are analyzed by means of the theory of envelope and topological mapping. The effects of the shape factor on the cubic curves are made clear. Necessary and sufficient conditions are derived for the curve to have one or two inflection points, a loop or a cusp, or to be locally or globally convex. Those conditions are completely characterized by the relative position of the edge vectors of the control polygon and the shape factor. The results are summarized in a shape diagram, which is useful when the cubic parametric curves are used for geometric modeling. Furthermore we discussed the influences of the shape factor on the shape diagram and the ability for adjusting the shape of the curve.

Sepsis-induced cardiomyopathy (SICM) may be defined as a non-ischemic cardiac dysfunction associated with sepsis. SICM is characterized by a decrease in left ventricular contractility, ultimately associated with left ventricular dilation, with or without right ventricular dysfunction. Echocardiography stands as the current gold standard in diagnosis of SICM. Left ventricular ejection fraction (LVEF) is the most frequently utilized parameter for evaluating left ventricular systolic function, but some traditional parameters, including LVEF, are dependent on cardiac preload and afterload, limiting their clinical application. Advanced echocardiography techniques, such as speckle-tracking analysis, have the potential to diagnose and evaluate myocardial dysfunction even in the early phases of sepsis, facilitating risk stratification for proactive personalized treatment of patients. This article reviews the progress in the application of various echocardiographic parameters in SICM.

Liposomal amphotericin B (L-AmB) has become the cornerstone for the treatment of severe invasive fungal infections. However, renal toxicity may be an associated risk. Our aim was to evaluate the incidence of acute kidney injury (AKI) in critically ill patients receiving L-AmB for more than 48 hours. Clinical, demographic and laboratory variables were obtained retrospectively from electronic health record. Follow-up of the patients was for 7 days after L-AmB infusion. Patients were analyzed globally and differentiated between patients with "low" and "high" risk of developing AKI with machine learning techniques. Sixty-seven patients were included: 61 years, 67% male, with mean SOFA score of 4 (3-6.5) and a crude intensive care unit mortality of 34.3%. No significant variations in serum creatinine were observed during the observation period, except for the decrease in the high-risk subgroup. Overall, 26.8% of patients developed AKI-I, while 25% and 13% of patients at low and high risk of AKI developed AKI-I, respectively. The random forest models performed in overall and low-risk subgroup identified several major contributor’s factors to the development of AKI other than L-AmB administration. The development of AKI is multifactorial and the administration of L-AmB appears to be safe in this group of patients.

Attention Deficit Hyperactivity Disorder (ADHD) it is known as a neuropsychiatric disorder. Anatomicaly components with implications in this previously mentioned disorder, are the anterior cingulate gyrus and dorsolateral prefrontal cortex (DLFPC) that are are found having a role in appearing this disease. ADHD is associated with cognitive and functional deficits that relate to diffuse abnormalities in the brain. ADHD is a specific pathology in children but may persisit to youth and also not so hard to find to adults.Till now, hard to find the curative treatment knowing ADHD as a neuropsychiatric disorder with enlarge unknown scientific points. Genetic and environmental component play an important role in diagnosis. Patients life style, a relevant history of individual geneticsand environmental factors are important in diagnosisThe management of ADHD, is also an important part togeter with future trends.

Mobile robots need an environmental perception ability in order to interact with the surrounding environment. In this paper we present the G-SLAM method, where the map is consisted of a cloud of scattered points in the continuous space and each point is accompanied by an obstacle existence probability. On the other hand the robot's pose (and trajectory) is estimated by an particle filters while the cloud of points is estimated by an adaptive recursive algorithm which is presented. Main feature of the presented method is the adaptive repositioning of the scattered points and their convergence around obstacles. In addition to our previous publications, In this paper a mathematical derivation of the method is presented and real case scenarios are discussed, presented and compared with other methods.

The isotopic and nuclear techniques discussed, namely: Fallout Radionuclide, Fingerprint, and Isotope Hydrology, are linked to the evaluation of soil and water degradation processes. A traditional literature review was conducted to gain the most comprehensive understanding of both the current state of the art and the subject matter, with the aim of proposing a hypothesis that integrates the synergistic convergence of these techniques in order to offer results that are more reliable. A case study is presented as a synthesis of the preceding discussion.

Hypertension is a global public health challenge, with a high prevalence across various regions and significant implications for cardiovascular risk. This article reviews the effectiveness of herbal medicine as a potential therapeutic approach for hypertension, offering an alternative or complementary solution to conventional pharmacological treatments. It highlights several natural agents that have demonstrated efficacy in lowering systolic blood pressure (SBP) in clinical and meta-analytical studies. The methodology involved a systematic review of articles that discuss herbal therapeutics for hypertension, focusing on their efficacy compared to placebo and standard treatments. The findings suggest that certain nutraceuticals, such as garlic, hawthorn, and CoQ10, can significantly reduce SBP, presenting a viable option for managing hypertension. This review underscores the need for further research to validate these findings and optimize herbal treatment strategies, potentially expanding the use of these natural products in clinical practice. The article aims to increase awareness among medical professionals and patients about the benefits and applications of herbal medicines in treating hypertension.

The microstructure of the substrate plays a crucial role in the anodizing process. Anodizing cast aluminum alloys is quite challenging due to the higher levels of alloying elements present compared to pure aluminum. Elements such as silicon, iron, and copper significantly impact the growth and quality of the anodic layer. Additionally, anodizing parameters such as electrolyte composition, current density, and temperature are critical in determining the morphology and thickness of the anodic film. The casting process, surface condition, and post-treatment also affect the properties of the anodic layer. Optimizing these parameters is essential to achieve a durable and high-quality anodic layer. This work aims to provide a comprehensive understanding of the various factors affecting the anodizing of cast aluminum alloys and the properties of the anodic layer, including its thickness, corrosion resistance, and wear resistance.

Procedural Sedation and Analgesia (PSA) in the Emergency Department (ED) presents a crucial aspect of emergency medicine, enabling the execution of painful or distressing procedures with minimal patient discomfort. This narrative review delineates the pharmacological framework, methodologies, and clinical considerations integral to optimizing PSA, with a particular focus on pediatric and geriatric populations. Through a comprehensive review and analysis of current practices, this work evaluates the pharmacokinetics and pharmacodynamics of widely utilized sedatives and analgesics, including propofol, ketamine, dexmedetomidine, fentanyl, midazolam, etomidate, nitrous oxide, and remimazolam. Special attention is dedicated to the selection criteria based on patient-specific risk factors, procedural requirements, and the management of potential adverse effects. The manuscript also explores innovative sedation techniques and the integration of new pharmacological agents, emphasizing evidence-based approaches to enhance patient safety and outcome. Results underscore the significance of tailored sedation strategies, especially for vulnerable groups such as pediatric and geriatric patients, highlighting the need for meticulous pre-procedural assessment and monitoring to mitigate risks. Conclusions drawn advocate for a nuanced application of PSA, guided by current evidence and clinical guidelines, to improve the quality of care in emergency settings. This research reinforces the imperative for ongoing education, skill development, and adaptation of new evidence into clinical practice to advance procedural sedation and analgesia in the ED.

In steel structures, oblique thin steel plates serve as panel zones in structures spanning large spaces (e.g., warehouses and gymnasiums). Considerable research has been conducted on the shear buckling of panels due to seismic loads acting on a structure. Conversely, under snow or wind loads, the panel zone may experience compressive and tensile stresses simultaneously from two directions. Considering the economic preference for thin steel plates, evaluating the elastic critical local buckling stresses in the panel zone under biaxial normal stress may provide essential information to structural engineers. In this study, an elastic buckling analysis based on the energy method is performed to clarify the impact of panel geometry and boundary conditions on the elastic local buckling stresses of oblique panel zones. As confirmed, the buckling stresses derived from the energy method could simulate the local buckling stresses with accuracy comparable to that of finite element analysis, and an engineer-friendly design formula was proposed. Finally, we determined the correlation of the buckling stresses under biaxial stresses and presented a method for evaluating this correlation. Engineers can utilize the provided design equations to more efficiently and accurately calculate buckling loads, facilitating safer and more economical design of structures with oblique plates.

Groundwater pollution in intensive horticultural areas is becoming an increasingly important problem. Therefore, this study evaluates nitrogen (N) fertilization in open field processing pepper crop in Extremadura, Spain. Previous research on the effect of N on sweet peppers grown in greenhouses is abundant, but data on outdoor cultivation, especially considering variety and site influences, are lacking. Field trials were conducted in 2020, 2021 and 2022 to determine the opti-mum N fertilizer rate for processing peppers, with the aim of reducing environmental impacts such as nitrate leaching while maintaining crop yields. Different N rates were applied in the trials, ranging from no N fertilizer to 300 kg N/ha. Meas-urements included crop yield, biomass, intercepted photosynthetically active radiation (PAR), and canopy cover. The study also developed a critical nitrogen curve (CNC) to determine the minimum N concentration required for optimal growth. The results showed that applying more than 200 kg N/ha did not significantly increase yield. Nitrogen-free treatments resulted in earlier fruit maturity, concentrating the harvest and reducing waste. In addition, excessive N application led to envi-ronmental problems such as groundwater contamination due to nitrate leaching. The study concludes that outdoor pepper crops in this region can achieve optimal yields with lower N rates (around 120 kg N/ha) compared to current practices, thereby reducing environmental risks and fertilizer costs. It also established relationships between biomass, canopy cover, and N uptake to improve fertilization strategies. These data support future crop modelling and sustainable fertili-zation practices.

Antidepressants are among the most used medications in the US, with significant deleterious effects on people’s well-being. At any given time, depression impacts approximately 1 in 10 Americans, causing wide and broad societal costs. Interest is developing for non-pharmacological treatments and preventative measures. We summarize the literature on non-invasive dietary and lifestyle approaches for treating depression, including recent work with the psychedelic treatment of depression. This review aims to inform future research and treatment programs for depression. This review provides an evidentiary summary of integrative therapeutic approaches for depression.

Molnupiravir, a prodrug known for its broad antiviral activity, demonstrated efficacy in animal models of Covid-19, prompting clinical trials where initial results indicated a significant effect against the disease. However, subsequent clinical studies did not confirm these findings, leading to the rejection of molnupiravir for permanent market authorization in many countries. This report critically assessed 19 studies published in 17 reports that investigated the efficacy of molnupiravir in animal models of Covid-19 with the purpose of determining how well the design of these models informed human studies. We found that the administered doses of molnupiravir in most studies involving animal Covid-19 models were disproportionately higher than the dose rec-ommended for human use. Specifically, when adjusted for body surface area, half of the doses of molnupiravir used in the animal studies were more than twice as high as the human dose. Addi-tionally, the drug was frequently given prophylactically or shortly after SARS-CoV-2 inoculation in these models, in contrast to clinical trials where such timing is not consistently achieved. Furthermore, the recommended five-day treatment duration for humans was exceeded in several animal studies. Collectively, we suggest that these design elements in the reported animal studies contributed to a bias favoring molnupiravir, and thus inflated expectations for its efficacy against Covid-19. Addressing these elements may offer avenues to enhance the clinical efficacy of mol-nupiravir for treatment of Covid-19 that include dose increment, early treatment, and admin-istration by inhalation along with use of molnupiravir in antiviral combination therapy.

The ability of thermoresponsive polymers to respond to temperature with a reversible conformational change makes them promising ‘smart’ materials for solutions in medical and biotechnological applications. In this work, two such polymers and structural isomers were studied: poly(N-isopropyl acrylamide) (PNiPAm) and poly(2-isopropyl-2-oxazoline) (PiPOx). We compare the critical solution temperatures (CST) of these polymers in D2O and H2O in the presence of Hofmeister series salts, as results obtained under these different solvent conditions are often compared. D2O has a higher dipole moment and electronegativity than H2O, which could significantly alter the CST transition. We used two complementary methods to measure the CST, dynamic light scattering (DLS) and differential scanning calorimetry (DSC), and found that the CST decreased significantly in D2O compared to H2O. In the presence of highly concentrated kosmotropes, the CST of both polymers decreased in both solvents. The influence of the kosmotropic anions was smaller than the water isotope effect at low ionic strengths but considerably higher at physiological ionic strengths. However, the Hofmeister anion effect was quantitatively different in H2O than in D2O, with the largest relative differences observed for Cl-, where the CSTs in D2O decreased more than in H2O measured by DLS but less by DSC. PiPOx was more sensitive than PNiPAm to the presence of chaotropes. It exhibited much higher transition enthalpies and multistep transitions, especially in aqueous solutions. Our results highlight that measurements of thermoresponsive polymer properties in D2O cannot be compared directly or quantitatively to application conditions or even measurements performed in H2O.

In this paper, we consider the relation of more than four harmonic points in a line. For this purpose, starting from the dependence of the harmonic points, Desargues’ theorems, and perspectivity, we note that it is necessary to conduct a generalization of the Desargues’ theorems for projective complete n-points, which are used to implement the definition of the generalization of harmonic points. We present new findings regarding the uniquely determined and constructed sets of H-points and their structure. The well-known fourth harmonic points represent the special case (n=4) of the sets of H-points of rank 2, which is indicated by P42.

This paper proposes an optimal path type classification scheme for the three-point Dubins problem. It allows to directly extract the shortest path type from a Dubins set, evaluating only the relative initial and final configurations with the via point position using a suitable partition of the Cartesian plane. Two alternative approaches are proposed to address the problem: an analytical approach and a heuristic one. The latter was revealed to be much faster from a computational point of view. The proposed classification logic makes the path planning for the three-point Dubins problem much more effective and suitable for real-time applications. Numerical examples are provided to show the efficiency of the proposed strategy.

A novel theoem is presented about a circle with four antipodal points, arbitrarily ordered counterclockwise (or clockwise), in a Euclidean plane.

Lassa Fever is a deadly viral haemorrhagic disease, causing annually several hundreds of deaths in the Gulf of Guinea. This zoonotic disease is primarily transmitted to humans by rodents of the genus Mastomys, while secondary interhuman transmission accounts for approximately 20% of cases. Although this disease has been endemic in rural zones of the Gulf for hundreds of years, it is also characterised by epidemic outbreaks in the dry season, responsible for heavy death tolls. No licensed vaccine or satisfying treatment is currently available. Disease management is hindered by the incomplete knowledge of the epidemiology and distribution of the disease, resulting from an inadequate health and surveillance system. Additional scientific constraints such as the genetic diversity of the virus and the lack of understanding of the mechanisms of immune protection complexify the development of a vaccine. The intricate socio-economic context in the affected regions, and the lack of monetary incentive for drug development, allow the disease to persist in some of West Africa’s poorest communities. The increase in the number of reported cases and in the fatality rate, the expansion of the endemic area, as well as the threat Lassa Fever represents internationally should urge the global community to work on the disease control and prevention. The disease control requires collaborative research for medical countermeasures and tailored public health policies. Lassa Fever, created by the interconnection between animals, humans, and ecosystems, and embedded in an intricate social context, should be addressed with a ‘One Health’ approach. This article provides an overview of Lassa Fever, focusing on Nigeria, and discusses the perspectives for the control of disease.

This study presents a critical literature review on the models of users' adoption of blockchain applications in supply chains. This review pertaining to blockchain technology adoption by supply chain stakeholders is significant as it is a pre-requisite for the technical sustainability of blockchain technology in supply chains. Through a critical literature review, the previous studies related to technology adoption models were analyzed to explore practices brought about by blockchain applications for supply chain management. This study examined the suitability of the existing models (e.g., the technology-organization-environment (TOE) framework, task technology fit (TTF), unified theory of acceptance and use of technology (UTAUT)) of technology adoption for blockchain applications in supply chains and came up with a new unified model, namely, TOE-TTF-UTAUT. This review provides implications for a more appropriate research design using mixed methods. When adopting the TOE-TTF-UTAUT model in a study, two phases of research using mixed methods can be performed. The first phase is an exploratory sequential design in which a qualitative approach to explore the TOE and supply chain task constructs is followed by a quantitative approach using a survey and quantitative analyses to investigate the factors affecting blockchain adoption in supply chains. The second phase adopts explanatory sequential design in which the quantitative findings from the first phase are reviewed for follow-up by qualitative interviews to obtain explanations.

Liver injury caused by various factors significantly impacts human health. Stem cell transplantation has potential for enhancing liver functionality, but safety concerns such as immune rejection, tumorigenesis, and the formation of emboli in the lungs remain. Recent studies have shown that stem cells primarily exert their effects through the secretion of extracellular vesicles (EVs). EVs have been shown to play crucial roles in reducing inflammation, preventing cell death, and promoting liver cell proliferation. Additionally, they can function as carriers to deliver targeted drugs to the liver, thereby exerting specific physiological effects. EVs possess several advantages, including structural stability, low immunogenicity, minimal tumorigenicity targeting capabilities, and convenient collection,. Consequently, these factors have garnered significant attention from researchers and are expected to become alternative therapeutic agents to stem cell therapy. This article provides a comprehensive review of the current research progress on the use of stem cell-derived EVs in the treatment of liver injury.

Coronavirus disease 2019 (COVID-19) has affected medical practice. More than 7,000,000 patients died worldwide after being infected with COVID-19; however, no specific laboratory markers have yet been established to predict death related to this disease. In contrast, electrocardiographic changes owing to COVID-19 include QT prolongation and ST-T changes; however, there have been no studies on ambulatory electrocardiographic markers of COVID-19. We encountered three patients diagnosed as having COVID-19 who did not have a prior history of significant structural heart diseases. All had abnormalities in ambulatory echocardiogram parameters detected by high-resolution 24-h electrocardiogram monitoring: positive late potentials (LPs) and T-wave alternans (TWA), abnormal heart rate variability (HRV), and heart rate turbulence (HRT). Case 1 involved a 78-year-old woman with a history of chronic kidney disease, Case 2 a 76-year-old man with hypertension and diabetes, and Case 3 a 67-year-old man with renal cancer, lung cancer, and diabetes. None of them had a prior history of significant structural heart disease. Although no significant consistent increases in clinical markers were observed, all three patients died, mainly because of respiratory failure with mild heart failure. LP, TWA, HRV, and HRT were all positive in three cases with no significant structural cardiac disease at the initial phase of admission. There is a possibility that LP, TWA, HRV, and HRT have the potential to be risk stratifiers of COVID-19 pneumonia in the early phase of admission. Further accumulation of data regarding ambulatory electrocardiographic markers in patients with COVID-19 is needed.

Densely urbanized areas, with a low percentage of green vegetation, are highly exposed to Heat Waves (HW) which nowadays are increasing in terms of frequency and intensity also in the middle-latitude regions, due to ongoing Climate Change (CC). Their negative effects may combine with those of the UHI (Urban Heat Island), a local phenomenon where air temperatures in the compact built up cores of towns increase more than those in the surrounding rural areas, with significant impact on the quality of urban environment, on citizens health and energy consumption and transport, as it has occurred in the summer of 2003 on France and Italian central-northern areas. In this context this work aims at designing and developing a methodology based on aero-spatial remote sensing (EO) at medium-high resolution and most recent GIS techniques, for the extensive characterization of the urban fabric response to these climatic impacts related to the temperature within the general framework of supporting local and national strategies and policies of adaptation to CC. Due to its extension and variety of built-up typologies, the municipality of Rome was selected as test area for the methodology development and validation. First of all, we started by operating through photointerpretation of cartography at detailed scale (CTR 1: 5000) on a reference area consisting of a transect of about 5x20 km, extending from the downtown to the suburbs and including all the built-up classes of interest. The reference built-up vulnerability classes found inside the transect were then exploited as training areas to classify the entire territory of Rome municipality. To this end, the satellite EO HR (High Resolution) multispectral data, provided by the Landsat sensors were used within a on purpose developed "supervised" classification procedure, based on data mining and “object-classification” techniques. The classification results were then exploited for implementing a calibration method, based on a typical UHI temperature distribution, derived from MODIS satellite sensor LST (Land Surface Temperature) data of the summer 2003, to obtain an analytical expression of the vulnerability model, previously introduced on a semi-empirical basis.

A review of quantitative risk assessment (QRA) models of L. monocytogenes in produce was carried out, with the objective of appraising and contrasting the effectiveness of the control strategies placed along the food chains. Despite nine of the thirteen QRA models recovered focused on fresh or RTE leafy greens, none of them represented important factors or sources of contamination in the primary production, such as type of cultivation, water, fertilisers or irrigation method/practices. Cross-contamination at processing and during consumer’s handling was modelled using transfer rates, which were shown to moderately drive the final risk of listeriosis; highlighting therefore the importance of accurately representing the transfer coefficient parameters. Many QRA models coincided in the fact that temperature fluctuations at retail or temperature abuse at home were key factors contributing to increasing the risk of listeriosis. In addition to a primary module that could help assess current on-farm practices and potential control measures, future QRA models for minimally-processed produce should also contain a refined sanitisation module able to estimate the effectiveness of various sanitisers as a function of type, concentration and exposure time. Finally, L. monocytogenes growth in the products down the supply chain should be estimated by using realistic time-temperature trajectories, and validated microbial kinetic parameters, both of them currently available in the literature.

The classification of Trojans in modern analog microcircuits is considered. Using high-speed operational amplifiers (Op-Amps) as an example, the relationship between Op-Amp circuit design and the formation of undesirable states in typical switching circuits is shown. Circuit solutions are proposed to minimize the Trojan states of high-speed Op-Amps. These include limiting the maximum output currents of the input stages of the Op-Amp during the transient process and the use of differentiating transient correction circuits in the Op-Amp.

A method for studying properties of the earth's surface tremor, measured by means of GPS, is proposed. Four characteristics of tremor are considered: the entropy of the distribution of wavelet coefficients, the Donoho-Johnston wavelet index, and two estimates of the spectral slope. The anomalous areas of tremor are determined by estimating the probability densities of extreme values of the studied properties. The criteria for abnormal tremor behavior are based on the proximity to, or the difference between, tremor properties and white noise. The greatest deviation from the properties of white noise is characterized by entropy minima and spectral slope and DJ index maxima. This behavior of the tremor is called "active". The "passive" tremor behavior is characterized by the maximum proximity to the properties of white noise. The principal components approach provides weighted averaged density maps of these 2 variants of extreme distributions of parameters in a sliding time window of 3 years are considered. Singular points are the points of maximum average densities. The method is applied to the analysis of daily time series from a GPS network in the West USA in 2009-2022. It turned out that singular points of tremor form well-defined clusters.

A method for studying properties of the earth's surface tremor, measured by means of GPS, is proposed. Four characteristics of tremor are considered: the entropy of the distribution of wavelet coefficients, the Donoho-Johnston wavelet index, and two estimates of the spectral slope. The anomalous areas of tremor are determined by estimating the probability densities of extreme values of the studied properties. The criteria for abnormal tremor behavior are based on the proximity to, or the difference between, tremor properties and white noise. The greatest deviation from the properties of white noise is characterized by entropy minima and spectral slope and DJ index maxima. This behavior of the tremor is called "active". The "passive" tremor behavior is characterized by the maximum proximity to the properties of white noise. The principal components approach provides weighted averaged density maps of these 2 variants of extreme distributions of parameters in a sliding time window of 3 years are considered. Singular points are the points of maximum average densities. The method is applied to the analysis of daily time series from a GPS network in the West USA in 2009-2022. It turned out that singular points of tremor form well-defined clusters.

Ultrasound is a well-known tool to produce thermal and non-thermal effects on cells and tissues. These effects require a correct application of ultrasound in terms of localization and acoustic energy delivered. This article describes a new device that combines ultrasound and Dry Needling treatments. The ultrasound transducer can rotate in 3D space mechanically to align itself in the direction of the needle. The transducer electronically focuses the acoustic pressure automatically on the needle tip and its surroundings. A computer, using graphical interface software, controls the angulation of the array and the focus position.

In this paper, we present a method to map information regarding service activity provision residing in governmental portals across European Commission. In order to perform this, we used as a basis the enriched Greek e-GIF ontology, modeling concepts, and relations in one of the two data portals (i.e., Points of Single Contacts) examined, since relevant information on the second was not provided. Mapping consisted in transforming information appearing in governmental portals in RDF format (i.e., as Linked data), in order to be easily exchangeable. Mapping proved a tedious task, since description on how information is modeled in the second Point of Single Contact is not provided and must be extracted in a manual manner.

We investigate the tunneling of quasiparticles through a potential barrier of finite height and width, in a system with a band structure consisting of a quadratic band crossing point (QBCP). We compute the results of the transmission coefficient at various incident angles, and also the conductivity and the Fano factor. We discuss the distinguishing signatures of these transport properties in comparison with other semimetals, as well as electrons in normal metals.

In this paper we provide amongst others some simple error bounds in approximating the weighted Riemann-Stieltjes integral $\int_{a}^{b}f\left(t\right) g\left(t\right) dv\left(t\right) $ by the use of three points formula \begin{equation*} f\left(b\right) \int_{c}^{b}g\left(s\right) dv\left(s\right) +f\left(a\right) \int_{a}^{d}g\left( s\right) dv\left( s\right) -f\left(x\right) \int_{c}^{d}g\left(t\right) dv\left(t\right) \end{equation*} where $x,$ $c,$ $d\in \left[a,b\right],$ $g,$ $v:\left[a,b\right] \rightarrow \mathbb{C}$ under bounded variation and Lipschitzian assumptions for the function $f$ and such that the involved Riemann-Stieltjes integrals exist.

The intensive care units in North West London are part of one of the oldest critical carenetworks in the UK, forming a mature and established strategic alliance to shareresources, experience and knowledge for the benefit of its patients. North WestLondon saw an early surge in COVID-19 admissions, which urgently threatened thecapacity of some of its intensive care units even before the UK government announcedlockdown. The pre-existing relationships and culture within the network allowed itsmembers to unite and work rapidly to develop agile and innovative solutions, protectingany individual unit from becoming overwhelmed, and ultimately protecting its patients.Within a short 50-day period 223 patients were transferred within the network todistribute pressures. This unprecedented number of critical care transfers, combinedwith the creation of extra capacity and new pathways, allowed the region to continue tooffer timely and unrationed access to critical care for all patients who would benefitfrom admission. This extraordinary response is a testament to the power and benefitsof a regionally networked approach to critical care, and the lessons learned maybenefit other healthcare providers, managers and policy makers, especially in regionscurrently facing new outbreaks of COVID-19.

This work focuses on the theoretical study of the effect of entanglement in the Yttrium Barium Copper Oxide (YBCO) superconductor on the critical current density, critical magnetic field, and penetration depth. Using the Ginzburg Landau (GL) theory, the expression for the GL coherence length, the critical current density, the lower critical magnetic field (Hc1), and the upper critical magnetic field (Hc2) for the entangled superconducting YBCO was obtained. At zero external magnetic fields, YBCO was found to undergo a transition from the normal state to the superconducting state at 93K and returned to normal. We found a direct relationship between the GL coherence length penetration depth and the temperature of the entangled superconducting YBCO. The graphs of the lower critical magnetic field (Hc1) and critical current density against temperature show a non-linear dependence.In contrast, the graph of the upper critical magnetic field (Hc2) against temperature (T) shows the linear dependence, which is in agreement with existing theoretical observations. On the other hand, the graph of critical current density against the distance of separation between the entangled electrons that form a cooper pair showed that the critical current density increases between 1.8 and 6 nanometers attaining a constant value after reaching 7 nanometers for infinite distances. Finally, for lower critical fields, the magnetic field decreases between 1.5 to 6 nanometers attaining a constant value of the magnetic field, for infinite values of distance of separation between the entangled pair of electrons.

A well-prepared public health workforce is essential for reducing disease burdens and improving population health, requiring an education that addresses global and complex challenges. This paper examines the integration of the relational employability framework in public health education to cultivate critical global citizenship among students and graduates. Our research, conducted at Edith Cowan University in Perth, Western Australia, involved two case studies using qualitative interviews. Case Study 1, drawn from Cook’s doctoral research, explored student experiences with the relational employability framework within an undergraduate capstone unit. Case Study 2, a school-funded project, gathered graduate perspectives to inform ongoing curriculum development. The findings indicate that the relational employability framework enhances global competencies among students and graduates, through research skills development and critical reflective practice. Students reported improved awareness of their learning needs, self-confidence, and an increased ability to engage with diverse perspectives and societal challenges. Graduates highlighted the framework’s role in understanding ethical standards, conducting rigorous research and applying evidence-based practices in professional settings. Additionally, the framework supported the development of a reflective mindset, enabling graduates to make informed, value-based career decisions and advance their professional growth. The study suggests that adopting a relational employability approach can effectively prepare globally competent and reflective public health professionals. We advocate for the broader implementation of this framework in health education and higher education, offering practical recommendations for curriculum transformation. Such an approach will equip future professionals to contribute meaningfully to public health debates and embody the principles of global citizenship in their practice.

Background: Ventilatory strategies in acute respiratory distress syndrome patients aim to mitigate the risk of acute lung injury (ALI). However, prolonged utilization of these strategies may precipitate alveolar carbon dioxide elevation and pH reduction. This scoping review endeavors to present extant knowledge concerning hypercapnia effects in experimental models, with or without ALI, specifically focusing on delineating the immunologically mediated pulmonary tissue damage; Methods: A systematic exploration encompassing PubMed, Web of Science, ScienceDirect, Cochrane Reviews, and Scielo databases was undertaken. Articles published between January 1, 2008, and December 31, 2022, were screened for their elucidation of hypercapnia's immunological impact on lung tissue, utilizing experimental or biological models, irrespective of ALI presence; Results: Following duplicate removal and predefined criteria filtering, 30 pertinent articles scrutinizing hypercapnia's influence on pulmonary epithelium were identified. It was observed that hypercapnia induces perturbations in innate immune response gene transcription, mediated via Nuclear Factor-kappa B attenuation. Furthermore, a compromised innate immune response against injurious agents was noted. Concurrently, disruption and subsequent resealing of alveolar epithelial cells were evidenced, primarily through Na/K-ATPase endocytosis, impeding fluid reabsorption at the alveolar epithelium level; Conclusions: In experimental settings, with or without ALI, hypercapnia's immunomediated mechanisms exacerbate innate immune system impairment and disrupt the respiratory epithelium's repair and healing processes.

Electric vehicles (EVs) are pivotal in addressing the escalating environmental crisis. While EV drivetrains excel compared to those of vehicles with internal combustion engines (ICE), their energy storage systems are hampered by limited range, lifespan, and lengthy charging times. Hybrid energy storage systems (HESS) present a viable current solution to these issues. This review thoroughly explores state-of-the-art in the emerging field of multisource EVs that utilize HESS, incorporating any combination of batteries (BTs), supercapacitors (SCs), flywheels (FWs), fuel cells (FCs), and/or transmotors. In addition, the paper systematically categorizes and evaluates different hybrid configurations, detailing potential topologies and their respective advantages and limitations. Moreover, the paper examines diverse control algorithms used to manage these complex systems, focusing on their effectiveness and operational efficiency. By identifying current research gaps and technological challenges, this study aims to delineate future research directions that could enhance the deployment and optimization of multisource EVs, thereby addressing critical challenges such as energy density, system reliability, and cost-effectiveness.

The Great Reset has been presented by the World Economic Forum (WEF) in response to the COVID-19 pandemic in 2022 as a model through which a “stakeholder economy” would achieve “resilient, equitable and sustainable” economic, social and environmental goals. A more equitable distribution of resources, better working conditions, and ecological transitions are included in a social, economic and environmental reform agenda. This article raises the question of whether the Great Reset project should be interpreted as a “realistic utopia” and what is its reform potential. In an attempt to answer the question of whether the Great Reset as a realist utopia is consistent with the current state of science and philosophy, the article re-examines the idea of utopia in the light of recent philosophical and scientific approaches, such as critical realism in philosophy, so-cial systems theory in sociology and complexity theory in science. A comparative conceptual analysis is carried out and discussed introducing the idea of a realist utopia in Rawls' theory of justice as fairness. In the final discussion, some doubts are raised about the logical coherence, rigor of scientific theorizing, policy prescriptions, and predictive potential of the Great Reset emerging paradigm. It is concluded that utopian projects of radical reform can become realistic when they offer explanations of the deep structural changes that underlie social and economic evolution, drawing from these explanations the policy implications and prescription that can support struc-tural changes, rather than from assumed long-term effects of exogenous shocks or “black swan” events such as the COVID-19 pandemic.

Coastal zones experience increasing climatic and human pressures, which lead to growing risks and tipping points (TPs) under future scenarios and natural resource scarcity. To avoid crossing TPs with irreversible coastal losses, this paper proposes the development of adaptation pathways based on advanced coastal oceanography and engineering knowledge that enables an objective assessment of evolving coastal risks. These pathways feature sequential interventions, combining conventional engineering works with nature-based solutions (NbS), steered by simulations and observations as a function of available coastal resources (space and sediment) and risks for infrastructure and socioeconomic assets. Such an adaptation has been developed for urban and peri-urban Mediterranean beaches, considering conventional coastal engineering together with NbS. Both types of interventions are assessed in terms of key physical variables, which serve to evaluate performance and estimate TPs. This analysis supports the new coastal protection and management plan promoted by the local government and the coastal adaptation plan of the central government. The approach and results illustrate the potential of adaptation pathways for beach sustainability, enhancing the compatibility between short/long-term coastal protection objectives under present/future climate and management scenarios. The adaptation pathways development underpins an increasing stakeholder cooperation to achieve shared decisions for coastal sustainability.

A cyclic antipodal points of a circle is a pair of points that are the intersection of the circle with a diameter of the circle. A recent proof of Ptolemy’s Theorem, simultaneously in both (i) Euclidean geometry; and (ii) the relativistic model of hyperbolic geometry (which is identified with the Klein model of hyperbolic geometry), motivates in this article the study of four cyclic antipodal points of a circle, ordered arbitrarily counterclockwise. The translation of results from Euclidean geometry into hyperbolic geometry is obtained by means of hyperbolic trigonometry, called gyrotrigonometry, to which Einstein addition gives rise. Formulas that extend the Pythagorean formula in both Euclidean and hyperbolic geometry are obtained as byproducts

(1) Background: Metabolic syndrome is associated with cardiovascular complications. Therefore, this study aims to establish cut points for the conicity index based on the components of the metabolic syndrome and to associate it with characteristics sociodemographic, food consumption and occupational factors in Brazilian rural workers; (2) Methods: Cross-sectional study carried out with farmers. The receiver operating characteristic curve was calculated and the cutoff points for the conicity index were identified by the area under the curve, sensitivity and specificity. The variables included in the binary logistic regression analysis were selected by considering p &lt; 0.20 in the bivariate test; (3) Results: The cut points were similar in females according to both criteria, resulting in a single cut-off of 1.269. In males, the cut points showed differences, resulting in 1.272 according to the NCEP-ATP III and 1.252 according to the IDF. We have shown that younger people, those who work more than 40 hours a week and the lowest contribution of culinary ingredients are associated with increased odds of abdominal obesity. While the consumption of the products they sell or produce decreases these chances; (4) Conclusions: The conicity index showed high discriminatory power for the identification of abdominal obesity in rural workers.

The study of dog point following has been increasingly popular, at least partially due to the initial claims that dogs outperform apes and the suggestion that our domestication process caused dogs to have a biological capacity to communicate with humans. We take the view that dog pointing is more complicated than was initially reported, and in this study, we explore several potential variables that may make a difference. Our variables include point type (ipsilateral (same-side) vs contralateral (cross-body) points), position (standing vs seated), and distance (proximal vs distal). We find that most dogs follow ipsilateral points while less than half of the dogs in our sample follow contralateral points, and that position and distance also affect dogs’ success. We suggest that dogs acquire ipsilateral points via associative mechanisms, but that contralateral points require the dogs to understand the humans’ communicative intent.

In this paper, we study a three step iterative scheme to approximate fixed points of Suzuki's generalized non-expansive mappings. We establish some weak and strong convergence results for such mappings in uniformly convex Banach spaces. Further, we show numerically that iterative scheme (1.8) converges faster than some other known iterations for Suzuki's generalized non-expansive mappings. To support our claim, we give an illustrative example and approximate fixed points of such mappings using Matlab program. Our results are new and generalize several relevant results in the literature.

The use of chemical pesticides in agriculture contributes to soil, water and air pollution, biodiversity loss and can harm non-target species. The European Commission has already established a Harmonized Risk Indicator to quantify the progress in reducing the risks linked to pesticides. Therefore, there is an increasing need to promote biopesticides or so-called low-risk pesticides (LRP). Extract from Melaleuca alternifolia – tea tree oil (TTO) is known for its antiseptic, antimicrobial, antiviral, antifungal, and anti-inflammatory properties. Tea tree oil has been extensively studied in pest management as well as in the pharmaceutical and cosmetic industry and there are already products based on its active substances on the market. This review focuses on the overall evaluation of tea tree oil in terms of effectiveness and safety as a biopesticide for the first time. The collected data can be an added value for further evaluation of tea tree oil in terms of the authorization extension as a fungicide in 2026.

Instagram has grown in popularity among youth and is currently the second-favorite social network in the world. One of the social media that is widely used nowadays is Instagram. According to Enterprise (2012:02), Instagram is a community shared among one member with other members from all over the world. This study examines the impact of Instagram on the physical and mental well-being of Indian youth. With the rapid proliferation of social media platforms in India, Instagram has emerged as a prominent influence on the lives and perceptions of young individuals.Through a systematic synthesis of existing literature, this review paper critically evaluates the effects of Instagram use on various dimensions of youth well-being, considering both the opportunities and challenges posed by this popular social media platform. The review explores the nuanced relationship between Instagram and youth health outcomes. Specifically, it examines the influence of Instagram on body image perceptions, self-esteem, social comparison, and mental health. The review considers the cultural context and nuances that shape the impact of Instagram within the Indian socio-cultural landscape.

Fused deposition modeling (FDM) is a rather new technology in the production of personalized dosage forms. Melting and printing of polymer–active pharmaceutical ingredient (API) – mixtures can be used to produce oral dosage forms with different dosage as well as release behavior. This process is utilized to increase the bioavailability of pharmaceutically relevant active ingredients that are poorly soluble in physiological medium by transforming them into solid amorphous dispersions (ASD). Release from such ASDs is expected to be faster and higher compared to the raw materials and thus enhance bioavailability. Printing directly from powder while forming ASDs was realized. Different techniques to change release patterns as well as a non-destructive way for determination of API distribution were shown. By measuring the melt viscosities of mixtures printed a rheological model for the printer used is proposed.

A critical analysis of the classical definition of outsiders is given. Some examples show that this notion is not universal and has at least two drawbacks. Particularly, the set of outsiders may have the probability arbitrary close to one half. On the other hand, the deleting of the set of outsiders may dramatically change the value of the median.

In this paper, a recent meta-heuristic optimization algorithm called the discrete-continuous hyper-spherical search algorithm is used to solve the mixed-integer nonlinear problem of soft open points (SOPs) and renewable distributed generators allocation along with new network reconfiguration methodology under different loading conditions to minimize the total power loss in balanced distribution systems. Multi-scenario studies, which aim to improve the investigation of the overall performance of the strategies, are conducted on IEEE 33-node and 83-node balanced distribution systems. The contributions of SOP losses to the total active losses, as well as the effect of increasing the number of SOPs connected to the system, are investigated to determine the real benefits gained from their allocation. The results obtained validate, with proper justifications, the effectiveness of allocating both SOPs and renewable distributed generators with the proposed network reconfiguration methodology to provide the best operation of distribution networks with minimum losses and enhanced power quality performance. It was also shown that SOPs successfully assist the growing integration plans of the renewable distributed generators units and can address issues related to voltage violations and network losses efficiently.

Using a theorem of Ulam and Hyers, we will prove the Hyers-Ulam stability of two-dimensional Lagrange's mean value points $(\eta, \xi)$ which satisfy the equation, $f(u, v) - f(p, q) = (u-p) f_x(\eta, \xi) + (v-q) f_y(\eta, \xi)$, where $(p, q)$ and $(u, v)$ are distinct points in the plane. Moreover, we introduce an efficient algorithm for applying our main result in practical use.

This thesis completion works it out to deepen into diverse modeling techniques for Point Absorbers. A combined frequency-time domain model is conceived, designed and developed in Matlab with FoRtran as a base., leading to obtain physical variables of primary importance, namely position, velocity and power to Energy net balance relationships of absorption. Integration of different degrees of freedom with heave as main executable leads in turn to a single buoy motion focus. Acquisition of the needed hydrodynamic coefficients is provided though application of NEMOH & BEMIO solvers due to the Boundary Element Methodology. Initially, this Wave-to-motion model is validated through comparison with previous experimental results for a floating cone cylinder shape (Buldra-FO3). A single, generic, vertical floating cylinder is contemplated then, that responds to the action of the passing regular waves excitation. Later, two equally sized vertical floating cylinders aligned with the incident wave direction are modeled for a variable distance between the bodies. For both unidirectional regular and irregular waves as an input in deep water, we approximate the convolutive radiation force function term through the Prony method. By changing the spatial disposition of the axisymmetric buoys, using for instance triangular or rectangular shaped arrays of three and four bodies respectively, the study delves into motion characteristics for regular waves. The results highlight efficient layouts for maximizing the energy production whilst providing important insights into their performance, revealing displacement amplification- and capture width-ratios, while deriving in possible interpretations of scenarios related to the the known park effect. These terms are encompassed by the novelty of a new conceptual Post-Processing methodology in the field, which leads to obtain an optimal distance for the separated bodies with effective energy absorption in a regular wave regime. In conclusion, this computational excursion envisions and proposes potentials fields of study, which will surely enhance new connections and link this renewable energy form.

In this study we discuss critical issues in modelling the structure and function of lymph nodes (LNs), with emphasis on how LN physiology is related to its multi-scale structural organization. In addition to macroscopic domains such as B-cell follicles and the T cell zone, there are vascular networks which play a key role in the delivery of information to the inner parts of the LN, i.e., the conduit and blood microvascular networks. We propose object-oriented computational algorithms to model the 3D geometry of the fibroblastic reticular cell (FRC) network and the microvasculature. Assuming that a conduit cylinder is densely packed with collagen fibers, the computational flow study predicted that the diffusion should be a dominating process in mass transport than convective flow. The geometry models are used to analyze the lymph flow properties through the conduit network in unperturbed- and damaged states of the LN. The analysis predicts that elimination of up to 60–90 % of edges is required to stop the lymph flux. This result suggests a high degree of functional robustness of the network.

Despite more than hundred years of research since Sir Sherrington’s studies on reflexes, his questions are still somehow unanswered. On what anatomical stage do the play of spinal reflex interaction take place? What are the physiological properties of this anatomical substrate? In this paper, we address these questions in light of the most advanced theory of motor control and the anatomical discoveries on the fascia that are changing how we think about control of action and perception. There are two sides of the problem: the neurological (reflex) connections that are at the base of movement, and the anatomical substrate that regulates and coordinates the movement. We recently advanced a hypothesis on how these two elements are connected and how they interplay. Here we further explain the concept of the somatic equilibrium point – SEP – and its central role in movement control and coordination. It is our belief that the concept of SEP explains how the neuro-mechanical control of movement is organized at peripheral level. At this level, intrafusal and extrafusal muscle fibres are combined in myofascial units, organized in anatomical directions. Myofascial units are closed systems whose behaviour can be affected by neural (voluntary) control or changes in external forces. SEPs represent the intrinsic equilibrium of the myofascial units, and are connected through the continuum of the fascia so that mechanical transfer of tension from segment to segment pre-adjust muscle fibers length and hence their excitation level. This is how coordination between segments is achieved. Finally, we suggest SEPs create the neurological representation of the referent configuration for action, and configurations are linked to the architecture of the fascial system.

We discuss methods for calculation of critical indices and amplitudes from the perturbative expansions. Several important examples of the Stokes flow through 2D and 3D channels are brought up. Power series for the permeability derived for small values of amplitude are employed to calculation of various critical exponents in the regime of large amplitudes. Special nonlinear approximations valid for arbitrary values of the wave amplitude are derived from the expansions. The technique developed for critical phenomena is applied then for relaxation phenomena. The concept of time-translation invariance is discussed, its spontaneous violation and restoration considered. Emerging probabilistic patterns correspond to a local breakdown of time-translation invariance. Their evolution leads to the timetranslation symmetry complete (or partial) restoration. We estimate typical time extent, amplitude and direction for such restorative process. The new technique is based on explicit introduction of origin in time. After some transformations we come to the exponential and generalized, exponential-type solution with explicit finite time scale, which was only implicit in initial parametrization with polynomial approximation. The concept of crash as a relaxation phenomenon, consisting of time-translation invariance breaking and restoration, is put forward. COVID-19 related mini-crash in the time series for Shanghai Composite is discussed as an illustration.

This work provides critical commentary on and corrections of a recently published taxonomy of Montiaceae. Valid citation and publication dates of novel taxa per the International Code of Nomenclature for Plants, Algae, and Fungi are summarized.

Objectives: The purpose of this systematic review was to ascertain critical care nurses’ understanding and experiences of patient advocacy in adult critical care settings. The specific objectives were to identify how critical care nurses define patient advocacy, to explore the understanding and experiences of critical care nurses regarding patient advocacy, to explore critical care nurses’ role in patient advocacy, and to ascertain the barriers to encouraging advocacy in the critical care setting. Research design: Systematic literature search of CINAHL and Medline databases, Google Scholar, and Cochrane Database of Systematic Reviews, as well as grey literature search, was conducted. Search dates were restricted from January 2005 to 2015 in both CINAHL and Medline. Findings: 62 studies were identified, of which 6 qualitative research papers were included. Nurses gave varied definitions of patient advocacy, which were categorized into three themes: communication, protection, and doing. Nurses perceive advocacy as truly listening to patients and their families. Conclusion: For critical care nurses to be effective advocates, there must be support, collaboration, and improved working relationship between professional groups. Moreover, nurses must be empowered to be able to give power to patients and family.

This comprehensive review has systematically examined the use of heterogeneous solid acid catalysts in the production of biodiesel from wastewater-derived sludge by using the PRISMA methodology. The manuscript highlighted the composition and characteristics of wastewater-derived sludge, presenting both the opportunities and challenges associated with its use as a feedstock for biodiesel production. Various types of catalysts were dis-cussed, with a detailed exploration of heterogeneous solid acid catalysts, including zeolites, hetero-polyacid (HPA), mixed metal oxides, and sulphonic acid group catalysts. The advantages and limitations of these catalysts were critically analyzed, providing a balanced view of their potential in industrial applications. The application section delved into the catalytic transesterification reaction, mechanisms of biodiesel production, and the effects of catalyst loading on yield. Performance metrics such as catalytic activity, stability, recyclability, cost-effectiveness, and environ-mental impact were thoroughly evaluated, offering a clear understanding of the efficacy of these catalysts. Synthesis and characterization techniques were also reviewed, shedding light on the latest preparation methods and characterization techniques. Recent advances in catalyst development were presented, showcasing the innovative strides made in enhancing catalyst performance. The environmental and economic implications of using solid acid catalysts for bio-diesel production were assessed, emphasizing the importance of sustainability and economic viability.

Chronic obstructive pulmonary disease (COPD) patients are particularly susceptible to respiratory infections like influenza, which exacerbate symptoms and increase healthcare utilization. While smoking cessation and influenza vaccination are recommended preventive measures, their combined impact on healthcare resource utilization is underexplored. The Charlson Comorbidity Index (CCI) assesses comorbidity burden in COPD patients and may influence healthcare outcomes. We conducted a retrospective analysis of 357 COPD patients, evaluating smoking cessation success over one year and influenza vaccination receipt, stratifying patients by CCI scores. Healthcare utilization outcomes included emergency room visits, hospitalizations, and medical expenses. Results showed that 51.82% of patients quit smoking and 59.66% received influenza vaccination, with higher comorbidity prevalence in advanced COPD stages (p=0.002). Both smoking cessation and influenza vaccination independently correlated with decreased emergency room visits, hospital admissions, days, and costs. Patients who both quit smoking and received influenza vaccination exhibited the lowest healthcare utilization rates. In conclusion, smoking cessation and influenza vaccination significantly reduce healthcare resource utilization in COPD patients, with the combination yielding synergistic benefits, particularly in those with lower CCI scores. Integrating these interventions and comorbidity management in COPD strategies is essential for optimizing patient outcomes and healthcare efficiency.

Bioimpedance analysis (BIA) is a validated non-invasive technique already proven to be useful for the diagnosis, prognosis, and management of body fluids in subjects with heart failure (HF) and chronic kidney disease (CKD). Although BIA has been widely employed for research purposes, its clinical application is still not fully widespread. The aim of this review is to provide a comprehensive overview of the state of art of BIA utilization by analysing the clinical benefits, limitations, and the potential future developments in this clinically unexplored field.

There is limited real-world data from India examining the treatment characteristics, safety, and efficacy of ceftazidime-avibactam against Gram-negative organisms especially multidrug-resistant pathogens including Carbapenem-Resistant Enterobacterales and Carbapenem-Resistant Pseudomonas. In this retrospective study, the real-world treatment patterns, effectiveness, and safety of ceftazidime-avibactam in treating Gram- negative infections were assessed. Data was extracted from electronic health records of adult patients admitted to the hospital with documented Gram-negative infection who had received treatment for at least 48 hours with ceftazidime-avibactam as a part of routine clinical management. Among the 189 patients, on day 3, clinical symptoms improvement was recorded in 79.6% of patients. Clinical success was achieved in 79.5% and 76.3% of assessed patients on day 7 and day 14/End-of-treatment, respectively. Microbiological success was reported in 76% of patients on day 7 and in 60.3% of patients on day 14 or EOT. The mean treatment duration of ceftazidime-avibactam therapy was 6.92 (± 4.1) days. No new safety concerns were identified. In conclusion, this study provides real-world evidence on treatment patterns and clinical outcomes associated with ceftazidime-avibactam in India, complementing the previously reported literature. The results suggest ceftazidime-avibactam is an effective and tolerable option for the management of Gram-negative infections in critically ill patients.

Geodetic networks are essential for most geodetic, geodynamics and civil projects, such as monitoring the position and deformation of man-made structures, monitoring the crustal deformation of the Earth, establishing and maintaining a geospatial reference frame, mapping, civil engineering projects and so on. Before the installation of geodetic marks and gathering of survey data, geodetic networks need to be designed according to the pre-established quality criteria. In this study, we present a method for designing geodetic networks based on the concept of reliability. We highlight that the method discards the use of the observation vector of Gauss-Markov model. In fact, the only needs are the geometrical network configuration and the uncertainties of the observations. The aim of the proposed method is to find the optimum configuration of the geodetic control points so that the maximum influence of an outlier on the coordinates of the network is minimum. Here, the concept of Minimal Detectable Bias defines the size of the outlier and its propagation on the parameters is used to describe the external reliability. The proposed method is demonstrated by practical application of one simulated levelling network. We highlight that the method can be applied not only for geodetic network problems, but also in any branch of modern science.

Poverty has long been associated intricately with neurological disorders. Majority of the previous studies designed to describe the effects of poverty on neurological ailments have mostly linked the association of hypoxic ischemic encephalopathy and nutritional deficiency disorders with poverty. Authors herein try to delve deeper into this issue. The association of begging with neuropsychiatric disorders is robust. The burden of probable autosomal dominant neurological ailments is very common among beggars; followed by neurological disorders with social stigma like abnormal movements, facial dysmorphism and gait unsteadiness. Dearth of support from family members in autosomal dominant neurological disorders (as family members are likely to be suffering from similar neurodegenerative disorder ) and poor perception about neurological diseases, misconceptions, myths and low educational attainment at large in the society can be implicated as the often overlooked but important factors underneath this association of begging and neurological disorders.

To clarify the relationships among critical temperature, critical magnetic field, and critical current density, this paper describes many-body interactions of quantum magnetic fluxes (i.e., vortices) and calculates pinning-related critical current density. All calculations are analytically derived, without numerical or fitting methods. Afteralculating a magnetic flux quantum mass, we theoretically obtain the critical temperature in a many-body interaction scenario (which can be handled by our established method). We also derive the critical magnetic field and inherent critical current density at each critical temperature. Finally, we determine the pinning-related critical current density with self-fields. The relationships between the critical magnetic field and critical temperature, inherent critical current density and critical temperature, and pinning critical current density and temperature were consistent with experimental observations. From the critical current density and critical magnetic field, we clarified the magnetic field transition. It appears that a magnetic flux quantum collapses when the lattice of magnetic flux quanta melts. Our results, combined with our previously published papers, provide a comprehensive understanding of the transition points in high-T_c cuprates.

In the brain, astrocytes regulate shape and functions of the synaptic and vascular compartments through a variety of released factors and membrane-bound proteins. An imbalanced astrocyte activity can therefore have drastic negative impacts on brain development, leading to the onset of severe pathologies. Clinical and pre-clinical studies show alterations in astrocyte cell number, morphology, molecular makeup and astrocyte-dependent processes in different affected brain regions in neurodevelopmental (ND) and neuropsychiatric (NP) disorders. Astrocytes proliferate, differentiate and mature during the critical period of early postnatal brain development, a time window of elevated glia-dependent regulation of a proper balance between synapse formation/elimination, which is pivotal in refining synaptic connectivity. Therefore, any intrinsic and/or extrinsic factors altering these processes during the critical period may result in an aberrant synaptic remodelling and onset of mental disorders. The peculiar bridging position of astrocytes between synaptic and vascular compartments further allows them to “compute” the brain state and consequently secrete factors in the bloodstream, which may serve as diagnostic biomarkers of distinct healthy or disease conditions.Here, we collect recent advancements regarding astrogenesis and astrocyte-mediated regulation of neuronal network remodelling during early postnatal critical periods of brain development, focusing on synapse elimination. We then propose alternative hypotheses for an involvement of aberrancies in these processes in the onset of ND and NP disorders. In light of the well-known differential prevalence of certain brain disorders between males and females, we also discuss putative sex-dependent influences on these neurodevelopmental events.From a translational perspective, understanding age- and sex-dependent astrocyte-specific molecular and functional changes may help to identify biomarkers of distinct cellular (dys)functions in health and disease, favouring the development of diagnostic tools or the selection of tailored treatment options for male/female patients.