Large datasets play a crucial role in the progression of surgical robotics, facilitating advancements in the fields of surgical task recognition and automation. Moreover, public datasets enable the comparative analysis of various algorithms and methodologies, thereby assessing their effectiveness and performance. The ROSMA (Robotics Surgical Maneuvers) dataset provides 206 trials of common surgical training tasks performed with the da Vinci Research Kit (dVRK). In this work, we extend ROSMA dataset with two annotated subsets: ROSMAT24, which contains bounding box annotations for instrument detection, and ROSMAG40, which contains high and low level gesture annotations. We propose an annotation method that provides independent labels for the right-handed tool and the left-handed tool. For instrument identification, we validate our proposal with a YOLOv4 model in two experimental scenarios. We demonstrate the generalization capabilities of the network to detect instruments in unseen scenarios. For gesture segmentation, we propose two label categories: high-level annotations that describe gestures at a maneuvers level, and low-level annotations that describe gestures at a fine-grain level. To validate this proposal, we have designed a recurrent neural network based on a bidirectional long-short term memory layer. We present results for four cross-validation experimental setups, reaching up to a 77.35% mAP.

Background: The modified Duke index derived from coronary computed tomography angiography (CCTA) was designed to predict cardiovascular outcomes based on the severity of coronary ste-nosis. However, it does not take into consideration the presence or severity of peri-coronary in-flammation. The peri-coronary fat attenuation index (FAI) is a novel imaging marker determined by CCTA which reflects the degree of inflammation in the coronary tree in patients with coronary artery disease. Purpose: To assess the association between the modified Duke index assessed by CCTA, cardiovascular risk factors and peri-coronary inflammation in the coronary arteries of pa-tients with coronary artery disease. Methods: One hundred seventy-two patients who underwent CCTA for typical angina were assigned into two groups based on the modified Duke index: group 1 – patients with low index ≤ 3 (n=107) and group 2 – patients with high index > 3 (n=65). Demo-graphic, clinical and CCTA data were collected for all patients, and FAI analysis of coronary in-flammation was performed. Results: Patients with increased values of the modified Duke index were significantly older compared to those with a low index (61.83 ± 9.89 vs. 64.78 ± 8.9; p = 0.002). No differences were found between the two groups in terms of gender distribution, hypertension, hypercholesterolemia or smoking history (all p > 0.5). The FAI score was significantly higher in patients from group 2, who presented a significantly higher score of inflammation compared to the patients in group 1, especially at the level of the right coronary artery (FAI score 20.85 ± 15.80 vs. 14.61 ± 16.66; p = 0.01 for the right coronary artery, 13.85 ± 8.04 vs. 10.91 ± 6.5; p = 0.01 for the circumflex artery, and 13.26 ±10.18 vs. 11.37 ± 8.84; p = 0.2 for the left anterior descending artery). CaRi-Heart® analysis identified a significantly higher risk of future events among patients with a high modified Duke index (34.84 % ± 25.86 % versus 16.87 % ± 15.80 %; p

Abstract: The VSI represents a significant advancement in the assessment of gastrointestinal-specific anxiety among patients with Irritable Bowel Syndrome (IBS) and other Chronic Inflammatory Bowel Diseases (IBD). However, an Italian version of the instrument is not yet available for the reference population. This study utilized a national sample of 500 individuals, including healthy controls and patients with Ulcerative Colitis and Crohn's Disease, to test the validity and reliability of the Italian VSI. Using back-translation methodology to ensure translation fidelity, the research applied a questionnaire and the VSI through an online format to 500 participants. Data analysis revealed that the Italian VSI had excellent psychometric properties, demonstrating high internal consistency (Cronbach’s α = 0.95) and construct validity. The scale proved sensitive in detecting significant differences in visceral sensitivity among groups, highlighting its utility as a clinical and research assessment tool. Specifically, the Italian VSI exhibited a unidimensional factorial structure and maintained a strong correlation with other measures of anxiety and the severity of gastrointestinal symptoms, confirming its role in enhancing the understanding and management of IBS and IBD in Italy.

Annually, the oak forests of the Zagros Mountain chains, in western Iran and northeastern Iraq, face recurring challenges posed by forest fires, particularly in the Kurdo-Zagrosian forests situated in western Iran and northeastern Iraq. Assessing fire susceptibility relies significantly on vegetation condition. Integrating in situ data, Remote Sensing (RS) data, alongside the integration of Geographical Information Systems (GIS), presents a cost-effective and precise approach to capturing environmental conditions before, during, and after fire events, minimizing the need for extensive fieldwork. This study refines and applies the Zagros Grass Index (ZGI), a local vegetation index tailored to discern between grass-covered surfaces from tree canopies in Zagros forests, identifying the grass masses as the most flammable fuel type. Utilizing Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Difference Vegetation Index (NDVI) product as input, from 2013 to 2022, the ZGI aims to mitigate the influence of tree canopies, isolating NDVI values solely attributable to grass cover. By incorporating phenological characteristics of forest trees and grass species, the ZGI outperforms NDVI in mapping grass-covered areas that are crucial for fire susceptibility assessment in the study region. Results demonstrate a strong overlap between ZGI-based maps and recorded fire occurrences, validating the efficacy of the index in fire susceptibility estimation.

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

Introduction: Epilepsy is one of the most common neurological diseases. Epilepsy poses a significant burden on the quality of life of affected individuals and their families. The aim of this study was to determine the psychiatric disorders in epileptic patients. Methods and Materials: This descriptive-analytical study was conducted in 2017 with a simple random sampling method on patients with epilepsy who admitted to the neurology department. Results: Among the 150 examined patients, 88 (58.7%) were female and 63(42%) had epilepsy more than 10 years. The most common psychiatric disorder among epileptic patients was depression (68 patients = 45.3%) and anxiety (65 patients = 43.3%) patients. Conclusion: Most of patients had more than 10 years history of epilepsy. Also, Anxiety and depression were the most common symptoms in epileptic patients. It need to more study to determine the psychiatric disorders in epileptic patients.

The study aimed to estimate the prevalence of respiratory symptoms and to assess respiratory health risks associated with Particulate Matter (PM) exposure among the residents of Windhoek, Namibia. Objectives: To measure particulate pollution concentration in Windhoek through monitoring of particulate matter concentration and to identify any associations between particulate pollution, individual location and respiratory health among the Windhoek resident’s. Methods: an adapted standardized self-administered questionnaire was used to collect respiratory health related data as well as previous exposure, while PM monitoring was done using ASTM D1739 reference method. Results: A high prevalence was observed for cough (43%), breathlessness (25%), and Asthma (11.2%). PM was found to be a significant risk factor for episode of cough and phlegm, while high PM exposure category had increased odds ratio for episode of phlegm and cough (OR: 2.5, 95% CI: 0.8-8.0). No association was observed between location and respiratory health outcomes. Conclusion: The study found high levels of PM concentration across all Windhoek suburbs which were above the German, American and EPA. Enactment of legislation relating to the control and monitoring of PM related emissions at point of generation is required at country and city level.

Climate change is challenging the agricultural sector worldwide. The pressure exerted by the altered thermal conditions drives the zonal shift for various cultivations. This study presents the multiyear analysis of the Growing Degree Days (GDD) index over the Northern Mediterranean Basin (NMB), focused on the high-value vine cultivation derived from the E-OBS dataset. To handle this extensive environmental dataset, R-language scripts and packages were applied, along with the capabilities of the GIS software. The investigated time period spans from 1969 to 2018, and the performed analysis indicates a broad shift/expansion in areas of GDD exceeding 2000 heat units. The extracted results specify the viticultural areas where the GDD index surpasses the suitable values for vine cultivation, owing to the increase of the thermal stress risk. In addition to mapping areas with GDD ≥ 2000, spatial calculations of the surface of areas meeting this criterion per country in the study area were made. In the northern parts of the NMB, the rise of the GDD index values indicates the establishment of vine plantations in the future.

Floods are a common natural disaster whose severity in terms of duration, water resource volume, peak and accumulated rainfall-based damage are likely to differ significantly for different geographical regions. In this paper, we first propose a novel hourly flood index (SWRI24−hr−S), derived from normalising the existing 24-hourly water resources index (WRI24−hr−S) in literature, to monitor flash flood risks on an hourly scale. The proposed SWRI24−hr−S is adopted to identify a flood situation and derive its characteristics, such as the duration (D), volume (V) and peak (Q). The comprehensive result analysis establishes the practical utility of SWRI24−hr−S in identifying flood situations at seven study sites in Fiji between 2014 and 2018 and deriving their characteristics (i.e., D, V, and Q). Secondly, this study develops a vine copula-probabilistic risk analysis system that models the joint distribution of flood characteristics (i.e., D, V, and Q) to extract their joint exceedance probability for the seven study sites in Fiji, enabling probabilistic flood risk assessment. The vine copula approach, particularly suited to Fiji’s study sites, introduces a novel probabilistic framework for flood risk assessment. The results show moderate differences in the spatial patterns of joint exceedance probability of flood characteristics in different combination scenarios generated by the proposed vine copula approach. In the worst-case scenario, the probability of any flood event occurring where the flood volume, peak and duration are likely to exceed the 95th-quantile value (representing an extreme flood event) is found to be less than 5% for all study sites. The proposed hourly flood index and the vine copula approach can be feasible and cost-effective tools for flood risk monitoring and assessment. The methodologies proposed in this study can be applied to other data-scarce regions where only rainfall data is available, offering crucial information for flood risk monitoring, assessment, and the development of effective mitigation strategies.

Recent analyses of cosmic microwave background surveys have revealed hints that there may be a non-trivial running of the running of the spectral index. If future experiments were to confirm these hints, it would prove a powerful discriminator of inflationary models, ruling out simple single field models. We discuss how isocurvature perturbations in multi-field models can be invoked to generate large runnings in a non-standard hierarchy, and find that a minimal model capable of practically realising this would be a two-field model with a non-canonical kinetic structure. We also consider alternative scenarios such as variable speed of light models and canonical quantum gravity effects and their implications for runnings of the spectral index.

In the paper the verification of forecasts of precipitation conditions measured by the standardized precipitation index SPI is presented. For the verification of categorical forecasts a contingency table was used. Standard verification measures were used for the SPI value forecast. The 30 day SPI moved every 10 days by 10 days was calculated in 2013-2015 from April to September on the basis of precipitation data from 35 meteorological stations in Poland. Predictions of the 30 day SPI were created in which precipitation was forecasted in the next 10 days (the SPI 10-day forecast) and 20 days (the SPI 20-day forecast). Both for the 10 and 20 days, the forecasts were skewed towards drier categories at the expense of wet categories. There was a good agreement between observed and 10-day forecast categories of precipitation. Less agreement is obtained for 20-day forecasts – these forecasts evidently “over-dry” the assessment of precipitation anomalies. The 10-day SPI value forecast accuracy is acceptable, whereas for the 20-day forecast is unsatisfactory. Both for the SPI categorical and the SPI value forecast, the 10-day SPI forecast is reliable and the 20-day forecast should be accepted with reservation and used with caution.

Aim: To investigate inflammation indices and erythropoietin (EPO) levels for their potential role in distinguishing polycythemia vera (PV) from secondary polycythemia (SP), and to compare different parameter combinations in terms of diagnostic accuracy. Methods: This retrospective cohort was created from patients assessed for polycythemia from January 2020 to December 2023. PV diagnosis was made according to the 2016 WHO criteria (n=145). Those who did not fulfill the criteria were defined as having SP (n=84). Results: NLR, PLR and SII were significantly higher in the PV group (p

This research aimed to investigate the relationship between climate policy uncertainty (CPU), clean energy (ENERGY), carbon emission allowance prices (CARBON), and Bitcoin returns (BTC) for the period from August 2012 to August 2022. The empirical analysis strategies utilized in this study included the Fourier Bootstrap ARDL long-term coefficient estimator, Fourier Granger Causality, and Fourier Toda Yamamoto Causality methods. Following the confirmation of cointegration among the variables, we observed a positive relationship between BTC and CARBON, a positive relationship between BTC and CPU, and a negative relationship between BTC and ENERGY. In terms of causal associations, we identified one-way causality running from CARBON to BTC, BTC to CPU, and BTC to the ENERGY variable. The study underscores the potential benefits and revenue opportunities for investors seeking diversified investment strategies in light of climate change concerns. Furthermore, it suggests actionable strategies for policymakers, such as implementing carbon taxes and educational campaigns, to foster a transition towards clean energy sources within the cryptocurrency mining sector and thereby mitigate environmental impacts.

Button batteries pose a significant threat to young children and are found in many household items and children’s toys. Along with product manufacturers and retailers, parents and caregivers have a role in button battery ingestion prevention through vigilance regarding items containing button batteries in the home, and knowledge of button battery ingestion symptoms. There is limited information available about parent and caregiver perspectives towards button battery safety. Identifying the areas where increased education is required is important for informing safety campaigns and delivering targeted education. This study aimed to examine parent and caregiver elemental perspectives on button battery safety. One hundred and seventy-four parents and caregivers of children aged 0 to 5 completed a cross-sectional online survey. Distribution occurred via social media. The survey contained multiple-choice questions pertaining to button battery perspectives, and one open-ended question. Respondents recognized the dangers of button battery ingestion, yet only 37% reported being familiar with button battery ingestion symptoms. While 68% knew of household items containing button batteries, only 21% were aware of product recall information sources. Approximately 64% understood immediate post-ingestion steps and 17% found current safety labels unsatisfactory. In an open-ended question, parents and caregivers provided comments about button battery safety that revealed five broad themes; supervision and education; safe storage of button batteries in the home; ensuring children cannot access button batteries; disposing of button batteries safely; and avoiding purchasing items containing button batteries. This study provides a foundation for ongoing investigation of parent and caregiver perspectives on button battery home safety.

Floods are among the most serious natural disasters worldwide; they cause enormous crop losses every year and threaten world food security. There are many studies focused on flood impact assessments for administrative districts but fewer on postdisaster impact assessments for specific crops. Therefore, this study used remote sensing data, including the normalized difference vegetation index (NDVI), elevation data, slope data, and rainfall data, combined with crop growing season data to construct a crop flood damage assessment index (CFAI). First, an analytic hierarchy process (AHP) was used to assign weights to the impact factors; then, the weighted composite score method was used to calculate the CFAI; and finally, the impact was classified as slight, moderate, or severe based on the magnitude of the CFAI . This method was used for the Missouri River floods of 2019 in the U.S. Due to the lack of measured data, the disaster vegetation damage index (DVDI) was used to validate the results. The combined approach achieved a high degree of consistency in spatial distribution. The CFAI can respond well to the degree of crop impact after flooding, providing new ideas and reference standards for agriculture-related departments.

Surface water distribution extracted from remote sensing data has been used in water resource assessment, coastal management, and environmental change studies. Traditional manual methods for extracting water bodies cannot satisfy the requirements for mass processing of remote sensing data; therefore, accurate automated extraction of such water bodies has remained a challenge. The histogram bimodal method (HBM) is a frequently used objective tool for threshold selection in image segmentation. The threshold is determined by seeking twin peaks, and the valley values between them; however, automatically calculating the threshold is difficult because complex surfaces and image noise which lead to not perfect twin peaks (single or multiple peaks). We developed an operational automated water extraction method, the modified histogram bimodal method (MHBM). The MHBM defines the threshold range of water extraction through mass static data; therefore, it does not require the identification of twin histogram peaks. It then seeks the minimum values in the threshold range to achieve automated threshold. We calibrated the MHBM for many lakes in China using Landsat 8 Operational Land Imager (OLI) images, for which the relative error (RE) and squared correlation coefficient (R2) for threshold accuracy were found to be 2.1% and 0.96, respectively. The RE and root-mean-square error (RMSE) for the area accuracy of MHBM were 0.59% and 7.4 km2. The results show that the MHBM could easily be applied to mass time-series remote sensing data to calculate water thresholds within water index images and successfully extract the spatial distribution of large water bodies automatically.

The fetal splenic artery pulsatility index (PI) is a parameter that reflects fetal well-being and has been used as a predictor of adverse pregnancy outcomes. The aim of this study was to investigate the predictive value of splenic artery PI in GDM class A1 cases for NICU admission. In this prospective case controlled study, only sixty single pregnancy cases diagnosed with gestational diabetes mellitus class A1 were evaluated. Fetal splenic artery Doppler parameters Peak systolic velocity (PSV), Pulsatility index (PI), Resistivity index (RI) and End diastolic velocity (EDV) were measured in all cases. The rate of re-quirement of need of neanoatal intensive care unit was noted. In cases with need fetal intensive care, fetal splenic PI index was found to be statistically significantly lower than in healthy cases without it (0.94 ± 0.29 vs. 1.70 ± 0.53, respectively, p

This article presents a novel sustainable business management technique, emphasizing description and estimation over the outdated profit metric. Due to the intricacies and challenges of implementing the 2019 capital management method based on capital valuation (implemented in 2020–2022), a simpler approach became essential. While it is plausible for organizations to implement capital management based on their valuation, undertaking it with no outside help presents a challenge. The new descriptive method is fundamentally distinct in that detailed monetary valuations of capitals are omitted in favor of description and estimation. This paper establishes the groundwork for applying the new approach in several stages and introduces three new management indicators—the overall accomplishment of management goals index (evaluating management efficacy), the capital level index, and the adjustment (compliance) index—replacing the profit metric. Noteworthy advantages include separating the assessment of management outcomes from the organization's condition, including human and social capital into efficiency evaluations, and removing the profit indicator for management purposes, which prevents resource waste and enhances company efficiency and effectiveness.

Descriptive geometry has indispensable applications in many engineering activities, some of which are presented in the first chapter of this paper in order to place the development presented here among them. As a result of the continuous variability of the technological environment according to various optimization aspects, the engineering activities must also be continuously adapted to the changes, which an appropriate approach and formulation are required from the practitioners of descriptive geometry, and can even lead to improvement in the field of descriptive geometry. The imaging procedures are always based on the methods and theorems of descriptive geometry. Resolving contradictions in spatial geometry reconstruction research is a constant challenge, to which a possible answer in many cases is the search for the right projection direction. A special method of enumerating the possible infinite viewpoints for the representation of the surface edge curves is presented in another part of the paper. The procedure for determining the correct directions in a mathematically exact way is also presented through examples. The analysis and some of the results of the Monge mapping, which is suitable for the solution of a mechanical engineering task to be solved in a specific technical environment, are also presented.

Plant leaf area index (LAI) is a key characteristic affecting field canopy microclimate. In addition to traditional professional measuring instruments, smartphone camera sensors have been used to measure plant LAI. However, when smartphone methods were used to measure conifer forest LAI, very different performances were obtained depending on whether the smartphone was held at the zenith angle or at a 57.5° angle. To validate further the potential of smartphone sensors for measuring conifer LAI and to find the limits of this method, this paper reports the results of a comparison of two smartphone methods with an LAI-2000 instrument. It is shown that both methods can be used to reveal the conifer leaf-growing trajectory. However, the method with the phone oriented vertically upwards always produced better consistency in magnitude with LAI-2000. The bias of the LAI between the smartphone method and the LAI-2000 instrument was explained with regard to four aspects that can affect LAI: gap fraction, leaf projection ratio, sensor field of view (FOV), and viewing zenith angle (VZA). It was concluded that large FOV and large VZA cause the 57.5° method to overestimate the gap fraction and hence underestimate conifer LAI, especially when tree height is greater than 2.0 m. For the vertically upward method, the bias caused by the overestimated gap fraction is compensated for by an underestimated leaf projection ratio.

Properties of time domain parameters of the vibration signal have been extensively studied for the fault diagnosis of rolling element bearings (REB). Parameters like kurtosis and Envelope Harmonic-to-Noise Ratio are most widely applied in this field and some important progress has been made. However, since only one-sided information is contained in these parameters respectively, problems still exist in practice when the signals collected are of complicated structure and/or contaminated by strong background noises. A new parameter, named Shock pulse index (SPI), is proposed in this paper. It integrates the mutual advantage of both parameters above and can help effectively identify fault related impulse components under the interference of strong background noises, unrelated harmonic components and random impulses. The SPI optimizes the parameters of Maximum Correlated Kurtosis Deconvolution (MCKD), which is used to filter the signals under consideration. Finally, the interested transient information contained in the filtered signal can be highlighted through demodulation with Teager Energy Operator (TEO). Fault related impulse components can therefore be extracted accurately. Simulations and experiment analyses verify the effectiveness and correctness of the SPI.

Abstract: Doppler renal resistive index (RRI) has been used for several decades as a potential indi-cator for renal disease and progression. In recent years, RRI has emerged as a useful prognostic indicator for a range of co-morbidities in patients who are acutely unwell and as a potential marker for sub-clinical acute kidney injury (AKI) and post procedural AKI risk. Despite this, the clinical and theoretical determinants of RRI are poorly understood and remain contentious. Method: A narrative review of studies exploring the theoretical, experimental, and clinical evidence for factors affecting RRI. No date restrictions were set. Findings: Both experimental and clinical data confirm that RRI is markedly affected by a range of systemic and renal determinants and is influenced closely by the underlying risk factors and sys-temic vascular changes that lead to progressive renal damage. Discussion: This paper provides an overview of the key haemodynamic determinants of renal re-sistive index and aims to clarify their relative importance. With reference to a simplified theoretical model, evidence from experimental and clinical studies is reviewed. Pathophysiological factors and patient characteristics that influence RRI are explored to provide a better understanding of why RRI values change in the presence of common or complex pathologies. Conclusion: By gaining a better understanding of the complex systemic and renal factors that influ-ence RRI, ultrasound users will be better prepared to understand and interpret changes in RRI across a range of patient presentations.

Puerto Rico is a neotropical island located in the Caribbean. Like other neotropical regions, Puerto Rico streams discharges can vary with the seasons, atmospheric events, and human activities. The Lapa River is part of the Puerto Rico Heritage Rivers Program. This program identifies and manages the protection of hydrographic systems that maintain their natural conditions. The necessity of increasing the knowledge of the natural processes of the Lapa River and providing valuable information for the development of a future management plan for the ecosystem, the following objectives were established in this research: (1) to describe the temporal variations in water discharges in the Lapa River and (2) to describe the impact of atmospheric events on the water discharges at the Lapa River. This study concluded that the highest annual discharge averages recorded from 1989 to 2021 in the Lapa River occurred in 2011 and 2017. 2011, the annual mean discharge was 31.20 (ft3/s); in 2017, the average was 40.44 (ft3/s). In terms of atmospheric events, this study concludes that, during the evaluated period, the highest discharge event occurred after the impact of hurricanes Irma and Maria, with an average discharge of 164.40 ft3/s in October and 182.60 ft3/s in September. This event set a precedent in the river Lapa’s discharges, impacting the river basin’s flora, fauna, and morphology from its headwaters downstream.

So-called ‘zero’ or ‘null’ tenses have often been characterized as functionally deficient forms, deprived of any inherent content. In this paper, we will focus on the semantics of a morpho-phonologically null inflectional verbal paradigm in Anindilyakwa (Groote Eylandt, N.T., Australia, which is both temporally and aspectually underspecified. Through a quantitative corpus study conducted in the paper, we establish that ‘zero inflection’ in this language, contra prior works on such tenses in general (e.g. Bybee 1990) and in Anindilyakwa in particular (Bednall 2019), presents various degrees of sensitivity to traditional Vendlerian aspectual parameters. We show that while telicity is not a significant predictor for the temporal interpretation of zero-inflected Anindilyakwa verbs, and dynamicity is a good but not very good predictor, only a very broad opposition between change-of-state (including qua boundedness) and non-change-of-state, or perfective/imperfective, gives very significant biases towards past vs. present anchoring. We also show that atomic telicity is the only categorical Aktionsart predictor for temporal anchoring in this context correctly predict the temporal anchoring of such verbs, and stativity is not biased towards present interpretations, thereby questioning currently received typological theories of the semantics of so-called ‘zero-tenses’ / aspectuo-temporally underspecified tenses.

COPD is currently the fourth leading cause of death in the world. Globally, due to continued exposure to COPD risk factors and an aging population, the burden of COPD is expected to increase in the coming decades. The BODE (body mass index, airflow obstruction, dyspnea, and exercise capacity) index is a practical and multidimensional predictor for prognosis of COPD, and better than FEV1.We used the database of Kaohsiung Chang Gung Memorial Hospital medical center, Taiwan to analyze the correlation between BODE index, healthcare resource utilization, and Charlson comorbidity index (CCI). This retrospective study to collect COPD patients with complete BODE index data who had undergone a 6-minute walk examination in our hospital from January 2015 to December 2016. The medical cost and comorbidities database were analyzed from January 1, 2015, to August 31, 2017. Of 396 patients, 382 (96.5%) were male, with an average age of 71.3 ± 8.4 years. There was a significant association between the BODE index and the CCI of COPD patients (p < 0.001). Healthcare resource utilization was positively correlated with the BODE index during the 32 months of retrospective clinical outcomes: positively correlated with the number of hospitalizations (p<0.001), hospitalization days (p<0.001), hospitalization expenses (p=0.005), and total medical expenses (p=0.024), respectively. Our findings provide the crucial information for clinician to predict medical burden and comorbidities in patients with COPD by using BODE index.

Computer extended Descriptive Geometry (CeDG) is a new approach to solve and build computer models of three dimensional (3D) geometrical systems through descriptive geometry procedures that have demonstrated reliability and accuracy. CeDG may calculate a parametric algebraic exact form for the spatial curves generated in the intersection of two surfaces, as well as of the flattened pattern of any developable surface involved in those encounters. This study presents first the theoretical foundations and methodology to calculate those parametric algebraic curves. Secondly, a compound hopper is defined and modelled through CeDG (implemented in GeoGebra) and CAD (Solid Edge 2023) approaches to evaluate the advantages of CeDG against CAD. The results demonstrate the robustness and accuracy of the CeDG technique for surfaces intersection and flattening and the advantages of CeDG against Solid Edge 2023 in solving the hopper case study.

The pandemic has accentuated the power that influencers have to influence their followers. Various scientific approaches highlight the lack of moral and ethical responsibility of these creators when disseminating content under highly sensitive tags such as health. This article presents a correlational statistical study of 443 Instagram accounts with more than one million followers belonging to health-related categories. This study aims to describe the content of these profiles and their authors and to determine whether they promote health as accounts that disseminate health-related content, identifying predictive factors of their content topics. In addition, it aims to portray their followers and establish correlations between the gender of the self-described health influencers, the characteristics of their audience and the messages that these prescribers share. Health promotion is not the predominant narrative among these influencers, who tend to promote beauty and normative bodies over health matters. A correlation is observed between posting health content, the gender of the influencers and the average age of their audiences. The study concludes with a discussion on the role of public media education and the improvement of ethical protocols on social networks to limit the impact of misleading and false content on sensitive topics, increasing the influence of real health prescribers.

Droughts are a common occurrence in various climates and are primarily caused by a prolonged decrease in rainfall. Several factors contribute to droughts, including temperature, wind speed, relative humidity, rainfall timing, amount, and intensity during the growing season. The objective of this study is to establish a new index, named soil moisture and evapotranspiration revealed drought index (SERDI), for displaying dry and wet conditions based on combining both soil moisture and evapotranspiration (Penman-Monteith) to improve drought early warning and its severity globally. For validation of the SERDI with other indices such as LST, VHI, NDVI, and NDWI, different ways used such as R-square, RMSE, MAPE, and P-value to estimate the accuracy, variability of data, the forecast conditions, and how the significance of data. The results showed that the low RMSE and high r² were found between SERDI with LST and VHI. In contrast, the low R- square and high RMSE were between SERDI with NDVI and NDWI in most of the semi-arid areas. Furthermore, most of the semi-arid areas from Iran, Iraq, Syria, Jordan, and Israel experienced moderate and severe dry conditions, except some parts of these regions had normal conditions in Iran and Syria. The SERDI analysis revealed a strong correlation between (LST) and a moderate correlation with (VHI) across all study areas. However, the relationship between other indices, like (NDWI) and (NDVI), varied depending on the regions. To conclude, SERDI can be used globally for detecting drought based on soil moisture and evapotranspiration.

(1) Background: This paper investigates the epidemiological risk related to temperature before and during COVID-19 in Italy; (2) Methods: Deaths in 2015-2019 and temperatures were correlated. Excess and COVID-19 deaths were examined to estimate the relationships with temperatures; (3) Results: Annual deaths were higher during the cold months (+45,000, SD = 4,700, S = 21). The scenario worsened during COVID-19. Mortality was higher during minimum temperature periods, although the curve moderately rose in the warmest months (r = -0.75, 95% CI = [-0.87; -0.56], S = 23). COVID-19 deaths showed a decreasing seasonality. Monthly excess deaths during COVID-19 were high (+4,200, IQR = [2,800; 8,000], S = 28) with a doubt of seasonality. COVID-19 mortality was correlated with regional latitude (r = 0.86, 95% CI = [0.68; 0.94], S = 20). Discrepancies between COVID-19 and excess deaths were found. The exposed population was subject to aging; (4) Conclusions: The epidemiological risk in Italy is seasonal and geographically dependent. Low and very high temperatures can lead to mortality peaks. Therefore, COVID-19 and any other epidemiological risk must be evaluated in light of this evidence. Health systems need to be strengthened during cold and extremely hot periods. Future research should investigate these phenomena at the causal level.

The International Roughness Index (IRI) is the standard scale for evaluating road roughness in many countries in the world. The Taipei City government actively promotes a Road Smoothing Project and plans to complete the rehabilitation of the main and minor roads within its jurisdiction. This study aims to detect the road surface roughness in Taipei City and recommend appropriate IRI thresholds for road rehabilitation. A total of 171 asphalt concrete pavement sections in Taipei City with a total length of 803.49 km were analyzed and compared by IRI. The longitudinal profile of the detected road sections was measured using an inertial profiler. The statistical analysis showed that the IRI value prior to road leveling was mainly distributed between 5 and 8 m/km, while the IRI value after road leveling was mainly distributed between 3 and 4.5 m/km. This confirms that the implementation of the Road Smoothing Project has a significant effect on improving road smoothness. Moreover, based on the analysis results, it is recommended that the IRI threshold value for road rehabilitation in Taipei City be set at 4.50 m/km.

Phlebotomus (Paraphlebotomus) sergenti Parrot, 1917, the proven vector of Leishmania tropica Wright, 1903, the causative agent of anthroponotic cutaneous leishmaniasis, is widely distributed in Morocco. Previous works using molecular markers (ITS2 rDNA and Cyt b mtDNA) have hy-pothesized the existence of multiple closely related populations of sandfly species (cryptic species) that would exhibit distinct vectorial capacities. In this work, descriptive characteristics of wings (size and shape of the right and left wings) were measured in samples collected from fourteen sta-tions in central Morocco. These analyses support the existence of distinct P. sergenti populations, enlightening significant phenotypic variations of P. sergenti’s wings, regarding their size and shape, depending on geographic origin. In addition, geomorphometric analyses of wing’s length, centroid size, alpha, and beta distances allowed clear discrimination of P. sergenti sub-populations. These data pinpoint the adaptative ability of P. sergenti to local environmental conditions. Additional studies are now required to further shed light on the genetic structure of P. sergenti populations in Morocco.

The COVID-19 pandemic has had a substantial impact on global health, notably the virus's association with autoimmune illnesses. Autoimmune illnesses occur when the immune system of the body targets healthy cells, causing damage and inflammation. The potential impact of COVID-19 on autoimmune disorders, the hazards of COVID-19 vaccinations for persons with autoimmune diseases, and the potential risks of COVID-19 vaccines are all discussed in this essay. COVID-19 can cause autoimmune illnesses by causing inflammation, organ and tissue damage, and molecular mimicry, in which the immune system mistakenly assaults healthy cells for the virus. However, not everyone infected with COVID-19 develops autoimmune disorders. While some research has found a link between COVID-19 and autoimmune illnesses, this does not always suggest causation. Other factors, such as genetics and environment, may also play a role in the emergence of autoimmune illnesses. COVID-19 can aggravate existing autoimmune disorders by causing the immune system to attack healthy cells, making management more difficult and increasing the risk of consequences. People with autoimmune disorders, on the other hand, may not be at a higher risk of severe COVID-19 than the general population. Some research has found that persons with autoimmune disorders are more likely to have severe COVID-19, whereas others have found no difference. COVID-19 vaccinations may represent dangers to persons with autoimmune illnesses since they contain antigens that can activate the immune system. Furthermore, due to their already overactive immune systems, some vaccines may not perform as well for people with autoimmune disorders, and some people with autoimmune diseases may have severe reactions to immunizations, producing inflammation and other symptoms. COVID-19 may not be any more hazardous to those with autoimmune illnesses than it is to the general population. The connection between COVID-19 and autoimmune disorders is complicated and under investigation. While some research implies that people with autoimmune disorders have a higher risk of severe COVID-19, others demonstrate no difference in death rates between them and the general population. There are also counterarguments that COVID-19 can induce and exacerbate autoimmune disorders, as well as worries about COVID-19 vaccine hazards for people who have autoimmune diseases. More research is required to completely understand the influence of COVID-19 on autoimmune illnesses, as well as the dangers and benefits of vaccinations for these people.

Purpose of review: Medication overuse headache (MOH) is an important problem worlwide areas of different controversy regarding its entity. This article reviews the risk factors, comorbidities, pathophysiology, clinical presentation, effective management and prognosis of MOH, by summaries and integrates the results and finding in previously performed more than 15000 studies (from the year of 2010 to 2023) available from the scientific database of the University Medical Library in the University Clinical centre of Niš, which aimed to investigate and define a complexcity of this type of headache. Recent finding: It has been proposed that all acute migraine medications can lead to MOH, with differences in the propensity of different agents to cause the problem. Early data suggests that triptans and other pain killers used for the acute treatment of migraine, may be an exception. Recent studies show that practicioners and the general public are still largely unaware of the problem of medication overuse and its damaging effects. Summary: Although it is likely that MOH does occur and restricting the amount of acute medications is necessary to prevent it. It is also possible that increasing amounts of acute medications are simply a reflection of poorly controlled headaches, rather than a couse. Further researches need to be developed to identify more precisious mechanism in MOH effecitive management and its evolution. Key word: medication overuse headache (MOH)

Purpose of review: Medication overuse headache (MOH) is an important problem worlwide areas of different controversy regarding its entity. This article reviews the risk factors, comorbidities, pathophysiology, clinical presentation, effective management and prognosis of MOH, by summaries and integrates the results and finding in previously performed more than 15000 studies (from the year of 2010 to 2023) available from the scientific database of the University Medical Library in the University Clinical centre of Niš, which aimed to investigate and define a complexcity of this type of headache. Recent finding: It has been proposed that all acute migraine medications can lead to MOH, with differences in the propensity of different agents to cause the problem. Early data suggests that triptans and other pain killers used for the acute treatment of migraine, may be an exception. Recent studies show that practicioners and the general public are still largely unaware of the problem of medication overuse and its damaging effects. Summary: Although it is likely that MOH does occur and restricting the amount of acute medications is necessary to prevent it. It is also possible that increasing amounts of acute medications are simply a reflection of poorly controlled headaches, rather than a couse. Further researches need to be developed to identify more precisious mechanism in MOH effecitive management and its evolution.

Rapid development of high-throughput omics technologies generates an increasing interests in algorithms for cutoff point identification. Existing cutoff methods and tools identify cutoff points based on association of continuous variables with another variable, such as phenotype, disease state or treatment group. These approaches are not applicable for descriptive studies in which continuous variables are reported without known association with any biologically meaningful variables. The most common shape of the ranked distribution of continuous variables in high-throughput descriptive studies corresponds to a biphasic exponential/super-exponential curve, where the first phase includes big number of variables with values slowly growing with rank and the second phase includes smaller number of variables rapidly growing with rank. This study describes an easy algorithm to identify the boundary between these phases to be used as a cutoff point. The major assumption of that approach is that small number of variables with high values dominate biological system and determine its major processes and functions. This approach was tested on three different datasets: genes in the human cerebral cortex, mammalian genes sensitive to chemical exposures, and proteins expressed in human heart. In every case, the described cutoff identification method produced shortlists of variables (genes, proteins) highly relevant for dominant functions/pathways of the analyzed biological systems. Thus, our described method for cutoff identification may be used to prioritize variables for a focused functional analysis, in situations where other methods of dichotomization of data are inaccessible.

In Taiwan, mountainous areas account for approximately two-thirds of the total area. The steep terrain and concentrated rainfall during typhoons cause landslides, which pose a considerable threat to mountain settlements. Therefore, models for analyzing rainfall-induced landslide hazards are urgently required to ensure adequate land use in mountainous areas. In this study, focusing on Pingtung County in southern Taiwan, we developed a landslide hazard index (IRL) to land use. Using FORMOSA-2 and SPOT-5 satellite images, data were collected before and after four typhoons (one in 2009 and three in 2013). The ArcGIS random tree classifier was used for interpreting satellite images to explore surface changes and disasters, which were used to analyze slope disturbances. The product of the maximum 3-h rolling rainfall intensity and effective accumulated rainfall was used as a rainfall trigger index (IRT). Considering environmental and slope disturbance factors, an index of slope environmental strength potential (ISESP) was developed through logistic regression (LR). Landslide hazard to land use was estimated using IRT and ISESP. The average coefficient of agreement (Kappa) was approximately 0.71 (medium to high accuracy); the overall accuracy of slope environmental strength potential analysis was approximately 80.4%. At a constant ISESP, IRT increased with the increasing hazard potential of rainfall-induced landslides. Furthermore, IRT and ISESP were positively correlated with landslide occurrence. When large ISESP values occur (e.g., fragile environment and high land development intensity), small IRT values may induce landslides.

The Work Ability Index (WAI) is the most widely used questionnaire for the self-assessment of working ability. Because of its different applications, shorter versions, and widespread use in healthcare activities, it is worthwhile assessing its characteristics. The WAI was distributed online among the workers of a healthcare company; the results were compared with data contained in the workers' personal health records and with absence registers. 340 out of 575 workers (59.1%) participated; 6.5% of them reported poor work ability. Exploratory factor analysis indicated that the one-factor version best described the characteristics of the WAI. The scores of the complete WAI, the shorter form without the list of diseases, and the minimal one-item version (WAS) had equal distribution and were significantly correlated. The WAI score was inversely related to age and significantly lower in women than in men, but it was higher in night workers than in colleagues due to the probable effect of selective factors. The WAI score was also correlated with absenteeism, but no differences were found between males and females in the average number of absences, suggesting that cultural or emotional factors influence the self-rating of the WAI. Workers tended to overreport illnesses in the online survey compared to data collected during occupational health checks. Musculoskeletal disorders were the most frequently reported illnesses (53%). Psychiatric illnesses affected 21% of workers and had the greatest impact on work ability. Multilevel ergonomic and human factor intervention seems to be needed to recover the working capacity of healthcare workers.

This paper initiates the study of the mathematical aspects of the ad-hoc Lanzhou index. If G is a graph with the vertex set {x1,⋯,xn}, then the ad-hoc Lanzhou index of G is defined by Lz¯(G)=∑i=1ndi(n−1−di)2, where di represents the degree of the vertex xi. Several identities for the ad-hoc Lanzhou index, involving some existing topological indices are established. The problems of finding graphs with the extremum values of the ad-hoc Lanzhou index from the following sets of graphs are also attacked: (i) set of all connected ξ-cyclic graphs of a fixed order, (ii) set of all connected molecular ξ-cyclic graphs of a fixed order, (iii) set of all graphs of a fixed order, (iv) set of all connected molecular graphs of a fixed order.

The aims of this research were to know the physicochemical parameters, texture properties and sensory profile of vegetarian sausages through the flash profile, overall liking and purchase intention. Additionally, protein, fat and carbohydrate contents, pH, water activity, color, instrumental texture and descriptive profile were quantified with the overall liking and purchase intention of four sausages: ovo-vegetarian (SO), classic vegan (SC), fine herb vegan (SH) and vegan quinoa (SQ). Regarding the physicochemical properties, significant differences (p &lt; 0.05) were obtained. Using the flash profile, consumers described SO with attributes of elasticity, tamale smell, strange smell, characteristic flavor, pastiness, softness, pastel color. SC described as soft, pale color, characteristic odor, characteristic flavor, porous and flexible; SH and SQ characterized by the presence of ingredients, stew flavor, spices, pale and soft color. The SO sample presented greater overall liking and purchase intention compared to the other samples, and had a better texture and higher protein content. Through the HMFA analysis, a positive correlation was obtained between the texture and descriptive sensory of the flash profile, and on the other hand, a correlation between the physicochemical characteristics pH, aw, color, overall liking and purchase intention.

The aim of this study was to evaluate patients' knowledge and perception of the use of systemic antibiotics in the treatment of endodontic infections and to determine the possible contribution of patients to the development of bacterial resistance. Five hundred and fifty patients were asked to respond to a survey on the perception of systemic antibiotic use in the treatment of endodontic infections and antibiotic resistance during January 2022 and March 2023. Data were analyzed using descriptive statistics and Pearson's Chi-square test. 514 patients were included in the study, 65.9% of whom were women. While 34.6% of the population studied thought that it was always necessary to take antibiotics prior to endodontics, 49.4% considered that they were necessary after endodontics, regardless of the clinical symptoms (p&gt;0.05). The prevalence of self-medication was 17.3% and women self-medicate more than men, with significant differences (p&lt;0.05), although they have greater knowledge of antibiotic resistance than men (p&gt;0.05). Forty-four percent of the population expect to take antibiotics when faced with dental pain, mainly women (p&lt;0.05). The general population is contributing to the serious problem of bacterial resistance. It is necessary to promote educational strategies focused on the correct use of antibiotics in the community.

The rabbit is a popular animal model for human biomechanical research involving surgery at the hind limb. General anesthesia in rabbits is associated with significantly higher mortality rates than in dogs and cats. In addition, as prey animals, rabbits tend to mask signs of pain, making early detection particularly difficult. Regional anaesthesia, as an adjunct to general anaesthesia, may markedly reduce the need for systemic anaesthetic and analgesic drugs, limiting their associated side effects. In other species, a block of the sciatic (ScN) and the femoral nerves (FN) is usually applied in patients undergoing hind limb surgery. In phase 1 of this study, the ScN and the FN have been localized and an appropriate approach under sonographic guidance has been evaluated. In phase 2, a mixture of methylene blue and lidocaine have been administered to the ScN and the FN in 10 cadavers (20 hind limbs). Staining of the nerves was evaluated by dissection. Ultrasonographically, the ScN appeared as a binocular structure surrounded by a hyperechoic rim. The FN appeared as a hypoechoic structure in the dorsal part of the IPM, becoming hyperechoic/honey-comb-like in the ventral part. Both nerves could be successfully stained in all animals over a median length of 2.3 cm which was considered effective. This technique allows a feasible and accurate access to block of the ScN and the FN and may lead to successful analgesia in rabbits undergoing hind limb surgery.

Background: We aimed to study the frequency, management, and outcomes of patients with blunt pancreatic trauma. Methods: We reviewed the medical records for all patients admitted with pancreatic injuries between 2011 and 2017 at the only level 1 trauma center in the country. Results: There were 71 patients admitted with pancreatic trauma (0.6% of trauma admissions and 3.4% of abdominal injury admissions) with a mean age of 31 years. Sixty-two patients had pancreatic injury grade I-II and 9 had grade III-IV. Thirty-eight percent had GCS <9 and 73% had ISS >16. The level of pancreatic enzymes was significantly proportional to the grade of injury. Over half of patients required a laparotomy, of them 12 patients had an intervention on the pancreas. Eight patients developed complications related to pancreatic injuries ranging from pancreatitis to pancreatico-cutaneous fistula while 35% developed hemorrhagic shock. Mortality was 31% and regardless of the grade of injury, the mortality was associated with high ISS, low GCS and presence of hemorrhagic shock. Conclusion: Pancreatic injuries following blunt trauma are rare and the injured subjects are usually young male. However, most injuries are of low-grade severity. This study shows that shock, higher ISS and lower GCS are associated with worse in-hospital out-comes. Non-operative management may suffice in patients with lower grade injuries, which may not be the case in patients with higher grade injuries unless carefully selected

Nowadays, inherently safer designs are considered as key priorities to prevent or mitigate serious incidents with devastating consequences. The need for process safety assessment during early design phases has motivated the development of several contributions related to computer-aided assessment methodologies in order to measure the inherent safety of chemical processes. In this work, the large-scale production of chitosan from shrimp wastes was evaluated from process safety point of view using the numerical descriptive inherent safety technique (NuDIST).To this end, simulation of the chitosan production was performed using Aspen Plus ® to obtain extended mass and energy balances. The assessment of all the chemicals involved within the process was carried out for the following safety parameters: explosivity (EXP), flammability (FL) and toxicity (TOX). The safety assessment of the process included the parameters of temperature (T), pressure (P) and heat of reaction (HR). The maximum chemical safety score was estimated in 171.01 with ethanol as main contributor to the parameter of explosivity and flammability. The score associated with operating data was calculated in 209.30 and heat of reaction reported to be the most affecting parameter. The NuDIST score was estimated in 380.30. This NuDIST value revealed the low hazards associated with the handling of substances such as shrimp wastes, chitosan and water, as well as the non-extreme temperature and pressure conditions. In general, the large-scale production of chitosan from shrimp shells showed to be an inherently safe alternative of waste valorization.

In geotechnical engineering applications, it is very important to obtain the undrained shear strength of remolded soils accurately and reliably. This study aims to obtain a trustworthy solution to determine the undrained shear strength of remolded clay mixtures using Atterberg limit test results in various states of consistency. An experimental study was carried out involving a wide range of clay mixtures of varying plasticity and geological origin. In the analyses, the variation of the remolded undrained shear strength depending on the cone penetration depth, water content, flow index, liquidity index and log liquidity index were investigated. In the study, the highest undrained shear strength of 100% Na-montmorillonite (NaM) was obtained at 171.89 kPa at 56.60% water content, while the lowest undrained shear strength was obtained for 100% Sepiolite (S), 9.28 kPa at 31.65% water content. The results of this study revealed that the shear strength is significantly affected by soil conditions, rather than dominant clay mineral. Besides, it was observed that the undrained shear strength at the plastic limit was approximately 30-35 times greater than that at liquid limit. The equations of liquid limit-flow index and plasticity index- flow index were proposed. It was concluded that the interdependence between undrained shear strength, liquidity index, log liquidity index, and flow index is not unique due to the different physical and chemical properties of clays.

Suicide is an important public health problem, fundamentally affecting the younger population and responding to multiple biological, psychological, and social causes. The objective of this study was to characterize changes suicide mortality, suicide methods and years of potential life lost during 2005 and 2019 in Paraguay. This observational, descriptive study used data from the Vital Statistics Information Subsystem of the Ministry of Public Health and Social Welfare. The average mortality rate from suicide was 4.9 per 100,000 inhabitants, with an increase from 4.2 between 200-2009 to 5.8 during 2014 and 2019. Suicide was more common in men (75%) than in women. In men, the highest mortality rate was observed among the 20-24 years-old whereas in women the age most affected were the 15–19-year-old age group. The most used method for suicide was strangulation. The most frequent places of suicide occurrence were at home (73%). The seasonality of suicide occurrence showed a slight increase in the spring-summer months compared with autumn winter (53% vs 47%). The rate of potential years of life lost statistically significantly increased from2005 to 2019. Public health measures need to be implemented to investigate the underlying reasons and to implement interventions in the population to decrease suicide mortality in Paraguay.

AI (Artificial Intelligence) chatbots has been widely applied. AI (Artificial Intelligence) chatbots has been widely applied. ChatGPT could enhance individual learning capabilities and clinical reasoning skills, facilitate students' understanding of complex concepts in healthcare education: (1) Background: There is currently less emphasis on its application in nursing education. The application of ChatGPT in nursing education needs to be verified; (2) Methods: A descriptive study is used to analyze the scores of ChatGPT on the registered nurse license exam(RNLE) and compare to the pass rate of candidates in Taiwan; (3) Results: The average score of four exams were around 51.6 to 63.75 by ChatGPT, and pass the RNLE in 2022 1st and 2023 2nd. However, ChatGPT may generate misleading or inaccurate explanations, or it could lead to hallucinations; (4) Conclusions: ChatGPT may have potentially to assist with nursing education. Although AI can simulate human behavior in context, it still cannot replace human creativity, critical thinking, and clinical reasoning.

All countries are facing decisions about which groups to prioritise for COVID-19 vaccination after the first vaccine product has been licensed, at which time supply shortages are inevitable. Here we define the key target populations and their size in China for a phased introduction of COVID-19 vaccination with evolving goals, accounting for the risk of illness and transmission. Essential workers (47.2 million) like healthcare workers could be prioritized for vaccination to maintain essential services. Subsequently, older adults, individuals with underlying health conditions and pregnant women (616.0 million) could be targeted to reduce severe COVID-19 outcomes. Then it could be further extended to target adults without underlying health conditions and children (738.7 million) to reduce symptomatic infections and/or to stop virus transmission. The proposed framework could assist Chinese policy-makers in the design of a vaccination program, and could be generalized to inform other national and regional COVID-19 vaccination strategies.

This paper considers two types of Protestant ethnic groups of some areas of Urals and Western Siberia. The first type consist of representatives of members of different ethnic groups consisting of well-educated professionals, incorporated into industrial society and associated with the intellectualism of Protestantism. The second type is represented by the indigenous peoples of the Polar Urals and Western Siberia, who use the Protestant religious organizations as tool for restoring life-sustaining elements of the native peoples’ traditional economy. I employed the inductive approach and the comparison method; during the fieldwork I used ethnographic participant observations, sociological structured interviews and closed-ended questionnaires. The empirical data have been collected in the Southern, Middle and Polar Urals and Western Siberia.

The aim of this report is to evaluate the segmental rib index (RI) from T1-T12 spinal level in mild and moderate idiopathic scoliosis (IS) curves of thoracic, thoracolumbar and lumbar type by gender. The relationship of segmental RI to the frontal plane radiological deformity presented as the Cobb angle and to the posterior truncal surface deformity presented as the scoliometric readings of Angle of Trunk Rotation (ATR) in these patients is also assessed. Any statistical significant rela-tionship of these parameters would be very important for biomechanical relations of the rib cage (RC) deformity presented as the rib hump deformity (RHD) and the deformity in the spine and it would thus provide valuable information about scoliogeny. The segmental rib index (RI) is presented in 83 boys and girls with mild and moderate IS. The measurements include the scoliometric readings for truncal asymmetry (TA), the Cobb angle assessment and the segmental RI from T1-T12. The statistical package SPSS 23 was used for statistical analysis. The TA is documented and the Cobb angle is presented by gender and curve type. The segmental RI of thoracic, thoracolumbar and lumbar curves are presented for the first time. The correlations of the segmental RI to surface deformity presented as the rib hump deformity (RHD) in all IS patients and particularly in thoracic curves, to Cobb angle by gender and age and the comparison of the segmental RI index of asymmetric but not scoliotic children to the scoliotic peers by curve (in thoracic, thoracolumbar, lumbar curves) in boys and girls are presented. The findings emphasize the significant protagonistic role of the thoracic asymmetry in relation to the spinal deformity mainly in girls for the thoracic and in boys for the thoracolumbar curves. The cut-off point of age of the examined scoliotics is 14 years, that is when the RI shows stronger correlation with the spinal deformity, namely when the thoracic deformity is decisively effective to the developing thoracic spinal deformity, in terms of Cobb angle. In summary, the results of this study provide aetiological implications for IS, as far as the role of thorax is con-cerned.

The Metropolitan Economic Freedom Index (MEFI) ranks cities based on their support of free market enterprise. In its current state, MEFI purports to measure three constructs (government spending, taxation, and labor market freedom) with three equally weighted variables for each one, assuming perfect substitutability of variables. This study investigates the statistical consistency of MEFI through Confirmatory Factor Analysis. Multiple models investigate current variable selection by providing a potentially better indicator of labor market freedom, aggregation assumptions by removing the requirements for fixed and equal weights, and statistical consistency by evaluating the fit between the data and models. Results indicate that the current MEFI model is not statistically consistent with the data, that weighting of variables should not be equal, that variable selection should be investigated, and that constructs should be re-imagined. The models investigated provide an initial starting point for redefining MEFI.

Clopidogrel is one of the most prescribed antiplatelet drugs for cardiovascular diseases prevention. Clopidogrel is a prodrug metabolised by CYP2C19 in active metabolites with anti-aggregant effect. Pharmacogenetic variants such as CYP2C19*2 variant can alter the anti-aggregant effect of clopidogrel leading to a higher risk of cardiovascular disease relapse. The aim of this study was to evaluate the prescription characteristics of CYP2C19 pharmacogenetics in patients on clopidogrel treatment, based on a specific query in a clinical data warehouse. We evaluated the demographics of patients, prescribers, medical indications, CYP2C19 pharmacogenetic tests and therapeutic changes. Neurologists were the main prescribers of CYP2C19 pharmacogenetic tests associated with clopidogrel treatment in a context of suspicion of stroke relapse. Pharmacogenetic tests were mainly prescribed a posteriori to clopidogrel prescription. Clopidogrel pharmacogenetic resistance was associated with the prescription of lysine acetylsalicylate in substitution of clopidogrel. Clear clinical practice guidelines are needed to position CYP2C19 pharmacogenetic testing for patients on clopidogrel treatment.

The following article analyzes the determinants of the innovation index in Europe. The data refer to the European Innovation Scoreboard-EIS of the European Commission for the period between 2010 and 2019 for 36 countries. The data are analyzed using the following econometric techniques: Panel Data with Random Effects, Panel Data with Fixed Effects, Dynamic Panel Data, Pooled OLS, WLS. The results show that the Innovation Index is negatively connected to some variables, among which the most significant are "GDP per capita", "R&D expenditure public sector", "Venture capital", "Tertiary education", and positively connected to some variables among which the most relevant are: "Government procurement of advanced technology products", "Average annual population growth", "Finance and support", "Human resources", "Marketing or organisational innovators", "Linkages". A clustering was then carried out using the unsupervised k-Means algorithm optimized with the Silhouette coefficient which shows the presence of 2 clusters per value of the Innovation Index. Eight machine learning algorithms has been used for prediction with real data. The Tree Ensemble Regression algorithm has been chosen as best performer. A further prediction has been made with the augmented data. The result shows that the best performing algorithm is Linear Regression with an innovation index value predicted to grow by approximately 3.38%.

This article analyzes the determinants of the "Broadband Price Index" in Europe. The data used refer to 28 European countries between 2016 and 2021. The database used is the Digital, Economy and Society Index-DESI of the European Commission. The data were analyzed using the following econometric techniques, namely Panel Data with Random Effects, Panel Data with Fixed Effects, Pooled OLS, WLS and Dynamic Panel. The value of the "Broadband Price Index" is positively associated with the DESI Index, and "Connectivity" while it is negatively associated with "Fixed Broadband Take Up", "Fixed Broadband Coverage", "Mobile Broadband", "e-Government", "Advanced Skills and Development", "Integration of Digital Technology", "At Least Basic Digital Skills ", "Above Basic Digital Skills "," At Least Basic Software Skills ". A cluster analysis was carried out below using the k-Means algorithm optimized with the Silhouette coefficient. The analysis revealed the existence of three clusters. Finally, an analysis of the machine learning algorithms was carried out to predict the future value of the "Broadband Price Index". The result shows that the most useful algorithm for prediction is the Artificial Neural Network-ANN with an estimated value equal to an amount of 9.21%.

Many metrics exist for the evaluation of binary classifiers, all with their particular advantages and shortcomings. Recently an “Efficiency Index” for the evaluation of classifiers has been proposed, based on the consistency, or matching, and contradiction, or mismatching, of outcomes. This metric and its confidence intervals are easy to calculate from base data in a 2x2 contingency table, and values can be qualitatively and semi-quantitatively categorised. For medical tests, in which context the Efficiency Index was originally proposed, it facilitates communication of risk (of correct diagnosis versus misdiagnosis) to both clinicians and patients. Variants of the efficiency index (balanced, unbiased) which take into account disease prevalence and test cut-offs have also been described. The objectives of the current paper were firstly to extend the EI construct to other formulations (balanced level, quality) and secondly to explore the utility of EI and all four of its variants when applied to the dataset of a large prospective test accuracy study of a cognitive screening instrument. This showed that the balanced level, quality, and unbiased formulations of EI are more stringent measures.

Let G[F,Vk, Huv] be the graph with k pockets, where F is a simple graph of order n ≥ 1,Vk= {v1,v2,··· ,vk} is a subset of the vertex set of F and Hvis a simple graph of order m ≥ 2,v is a specified vertex of Hv. Also let G[F,Ek, Huv] be the graph with k edge pockets, where F is a simple graph of order n ≥ 2, Ek= {e1,e2,···ek} is a subset of the edge set of F and Huvis a simple graph of order m ≥ 3, uv is a specified edge of Huvsuch that Huv− u is isomorphic to Huv− v. In this paper, we derive closed-form formulas for resistance distance and Kirchhoff index of G[F,Vk, Hv] and G[F,Ek, Huv] in terms of the resistance distance and Kirchhoff index F, Hv and F, Huv, respectively.

Introduction: The viral respiratory disorder known as severe acute respiratory syndrome (SARS) is caused by the SARS-associated coronavirus. End of May 2021, there have been over 170 million reported cases and more than 3.53 million deaths worldwide. In the field of cardiovascular performance, the shock index (SI) is a simple and widely used formula that measures the physiological response prior to systemic hypotension. It is obtained by dividing the heart rate by the systolic blood pressure. Another parameter, the modified shock index (MSI), is defined as the ratio of heart rate to mean arterial pressure (MAP). Methods: In this retrospective study, we examined the data of COVID-19 patients who were admitted to the ICU between June 1st, 2020, and January 31st, 2021. The patient details were collected from the Medical Records Department (MRD) in a tertiary care center. A case-recorded proforma was used to record the patient information, which was then analyzed using SPSS software. Results: The mean age of the patients was 67 years, consisting of 64 males (68.9%) and 29 females (31.1%). The standard deviation was calculated as 13.557. Among the patients, the minimum age recorded was 28, while the maximum age was 97. Patients with known CAD (Coronary Artery Disease) had a higher mortality rate among comorbidities. The p-value for Shock Index and Mortality Status was 0.205 (with an alpha value greater than 0.05), indicating no significant association. However, the modified shock index (MSI) showed a significant association with mortality status. The Pearson chi-square value for MSI and Mortality Status was 4.19, with a p-value of 0.041 (with an alpha value less than 0.05). These results suggest that there is a higher risk of mortality for patients with a Modified Shock Index of less than 0.7 or greater than 1.3. The MSI Odds ratio was found to be 4.500, indicating that such patients have a 4.5 times higher risk of mortality compared to others. Conclusion: In conclusion, our study found that there is no significant association between the Shock Index (SI) and mortality, as the p-value was greater than 0.05. However, the Modified Shock Index (MSI) showed a significant association with mortality status, with a p-value less than 0.05. This suggests that patients with a Modified Shock Index less than 0.7 or greater than 1.3 are at a higher risk of mortality. It is important to consider these findings when assessing the prognosis and potential interventions for COVID-19 patients.

Transition from basic to higher education is regarded as a ‘juggle of many balls’ because students ought to balance between theoretical and clinical requirements, including social life. As a result, a significant number of undergraduate first-year nursing students succumb to these challenges due to lack of coping mechanisms emanating from poor resilience. As a result, the aim of this study was to determine the factors that influence resilience among undergraduate first-year nursing students at a South African university. A quantitative cross-sectional descriptive research design was followed. Data was collected using an adapted self-administered online questionnaire. Principal component analysis extraction method and Varimax rotation were used to analyse data. A total of 123 participants completed the questionnaire. The eigenvalues showed that the first factor explained 23.9% of the variance, the second factor 11.2%, a third factor 7.5% while the fourth factor explained 5.9% of the variance. The fifth until the eight factor had eigenvalues greater than 1 but less than 2. This study showed that resilience can be dependent on various factors such as lecture support, parental support, academic achievement, peer and mentor support, optimism about the future and being self-determined.

In the evolving landscape of vibration analysis, the integration of machine learning technologies for semi-automated analytical processes presents challenges in establishing clear cause-and-effect relationships in decision-making formulas. This research addresses this gap by exploring analytical diagnosis through residual signals, enabling the identification of anomalies and underperformance in machinery. Vibration signature analysis, focusing on distinctive vibration patterns, proves instrumental in detecting bearing defects and optimizing maintenance for enhanced operational efficiency and safety. Mathematical modeling, particularly worst-case analysis, provides a structured framework for decision-making under uncertainty. The research employs descriptive methods to analyze bearing wear data, transforming it into quantitative data for multiple regression equations. The derived equations reveal the dominance of harmonics in determining bearing wear stages, with PeakVue and overall vibration further indicating damage progression. The findings emphasize the significance of harmonic detection and high-frequency vibration analysis in predicting bearing health, offering a comprehensive approach to enhance machinery reliability. The study concludes with practical recommendations for bearing damage diagnosis based on the developed mathematical models, providing valuable insights for predictive maintenance strategies.

Background Candida auris is an emerging multidrug-resistant fungal pathogen that represents a serious threat to healthcare settings currently. Objective: Its objective was to determine the prevalence of C. auris in the hospital since its initial detection in late 2019. Methods: Using an adapted risk assessment tool, we reviewed the charts. and medical files of all suspected? and confirmed cases of C. auris cases reported at King Khalid University Hospital, Riyadh between November 2019 and December 2022. Anonymized data were retrieved in a pre-established datasheet and analyzed to determine the epidemiological characteristics of C. auris infection in our facility. We established our initial prevalence by age, gender, risk factors, and according to sampling source. Results: Of the 53 confirmed cases positive for C. auris during the study period, 33 (62%) were males. Their ages ranged between 15 and 98; most positive cases occurred in 50 and above. Only one of the confirmed cases was hospital-acquired. All patients had at least one risk factor, and Urine samples yielded the greatest number of positive cases while admission to healthcare facilities constituted the highest risk in our study. Conclusion: Establishing a local prevalence could serve as our baseline/benchmark to compare with regional and international benchmarks.

Recent advancements in experimental and computational methods for RNA secondary structure detection have revealed the crucial role of RNA structural elements in diverse molecular processes within living cells. It has been demonstrated that the secondary structure of the entire viral genome is often responsible for performing crucial functions in the viral life cycle and also influences virus evolution. To investigate the role of viral RNA secondary structure, alongside experimental techniques, the use of bioinformatics tools is important for analyzing various secondary structure patterns, including hairpin loops, internal loops, multifurcations, external loops, bulges, stems, and pseudoknots. Here, we have introduced a Python package for analyzing RNA secondary structure elements in viral genomes, which includes the recognition of common secondary structure patterns, the generation of descriptive statistics for these structural elements, and the provision of their basic properties. We applied the developed package to analyze the secondary structures of complete viral genomes collected from the literature, aiming to gain insights into viral function and evolution. Both the package and the collection of secondary structures of viral genomes are available at http://github.com/KazanovLab/RNAsselem.

In the last decade there has been a growing interest in infrared thermography in the field of sports medicine in order to elucidate the mechanisms of thermoregulation. The aim of this study was to describe bilateral variations in skin temperature of the anterior thigh and patellar tendon in healthy athletes, to provide a model of baseline tendon and muscle thermoregulation in healthy sprinters following a unilateral isokinetic fatigue protocol. Fifteen healthy national-level sprinters underwent unilateral isokinetic force testing and electrostimulation in which body temperature was measured before, during, and after the protocol using an infrared thermographic camera. ANOVA detected a significant difference in the time x side interaction for patellar temperature changes (p≤0.001) and a significant difference in the time x side interaction for quadriceps temperature changes (p≤0.001). The thermal challenge produces homogeneous changes evident in quadriceps areas, but not homogeneous in tendon areas. these data show that metabolic and blood flow changes may depend on the physical and mechanical properties of each tissue.

Using the h-index to assess individual researchers is not only unethical and unfair but also inaccurate and misleading. This index fails to offer a reliable measure of a researcher's impact based on their citation scores. Beyond statistical and conceptual considerations, authorship practices, especially in the case of multi-authored publications, give rise to significant problems that often go unnoticed. While some modifications of the h-index have been proposed to mitigate these weaknesses, the fundamental deficiencies persist. Most of these flaws have been effectively addressed by the c-score, a composite citation index. The c-score excludes self-citations, normalizes the number of citations by considering the number of authors in each paper, and takes into account first, single, and last authorship. This approach provides a more realistic measure of the impact of each individual researcher based on raw citations.

The Randić index of a graph G is the sum of (dG(u)dG(v))−1/2 over all edges uv of G, where dG(u) denotes the degree of vertex u in G. In this paper, we investigate a few graph transformations that decrease Randić index of graph. By applying those transformations, we determine the minimum Randić index on tricyclic graphs, and characterize the corresponding extremal graphs.

This purpose was to compare the ability of body shape index (ABSI) and body roundness index (BRI) with waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and body adiposity index (BAI) to predict metabolic risk. The cross-sectional study was conducted in 17,360 Chinese subjects (were aged 18-95 years old) who escaped cardiovascular disease (CVD) or diabetes. Biochemical and anthropometric variables were measured by trained staff. Receiver operating characteristic curve (ROC) and optimal cutoff values of obesity indices were recruited to compare the predictive ability for metabolic risk factors. The mean age of subjects was 53.7(13.1) years, 41.6 % were males. Within young group (<60 years), the areas under the curve (AUC) demonstrated that WC, BMI, WHR, WHtR and BRI were able to similarly predict high metabolic risk in males (0.74 vs. 0.74 vs. 0.73 vs. 0.73 vs. 0.73) and in females (0.73 vs. 0.73 vs. 0.71 vs. 0.73 vs. 0.73), while the approximate predictive ability were only acquired in males (0.73 vs. 0.73 vs. 0.70 vs. 0.73 vs. 0.73) within elder group (≥60 years). The optimal cut-off values of BRI for high metabolic risk were calculated in males (<60 y: 3.49 vs. ≥60 y: 3.46) and females (<60 y: 3.47 vs. ≥60 y: 3.60). Meanwhile, BRI displayed a strong prediction to elevated BP and elevated TG in males (AUC = 0.64; AUC = 0.70) and to elevated BP, elevated TG and elevated SUA in females (AUC = 0.67; AUC = 0.69; AUC =0.70). BRI was able to similarly predict high metabolic risk compared to WC, BMI, WHR, WHtR and BAI, while ABSI was not. Moreover, BRI revealed specific predictive ability for elevated BP, elevated TG and elevated SUA.

Effectively responding to children’s nutritional status and eating behaviors in Mozambique requires a community-based care approach grounded in sound nursing research that is evidence-based. The Community Assessment, Intervention, and Empowerment Model (MAIEC) is a nursing theoretical model that bases clinical decision-making for community health nurses using communities as a unit of care. We used the MAIEC to identify a community-based nursing diagnosis to address children’s nutritional status and eating behaviors in Mozambique. Objectives: (1) To conduct a descriptive study of children’s nutritional status and eating behaviors in a school community in Mavalane, Mozambique, and (2) to identify a community-based nursing diagnosis using the MAIEC clinical decision-making matrix in the same school community. Method: A cross-sectional, quantitative study was conducted to assess the nutritional status of children using anthropometric data, including brachial perimeter and the tricipital skinfold, and standard deviation for the relation of weight-height, in a sample of 227 children. To assess community management of the problem and identify a community-based nursing diagnosis, we surveyed 176 parents/guardians and 49 education professionals, using a questionnaire based on the MAIEC clinical decision matrix as a reference. Results: Malnutrition was identified in more than half of the children (51.3%). We also identified a community-based nursing diagnosis of impaired community management related to the promotion of child health and healthy eating as evident by lack of community leadership, participation, and processing among more than 70% of the community members (parents/guardians and education professionals). Conclusion: A nursing diagnosis and diagnostic criteria for nutritional status and community management were identified. The need to intervene using a multidisciplinary public health approach is imperative, with the school community as the unit of care. In addition, reliable anthropometric data were used to complement the nursing diagnosis and guide future public health interventions.

Sombor index was recently defined in 2021 as a new vertex degree based topological index by Gutman and has received great attention of mathematicians and chemists. In this work, we determine how much the Sombor index is effected when we delete a vertex or an edge from a graph. Using the formulae obtained here successively, one can calculate the Sombor indices of large graphs by means of Sombor indices of smaller graphs which are obtained by deletion of vertices or edges.

Global change is affecting vegetation cover and processes through multiple pathways. Long time series of surface land surface properties derived from satellite remote sensing offer a unique abilities to observe these changes, particularly in areas with complex topography and limited research infrastructure. Here, we focus on Nepal, a biodiversity hotspot where vegetation productivity is limited by moisture availability (dominated by a summer monsoon) at lower elevations and by temperature at high elevations. We analyze normalized difference vegetation index (NDVI) from 1981 to 2015 semimonthly, at 8 km spatial resolution. We use a random forest (RF) of regression trees to generate a statistical model of NDVI as a function of elevation, land use, CO2 level, temperature, and precipitation. We find that NDVI has increased over the studied period, particularly at low and middle elevations and during fall (post-monsoon). We infer from the fitted RF model that the NDVI linear trend is primarily due to CO2 level (or another environmental parameter that is changing quasi-linearly), and not primarily to temperature or precipitation trends. On the other hand, interannual fluctuation in NDVI is more correlated with temperature and precipitation. RF accurately fits the available data and shows promise for estimating trends and testing hypotheses about their causes.

This study investigated clinical nurses’ knowledge and visual differentiation ability of the pressure injury classification system (PICS) and incontinence-associated dermatitis (IAD), additionally analyzing possible influencing factors. A convenience sample of 248 nurses took the PICS and IAD knowledge test (KT) and completed the visual differentiation ability test (VDAT), consisting of 21 photographs with clinical information. The overall mean score for correct answers was 12.65±2.90 points in PICS & IAD KT and 11.43±4.57 points in VDAT. Incorrect responses were most common for statements related to stage Ⅱ, Ⅲ, IAD for PICS & IAD KT, and deep tissue pressure injury (DTPI), unstageable, and stage Ⅲ for VDAT. Significant correlations were found between PICS & IAD KT and VDAT (r=.252, p<.001). Factors affecting scores for VDAT were the scores of PICS & IAD KT, debridement experience in nursing patients with PI, and the management frequency of PI and IAD. Results indicate that nurses have an overall understanding of PICS and IAD, but low visual differentiation ability regarding stage Ⅲ, DTPI, and unstageable PI. Continuing education is needed to further improve knowledge and visual differentiation ability for PICS and IAD.

Influenza in pregnancy is associated with elevated morbidity and mortality. Influenza vaccines are safe and effective in pregnancy. There are no Mexican surveys in physicians on knowledge, beliefs, and practices towards influenza and influenza immunization during pregnancy. A 32 questions cross-sectional and descriptive survey was conducted addressing general knowledge of influenza, as well as beliefs and practices regarding influenza vaccination during pregnancy among Mexican physicians responsible for prenatal care, traditionally Obstetricians (OBGYNs), and Family Physicians (FPs). A total of 206 surveys were available, 98 (47.6%) from OBGYNs, and 108 (52.4%) from FPs representing an estimated 2,472 daily pregnancy consultations. 54 from 206 (26.2%) weren´t aware that influenza is more severe during pregnancy, 106 from 206 (51.5%) ignored the potential side effects of influenza infection on the fetus, and 56.8% did not know when to vaccinate pregnant women. Pregnancy as a risk factor for developing influenza complications was known only by 99 from 206(48.1%), and 6.1 % believed that vaccination does not confer protection to the fetus. Current beliefs of Mexican OBGYNs and FPs for both influenza morbidity and mortality, and the importance of influenza vaccination during pregnancy, is suboptimal. Understanding drivers for beliefs should be assessed to improve influenza vaccination recommendations, as knowledge alone is not sufficient.

Purpose: Using an identical experimental structure with both Thai and Singaporean undergraduates, we investigated relationships (interactions) among social support, stress, resilience, mindfulness, and self-efficacy on psychological well-being (PWB). Stress indicated a negative influence on PWB, but mindfulness, resilience, self-efficacy, and social support indicated positive influences. Methods: A cross-sectional predictive design was used with 966 Thai and 673 Singaporean university students. After calculating an adequate sample size and performing convenience sampling, we administered the following six standard scales: the Perceived Stress Scale, the Connor–Davidson Resilience Scale, the Mindfulness Awareness Scale, the General Self-Efficacy Scale, the Multi-dimensional Scale of Perceived Social Support, and the Psychological Well-being Scale—along with a demographic questionnaire. Descriptive statistics, correlation analysis, and structural equation modeling were performed for participants’ PWB. Results: Mindfulness had significant effects for both factors of PWB, including autonomy and growth, and cognitive triad, across two samples. In the Thai sample, resilience most strongly predicted autonomy and growth and perceived stress did so the cognitive triad, whereas in the Singaporean sample, perceived control most strongly predicted autonomy and growth and support from friends did so the cognitive triad. Conclusion: These findings provide specific knowledge toward enhancing psychosocial interventions and toward promoting PWB to strengthen mindfulness, resilience, perceived control of stress, and social support. stress, resilience, mindfulness, psychological well-being, university students

Sensory descriptive analysis was used to evaluate the aged Feng-flavored baijiu. The results indicated that there are notable differences in the samples of different ages. The samples with shorter storage times and fresh distilled Baijiu present bran flavor, and fresh green flavor. with the increase of storage time, the fragrance of honey, sweetness, flowers, and aging gradually increases. The samples of Feng-flavored baijiu were dected by Headspace solid-phase microextraction (HS-SPME) combined with comprehensive two-dimensional gas chromatography time-of-flight mass spectrometry (GC×GC–TOFMS) , in total, 496 sustances were identified in all samples, mainly containing 14 types of substances, such as esters, aldehydes etc., of which 42 substances were found in Feng-flavored baijiu for the first time. Chemometrics was used to analyze the key differential compounds. 143 differential compounds closely related to aging were preliminarily screened, and principal component analysis revealed that these samples were separated by year. 65 differential compounds were selected out by partial least squares discriminant analysis(PLS-DA). Furthermore, 43 key differential compounds were selected from the aged Feng-flavored baijiu combined with variable importance in projection and Pearson correlation coefficients. Partial least squares regression (PLSR) was used to research the correlation of sensory properties and key differential compounds, and the results indicated that most compounds were closely related to the aged Baijiu . This study afford theoretical basis and reference for flavor research of Feng-flavored baijiu.

The morphology and maturation process of gonads of 70 Burmeister´s porpoises, with body lengths ranging 135–183 cm (n= 34 females) and 64.5-182 cm (n= 36 males) were described. Samples were collected in six ports of central and northern Peru in 1987-1999. In the field, females were classified as immature, mature (resting, lactating, pregnant) and males as immature, pubescent and mature based on, respectively, the presence of ovarian corpora and the relative quantity of semen in cut epididymides. The ovaries of P. spinipinnis are ovoid or bean-shaped and flattened, with corpora modifying surface appearance. In the laboratory, ovaries were examined macro- and microscopically, measured, weighed and sliced in 1-3 mm sections. The number of corpora ovarica (lutea, albicantia, atretica) found in each ovary as well as their macroscopic and microscopic characteristics were documented in some detail. The follicles, their oocytes and nucleus were measured. Follicular development in P. spinipinnis is predominantly left-sided, but occurs in both ovaries in 16.3% of females, mainly in those with numerous corpora. Macroscopically, several corpora atretica with luteinization had characteristics similar to those of corpora albicantia, making microscopic determination essential. Inconclusive evidence of recent ovulation was found in January. Two of three immature females showed good follicular development in March and April. The body length at 50% sexual maturity in females was estimated at 152.7 cm. There was no evidence of reproductive senescence. The testes of P. spinipinnis are elongated and cylindrical. Of the 36 males examined macroscopically, 7 were immature, 5 pubescent and 24 mature. The histological analysis determining the presence and abundance of Sertoli cells, spermatogonia, spermatocytes, spermatids and spermatozoa, the relative amount of interstitial tissue, the elongation and mean diameter of the seminiferous tubules and the relative size of the lumen allowed to confidently determine sexual maturity status. The field evaluation of maturity based on the presence of sperm in the epididymides is a useful but, in 8.3% of cases, not exact method. For males the body length at 50% sexual maturity was estimated at 157 cm. No histological evidence of male reproductive seasonality was found. Spermatogenesis was perceptible year-round and tubule diameters had non-specific variations for each month.

This paper studies the contemporaneous relationship between S&P 500 index returns and log-increments of the market volatility index (VIX) via a nonparametric copula method. Specifically, we propose a conditional dependence index to investigate how the dependence between the two series varies across different segments of the market return distribution. We find that: (a) the two series exhibit strong, negative, extreme tail dependence; (b) the negative dependence is stronger in extreme bearish markets than in extreme bullish markets; (c) the dependence gradually weakens as the market return moves toward the center of its distribution, or in quiet markets. The unique dependence structure supports the VIX as a barometer of markets' mood in general. Moreover, applying the proposed method to the S&P 500 returns and the implied variance (VIX²), we find that the nonparametric leverage effect is much stronger than the nonparametric volatility feedback effect, although, in general, both effects are weaker than the dependence relation between the market returns and the log-increments of the VIX.

Resumo: Este estudo teve como objetivo avaliar a Saúde Mental Positiva (SPM) e a sua relação com características sociodemográficas, literacia em saúde mental e escala de vulnerabilidade psicológica (PVS) em estudantes universitários portugueses com idades compreendidas entre os 17 e os 62 anos. Foi realizado um estudo descritivo-correlacional. Uma pesquisa online foi realizada para avaliar variáveis ​​demográficas, e vários questionários foram aplicados para avaliar saúde mental positiva, vulnerabilidade psicológica e alfabetização em saúde mental. Os dados foram coletados de 1º de novembro de 2019 a 1º de setembro de 2020. No geral, 3.405 alunos participaram do estudo. Os resultados mostram que 67,8% dos alunos revelaram um alto nível de PMH, 31,6% apresentaram um nível médio de PMH e 0,6% apresentaram um nível baixo de PMH. Os estudantes do sexo masculino relataram maior satisfação pessoal (t (3170) = -2,39, p=0,017) e autonomia (t (3170) = -3,33, p=0,001), no PMH em relação ao sexo feminino. Alunos sem bolsa pontuaram mais alto (t (3.127) = -2,04, p=0,42) no PMH do que alunos com bolsa. Estudantes que não foram deslocados de casa relataram maior (t (3170) = -1,99, p=0,047) Autocontrole em PMH do que aqueles deslocados de sua casa. Estudantes universitários com resultados de PMH mais altos têm resultados de PVS mais baixos e resultados de Alfabetização mais altos. Os achados deste estudo contribuirão para identificar as necessidades de intervenção dos alunos na PMH. Estudantes universitários com resultados de PMH mais altos têm resultados de PVS mais baixos e resultados de Alfabetização mais altos. Os achados deste estudo contribuirão para identificar as necessidades de intervenção dos alunos na PMH. Estudantes universitários com resultados de PMH mais altos têm resultados de PVS mais baixos e resultados de Alfabetização mais altos. Os achados deste estudo contribuirão para identificar as necessidades de intervenção dos alunos na PMH.

Risk management for technological hazards mainly focuses on the consequences on human lives. Although technological risk analysis evaluates environmental vulnerability, it does not reflect the consequences on environmentally exposed elements, such as rivers, water springs, flora, and fauna. This paper's objective was to propose a conceptual framework and create a multidisciplinary evaluation model for environmental risk analysis in the oil and gas industry. Initially, the problem was approached from a global perspective to justify the necessity of a holistic environmental risk analysis methodology in the oil industry, using environmental risk factors as well as underlying factors, such as environmental fragility and lack of resilience. The holistic assessment was carried out based on probabilistic risk analysis methodologies to obtain a holistic environmental risk index, HERI. This methodology was applied to an oil and gas industry company in Colombia. This allowed greater disaggregation of the results to establish priorities for risk reduction actions and identify the company's weaknesses.

The objective of this study was to evaluate the glycemic index and the satiety response of three Mexican kinds of honey. The values of fructose ranged from 272.40-395.10 g/kg, while the glucose value ringed 232.20-355.50 g/kg. The ratio F/G of sample honey was 1.45, 1.00, and 1.17 for Highland, Multifloral, and Avocado honey, respectively. Twenty-six participants completed this study, which was previously approved by the ethics committee of the Facultad de Salud Pública y Nutrición (CE 2/2018-19). Highland and Avocado honey is classified as medium-GI (69.204.07 and 66.365.74, respectively), while Multifloral honey is classified as high-GI (74.245.98). The Highland honey presented the best satiety response. The difference in IG values and the effect of the satiety response of Highland honey could be explained by the different fractions of carbohydrates in samples and other components such as phytochemicals.

Chellali et al. introduced two degree concepts, ve-degree and ev-degree (Chellali et al, 2017). The ve-degree of a vertex equals to number of different edges which are incident to a vertex from the closed neighborhod of v. Moreover the ev-degree of an edge e=ab equals to the number of vertices of the union of the closed neighborhoods of a and b. The most private feature of these degree concepts is, total number of ve-degrees and total number of ev-degrees equal to first Zagreb index of the graphs for triangle-free graphs. In this paper we introduce ve-degree entropy, ev-degree entropy and investigate the relations between these entropies and the first Zagreb index entropy. Finally we obtain the maximal trees with respect to ve-degree irregularity index.

This study aimed to determine clinical instructors’ perceptions of the assessments used to evaluate the clinical knowledge of undergraduate nursing students. This study uses a descriptive phenomenological approach. Purposive sampling was used to recruit sixteen clinical instructors for semi-structured interviews between August to December 2019. All interviews were audio-recorded and transcribed verbatim. Data were analyzed using Colaizzi’s seven-step method. Four criteria were used to ensure the study’s validity: credibility, transferability, dependability, and confirmability. Three themes were identified in the clinical instructors’ views on evaluating the clinical performance of student nurses: familiarity with students, patchwork clinical learning, and differing perceptions of the same scoring system. Study results suggest the need for a reliable, valid, and consistent approach to evaluating students’ clinical knowledge. If the use of patchwork clinical internships for student nurses is unavoidable, a method for assessing student nurses’ clinical performance that requires instructor consensus is necessary.

Objective: This study examined the impact of Japan’s state of emergency on trends in diabetes care during the coronavirus disease 2019 (COVID-19) pandemic. Design: A descriptive and retrospective study. Setting: Showa University Hospital, Japan. Participants: Patients with diabetes who received medical treatment from 2018 to 2020. Determinants of interest: Number of patients with diabetes visiting the hospital per week. To examine the impact of the Japan’s state of emergency, the number hospital visiting by patients with diabetes was summarized from 28 weeks of data, from calendar week 8 to week 35, for each year. Results: Compared with the mean of 2018 and 2019, no significant difference was found between the three periods (before, during, and after the state of emergency). However, the numbers of patients from both inside and outside Tokyo increased at 7 weeks after the state of emergency was lifted. Conclusions: A significant increase in the numbers of patients with diabetes was seen compared with the same period in 2018 and 2019, suggesting that the state of emergency may have hindered diabetes care. Therefore, patients with diabetes should be followed up continuous of diabetes care while keeping a close eye on measures.

In the current context of worldwide honey bee colony losses, among which the varroa mite plays a major role, hope to improve honey bee health lies in part in the breeding of varroa resistant colonies. To do so, methods used to evaluate varroa resistance need better understanding. Repeatability and correlations between traits such as Mite Non-Reproduction (MNR), Varroa Sensitive Hygiene (VSH) and hygienic behaviour are poorly known, due to practical limitations and to their underlying complexity. We investigate (i) the variability, (ii) repeatability of the MNR score and (iii) its correlation with other resistance traits. To reduce the inherent variability of MNR scores, we propose to apply an Empirical Bayes correction. On the short-term (ten days) MNR had a modest repeatability of 0.4 whereas on the long- term (a month) it had a low repeatability of 0.2, similar to other resistance traits. Within our dataset there was no correlation between MNR and VSH. Although MNR is amongst the most popular varroa resistance estimates in field studies, its underlying complex mechanism is not fully understood. Its lack of correlation with better described resistance traits and low repeatability suggest that MNR need to be interpreted cautiously, especially when used for selection.

Primary cutaneous B-cell lymphomas (PCBCLs) are B-cell lymphomas that can occur in the skin without evidence of extracutaneous involvement. The 2005 WHO/EORTC classification of cutaneous lymphomas and its 2018 update have distinguished three main categories based on clinicopathological, immunohistochemical and genetic characteristics: primary cutaneous marginal zone lymphoma (PCMZL), primary cutaneous follicle centre lymphoma (PCFCL), and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL-LT). PCMZL and PCFCL are clinically indolent, while PCDLBCL-LT is an aggressive lymphoma. Due to its low incidence and lack of prospective studies, it is difficult to establish a standard treatment for each subgroup. The objective of our study was to describe the clinical and pathological characteristics of 103 patients with cutaneous B-cell lymphoma from 12 centres belonging to the Spanish Lymphoma Oncology Group. The median age was 53 years (40-65). According to skin extension, 62% had single site lymphoma, 17% had regional lymphoma and 20% had multifocal lymphoma. Histology: 66% had PCMZL, 26% had PCFCL, and 8% had PCDLBCL-LT. Twenty-three percent of the patients were treated exclusively with surgery, 26% with radiotherapy only, 21% with surgery plus radiotherapy, 10% with polychemotherapy, and 5% with rituximab monotherapy. Overall, 96% of patients achieved a complete response, and 44% subsequently relapsed, most of them relapsing either locally or regionally. The 10-year OS was 94.5% for the entire cohort, 98% for the PCMZL cohort, 95% for the PCFCL cohort and 85.7% for the PCDLBCL-LT cohort. Our data are comparable to those of other published series, except for the high frequency of PCMZL. The expected heterogeneity in therapeutic management has been observed.

Background: We aimed to assess the association between DII and PD and the mediation effect of DII in the association of PD with systemic inflammation. Using the National Health and Nutrition Examination Survey (NHANES) 2009-2010, 2011-2012 and 2013-2014, participants that received periodontal exam and provided dietary recall data were included. The inflammatory potential of diet was calculated via DII. Periodontitis was defined according to the 2012 case definition. The clinical outcomes of interest were mean periodontal probing (PPD), mean clinical attachment loss (CAL) and thresholds of PPD and CAL. White blood cells (WBC), segmented neutrophils and C-reactive protein (CRP) were used as proxies for systemic inflammation. The periodontal measures were regressed across DII values using adjusted multivariate linear regression. Adjusted mediation analysis appraised the influence of DII in the association of periodontitis and systemic inflammation. 10,178 participants were included. DII was significantly correlated with mean PPD, mean CAL, thresholds of PPD and CAL, WBC, segmented neutrophils and DII (p&lt;0.01). A linear regression logistic adjusted for multiple confounding variables confirmed the association between DII and mean PPD (B = 0.02, Standard Error [SE]: 0.02, p&lt;0.001) and CAL (B = -0.02, SE: 0.01, p&lt;0.001). The association of mean PPD and mean CAL with both white blood cells and segmented neutrophils were mediated by DII (from 2.1 to 3.5%, p&lt;0.001). In the 2009-2010 subset, the association of mean CAL with serum CRP was mediated by DII (52.0%, p&lt;0.01). In conclusion, inflammatory diet and PD may be associated. Also, the inflammatory diet significantly mediated the association of leukocyte counts and systemic inflammation with periodontitis.

Groundwater represents a pivotal asset in conserving natural water reservoirs for potable consumption, irrigation, and diverse industrial uses. Nevertheless, human activities intertwined with industry and agriculture contribute significantly to groundwater contamination, highlighting the critical necessity to appraise water quality for safe drinking and effective irrigation. This research primarily focused on employing the Water Quality Index (WQI) to gauge water's appropriateness for these purposes. However, the generation of an accurate WQI can prove time-intensive owing to potential errors in sub-index calculations. In response to this challenge, an artificial intelligence (AI) forecasting model was devised, aiming to streamline the process while mitigating errors. The study collected 422 data samples from Mirpurkash, a city nestled in the province of Sindh, for a comprehensive exploration of the region's WQI attributes. Furthermore, the study probed into unraveling the interdependencies amidst variables in the physiochemical analysis of water. Diverse machine learning classifiers were employed for WQI prediction, with findings revealing that random forest and gradient boosting eclipsed other algorithms, achieving an accuracy rate of 99%. In close pursuit were SVM and XGBoost, registering accuracy scores of approximately 95% and 93%, respectively, while KNN and Decision Trees garnered accuracy rates of 88% and 87%, respectively. In addition to WQI prediction, the study conducted an uncertainty analysis of the models using the R-factor, providing insights into the reliability and consistency of predictions. This dual approach, combining accurate WQI prediction with uncertainty assessment, contributes to a more comprehensive understanding of water quality in Mirpurkash and enhances the reliability of decision-making processes related to groundwater utilization

Objective Image Quality Assessment (IQA) measures are playing an increasingly important role in the evaluation of digital image quality. New IQA indices are expected to be strongly correlated with subjective observer evaluations expressed by MOS/DMOS scores. One such recently proposed index is the SuperPixel-based SIMilarity (SPSIM) index, which uses superpixel patches instead of the rectangular pixel grid.The authors in this paper have been proposed three modifications of SPSIM index. For this purpose, the color space used by SPSIM was changed and the way SPSIM determines similarity maps was modified using methods derived from the algorithm for computing the MDSI index. The third modification was a combination of the first two. These three new quality indices were used in the assessment process. The experimental results obtained on many color images from five image databases demonstrated the advantages of the proposed SPSIM modifications.

The Body Mass Index (BMI) formula has been developed by Belgian mathematician Adolphe Quetelet and published in 1840 [1] as a law of nature and society, based on statistics about the weight and height of the population of that time, the first part of the 19^th century. He called it “social physics”. From then, for nearly two centuries, the BMI had been the most important formula describing the normal relations and ratio of weight to the square of the height for humans. The problem arises if the BMI formula, developed in the first part of the 19^th century is still good today when the type of work people perform is very different? In modern times, most people are less muscular than at the time when the BMI was developed because they do not work physically as heavy as at that time. In many cases, the Body Mass index can predict mortality, morbidity and illness but not always, for example cases such as (a) the obesity paradox for some cardiovascular problems and (b) the U shape mortality paradox as well as (c) false positive obesity diagnostic in regard to people who are strong and muscular, have low body fat percentage but are classified as obese by the BMI and (d) cases where BMI is normal but people have an “obese metabolism” (e) BMI normal but high fat percentage. The objective is to develop a formula good for all body types, a formula that makes the difference between fat and non-fat body weight such as muscle and body frame and quantifies the effect of strength and fitness, which BMI does not. Another objective is to develop a formula to predict the health risks and fitness status of people, better than BMI. The first generalizations of BMI using anthropometric metrics could be found in [2], where I discuss and analyze many formulae, developed, tested, and simulated by me, using similar new methods, accounting for body shape, physical shape and body function, making the difference between muscle mass and fat, fat and non fat body weight. Nearly all formulae and methods developed and proposed in this new model are new, never published before. Many experiments published before, in highly cited papers show that grip strength and muscle strength is a predictor of health, mortality, morbidity, endocrine and metabolic disease outside the BMI and anthropometric measures. The purpose of my formula is to explain the outcome of those experiments and create a formula which predicts these experiments [21-41].

The classic Body Mass Index, (BMI), developed in the 19^th century by the Belgian mathematician Adolphe Quetelet [1] is an important indicator of the risk of death, of obesity, of negative health consequences, body fat percentage and of the shape of the body. While he BMI is assumed to indicate obesity in sedentary people and in people who do not practice sports, it is undisputed and a consensus among researchers [2][3][4][5][9][25] that Body Mass Index (BMI) is not a good indicator for obesity in people who developed their body through heavy physical work or sport but also in other segments of population such as those who appear to have a normal weight but in fact have a high body fat percentage and obese methabolism. The BMI also does not include all the variables essential for a health predictor. The BMI is not always a good predictor of metabolic disease, people who appear of healthy weight according to BMI have in some cases an obese metabolic syndrome. The BMI was developed as a law of natural sciences and “social physics” [1], as it was called then, before the middle of the 19^th century, and it had been used from the 70s for medical purposes, to detect obesity and the risk of mortality [6][7]. The BMI has a huge importance for modern society, affected by an obesity epidemic [8]. BMI has applications in medicine, sport medicine, sport, fitness, bodybuilding, insurance, nutrition, pharmacology. The main limitation of the BMI is that it does not account for body composition including non fat body mass such as muscles, joints, body frame and makes no difference between fat and non fat components of the body weight. The body composition and the proportion of fat and muscles make a difference in health outcomes [12][13][14][25][26][27][35][36][37] [38][39][40][41][42][43][44]…[100]. Body composition makes a difference also in the level of sport performance for athletes of every level. In nearly two centuries since the Body Mass Index was developed, no formula had been successfully developed to account for body composition and make the difference between muscle and fat in a consistent way. This can be considered a longstanding open problem of major importance for society. The objective of this analysis is to develop new formulae taking into account the health implication of body composition measured through indirect, simple indicators and making the difference between muscles and fat, healthy and non healthy metabolism. The formulae developed in this article are the only formula to successfully generalize BMI and make this difference. I develop a direct generalization of BMI, in the mathematical and physiological sense to account for fat and fat free mass and muscles, small and large body frames. It is the first such generalization because the classic BMI can be determined as a particular case of my formulae in the strict mathematical and practical physiologic sense. No other formula generalized the BMI to make the difference between fat and a large frame and muscles has ever been published in nearly two centuries since the BMI formula had been developed. The formulae I developed explain and generalize the conclusions of a large number of highly cited empirical experiments cited in the reference section. [35][36][37][38][38][39] [40][42][43][44]..[100] Most of the experimental proof I bring in support of my formulae and bodyweight quantification theory comes from many highly cited experimental research publications in medicine, sports medicine, sport science and physiology. My formulae explain also performance in decades of competitive sports and athletics

Seaweeds are regarded as one of the valuable coastal resources because of their usage in human food, cosmetics, and other industrial items. They also play a significant role in providing nourishment, shelter, and breeding grounds for fish and many other sea species. This study introduces a newly developed seaweed enhancing index (SEI) using spectral bands of near-infrared (NIR) and shortwave infrared (SWIR) of Landsat 8 satellite data. The seaweed patches in the coastal waters of Karachi, Pakistan were mapped using SEI, and its performance was compared with other commonly used indices - Normalized Difference Vegetation Index (NDVI) and Floating Algae Index (FAI). The accuracy of the mapping results obtained from SEI, NDVI, and FAI was checked with field verified seaweed locations. The purpose of the field surveys was to validate the results of this study and to evaluate the performance of SEI with NDVI and FAI. The performance of SEI was found better than NDVI and FAI in enhancing submerged patches of the seaweed pixels what other indices failed to do.

Refractive index measurements have been an important task for a long time because that index plays an essential role in describing the optical properties of a material. Many methods have been developed to perform that task. Some of them use interferometry to achieve high precision, however these configurations are complicated. Some measure the critical angle using simple structures, but the accuracy is not satisfactory because it is difficult to judge the exact critical angle with intensity variations. Here we propose several new schemes based on measuring the polarization change in the total internal reflection. The proposed method has the merits of simple structure and easy incident angle determination that gives the maximum phase change. Additionally, it is possible to find the material dispersion by measuring the wavelength dependence of the polarization ellipticity. Some useful formulas relating the refractive index with the maximum phase change are obtained. This work can provide valuable alternatives for index measurement.

The utilization and engineering of thermo-optic effects have found broad applications in integrated photonic devices, facilitating efficient light manipulation to achieve various functionalities. Here, we perform both an experimental characterization and theoretical analysis of these effects in integrated micro-ring resonators in high index doped silica (HIDS), which has had many applications in integrated photonics and nonlinear optics. By fitting the experimental results with theory, we obtain fundamental parameters that characterize their thermo-optic performance, including the thermo-optic coefficient, the efficiency for the optically induced thermo-optic process, and the thermal conductivity. The characteristics of these parameters are compared to those of other materials commonly used for integrated photonic platforms, such as silicon, silicon nitride, and silica. These results offer a comprehensive insight into the thermo-optic properties of HIDS based devices. Understanding these properties is essential for efficiently controlling and engineering them in many practical applications.

Initially, renal resistive index (RRI) was investigated to improve diagnosis in kidney diseases, but failed to meet this goal. Recently many papers highlighted the prognostic significance of RRI in chronic kidney disease, in the estimation of revascularization success of renal artery stenoses or the evolution of the graft and recipients in renal transplantation. Moreover, RRI gained importance in prediction of acute kidney injury in critically ill patients. Along with RRI study in renal pathology have been revealed correlations of this index with parameters of systemic circulation. The theoretical and experimental premises of this connection were reconsidered, and studies for analyzing the link between RRI and arterial stiffness, central and peripheral pressure or left ventricular flow were conducted with this purpose. A high amount of data is currently indicating that RRI is influenced more by pulse pressure and vascular compliance than by renal vascular resistance – assuming that RRI reflects the complex interplay between systemic circulation and renal microcirculation and should be considered as a marker of systemic cardiovascular risk beyond its prognostic relevance for kidney disease. In this review we will go through clinical research that revealed the implications of RRI in renal and cardiovascular disease.

The evaluation of robotic hands is a subjectively biased, complex process. The fields pertaining to robotic hands are human-centric in nature, making human hands a good standard for benchmark comparisons of robotic hands. To achieve this, we propose a new evaluation index, where we evaluate robotic hands on three fronts: their form, features and performance. An evaluation on how anthropomorphic robotic hands are in basic mobility, and appearance constitutes the ``Form'', while features that can be read, changed and actuated for effective control of robotic hands constitutes the ``Features''. We derived these key features from an extensive analysis of robotic hands in literature. Finally, the robotic hands carry out a series of tasks that evaluate their ``Performance''. An individual score for each category is drawn and we carry out a three-pronged analysis. We also propose an additional feature in the form of price to provide context when analysing multiple hands.

Objective: To explore sex differences in cardiovascular disease (CVD) related risk factors such as diabetes, hypertension, and demographic, anthropometric, biochemical, clinical, and nutritional differences among 40-60 years old Pakistani CVD patients.Design: This was a cross-sectional, descriptive study.Setting: The present study was conducted at the Mayo/King Edward Medical University (K.E.M.U) Hospital Cardiology Department (CCU-I & CCU-II), Lahore, from February 2020 to June 2020. A self-administered questionnaire was used for data collection.Participants: A random sample of 300 cardiac patients was included in the study. Patient records, food frequency questionnaire and 24-hour dietary recall was used to solicit information about demographic, anthropometric, biochemical, and clinical measurements; dietary intake parameters; and CVD risk factors such as hypercholesterolemia, hypertension, diabetes, and smoking. Results: Men CVD patients had higher BMI (33.43 kg/m² vs. 28.69 kg/m²) and higher prevalence of hypertension (81.1% vs. 59%), hypercholesterolemia (82.4% vs. 54.5%) and smoked more cigarettes (72.6% vs. 9%) as compared to women while there was higher prevalence of diabetes among women as compared to men (59% vs. 29.4%). There were 85% women vs. 80% men consuming white bread, while half of the men reported using meat daily, as compared to only 16.6% women. There were 51.5% women and 17% men who reported consuming fruits and vegetables daily. There were 40% men and 16% women who reported consuming soft drinks. Conclusion: The study showed significant sex differences in the nutritional status and risk factors of patients with CVD.

We evaluated epidemiological evolution and economic impact of COVID-19 pandemic in the European Union (EU) and worldwide, and the effects of control strategies on them. We collected incidence, mortality, and gross domestic product (GDP) data between the first quarter of 2020 and of 2023. Then, we reviewed the effectiveness of the mitigation and zero-COVID control strategies. The statistical analysis was done calculating the incidence rate ratio (IRR) of two rates and its 95% confidence interval (CI). In the EU, COVID-19 presented six epidemic waves. The sixth one at the beginning of 2022 was the biggest. Globally, the biggest wave occurred at the beginning of 2023. Highest mortality rates were observed in the EU during 2020-2021 and globally at the beginning of 2021. In mitigation countries, mortality was much higher than in zero-COVID countries (IRR= 6.82; CI:6.14-7.60; p<0.001). A GDP reduction was observed worldwide, except in Asia. None of the eight zero-COVID countries presented a GDP growth percentage lower than the EU percentage in 2020, and 3/8 in 2022 (p=0.054). COVID-19 pandemic caused epidemic waves with high mortality rates and a negative impact on GDP. The zero-COVID strategy was more effective in avoiding mortality and potentially had less impact on GDP.

The present study describes a comprehensive analysis of the Adverse Drug Reactions (ADRs) documented in the Database of the Spanish Pharmacovigilance System (FEDRA) concerning the use of biological medications used for severe refractory asthma, specifically omalizumab, mepolizumab, reslizumab, benralizumab, dupilumab, and tezepelumab. Emphasis was placed on ADRs not documented in the Technical Sheet (Summary of Product Characteristics, SmPC) of the respective specialties (Xolair®, Nucala®, Cinqaero®, Fasenra®, Dupixent®, and Tezspire®), which could potentially trigger a warning signal in Pharmacovigilance, indicating previously unidentified risks. The analysis encompassed data from the inception of each drug ́s marketing until January 22, 2024, including cases originating from various sources: direct submissions to the Spanish Pharmacovigilance System, communications from the Pharmaceutical Industry, and findings from literature review. Notifications were analyzed independently of their origin, so a complete review of all ADRs associated with these medications was ensured. In essence, this investigation highlights the critical role of post-marketing safety information, emphasizing the relevance of comprehensive reporting by healthcare professionals to facilitate a robust Pharmacovigilance system, ultimately advancing patient care and safety.

In Japan, bariatric surgical treatment was started in 1982. The Japanese Society for Treatment of Obesity (JSTO) was established in 2007 and then JSTO started national registry of bariatric surgery cases and multidisciplinary educational program. 44 facilities registered 4055 bariatric surgical cases until 2021. In this study, the purpose is to clarify the indication, the safety and the effectiveness of the sleeve gastrectomy using national registry data base compiled by JSTO. Preoperative BMI was ranged from 27.6 to 90.7kg/m², and the mean value was 42.7. As gender, men/women was 1/1.3. Age was 42.2 as mean.　As preoperative comorbidities, DM ratio was 54.4% of the patients, Hypertension 64.5%, dyslipidemia 65.1%, and sleep apnea syndrome 69.8%. As operation method, laparoscopic method were taken in 99.7% of the cases. The intra operative incidents rate was 0.9 %. Conversion rate to open method was 1.1%. Postoperative morbidity ratio was 5.6% and mortality was 0 %. Reoperations were performed in 1.5 % of the cases. Postoperative hospital stay was 5 days in Median value. Body weight loss was 27.6 kg in the mean value after follow up days of 279±245. As the effect on the preoperative metabolic comorbidities, DM has improved in 82.9 % of the cases, hypertension 67.9 % and Dyslipidemia 66.6%. In conclusion, using JSTO database, we evaluated the indication, postoperative complications and weight loss effect of sleeve gastrectomy in Japan. Regarding the evaluation of the effect on preoperative comorbidities, future follow-up based on more detailed criteria was considered to be necessary.

AFM nanoindentation showed variation in stiffness (Elastic modulus) due to heterogenous nature of the collagen fibres. The S values varied from 5 N/m to 11.11 n/m corresponding to an E change of 2.25 to 1.38 GPa. The variation in effective modulus (Eff) with respect to displacement indicated crossing the parabolic limit. A softening index n was proposed due to the heterogenous behaviour of the biomaterials

The main objective of this paper is to develop a readiness index model that can serve as an analytical tool for exploring the achievements of electrification of transportation systems. We have applied this readiness index model to evaluate the readiness positioning of China, Norway, and Sweden to-wards transport electrification. We have chosen these three countries as they represent diversity among countries that are in the process of adopting electric transport system solutions. Our developed readiness index model has four key dimensions, technological readiness, political readiness, societal readiness, and economic readiness. The embeddedness of all four dimensions in one model provides a multi-perspective way of analyzing and evaluating the readiness levels of countries moving towards transforming the transportation system. Therefore, we named the model a “multidimensional readiness index.” Our main conclusions are that the political processes and political decisiveness involved are the most important factors followed by the societal needs and economic ability, with the current technology available as the fourth. Without the participation of dedicated and determined political decision-makers being involved, the other three factors are challenging to obtain. Political decision-makers need to facilitate the use of economic means to support the transformation in the society and affected industries to balance the initial economic disadvantages of the electrically powered systems until they pass the cost disadvantage turning point. The development of the relevant technology is no longer a great barrier as it was at the beginning of this transformation, about 20 years ago. The technology for electrically powered transportation systems and devices is widely available now, although it is continuously evolving and being improved. Associated industries cannot be expected to initiate, finance, take the risk, and take the lead in this global societal transformation without clear and strong political support.

(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.

Obesity is treatment-resistant, and is linked with a number of serious, chronic diseases. Adult obesity rates in the United States have tripled since the early 1960s. Recent reviews show that an increased ratio of omega-6 to omega-3 fatty acids contributes to obesity rates by increasing levels of the endocannabinoid signals AEA and 2-AG, overstimulating CB₁R and leading to increased caloric intake, reduced metabolic rates, and weight gain. Cannabis, or THC, also stimulates CB₁R and increases caloric intake during acute exposures. The present meta-analysis reveals significantly reduced body mass index and rates of obesity in Cannabis users, in conjunction with increased caloric intake. We provide for the first time a causative explanation for this paradox, in which rapid and long-lasting downregulation of CB₁R following acute Cannabis consumption reduces energy intake and storage and increases metabolic rates, thus reversing the impact on body mass index of elevated dietary omega-6/omega-3 ratios.

Forest fire is a major ecological disaster, which has economic, social and environmental impacts on humans and also causes the loss of biodiversity. Forest officials issue the warnings to the public on the basis of fire danger index classes. There is no fire danger index for the country India due to the sparsely distributed meteorological stations. Previous studies suggest that Static Fire Danger Index (SFDI) as well as Dynamic Fire Danger Index (DFDI) have been derived from the satellite datasets. In this study, we have made an attempt to integrate both the Static and Dynamic fire danger indices and also used the Near Real Time (NRT) data sets that can be available for download through NASA FTP server after one hour of the satellite overpass. In this study, DFDI has been calculated from the MODIS Terra NRT Land Surface Temperature (MOD11_L2) and MODIS TERRA NRT surface reflectance MOD09. Finally, The Forest Fire Danger Index (FFDI) has been developed from the static and dynamic fire danger indices by the additive model and the overall accuracy was around 81.27%. Thus, the FFDI has been useful to predict the fire danger accurately and can be useful anywhere, where the meteorological stations are un-available.