Background: Low back pain (LBP) is a major cause of disability globally, and the diagnosis of LBP is challenging for clinicians. Objective: This study aimed to assess the accuracy level of arti-ficial intelligence as a Clinical Decision Support System (CDSS) called Therapa compared to MRI in predicting lumbar disc herniated patients. Methods: One hundred low back pain patients aged ≥18 years old were included in the study. The study was conducted in 3 stages, at first, a case se-ries was conducted by matching MRI and Therapha diagnosis for 10 patients. Subsequently, Delphi methodology was employed to establish a clinical consensus. Lastly, to determine the ac-curacy of the newly developed software, a cross-sectional study was undertaken, involving 100 patients. Results: The software showed a significant diagnostic accuracy with the area under the curve in the ROC analysis determined as 0.84 with a sensitivity of 88% and a specificity of 80%. Conclusion: The study’s findings revealed that CDSS using Therapha has a reasonable level of ef-ficacy, and this can be utilized clinically to acquire faster and more accurate screening of patients with lumbar disc herniation.

The emerging working mode of coordinated trucks and drones has demonstrated significant practical potential in various fields, including logistics and delivery, intelligence surveillance reconnaissance, area monitoring, and patrol. The seamless collaboration between trucks and drones is garnering widespread attention in academia and has emerged as a key technology for achieving efficient and secure transportation. This paper provides a comprehensive and in-depth review of the research status on the routing problem for coordinated trucks and drones, covering aspects such as application background, cooperative modes, configurations, issues have been taken into consideration, and solution methodologies.

It’s very well known that the world's attention is currently focused on the energy transition. The energy security, in addition to the drive to reduce greenhouse gas emissions in order to limit global warming, and the generalization of the access to energy, have contributed to adoption of the Moroccan Energy Strategy with a strong focus on Renewable Energies (RE). Morocco is notoriously poor in conventional fossil primary energy resources with an energy dependence on the order of 90%. The energy crisis and that resulted from Covid-19 pandemic and the geopolitical conflicts, combined compounded with steady increase in demand have heavily affected the security and the stability of the country's energy situation. The transition to RE, by strongly engaging in the implementation of several solar, wind and hydro energy projects benefiting from the country's excellent solar and wind energy potential, has made the country the leader in RE in Africa. By 2030, the share of RE in the installed capacity is expected to reach 52%. In this work, an overview of the current situation of RE (particularly solar energy) in Morocco is provided, including, the potentials, obstacles and challenges, and future perspectives. Thanks to its high solar potential location, it’s predictable that Morocco effort will be focused on this field: the Erasmus Plus Innomed Project is a virtuous example of international cooperation, aiming at create a Solar Energy Network, in synergy with EU Partners.

Tackling the intricacies of network dismantling in complex systems poses significant challenges. This task has relevance across various practical domains, yet traditional approaches focus primarily on singular metrics, such as the number of nodes in the Giant Connected Component (GCC) or average pairwise connectivity. In contrast, we propose a unique metric that concurrently targets nodes with the highest degree and reduces the GCC size. Given the NP-hard nature of optimizing this metric, we introduce MaxShot, an innovative end-to-end solution that leverages graph representation learning and reinforcement learning. Through comprehensive evaluations on both synthetic and real-world datasets, our method consistently outperforms leading benchmarks in accuracy and efficiency. These results highlight MaxShot’s potential as a superior approach to address the network dismantling problem effectively.

Background/Objectives: Adolescence represents a period of heightened vulnerability to risky sexual behaviours. In Portugal, adolescents are initiating sexual activity at increasingly younger ages. Yet, there are no studies evaluating their knowledge about sexually transmitted diseases and prevention methods at an earlier stage of their development. Study how middle school ad-olescents define their sexuality and assess their level of information regarding sexuality, STI, and prevention methods. Additionally, it explores adolescents' sources of information on sexuali-ty-related issues. Methods: A cross-sectional observational study was conducted involving the application of a questionnaire to 750 9th-grade students of Vila Nova de Gaia, Porto, Portugal. The questionnaire covered topics such as perceptions of sexuality, knowledge of sexuality and STI, methods of transmission prevention, and sources of information. Results: The mean age was 14.4 years, with 19.9% reporting having already initiated sexual ac-tivity. Overall, the knowledge about sexually transmitted infections is low, pointing to 7.08 out of a maximum score of 18. Condoms and immunisation are well-recognized preventive measures, but many misconceptions persist. Better knowledge is associated with better attitudes in the likelihood of having sexual intercourse. Conclusions: This study reveals adolescents' limited sexually transmitted infections knowledge, misconceptions about prevention, and reliance on peers and the internet over trusted sources, highlighting the need for comprehensive sexual education in middle school.

Citizens face online privacy threats from social media, organisations and governments. Privacy-enhancing tools (PETs) can help people to preserve their privacy, but the uptake of these is limited. We developed a conceptual framework for privacy self-protection, using a classification framework of four distinct privacy threats and our own novel staged model of PET adoption requisites. Through an expert survey (N = 12) and a lay user survey (N = 500), we identified suitable PETs for non-expert users and identified potential barriers to PET adoption. Based on the studies and our theoretical framework, we then developed and implemented a PET decision support tool called PEDRO, and conducted expert evaluations (N = 10).

Finding a suitable support is a key process in the life history of climbing plants. Climbers that find a suitable support have greater performance and fitness than those that remain prostrate. Numerous studies on climbing plant behavior have elucidated the mechanistic details of support searching and attachment. Far fewer studies have addressed the ecological significance of support-searching behavior and the factors that affect it. Among these, the diameter of supports influences their suitability for twining plants. When support diameter increases beyond some point climbing plants are unable to maintain tensional forces and therefore lose attachment to the trellis. Here we further investigate this issue by putting pea plants in the situation to choose between supports of different diameters while their movement was recorded by means of a three-dimensional motion analysis system. The results indicate that the way climbing plants move can vary depending on whether they are presented with one or two potential supports. Furthermore, when presented with a choice between a thin and a thick support, the plants showed a distinct preference for the former than the latter. The present findings shed further light on how climbers make decisions as far as support search is concerned, and provide evidence that plants adopt one of several alternative plastic responses in a way that optimally corresponds to environmental scenarios.

The problem of scheduling is an area that has attracted a lot of attention from researchers for many years. Its goal is to optimize resources in the system. The assigning task to the lecturer is an example of the timetabling problem, a class of scheduling. This study introduces a mathematical model to assign fixed tasks (the time and required skills to be fixed) to university lecturers. Our model is capable of generating a calendar that maximizes faculty expectations. The formulated problem is in the form of a multi-objective problem that optimal makes decisions require the trade-off presence of trade-offs between two or more conflicting objectives. To solve this, we use the Compromise Programming approach to multi-objective programming. We then proposed the new version of the Genetic Algorithm to solve the introduced model. Finally, the model and algorithm tested with real scheduling data collected at the Computing Fundamental Department, FPT University, Hanoi, Vietnam.

Artificial Intelligence (AI) and Machine Learning (ML) approaches that could learn from large data sources have been identified as useful tools to support clinicians in their decisional process; AI and ML implementations have had a rapid acceleration during the recent COVID-19 pandemic. However, many ML classifiers are “black box” to the final user, since their underlying reasoning process is often obscure. Additionally, the performance of such models suffer from poor generalization ability in presence of dataset shift. Here, we present a comparison between an explainable-by-design (“white box”) model (Bayesian Network (BN)) versus a black-box model (Random Forest), both studied with the aim to support clinicians of Policlinico San Matteo University Hospital in Pavia (Italy) during the triage of COVID-19 patients. Our aim is to evaluate whether the BN predictive performances are comparable with those of a widely used but less explainable ML model such as Random Forest and to test the generalization ability of the ML models across different waves of the pandemic.

With increasing electronic medical data and the development of artificial intelligence, Clinical Decision Support Systems (CDSSs) assist clinicians in diagnosis and prescription. Traditional knowledge-based CDSSs follow an accumulated medical knowledgebase and a predefined rule system, which clarifies the decision-making process; however, maintenance cost issues exist in the medical data quality control and standardization process. Non-knowledge-based CDSSs utilize vast amounts of data and algorithms to effectively decide; however, the deep learning black-box problem causes unreliable results. EXplainable Artificial Intelligence (XAI)-based CDSS provides a valid rationale and explainable results. It ensures trustworthiness and transparency by showing the recommendation and prediction results process through explainable techniques. However, existing systems have limitations, such as the scope of data utilization and the lack of explanatory power of AI models. This study proposes a new XAI-based CDSS framework to address these issues; introduce resources, datasets, and models that can be utilized; and provides a foundation model to support decision-making in various disease domains. Finally, we propose future directions for CDSS technology and highlight societal issues that need to be addressed to emphasize the potential of CDSS in the future.

Strip steel surface defect recognition research has important research significance in industrial production. Aiming at the problems of defect feature extraction difficulty, slow detection speed and insufficient dataset, YOLOv5 is improved on the basis of YOLOv5, and YOLO-LFPD (Lightweight fine particle detection) model is proposed. By introducing the RepVGG (Re-param VGG) module, the robustness of the model to the surface defect features of strip steel is enhanced, and the expressive ability of the model is improved. FasterNet is used to replace the backbone network, which ensures the accuracy and accelerates the inference speed, making the model more suitable for real-time monitoring. The use of pruning, GA genetic algorithm with OTA loss function method further reduces the model size while better learning the strip steel defect feature information, thus improving the generalisation ability and accuracy of the model. The experimental results show that the introduction of the RepVGG module and the use of FasterNet can well improve the model performance, with a reduction of 48% in the number of parameters, a reduction of 13% in the number of GFLOPs, an inference time of 77% of the original, and an optimal accuracy compared with the network models in recent years. The experimental results on the NEU-DET dataset show that the accuracy of YOLO-LFPD is improved by 3% to 81.2%, which is better than other models, and provides new ideas and references for the lightweight strip steel surface defect detection scenarios and application deployment.

In this paper, we study the asymptotic behavior of the sequential empirical process and the sequential empirical copula process, both constructed from residuals of multivariate stochastic volatility models. Applications for the detection of structural changes and specification tests of the distribution of innovations are discussed. It is also shown that if the stochastic volatility matrices are diagonal, which is the case if the univariate time series are estimated separately instead of being jointly estimated, then the empirical copula process behaves as if the innovations were observed; a remarkable property. As a by-product, one also obtains the asymptotic behavior of rank-based measures of dependence applied to residuals of these time series models.

Diffusion magnetic resonance imaging (dMRI) is an imaging technique that provides information on the microstructural organization of biological tissue. dMRI allows for non-invasive visualization and quantitative assessment of white matter architecture in the brain by characterizing restrictions on the random motion of water molecules. Ultra-high field MRI scanners, such as those operating at 7 Tesla (7T) or higher, can boost signal-to-noise ratio (SNR) to improve dMRI compared with what is attainable at conventional field strengths such as 3T or 1.5T. However, at 7T wavelength effects cause lower transmit magnetic field efficiency in the human brain, mainly in the posterior fossa region, manifesting as signal dropouts in this region. Recently, we reported a simple approach of using a wireless radiofrequency (RF) surface array to improve transmit efficiency and signal sensitivity at 7T. Here we demonstrate the feasibility and effectiveness of using this RF enhancer for in-vivo dMRI at 7T. The use of the RF enhancer can effectively recover signal dropouts in the regions with intrinsically lower SNR such as cerebellum, leading to a better depiction of principal fiber orientations and enhanced visualization of extended tracts to the brainstem and pons enabling more comprehensive delineation of the full white matter architecture.

This paper proposes a model that combines multi-criteria and multi-faceted risk assessment. Using two data sources, a fuzzy Technique for Order of Preference by Similarity to Ideal Solution FTOPSIS method combined with FMEA assessment. The FMEA method presented in this paper combines the technique of prioritising preferences according to FTOPSIS similarity to the ideal solution and conviction structure to overcome the defects of traditional FMEA indicators. The paper describes the exact process and tool selection, and the results obtained in the study verified accurate data. Finally, a numerical case study was presented on hospital reorganization services and case adaptation to prioritize surgical abandonment in Poland. The problem considered in the publication is the priority of patients’ operations in hospitals. The selection of relevant criteria, their importance and patient preferences are presented. The results obtained from the method provide a viable action plan for the proposed research problem. The proposed method is multi-faceted and can be part of an information system supporting reorganization, restructuring, and modification of the operational process.

The systems ESTE are running in nuclear crisis centers at various levels of emergency preparedness and response in Slovakia, the Czech Republic, Austria, Bulgaria, and Iran (at NPP monitored by International Atomic Energy Agency, IAEA). ESTE is a decision support system, running 24/7, and serves the crisis staff to propose actions to protect inhabitants against radiation in case of a nuclear accident. ESTE is also applicable as decision support system in case of a malicious act with radioactive dispersal device in an urban or industrial environment. Dispersion models implemented in ESTE are Lagrangean particle model (LPM) and Puff trajectory model (PTM). Described are models approaches as implemented in ESTE. PTM is applied in ESTE for the dispersion calculation near the point of release, up to 100 km from the point of nuclear accident. LPM for general atmospheric transport is applied for short-range, meso-scale and large-scale dispersion, up to dispersion on the global scale. Additionally, a specific micro-scale implementation of LPM is applied for urban scale dispersion modelling too. Dispersion models of ESTE are joined with radiological consequences models to calculate a complete spectrum of radiological parameters - effective doses, committed doses and dose rates by various irradiation pathways and by various radionuclides. Finally, radiation protective measures, like sheltering, iodine prophylaxis, or evacuation, evaluated on the base of predicted radiological impacts are proposed. Dispersion and radiological models of the state-of-the-art ESTE systems are described. Results of specific analyses, like number of particles applied, initial spatial distribution of the source, height of the bottom reference layer, are presented and discussed.

Many spatial decision support systems suffer from user adoption issues in practice due to lack of trust, technical expertise, and resources. Automated machine learning has recently allowed non-experts to explore and apply machine learning models in the industry without requiring abundant expert knowledge and resources. This paper reviews recent literature from 136 papers, and proposes a general framework for integrating spatial decision support systems with automated machine learning to lower major user adoption barriers. Challenges of data quality, model interpretability, and practical usefulness were discussed as general considerations for system implementation. Research opportunities related to spatially explicit models in AutoML, and resource-aware, collaborative/connected, and human-centered systems were also discussed to address these challenges. This paper argues that integrating spatial decision support systems with automated machine learning can not only encourage user adoption, but also mutually benefit research in both fields — bridging human-related and technical advancements for fostering future developments in spatial decision support systems and automated machine learning.

Background: The purpose of this study is to carry out bioinformatic analysis of lncRNA data obtained as a result of genomic analysis of kidney tissue samples taken from rats with nephrotoxicity induced by methotrexate (MTX) and from rats without pathology and modeling with tree-based machine learning method. Another aim of the study is to identify potential biomarkers for the diagnosis of nephrotoxicity and to provide a better understanding of the nephrotoxicity formation process by providing the interpretability of the model with explainable artificial intelligence methods as a result of the modeling. Methods: To identify potential indicators of drug-induced nephrotoxicity, 20 female Wistar Albino rats were separated into two groups: nephrotoxicity and control. Kidney tissue samples were collected from the rats, and genomic, histological, and immunohistochemical analyses were performed. The data set obtained as a result of genomic analysis was modeled with Random Forest (RF), one of the tree-based methods. Modeling results were evaluated with sensitivity (Se), specificity (Sp), balanced accuracy (B-Acc), negative predictive value (Npv), accuracy (Acc), positive predictive value (Ppv), and F1-score performance metrics. The Local Interpretable Model-Agnostic Annotations (LIME) method was used to determine the lncRNAs that could be biomarkers for nephrotoxicity by providing the interpretability of the RF model. Results: The outcomes of the histological and immunohistochemical analyses done in the study supported the conclusion that MTX use caused kidney injury. According to the results of the bioinformatics analysis, 52 lncRNAs showed different expression in the groups. As a result of modeling with RF for lncRNAs selected with Boruta variable selection, the B-Acc, Acc, Sp, Se, Npv, Ppv, and F1-score were 88.9%, 90%, 90.9%, 88.9%, 90.9%, 88.9% and 88.9%. respectively. lncRNAs with id rnaXR_591534.3 rnaXR_005503408.1, rnaXR_005495645.1, rnaXR_001839007.2, rnaXR_005492056.1 and rna_XR_005492522.1 the lncRNAs with the highest variable importance values produced from RF modeling can be used as nephroxicity biomarker candidates. Also, according to the LIME results, the high level of lncRNAs with id rnaXR_591534.3 and rnaXR_005503408.1 especially increased the possibility of nephrotoxicity. Conclusions: With the possible biomarkers obtained as a result of the analyses made within the scope of this study, it can be ensured that the procedures for the diagnosis of drug-induced nephrotoxicity can be carried out easily, quickly and effectively.

Megaselia scalaris and Senotainia tricuspis are two parasitoid flies of the honeybee Apis mellifera and are known to infest apiaries of different European and Mediterranean countries. However, their prevalence is still little known and no systematic control of their presence and countermeasures are currently adopted. To achieve a better knowledge about their distribution in apiaries, quantitative PCR (qPCR) based methods for their rapid detection directly in hive matrices were developed in this study. These were applied to samples of adult honeybees and hive debris collected in the summer season in Central Italy and Kosovo. In total 16 samples per type per region were analyzed. Both flies were detected in the two geographical contexts but more frequently in Central Italy. The positive apiaries in Central Italy were re-sampled one year later by capturing viable honeybees and isolating emerging flies after differentiation into adults. These were genotyped by sequencing regions of the mitochondrial cytochrome oxidase subunit I gene COI for M. scalaris and cytochrome B gene cytB for S. tricuspis amplified with specific primers designed in this study. Different genotypes of M. scalaris were detected and these were related to biotypes from distant nations. Some fly isolates were shown to harbor DNA or RNA of honeybee microbial pathogens. Results suggested to implement efficient control against these parasites in apiaries to limit their detrimental effects. The qPCR tests that have been developed can facilitate larger screening studies and early detection.

The abnormal accumulation of cells in the human brain, if left untreated, may cause brain damage. Management and treatment of these tumours require an early and accurate diagnosis, while their prognostic characterisation can also be beneficial in the choice of care planning for the patient. CDSSs are being continuously developed and integrated into routine clinical practice as they assist clinicians and radiologists to deal with an enormous amount of medical data, reduce clinical errors, and improve diagnostic capabilities. They assist detection, classification, and grading of brain tumours as well as alerting physicians of requirement of change in treatment plans. The aim of this systematic review is to identify various CDSSs used in brain tumour diagnosis and prognosis, that rely on data captured by any imaging modality. Based on the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol, the literature search was conducted in PubMed and Engineering Village Compendex databases. This review examines various CDSS tool types, system features, techniques used, accuracy, and outcome, to provide the latest evidence available in the field of neuro-oncology. An overview of different types of CDSSs used to support clinical decision-making in the management and treatment of brain tumours, along with highlighting their benefits, challenges, and future perspectives has been provided.

Decision makers have to work on resolving multiple forms of problems within their organizations. The problems can be structured, semi-structured, or unstructured. Handling these issues requires intensive time dedication and resource allocation. Looking at the perspective of strategic decision making in Saudi Arabia, current operations are lacking in various sectors. This indulges an immediate need to introduce proper systems and highlight the loopholes that would allow the leaders make informed decisions aided by a support system. For this reason, the researchers set out to work on two research questions. The first question focused on how decision makers ensured accuracy of the decisions they are making. It would allow to identify why such system is important that should also guarantee consistency and accuracy. The second question asked about the proper process that would govern and control the outcome of decision. Considering the above questions, this research aimed at identifying the ideal framework, and whether the proposal developed would fit into the Saudi organizations. A case study in health sector has been reviewed containing various models across the world. Following this, interviews with five decision makers in their organization were conducted to perform the qualitative research. The researcher identified that most organizations lacked systems to ensure their decisions were accurate. The research also concluded that the tools and elements presented in the proposed informed decision framework would fit into most Saudi organizations to eliminate the identified problem, and especially due to the inclusion of the non-digital sources of information as part to the decision process. Furthermore, the analysis was conducted and discussion was determined stating validations of the study.

In schizophrenia, cognition is closely linked to social competence and influences long-term prognosis. Thus, treatment should target cognitive improvement to enhance the patients’ societal adaptation. This study evaluated the effects of computer-assisted cognitive remediation therapy (CR) using RehaCom® on cognition in patients with schizophrenia. Thirty patients were randomized, with 15 assigned to the CR group and treatment usual care (TAU) and 15 to the TAU alone groups. Over 12 weeks, patients received CR twice weekly, including two computer sessions and one verbal session. Outcomes measured were cognition using the Brief Assessment of Cognition in Schizophrenia and Schizophrenia Cognition Rating Scale, intrinsic motivation using the Quality of Life Scale and Intrinsic Motivation Inventory, psychiatric symptoms using the Positive and Negative Syndrome Scale, negative symptoms using Scale for the Assessment of Negative Symptoms, and functional level using modified Global Assessment of Functioning scale for Functioning. The CR + TAU group demonstrated considerable improvements in cognition, intrinsic motivation, negative symptoms, and functional level compared to the TAU-alone group. These findings indicate that the CR using RehaCom® enhances cognition and other outcomes in schizophrenia.

Magnetic resonance (MR) image acquisitions are usually time-consuming, limiting utilization in neuroimaging. For multiple sclerosis (MS) patients, MR imaging plays a major role in drug therapy decision-making. The purpose of this study was to evaluate whether an ultrafast, T2-weighted (T2w), deep-learning-enhanced (DL), echo-planar-imaging-based (EPI) fluid-attenuated inversion recovery (FLAIR) sequence (FLAIRUF) that has been targeting neurological emergencies so far might even be an option to detect MS lesions of the brain compared to conventional FLAIR sequences. Therefore, 17 MS patients were enrolled prospectively in this exploratory study. Standard MR protocols and ultrafast acquisitions were conducted at 3 tesla (T), including three-dimensional (3D)-FLAIR, turbo/fast spin echo (TSE)-FLAIR, and FLAIRUF. Inflammatory lesions were grouped by size and location. Lesion conspicuity and image quality were rated on an ordinal five-point Likert scale, and lesion detection rates were calculated. Statistical analyses were performed to compare results. Altogether, 568 different lesions were found. Data indicated no significant differences in lesion detection (sensitivity and positive predictive value [PPV]) between FLAIRUF and axially reconstructed 3D-FLAIR (lesion size ≥ 3 mm × ≥ 2 mm) and no differences in sensitivity between FLAIRUF and TSE-FLAIR (lesion size ≥ 3 mm total). Lesion conspicuity in FLAIRUF was similar in all brain regions except for superior conspicuity in the occipital lobe and inferior conspicuity in central brain regions. Further findings include location-dependent limitations of signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) as well as artifacts such as spatial distortions in FLAIRUF. In conclusion, FLAIRUF could potentially be an expedient alternative to conventional methods for brain imaging in MS patients since the acquisition can be performed in a fraction of time while maintaining good image quality.

This article should examine ideas of how a chatbot can support decision making processes by col-lecting general opinion about the certain topics. The ChatGPT is tested in this article in respect of natural gas security of supply of the Republic of Serbia in the context of the current political situation in the world. The author first describes its own stance on the topic and then the ChatGPT is asked for its opinion (which most probably collects and compiles phrases from English speaking sources to build a text in a smart way). The topic is ort only about security of gas supply of Serbia but also political and highly sensitive, so it is examined if the ChatGPT can be useful tool to reach a balance between less on more favorable options in the process of policy making.

Coronaviruses cause infections in humans and diverse species of animals and birds with a global distribution. Bovine coronavirus (BCoV) produces predominantly two forms of disease in cattle, a respiratory form, and a gastrointestinal form. All age groups of cattle are affected by the respiratory form of coronavirus whereas the gastroenteric form causes neonatal diarrhea or calf scour in young cattle and winter dysentery in adult cattle. The tremendous impacts of bovine respiratory disease and the associated losses are well-documented and underscores the importance of this pathogen. Beyond this, studies have demonstrated significant impacts on milk production associated with outbreaks of winter dysentery, with up to a 30% decrease in milk yield. Research data so far have shown that the viral structure or strain is not a determinant of tissue tropism and clinical form of the disease. In North America, BCoV was identified for the first time in 1972, and it continues to be a significant economic concern for the cattle industry. The virus is classified under Coronaviridae family, Betacoronavirus genus and Betacorovirus 1 species. A number of conventional and molecular diagnostic assays are available for the detection of BCoV from clinical samples. Conventional assays for BCoV detection include virus isolation, which is challenging from clinical samples, electron microscopy, fluorescent antibody assays, and various immunoassays. Molecular tests are mainly based on nucleic acid detection and predominantly include conventional and real-time polymerase chain reaction (PCR) assays. Isothermal amplification assays and genome sequencing have also been used increasingly in recent years for the detection and identification of BCoV. Loop-mediated isothermal amplification, helicase-dependent amplification, recombinase polymerase amplification, and multienzyme isothermal rapid amplification are some examples of the isothermal amplification assays for used BCoV. Point-of-care testing has gained some popularity recently as they can offer user-friendly testing on the farm (barn-side). The present study reviewed literature on coronavirus infections in cattle from the last three and a half decades and presents information mainly on the current and advancing diagnostics in addition to epidemiology, clinical presentations, and the impact of the disease on the cattle industry.

In Germany, as in many developed countries, over 60% of buildings were constructed before 1978, where most are in critical condition, requiring either demolition with plans for redevelopment or renovation and rehabilitation. Given the urgency of climate action and relevant sustainable development goals set by the United Nations, more attention must be shifted toward the various sustainability aspects when deciding on the strategy for renovation or redevelopment of existing buildings. To this end, this study focused on developing a smart decision support framework for aging buildings based on lifecycle sustainability considerations. The framework integrated digital technological advancements, such as building information modeling (BIM), point clouds processing with field information modeling (FIM)®, and structural optimization, together with life-cycle assessment to evaluate and rate the environmental impact of different solutions. Three sustainability aspects, namely, cost, energy consumption, and carbon emissions, were quantitatively evaluated and compared in two scenarios, namely, renovation, and demolition or deconstruction combined with redevelopment. A real building constructed in 1961 was the subject of the experiments to validate the framework. The result outlined the limitations and advantages of each method in terms of economics and environmental impact. It was further observed that optimizing the building design with the goal to reduce embodied energy and carbon in compliance with modern energy standards, was crucial to improve overall energy performance. This work demonstrated that the developed BIM-based framework to assess the environmental impact of rehabilitation work in aging buildings can provide effective ratings to guide decision-making in real-world projects.

The last half of the 20th century was characterized by the most impactful ecosystem changes throughout regulations and guidelines minimalizing environmental harms. Many of them emphasize the importance of enterprise sustainability for renewable energy policy. When dealing with numerous alternatives for the implementation of renewables-based policy, decision-makers need to analyze their impacts on environmental, economic, and social dimensions from a long-term perspective. The aim of this paper is to highlight a challenge to apply the multi-criteria sustainability decision-making framework (MDCA) to mainstream energy policy. The integrative framework covers an approach for the needs of analyzing factors influencing the energy technology selection. In this study, the MDCA-approach combines lifecycle-based methods, Analytical Hierarchy Process, PESTEL (Political, Economic, Social, Technological, Environment and Legal). To demonstrate the applicability and usability of the method three photovoltaic technologies are assessed. The results showed that string ribbon technology is the most sustainable along its life cycle, with a 0.503 sustainability score. The study highlighted the need to embody robust methodologies assessing sustainability-oriented technologies, not used anymore for supporting energy policies. This challenge regarding example evidence can give energy decision-makers a tool to realize their energy policy and in consequence, enhance enterprise sustainability.

Building information modeling (BIM) is the digital representation of physical and functional characteristics (such as geometry, spatial relationship, and geographic information) of a facility to support decisions during its life cycle. BIM has been extended beyond 3D geometrical representations in recent years, and now includes time as a fourth dimension and cost as a fifth dimension, as well as such other applications as virtual reality and augmented reality. The Internet of Things (IoT) has been increasingly applied in various products (smart homes, wearables) to enhance work productivity, living comfort, and entertainment. However, research addressing the integration of these two technologies (BIM and IoT) is still very limited, and has focused exclusively on the automatic transmission of sensor information to BIM models. This paper describes an attempt to represent and visualize sensor data in BIM with multiple perspectives in order to support complex decisions requiring interdisciplinary information. The study uses a university campus as an example and includes several scenarios, such as an auditorium with a dispersed audience and energy saving options for rooms with different functions (mechanical/electric equipment, classrooms, and laboratory). This paper also discusses the design of a common platform allowing communication among sensors with different protocols (Arduino, Raspberry Pi), the use of Dynamo to accept sensor data as input and automatically redraw visualized information in BIM, and how visualization may help in making energy-saving management decisions.

Adults’ with Intellectual Disabilities (ID) experiences on occupational participation were explored through the prism of Occupational Justice model (MOJ) aiming to shape and develop an occupation-centered model of Quality of Life (QoL). In this qualitative study participated thirteen adults with ID (N=13). A semi-structured interview based on MOJ was constructed and administered to explore perspectives on QoL, as well as injustices regarding occupational participation. The interviews were processed with QSR NVivo8 following content analysis research methodology. An Occupational – Quality of Life (O-QoL) model with an everyday occupations core component has been formed. This model includes three core O-QoL domains: (i) social well-being, (ii) emotional – physical well-being and (iii) material adequacy. Main indicators of O-QoL were the recreational occupations and social activities, while socio-environmental factors such as occupational deprivation have been identified as aggravating. In addition, specific occupations such as leisure activities, physical exercise / sports, art, video games and vocational training could also be beneficial for O-QoL. Moreover, the importance of promoting and supporting the rights of people with ID for employment, independent living and sexual expression was highlighted. The O-QoL could be a valuable conceptual framework in the field of ID, however further research for developing specialized assessment tools and Occupational Therapy interventions to promote O-QoL is needed.

Simple Summary (148 words) There is increasing evidence, that cannabinoids may play an important and dual role in tumour therapy. On one hand, they are cytotoxic against cancer cells with a low toxicity against normal, healthy tissues, and on the other, they may reduce typical side effects of chemotherapy. Publications on the main motive for use of cannabis (cannabinoids) by cancer patients show that patients' expectations exceed scientific facts. This article briefly describes results of combinations of cannabinoids with standard antineoplastic drugs on tumours and on side effects of tumour therapy. Although observations are still limited to animal studies with very few experiences in patients, preliminary data suggest that adjuvant cannabinoids may improve the survival of glioblastoma and perhaps of patients with other tumours. Benefits have also been reported about chemotherapy-induced nausea and vomiting, chemotherapy-induced peripheral neuropathic pain, loss of appetite and anxiety. Although results are promising, much more research is necessary. Abstract (192 words) Cancer, one of the leading causes of death worldwide, is on the rise. The high toxicity of conventional chemotherapy, often applied as drug cocktails, and resistance development limits the use of anti-neoplastic drugs and reduces the quality of life. With an easier access, a growing number of patients are using cannabis (cannabinoids) for alleviation of their symptoms, and in the hope of improving survival. This narrative article summarizes results observed with combinations of phytocannabinoids and standard chemotherapeutic agents in animal tumour models and in patients. Preliminary data suggest that standard antineoplastic agents combined with cannabinoids exert increased anti-cancer actions, reduce resistance development and improve survival. Respective experiences in patients are still scarce and concern small numbers with glioblastoma, and pancreatic carcinoma. Further benefits of combinations with cannabinoids have also been reported for chemotherapy-induced nausea and vomiting, loss of appetite (dronabinol), chemotherapy-induced peripheral neuropathic pain and anxiety (cannabidiol). In addition, phytocannabinoids, in particular cannabidiol, may play a role in the protection of organs such as heart, lung or kidney against chemotherapy-induced toxicity. Although results are promising, much more research is needed to determine whether positive experiences of adjuvant cannabinoids outweigh eventual risks.

In this study, tree selection/plantation DSS (Decision Support Systems) were reviewed and assessed based on essential objectives in the available literature. We reviewed existing DSS using multiple data sources and available online resources such as web interfaces. We compared the existing DSS, focusing primarily on five primary objectives in this study, which DSS may address when it comes to the tree selection, including a) Climate resilience, b) Infrastructure/Space Optimization, c) Agroforestry, d) Ecosystem services, e) Urban sustainability. Climate resilience of tree species and urban sustainability is addressed relatively less in existing systems, which can be holistically internalized in future DSS tools Based on this review, DNN (Deep Neural Networks) is recommended to address achieving trade-offs between complex objectives such as maximizing ecosystem services, climate resilience of tree species, maintaining Agroforestry, and other benefits.

Studying models of healthy aging and exceptional longevity is crucial to understand a possible longevity signature as most of them show resistance to age-related diseases. In particular, semi- and supercentenarians are a highly selected group, having survived significant adversities, including the Spanish Flu and COVID-19 pandemics, indicating distinctive immune system characteristics. This paper analyse the inflammatory scores (INFLA-score, Systemic Inflammation Response Index (SIRI)) and Aging-Related Immune Phenotype (ARIP) indicators calculated from the dataset of the DESIGN project, including 249 participants aged 19-111 years, trying to understand the immune-inflammatory (IMFLAM) role to achieve longevity. Statistical analyses, including linear regression and one-way ANOVA, were performed to explore the correlations between these parameters and age. Both INFLA-score and SIRI showed a significant increase with age. However, no statistical difference is observed when analysing the values for semi- and supercentenarians with those for other age groups, whose values are similar to that of adults and less than younger centenariansRegarding ARIP values, it is noteworthy that when comparing the CD8 Naive/Effector scores between groups, no significant differences were observed between the semi- and supercentenarian group and the other groups. These results support the idea that the control of IMFLAM response can promote extreme longevity.

Grinding processes’ stochastic nature poses a challenge in predicting the quality of the resulting surfaces. Post-production measurements for form, surface roughness, and circumferential waviness are commonly performed due to infeasibility in measuring all quality parameters during the grinding operation. Therefore, it is challenging to diagnose the root cause of quality deviations in real-time resulting from variations in the machine’s operating condition. This paper introduces a novel approach to predicting the overall quality of the individual parts. The grinder is equipped with sensors to implement condition-based maintenance and is induced with five frequently occurring failure conditions for the experimental test runs. The crucial quality parameters are measured for the produced parts. Fuzzy c-means (FCM) and Hotelling’s T-squared (T2) have been evaluated to generate quality labels from the multi-variate quality data. Benchmarked random forest regression models are trained using fault diagnosis feature set and quality labels. Quality labels from the T2 statistic of quality parameters are preferred over FCM approach for their repeatability. The model, trained from T2 labels achieves more than 94% accuracy when compared to the measured ring disposition. The predicted overall quality using the sensors’ feature set is compared against the threshold to reach a trustworthy maintenance decision.

An Environmental Decision Support System (EDSS) can be used as an important tool for rehabilitation and preservation of ecosystems. Nonetheless, high assimilation costs (both money and time) are one of the main reasons that these tools are not widely adapted in practice. This work presents a low-cost paradigm of "EDSS as a Service", this paradigm is demonstrated for developing Water Quality EDSS as a Service that utilizes the well-known CE-QUAL-W2 model as a kernel for deriving optimized decisions. The paradigm is leveraging new open-source technologies in software development (e.g. Docker, Kubernetes, and Helm) with cloud computing in order to significantly reduce assimilation costs of the EDSS for organizations and researchers working on rehabilitation and preservation of water bodies.

In this study, the decision-making process management of forest tending in the forestry business is decentralized, and forest tending decision-making activities at different points in time are integrated by decision makers at different geographical locations. The decision-making process was analyzed and optimized from a system perspective. Based on the optimized decision-making process, a forest tending business group decision support system (FTGDSS) was established. We first reviewed and discussed the characteristics and development of the forest tending business and forestry decision support system. Business Process Modeling Notation was used to draw a current state flow chart of the forest tending business, to identify and discover important decision points in the process of tending decision-making. We also analyzed the content and attributes of each decision point, and described the system structure, functional framework, knowledge base structure, and reasoning algorithm of FTGDSS in detail. Finally, FTGDSS was evaluated from the two dimensions of the technology adoption model. FTGDSS integrates different levels of time-space decision-making activities, historical tending data, business plans, decision-makers' management tendencies into the decision-making process and automatically extracts decision-making data from the forest business process management enterprise resource planning system (Smartforest) that improves the ease of use of the decision support system (DSS). It also improves the quality of forest tending decisions, and enables the DSS to better support multi-target management strategies.

This study examines the potential of combining decision support approaches to identify optimal bundles of ecosystem services. A forested landscape, Zona de Intervenção Florestal of Paiva and Entre-Douro and Sousa (Portugal), is used to test and demonstrate this potential. The landscape extends over 14,000 ha, representing 1,976 stands. The property is fragmented into 376 holdings. The overall analysis was performed in three steps. First, we selected six alternative solutions (A to F) in a Pareto frontier generated by a multiple criteria method within a decision support system (SADfLOR) for subsequent analysis. Next, an aspatial strategic multi-criteria decision analysis (MCDA) analysis was performed with the Criterium DecisionPlus (CDP) component of another decision support system (EMDS) to assess the aggregate performance of solutions A to F for the entire forested landscape with respect to their utility for delivery of ecosystem services. For the CDP analysis, SADfLOR data inputs were grouped into two sets of primary criteria: Wood Harvested and Other Ecosystem Services. Finally, a spatial logic-based assessment of solutions A to F for individual stands of the study area was performed with the NetWeaver component of EMDS. The NetWeaver model was structurally and computationally equivalent to the CDP model, but the key NetWeaver metric is a measure of the strength of evidence that solutions for specific land stands were optimal for the unit. Solutions D and B performed best in the aspatial strategic MCDA analysis, and a composite of the maps generated by NetWeaver demonstrated the spatial basis for the performance of solutions D and B in individual land stands. We conclude with a discussion of how the combination of decision support approaches encapsulated in the two systems could be further automated.

Manufacturing organizations shall recognize sustainability as a business occasion to capitalize on, rather than an undesirable pressing situation. Still, empirical evidence shows that this opportunity is hard to capture and communicate in global strategic decisions, through planning by tactical management, to daily operational activities. This paper systematically reviews the modeling challenges at the crossroad of value and sustainability decisions making, spotlighting methods and tools proposed in literature to link sustainability to customer value creation at strategic, tactical and operational level. While statistical results show that the topic of sustainability and value modeling is trending in literature, findings from content analysis reveal that recent attempts to promote a value-based view in the sustainability discussion remain at a strategic level, with most of the proposed indicators being suited for managerial decision-making. The lack of support at operational level points to the opportunity of cross-pollinating sustainability research with value-centered methodologies originating from the aerospace sector. The Value Driven Design framework is proposed as main hub from which to derive models supporting engineers and technology developers in the identification of win-win-win situations, where sustainable improvements are aligned with business advantages.

The scientific community has shown considerable interest in Industry 4.0 due to its capacity to revolutionise the manufacturing sector through digitalisation and data-driven decision-making. However, the actual implementation of Industry 4.0 within complex industrial settings presents obstacles that are typically beyond the scope of mainstream research articles. In this paper, a comprehensive case-study detailing our collaborative partnership with a leading medical device manufacturer is presented. The study traces their evolution from a state of limited digitalisation to the development of a digital intelligence platform that leverages data and machine learning models to enhance operations across a wide range of critical machines and assets. The main business objective was to enhance the energy efficiency of the manufacturing process, thereby improving its sustainability measures while also saving costs. The project encompasses energy modelling and analytics, Fault Detection and Diagnostics (FDD), renewable energy integration and advanced visualisation tools. Together, these components enable informed decision making in the context of energy efficiency.

Clustered regularly interspaced short palindromic repeats (CRISPR) based gene-editing has begun to transform the treatment landscape of genetic diseases. The history of the discovery of CRISPR/CRISPR-associated (Cas) proteins/single guide RNA (sgRNA)-based gene-editing since the first report of repetitive sequences of unknown significance in 1987 is fascinating, instructive, and inspiring for future advances. The recent approval of CRISPR-Cas9-based gene therapy to treat patients with severe sickle cell anemia and transfusion-dependent beta thalassemia has renewed hope for treating other hematologic diseases, including patients with germline predisposition to hematologic malignancies, who would benefit greatly from the development of CRISPR-based gene therapies. The purpose of this manuscript is three-fold: first, a chronological description of the history of CRISPR-Cas9-sgRNA-based gene editing; second, a brief description of the current state of clinical research in hematologic diseases, including selected applications in treating hematologic diseases with CRISPR-based gene therapy; and third, the current progress in gene therapies in inherited hematologic diseases and bone marrow failure syndromes, to hopefully stimulate efforts towards developing these therapies for patients with inherited bone marrow failure syndromes and other inherited conditions with germline predisposition to hematologic malignancies.

Partially state-owned firms are common in both developed and developing countries and contribute around 10% of the world's GDP. This has led to a rich literature exploring various aspects of competition between such “mixed”-ownership firms. This paper contributes to the existing literature by studying the effects of mixed ownership on the intensity of competition in oligopoly markets. Our findings indicate that state ownership exerts an anti-competitive influence, with a higher state ownership share resulting in less aggressive behavior by firms in the product market. This result implies that industries with a higher proportion of state ownership yield lower total surplus. Further, when considering factors such as taxes, soft budget constraints, and weak property rights, the anti-competitive effects of state ownership are accentuated.

Studies on the possible association between bacteria and oral squamous cell carcinoma (OSCC) remain inconclusive, largely due to methodological variations/limitations. The objective of this study was to characterize the species composition as well as functional attributes of the bacteriome associated with OSCC. DNA obtained from 20 fresh OSCC biopsies (cases) and 20 deep-epithelium swabs (matched control subjects) were sequenced for the V1-V3 region using Illumina’s 2x300 bp chemistry. High quality, non-chimeric merged reads were classified to species level using a prioritized BLASTN-algorithm. Downstream analyses were performed using QIIME, PICRUSt, and LEfSe. Fusobacterium nucleatum subsp. polymorphum was the most significantly overrepresented species in the tumors followed by Pseudomonas aeruginosa and Campylobacter sp. Oral taxon 44, while Streptococcus mitis, Rothia mucilaginosa and Haemophilus parainfluenzae were the most significantly abundant in the controls. Functionally, genes involved in bacterial mobility, flagellar assembly, bacterial chemotaxis and LPS synthesis were enriched in the tumors while those responsible for DNA repair and combination, purine metabolism, phenylalanine, tyrosine and tryptophan biosynthesis, ribosome biogenesis and glycolysis/gluconeogenesis were significantly associated with the controls. This is the first epidemiological evidence for association of F. nucleatum and P. aeruginosa with OSCC. Functionally, an “inflammatory bacteriome” is enriched in OSSC.

Background: Current obstructive sleep apnea treatment relies on manual PAP titration, but it has limitations. Complex interactions during titration and variations in SpO2 data accuracy pose challenges. Patients with co-occurring chronic hypercapnia may require precise oxygen titration. To address these issues, we propose a Clinical Decision Support System using Markov Decision Processes. Methods: This study, compliant with data protection laws, focused on adults with OSA-induced hypoxemia utilizing supplemental oxygen and CPAP/BiPAP therapy. PAP titration, conducted over one night, involved vigilant monitoring of vital signs and physiological parameters. Adjustments to CPAP pressure, potential BiLevel transitions, and supplemental oxygen were precisely guided by patient metrics. Markov Decision Processes outlined three distinct phases for sleep disorder management, incorporating expert medical insights. Results: In our study involving 14 OSA patients (average age: 63 years, 27% females, BMI 41 kg m−2), significant improvements were observed in key health parameters. The initial AHI of 61.8 events per hour significantly decreased to an average of 18.0 events per hour after PAP and oxygen titration (p < 0.0001), indicating a substantial reduction in sleep-disordered breathing severity. Concurrently, SpO2 levels increased significantly from an average of 79.7% before titration to 89.1% after titration (p < 0.0003). Pearson correlation coefficients demonstrated aggravation of hypercapnia in 50% of patients (N=5) with initial hypercapnia during the increase of CPAP pressure. However, transitioning to BiPAP exhibited a reduction in pCO2 levels, showcasing its efficacy in addressing hypercapnia. Simultaneously, BiPAP therapy correlated with a substantial increase in SpO2, underscoring its positive impact on oxygenation in OSA patients. Markov dynamic process analysis demonstrated realistic patient behavior during stable night conditions, emphasizing minimal apnea and good toleration to high CPAP pressure. Conclusions: the development of a framework for Markov Decision Processes of PAP and oxygen titration algorithms holds promise for providing algorithms for deviation in pCO2 and SpO2 markers. While challenges remain, including the need for high-quality data, the potential benefits in terms of patient management and care optimization are substantial, and this approach represents an exciting frontier in the realm of telemedicine and respiratory healthcare. Obstructive sleep apnea, PAP titration, hypoxia, hypercapnia, Markov decision processes

Cancer is the second major cause of disease-related dead worldwide, and its accurate early diagnosis and therapeutic intervention are fundamental for saving the patient’s life. Cancer, as a complex and heterogeneous disorder, results from disruption and alteration of a wide variety of biological entities, including genes, proteins, mRNAs, miRNAs, and metabolites that eventually emerge as clinical symptoms. Traditionally, diagnosis is based on clinical examination, blood tests for biomarkers, histopathology of biopsy, and imaging (MRI, CT, PET, US). Additionally, omics biotechnologies help to further characterize the genome, metabolome, microbiome traits of the patient that could have an impact on the prognosis and patient’s response to the therapy. The integration of all these data relies on gathering of several experts and may require considerable time, and, unfortunately, it is not without the risk of error in the interpretation and therefore in the decision. Systems biology algorithms exploit Artificial Intelligence (AI) combined with omics technologies to perform a rapid and accurate analysis and integration of patient’s big data and support the physician in making diagnosis and tailoring the most appropriate therapeutic intervention. However, AI is not free from possible diagnostic and prognostic errors in the interpretation of images or biochemical-clinical data. Here, we first describe the methods used by systems biology for combining AI with omics and then discuss the potential, challenges, limitations, and critical issues in using AI in cancer research.

This study aimed to demonstrate the potential role of Dual Energy CT in assessing Bone Mineral Density (BMD) in postmenopausal women. A retrospective study was conducted on 51 postmenopausal female patients who underwent DXA and DECT examinations for other clinical reasons. DECT images were acquired with spectral imaging using a 256-slice system. These images were processed and visualized using an HAP(fat) map. Statistical analysis was performed using the Bland-Altman method to assess agreement between DXA and DECT HAP(fat) measurements. Mean BMD, vertebral and femoral T-scores were obtained. For vertebral analysis, the Bland-Altman plot showed an inverse correlation (R2: -0.042; RMSE: 0.690) between T-scores and DECT HAP(fat) values for measurements from L1 to L4, while a good linear correlation (R2: 0.341; RMSE: 0.589) it was found for measurements at the femoral neck. In conclusion, we demonstrated the enhanced accuracy of BMD calculation through DECT, finding a statistically significant correlation only at the femoral neck where BMD results do not seem to be influenced by the overlap of the measurements on cortical and trabecular bone. This outcome could be beneficial in the future by reducing radiation exposure for patients already undergoing follow-up for chronic conditions.

Tropical cyclones devastate large areas, take numerous lives and damage extensive property in Bangladesh. Research on landfalling tropical cyclones affecting Bangladesh has primarily focused on events occurring since AD1960 with limited work examining earlier historical records. We rectify this gap by developing a new tornado catalogue that include present and past records of tornados across Bangladesh maximizing use of available sources. Within this new tornado database, 119 records were captured starting from 1838 till 2020 causing 8,735 deaths and 97,868 injuries leaving more than 1,02,776 people affected in total. Moreover, using this new tornado data, we developed an end-to-end system that allows a user to explore and analyze the full range of tornado data on multiple scenarios. The user of this new system can select a date range or search a particular location, and then, all the tornado information along with Artificial Intelligence (AI) based insights within that selected scope would be dynamically presented in a range of devices including iOS, Android, and Windows. Using a set of interactive maps, charts, graphs, and visualizations the user would have a comprehensive understanding of the historical records of Tornados, Cyclones and associated landfalls with detailed data distributions and statistics.

This study examines the capacity of a Site-Specific Fodder Management Decision Support System (SSFM-DSS) model to assist in successful cultivation of sericea lespedeza [SL; Lespedeza cuneata (Dum.-Cours.) G. Don.], with a specific focus on small-scale agricultural systems in the southeastern United States (U.S.). The study emphasizes incorporating advanced geospatial technologies, such as Geographic Information Systems (GIS), remote sensing, and Global Navigation Satellite Systems (GNSS), to improve fodder production. The research showcases the versatility of SL under varying environmental conditions, underscoring its significance in promoting sustainable livestock production. The methodology integrates empirical field data, geospatial analysis, and predictive modeling to formulate an SSFM strategy customized to address the distinct difficulties climate change presents, such as sudden and severe drought conditions. The study introduces an automated geospatial model for assessing the appropriateness of SL production throughout Alabama, Georgia, and South Carolina. The model uses many environmental criteria, including soil properties, climate fluctuations, and terrain. Furthermore, the research was instrumental in development of a WebGIS Dashboard, which offers farmers a decision assistance system to enhance the sustainable production of SL. The results highlight the significant impact that a SSFM-DSS can have on promoting sustainable agricultural practices, providing a solution to address the issues of food security and environmental concerns in agriculture.

The paper presents a new vision on the energy consumption management in the case of the Small and Medium Enterprises (SMEs), integrated into an advanced decision support platform, with technical and economic benefits on increasing the energy efficiency, which contains modules for database management, profiling, forecasting, and production scheduling. Inside each module, Artificial Intelligence and Data Mining techniques were proposed to remove the uncertainties regarding the dynamic of technological flows. Thus, the data management module includes the Data Mining techniques, that extract the technical details on the energy consumption needed in the development of production scheduling strategies, the profiling module uses an original approach based on clustering techniques to determine the typical energy consumption profiles required in the optimal planning of the activities, the forecasting module contains a new approach based on an expert system to forecast the total energy consumption of the SMEs, and production scheduling module integrates a heuristic optimization method to obtain the optimal solutions in flattening the energy consumption profile. The testing was done for a small enterprise from Romania, belonging to the domain of trade and repair of vehicles. The obtained results highlighted the advantages of the proposed decision support platform on the decrease in the intensity of energy consumption per unit of product, reduction of the purchase costs, and modification of the impact whom the energy bills have on the operational costs.

The concepts of accessibility and urban walkability are the cornerstones of urban policies for the contemporary city, called upon to adopt sustainable development models in line with the objectives of the 2030 Agenda and the ambitious objectives of the 'European Green Deal'. These concepts are closely linked to the paradigm of a sustainable city (livable, healthy and inclusive), founded on a system of quality public spaces and on a network of services and infrastructures, both tangible and intangible, capable of strengthening or building new relationships: social, economic and environmental. It is therefore necessary to recognize potential opportunities for connection and permeability in consolidated urban environments, very often fragmented and characterized by enclaves. Within this framework, the city of Cagliari represents an interesting case study as it is characterized by the presence of a series of military complexes, real 'enclaves' which condition the proximity connections and, more generally, the walkability. In this sense, building on previous research and analysis of policies and projects aimed at reintroducing, even partially, this military asset into civilian life (Green Barracks Project - GBP - 2019), this study proposes and applies a methodology to improve urban accessibility in a flexible network logic, where 'walkability' can become not only a moment of possible "choice" but the basis for planning oriented to the '15 min city' model or, more generally, to the renewed, inclusive, safe, resilient and sustainable “City of proximity”.

Objective: This study aimed to assess the impact of artificial intelligence (AI)-driven noise reduction algorithms on metal artifacts and image quality parameters in cone-beam computed tomography (CBCT) images of the oral cavity. Materials and Methods: This retrospective study included 70 patients, 61 of whom were analyzed after excluding those with severe motion artifacts. CBCT scans, performed using a Hyperion X9 PRO 13 × 10 CBCT machine, included images with dental implants, amalgam fillings, orthodontic appliances, root canal fillings, and crowns. Images were processed with ClariCT. AI deep learning model (DLM) for noise reduction. Objective image quality was assessed using metrics such as the differentiation between voxel values (ΔVVs), the artifact index (AIx), and the contrast-to-noise ratio (CNR). Subjective assessments were performed by two experienced readers, who rated overall image quality and artifact intensity on predefined scales. Results: Compared with native images, DLM reconstructions significantly reduced the AIx and increased the CNR (p<0.001), indicating improved image clarity and artifact reduction. Subjective assessments also favored DLM images, with higher ratings for overall image quality and lower artifact intensity (p<0.001). However, the ΔVV values were similar between the native and DLM images, indicating that while the DLM reduced noise, it maintained the overall density distribution. Orthodontic appliances produced the most pronounced artifacts, while implants generated the least. Conclusion: AI-based noise reduction using ClariCT. AI significantly enhances CBCT image quality by reducing noise and metal artifacts, thereby improving diagnostic accuracy and treatment planning. Further research with larger, multicenter cohorts is recommended to validate these findings.

This review focuses on the pivotal role of radiotracers in breast cancer imaging, emphasizing their importance in accurate detection, staging, and treatment monitoring. Radiotracers, labeled with radioactive isotopes, are integral to various nuclear imaging techniques, including positron emission tomography (PET) and positron emission mammography (PEM). The most widely used radiotracer in breast cancer imaging is 18F-fluorodeoxyglucose (18F-FDG), which highlights areas of increased glucose metabolism, a hallmark of many cancer cells. This allows for the identification of primary tumors, metastatic sites, and assessment of tumor response to therapy. In addition to 18F-FDG, this review will explore newer radiotracers targeting specific receptors, such as estrogen receptors or HER2, which offer more personalized imaging options. These tracers provide valuable insights into the molecular characteristics of tumors, aiding in tailored treatment strategies. By integrating radiotracers into breast cancer management, clinicians can enhance early disease detection, monitor therapeutic efficacy, and guide interventions, ultimately improving patient outcomes. Ongoing research aimed at developing more specific and sensitive tracers will also be highlighted, underscoring their potential to advance precision medicine in breast cancer care.

The rapid increase in the number of mobile phone base stations (MPBS) has raised global concerns about the potential adverse health effects of exposure to radiofrequency electromagnetic fields (RF-EMF). The application of machine learning techniques can enable healthcare professionals and policymakers to proactively address concerns surrounding RF-EMF exposure near MPBS. In this study, we investigated the potential of machine learning models to predict health symptoms associated with RF-EMF exposure in individuals residing near MPBS.We utilized support vector machine (SVM) and random forest (RF) algorithms, incorporating 11 predictors related to participants' living conditions. A total of 699 adults participated in the study, and model performance was assessed using sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve (AUC). The SVM-based model demonstrated strong performance, achieving accuracies of 85.3%, 82%, 84%, 82.4%, and 65.1% for headache, sleep disturbance, dizziness, vertigo, and fatigue, respectively. The corresponding AUC values were 0.99, 0.98, 0.920, 0.89, and 0.81. Compared to the RF model and a previously developed model, the SVM-based model exhibited higher sensitivity, particularly for fatigue, with sensitivities of 70.0%, 83.4%, 85.3%, 73.0%, and 69.0% for these five health symptoms. Particularly for predicting fatigue, sensitivity and AUC were significantly improved (70% vs 8% and 11.1% for SVM, MLPNN, and RF, respectively, and 0.81 vs 0.62 and 0.64, for SVM, MLPNN, and RF, respectively). These findings suggest that machine learning methods, specifically SVM, hold promise in effectively managing health symptoms in individuals residing near or planning to settle in the vicinity of MPBS.

Linear programming formulations of forest ecosystem management (FEM) problems proposed in the 60s have been adapted and improved upon over the years. Generating management alternatives for forest management planning is a key step in building these models. Global forests are diverse, and a variety of models have been developed to simulate management alternatives. Climate change has made forest management calculations even more complex, requiring flexibility, diverse parameters, models, and methods. Despite this complexity, consistent concepts can be applied in developing management alternatives for forest management planning. This work describes iGen, a flexible forest prescription generator that applies the AI technique Rule-Based System (AI-RBS). iGen projects the state and associated inputs and outputs for a set of management units using rules from its knowledge base. An Inference Engine uses the rules to simulate a set of prescriptions in a tree-like graph structure. Without needing IT specialists, forest managers can describe the potential development of their forest through variables, rules, formulas, functions, and procedures. A key feature of iGen is that it is not limited to, adapted to, or focused on any specific region, landscape, forest condition, projection method, or yield function. Instead, it aims to maximize generality, enabling it to address a broad range of FEM problems. This article introduces iGen, explaining its concepts, structure, and algorithms through two FEM problems: natural regeneration with shelterwood harvests and plantation/coppice. For data and iGen source programs, visit github.com/…/iGen.

Caries is a prevalent oral disease that primarily affects children and teenagers. Advances in ma-chine learning have caught the attention of scientists working with decision support systems to predict early tooth decay. Current research has developed machine learning algorithm for caries classification and reached high accuracy especially in ML for image data. Unfortunately, most studies on dental caries only focus on classification and prediction tasks, meanwhile dental carries prevention is more important. Therefore, this study aims to design an efficient feature for decision support system machine learning based that can identify various risk factors that cause dental caries and its prevention. The data used in the research work was obtained from the 2018 Korean Children's Oral Health Survey, which totaled nine datasets. The experimental results show that combining the mRMR and GINI Feature Importance methods when training with the GBDT model achieved the optimum performance of 95%, 93%, 99%, and 88% for accuracy, F1 score, precision, and recall, respectively. So, the proposed method has provided effective predictive model for dental caries prediction.

The main contribution of this paper is to develop a graphical tool to evaluate the suitability of a candidate parametric model to fit a data set. The practical motivation is to check the adequacy of the so called SAINT model proposed in Jarner and Kryger (2011). This model has been implemented in practice by an important European pension fund concerned with setting annuity reserves for all current or former employees of Denmark. So, one particular relevant question is whether this mortality model is actually fitting old-age. Our graphical test can be described as follows. First we transform the data by means of the parametric model which is being evaluated. Should the model be correct, the transformed data will be in accordance with an Exponential distribution with rate 1. Then we construct a family of local linear hazard estimates based on the data on the transformed scale. Finally we use the statistical tool SiZer to assess the goodness-of-fit of the Exponential distribution to the data on the transformed scale. If the model is correct the SiZer map should not reveal any significant feature in the family of kernel estimates. Our method allow us to establish a diagnostic regarding the validity of the SAINT model when describing mortality patterns in four different countries.

Mesenteric ischemia diagnosis is challenging with an overall mortality in up to 50% of cases despite advances in treatment. The main problem that affects the outcome is the delayed diagnosis because of non-specific clinical presentation. Multi Detector CT Angiography (MDCTA) is the first line investigation for the suspected diagnosis of vascular abdominal pathologies and is the diagnostic test of choice in suspected mesenteric bowel ischemia. MDCTA can accurately detect the presence of arterial and venous thrombosis, determine the extension and the gastrointestinal tract involved, and provide detailed information determining the subtype and the stage progression of the diseases helping clinicians and surgeons for the proper management. CT can differentiate forms that are still susceptible to pharmacological or interventional treatment (NOM= non-operative management) from advanced disease with transmural necrosis in which a surgical approach is required. Knowledge of CT imaging patterns and corresponding vascular pathways is mandatory in Emergency settings to reach a prompt and accurate diagnosis. The aims of this paper are 1. to provide technical information about the optimal CTA protocol; 2. To empathize the CTA arterial and venous supply to gastrointestinal tract and relative ischemic pattern; 3. To describe vascular, bowel and extraintestinal CT findings for the diagnosis of acute mesenteric ischemia.

The healthcare domain is increasingly adopting IoT and Electronic Health Record (EHR) systems, generating vast volumes of healthcare data. This shift is driven by the growing need of delivering the right information to the right individuals, at the right time. The latter underscores the importance of adopting a comprehensive strategy for efficiently collecting, utilizing, and analyzing health-related data to not only enhance overall healthcare management but also for the provision of timely and personalized prevention strategies. The latter is of highest importance especially in scenarios where lack of effective treatments or poor survival rates (such in pancreatic cancer) renders typical healthcare strategies ineffective. In this article, we introduce an innovative and integrated platform that is specifically designed and developed for accessing, processing, and analyzing data in challenging healthcare scenarios, such as dealing with pancreatic cancer. This platform, called iHelp, combines multidisciplinary technologies and provides healthcare professionals reliable risk modelling, analysis, and prediction techniques so that individuals (at risk of developing pancreatic cancer) can be provided with timely, reliable, and personalized prevention and intervention measures. A key innovation in the iHelp platform is the standardized data management approach called Holistic Health Records (HHRs) that facilitate the capturing of all health determinants in a standardized and well-structured way for processing towards the provision of health risk detection and personalized healthcare decision support. In the development of iHelp platform, the HHRs are evaluated through different real-world healthcare datasets, including datasets coming from hospital systems, data from wearables, questionnaires, and mobile applications.

Background/Objectives: The aim of this study was to investigate feasibility and safety of neuromuscular electrical stimulation (NMES) in patients on extracorporeal membrane oxygenation (ECMO) and assess thoroughly any potential adverse events. Methods: We conducted a safety and feasibility study including 16 ICU patients on ECMO support who were admitted to the cardiac surgery ICU from January 2022 to December 2023. Patients underwent a 45-minute NMES session, still on ECMO support, that included a warm up phase of 5 minutes, a main phase of 35 minutes and a recovery phase of 5 minutes. NMES was implemented on vastus lateralis, vastus medialis, gastrocnemius and peroneus longus muscle of both lower extremities. Two stimulators delivered biphasic, symmetric impulses of 75 Hz, with 400 μsec pulse duration, 5 sec on (1,6 sec ramp up and 0,8 sec ramp down) and 21 sec off. The intensity levels aimed to cause visible contractions and be well tolerated. Primary outcomes of the study were feasibility and safety, evaluated by whether the NMES sessions were successfully achieved, and by any adverse events and complications. Secondary outcomes included indices of rhabdomyolysis from biochemical blood test, 24 hours after the application of NMES. Results: All patients successfully completed their 45-minute NMES session, without presenting hemodynamic deterioration, adverse events or signs of rhabdomyolysis. The majority of patients achieved type 4 and 5 quality of muscle contraction. Conclusions: NMES is a safe and feasible exercise methodology in patients supported with ECMO.

Computational rhinology is a specialized branch of biomechanics leveraging engineering techniques for mathematical modelling and simulation to complement the medical field of rhinology. Computational rhinology has already contributed significantly to advancing our understanding of the nasal function, including airflow patterns, mucosal cooling, particle deposition, and drug delivery, and is foreseen as a crucial element in e.g. the development of virtual surgery as a clinical, patient-specific decision support tool. The current paper delves into the field of computational rhinology from a nasal airflow perspective, highlighting the use of computational fluid dynamics to enhance diagnostics and treatment of breathing disorders. The paper consists of three distinct parts – an introduction to and review of the field of computational rhinology, a review of published literature on in vitro and in silico studies of nasal airflow, and the presentation and analysis of previously unpublished high fidelity CFD simulation data of in silico rhinomanometry. While the two first parts of the paper summarize the current status and challenges in the application of computational tools in rhinology, the last part addresses the gross disagreement commonly observed when comparing in silico and in vivo rhinomanometry results. It is concluded that this discrepancy cannot readily be explained by CFD model deficiencies caused by poor choice of turbulence model, insufficient spatial or temporal resolution, or neglecting transient effects. Hence, alternative explanations such as nasal cavity compliance or drag effects due to nasal hair should be investigated.

Spatial relations between tumor cells and host-infiltrating cells are increasingly important in both basic science and clinical research. In this study we have tested the feasibility of using standard methods of immunohistochemistry (IHC) in a multiplex staining system using a newly developed set of chromogenic substrates for the peroxidase and alkaline phosphatase enzymes. Using this approach we have developed a set of chromogens characterized by 1) providing fine cellular detail, 2) non-overlapping spectral profiles, 3) absence of interactions between chromogens, 4) stable upon storage, and 5) compatible with current standard immunohistochemistry practices. When viewed microscopically under brightfield illumination the chromogens yielded the following colors; red, black, blue, yellow, brown, and green. By selecting compatible color combinations we have shown feasibility for four-color multiplex staining. Depending on the particular type of analysis being performed, visual analysis, without the aid of computer assisted image analysis, was sufficient to differentiate up to four different markers.

Background and Objectives To compare navigator-gated three-dimensional T1-weighted gradient-echo sequences (NG-3D T1W-GRE) with standard breath-hold T1W-GRE (BH T1W-GRE) for the detection of HCC nodules in patients with chronic viral hepatitis which undergo at magnetic resonance imaging (MRI) using gadoxetic acid. Methods and materials We evaluated 58 patients with hepatic nodules at least 1 cm in diameter detected by ultrasound who underwent liver MRI including NG-3D T1W-GRE sequences and breath hold T1-weighted gradient-echo sequences with different flip angles(FA) at 10-25-40° after contrast administration of gadoxetic acid at magnetic scanner operating at1.5 Tesla. Image quality and relative hepatic and nodular enhancement were evaluated by three blinded reviewers. Results In these patients, image quality of NG-3D T1W-GRE was assessed significantly better than quality of BHT1W- GRE (P < 0.005) and relative enhancement was significantly higher than that of BH- T1W-GRE ( P

Pregnancy-related morbidity and mortality remains high across the United States and the majority of deaths are preventable. Misdiagnosis and delay in diagnosis are thought to be contributors to preventable harm. These diagnostic errors in obstetrics are understudied. We present selected research methods to ascertain rates of and harm associated with diagnostic errors, the challenges in investigating them, and present future steps toward achieving diagnostic excellence in obstetrics.

As a part of the European Green Deal, the Corporate Sustainable Reporting Directive will apply to over 50,000 companies in Europe, meant to advance the quality of sustainability reporting in the EU, and reduce global emissions and emission distribution inequality. Part of the requirements centre around organisational emission quantification, which will bring much attention to the methodological aspects and resulting decision support capability, which calls for synthesis and argues for clarity. Currently, quantifying the emissions embedded in global transactions mostly focus on direct value-chain attributes, and do not consider unintended consequences beyond the scope of assessment. To achieve genuine reductions, estimated emissions must be considered from a systems perspective to accurately reflect their true impact. While emission inventories serve several purposes, incorrect application limits their potential. The CSRD aligns itself with the GHG Protocol, which does not explicitly facilitate this distinction, although new Land Sector and Removals Guidance draft does, in part. With first CSRD reports expected in 2025, and the GHG protocol entering a revisions period, it presents an opportunity to marry systems thinking with carbon literacy, thereby equipping the expected surge of activity with the sufficient tools for an accelerated transition.

(1) Background: Plasmodium vivax causes the largest malaria burden in Brazil, and chloroquine resistance poses a challenge to eliminating malaria by 2035. Illegal mining in the Roraima Yanomami indigenous territory can lead to the introduction of resistant parasites. This study aimed to investigate mutations in the pvcrt-o and pvmdr-1 genes to determine their potential as predictors of P. vivax chloroquine-resistant phenotypes. (2) Methods: Samples were collected in two health centers of Boa Vista. A questionnaire was completed, and blood was drawn from each patient. Then, DNA extraction, PCR, amplicon purification, and DNA sequencing were performed. After alignment with the Sal-1, the amplified fragment was analyzed. Patients infected with the mutant parasites were queried in the Surveillance Information System. (3) Results: 98% (157/164) of participants were from illegal mining areas. The pvcrt-o was sequenced in 151 samples, and the K10 insertion was identified in 13% of them. The pvmdr1 was sequenced in 80 samples: the MYF haplotype (958M) was detected in 92% of them, the TYF in 8%, while MYL was absent. No cases of recrudescence, hospitalization, or death were found. (4) Conclusions: Mutations in the pvcrt-o and pvmdr-1 genes have no potential to predict chloroquine resistance in P. vivax.

As global concerns about climate change intensify, the need for effective strategies to reduce carbon emissions has never been more urgent. This paper explores the crucial role of data automation (DA) and decision support systems (DSS) in enhancing decarbonation efforts within the realms of solid waste management (SWM), wastewater treatment (WWT), and contaminated soil remediation (CSR). Specifically, the paper provides: (i) an overview of the carbon footprint (CFP) in relation to environmental management (EM) and the role of DA and DSS in decarbonization; (ii) DA case studies in areas of SWM, WWT, and CSR; (iii) 3. life cycle assessment (LCA) based DSS case studies in areas of SWM, WWT, and CSR; (iv) multi-criteria decision analysis (MCDA) based DSS case studies in areas of SWM, WWT, and CSR; and (v) optimal contractual delivery methods based DSS case studies in EM practices. The analysis disclosed that adoption of DA and DSS in SWM, WWT, and CSR holds significant potential for decarbonizing these EM processes. By optimizing operations, enhancing resource efficiency, and integrating renewable energy sources, these technologies contribute to the reduction of GHG emissions and promote sustainable environmental practices. As the demand for more effective and eco-friendly solutions grows, the role of DA and DSS will become increasingly pivotal in achieving global decarbonization goals.

In the field of visualization, understanding users’ analytical process is important to determine the effectiveness of a designed visualization application. To understand the users’ analytical process, numerous studies have been performed to capture and analyze user interactions. Although many studies have emphasized the importance of analyzing user interactions to understand users’ analytical reasoning processes, few have successfully linked these interactions to users’ reasoning processes. This paper introduces an approach that bridges this gap by correlating semantic user interactions with analysis decisions through an interactive wire transaction analysis system and a visual state transition matrix. With the designed analysis system, interactive analysis can be performed to evaluate financial fraud in wire transactions. It also allows the mapping of captured user interactions and analytical decisions back onto the visualization, revealing users’ distinct results. The visual state transition matrix further aids to help understanding users’ analytical flows, revealing their decision-making processes. Classification machine learning algorithms are applied to assess the effectiveness of our approach in understanding analysts’ strategies by connecting them to their decisions. From the study, we observed an average of 72% accuracy in clearly classifying the semantic user interactions. For classifying individual decisions, we observed an average of 70% classification accuracy. This emphasizes the importance of capturing semantic user interactions to understand users’ analytical processes. Overall, it is determined that the proposed approach not only enhances the understanding of analytical behaviors but also offers a robust approach for evaluating user interactions in visualization tools.

Analysing and understanding donor behaviour in Non-profit Organisations (NPOs) is challenging due to the lack of human and technical resources. Machine learning (ML) techniques can analyse and understand donor behaviour at a certain level; however, it remains to be seen how to build and design an Artificial Intelligence enabled Decision Support System (AI-enabled DSS) to analyse donor behaviour. Thus, this paper proposes an AI-enabled DSS conceptual design to analyse donor behaviour in NPOs. A conceptual design is created following a Design Science Research approach to evaluate an AI-enabled DSS's initial DPs and features to analyse donor behaviour in NPOs. The evaluation process of the conceptual design applied formative assessment through conducting interviews with stakeholders from NPOs. The interviews were conducted using the Appreciative Inquiry framework to facilitate the process of interviews. The results of analysis based on the interviews provide insightful information not only about the proposed conceptual design for an AI-enabled DSS, but also about what is required to analyse donor behaviour NPOs using DSS. Evaluating the conceptual design results recommend efficiency, effectiveness, flexibility, and useability in the requirements of the AI-enabled DSS. This research contributes to the design knowledge base of AI-enabled DSS for analysing donor behaviour in NPOs. Future research will combine theoretical components to introduce a practical AI-enabled DSS for analysing donor behaviour in NPOs. This research is limited to such analysis on donors who donate money or volunteer time for NPOs.

To remain relevant in the green transition, companies are beginning to voluntarily account for the exchange of emissions in their supply chain transactions and using the resulting greenhouse gas inventories for climate resilient decision support. Market advantages of sustainability and transparency see a shift from internal decision support tools to external communication tools which potentially expose companies to the risk of uncovering greenwashing if claims are not supported by transparent data, sound modelling, and a climate just emissions inventory, which considers external impacts connected to the production system. The different methods and standards in place for such greenhouse gas inventories, despite all referring to the ISO life cycle analysis standards and guidelines, present mixed signals and leave room for different interpretations, that may ultimately lead to cascading greenwashing, misleading results, and false successes. The new GHG Protocol Land Sector and Removals Guidance draft addresses this in part. With the GHG Protocol moving into revision periods, we identify gaps that present barriers to companies, or allow for interpretations that goes against the intentions of reporting GHG emissions related to an activity or organisation. The literature agrees that not rectifying these subtle-ties present counterproductive decision support for the green transition’s overall goal: to reduce global emissions.

More than 110 countries including 500 cities worldwide have set the goal of reaching carbon neutrality. Heating contributes to most of the residential energy consumption and carbon emissions. The green energy transition of fossil-based heating systems is needed to reach the emission goals. However, the heating systems vary in energy source, heating technology, equipment location, and these complexities make it challenging for households to compare heating systems and make decisions. Hence, a decision support tool that provides a generalized ranking of individual heating alternatives is proposed for households as decision-makers to identify the optimal choice. This paper presents an analysis of 13 heating alternatives and 19 quantitative criteria in technological, environmental, and financial aspects, combines ideal solution based Multi-Criteria Decision Making with 6 weighting methods and 4 normalization methods, and introduces ensemble learning with a fuzzy membership function derived from Cauchy distribution to finalize the final ranking. The robustness of the proposed method is verified by 3 sensitive analyses from different aspects. Air to water heat pump, solar heating and direct district heating are the top three rankings in the final result under Danish national average data. A framework is designed to guide the decision-makers apply this ranking guideline with their practical feasible situations.

There is increasing demand from stakeholders for tools to support outcome-based approaches in environmental management. For such tools to be useful, understanding user requirements is key. In Scotland, UK, stakeholders were engaged in the development of an Environmental Decision Support System (EDSS) to support the management of land and freshwater resources for multiple policy outcomes. A structured participatory engagement process was employed to determine stakeholder requirements, establish development principles to fulfil these requirements and road-test prototypes. The EDSS specification that emerged from this bottom-up process was spatially-explicit, free at the point of use, and touch and mobile device compatible. This application, which is under development, does not closely resemble most existing published EDSS. We suggest that there is a mismatch between the way scientists typically conceptualise EDSS and the kinds of applications that are likely to be useful to decision-makers on the ground. Interactive mobile and web-based geospatial information services have become ubiquitous in our daily lives, but their importance is not reflected in current literature on EDSS. The current focus in environmental management on adaptive, stakeholder-centred strategies based on outcomes offers an opportunity to make better use of these new technologies to aid decision-making processes.

Cardiovascular (CV) morbidity and mortality are markedly increased in non-dialysis patients with chronic kidney disease (CKD). Thus, the precise management of CV risk factors involved in CKD is crucial to improving outcomes. Serum phosphate (Pi) and FGF-23 levels have been linked with a higher risk of CV events in CKD. However, the exact thresholds of Pi and FGF-23, at which the risk of adverse events increases, remain unknown. We evaluated the expression of intact FGF-23 (iFGF-23) and Pi in a non-dialysis CKD patient population (n=82; 42M:40F; median age 61 years) and investigated their association with CV and renal outcomes, in a 5-year follow-up period. At baseline, the median estimated glomerular filtration rate (eGFR), iFGF-23, and Pi were 45 ml/min/1.73m² (IQ 26.6-73.1), 69.9 µg/ml (IQ 33-117) and 3.4 mg/dL (IQ 3.3-3.9), respectively. Univariate analysis showed a strong association of both iFGF-23 and Pi with age, Charlson Comorbidity Index, hypertension, and diabetes. In addition, iFGF-23 and Pi were both associated with the composite outcome (major CV and cerebrovascular events – MACCEs, hospitalizations, and all-cause mortality) during follow-up. Moreover, Pi was independently associated with all-cause mortality during follow-up. The segmentation of the population in terciles, according to Pi (<3mg/dL; 3-3.6 mg/dL; ≥3.7 mg/dL) within reference serum levels, showed a distribution of the fatality of 0%, 20% and 80% (p =0.034), respectively. Our results reinforce the association of both iFGF-23 and Pi with composite CV outcomes in non-dialysis CKD patients and further suggest that Pi, within current reference levels, may behave as an independent risk factor for mortality in this population. It is suggested that a reassessment of Pi reference levels for early therapeutic intervention in this population may be justified.

The COVID-19 pandemic has underscored the intricate interplay between viral infections and opportunistic bacterial pathogens such as Klebsiella pneumoniae. K. pneumoniae harbors various antibiotic resistance determinants like extended-spectrum and plasmid-mediated AmpC β-lactamases and carbapenemases. In the two years following the pandemic, carbapenemase producing K. pneumoniae isolates obtained routinely in outpatient and inpatient setting demonstrated similar resistance patterns which prompted research. The aim was to compare and subsequently analyze carbapenem-resistant hospital and outpatient’s K. pneumoniae isolates’ resistance mechanisms, traits and molecular epidemiology, following the COVID-19 pandemic. Disk diffusion and broth dilution method were the methods of choice to determine antibiotic susceptibility. β-lactamases were screened by phenotypic methods and confirmed with PCR. In total 113 isolates were analysed. Resistance to amoxicillin-clavulanate and ertapenem was confirmed in all strains. High resistance rates (over 90%) were observed for extended-spectrum cephalosporins, and ciprofloxacin. OKNV testing and PCR detected OXA-48 in 106, NDM in 7 and KPC in only one isolate. ESBLs accompanied carbapenemases in 103 isolates. Carbapenem resistance in K. pneumoniae is becoming a global problem, hence careful monitoring of its resistance traits is of utmost importance in order to combat the arising threat. OXA-48 seems to continue predominating in the turbulent period after pandemic.

Existing studies provide evidence that buildings and the construction sector are the largest consumers of natural resources and carry the greatest responsibility for greenhouse gas emissions. In order to reverse this situation, future challenges involve utilising the least resources possible. To this end, building refurbishment becomes a crucial strategy given its potential to improve operational energy efficiency and to extend the life span of existing building stock, thereby reducing the environmental impact while also providing social and economic benefits to our cities. Life Cycle Sustainability Assessment (LCSA) has become one of the scientific community’s most widely recognised methodologies for the evaluation of the social, economic, and environmental dimensions (Triple Bottom Line), since it assesses sustainability using quantitative metrics. However, the implementation of this methodology to support the refurbishment process at the project stage in building design tools, such as BIM, remains scarce. One of the main obstacles lies in the difficulties of accessing the building information, given that the system boundaries only cover new materials and products. Hence, this study proposes a BIM plug-in development to support the multi-dimensional building material selection in the early design steps based on the LCSA of a building during the refurbishment stage and validates its application in a case study. The results show the viability of using this tool during the early design stages and demonstrate the consistency of the results to evaluate various material and product alternatives for the refurbishment of the envelope system of a multi-family residential building. This study contributes towards the integration of decision-making by providing real-time assessment of the building envelope.

The concept of transformative resilience emerges from complex recent literature and represents a way to interpret the potential opportunities to change in vulnerable territories, where a socio-economic change is required. This article extends the perspective of transformative resilience to assessing of the landscape multi-functionality of inland areas, exploring the potentials to identify a network of synergies among the different municipalities able to trigger a process of territorial resilience. A Spatial Decision Support System (SDSS) for multi-functionality landscape assessment aims to support the local actors to understand local resources and multi-functional values of the Partenio Regional Park (PRP) and surrounding municipalities, in the South of Italy, stimulating their cooperation to the management of environmental and cultural sites and the co-design of new strategies of enhancement.

This paper proposes a Case-Based Reasoning (CBR) system to contribute to reinforce the sustainable performance of an environmental management system. The CBR system aims to support the decision-making process to select environmental management actions aimed at reducing risky trends of the environmental state of a region. The CBR system takes advantage of a set of situation-solution pairs called cases, which are stored in a memory and then retrieved as candidates to solve new problems. Situations in this work are represented by a set of risky trends of the following key environmental variables: CO2 emissions, Air-Quality, Loss of Vegetation Cover, Water Availability, and Solid Waste, whose combination damage the environmental state quality of a region. Meanwhile, solutions are represented by a set of environmental management actions. Similar situations to a given current situation are retrieved from the memory of cases and then their solutions are combined, through an adaptation mechanism, until the solution of the current problem is obtained. We used risky trends derived from real data related to the environmental states of a Mexican region to test the proposed CBR system. The results obtained provided insights into the potential of CBR systems to support the decision-making process to select environmental management actions aimed at reducing risky trends of current environmental states.

In emergency scenarios service vehicles must identify potential route(s) and use the best available route. However, route identification requires intelligent decision-support systems which generally use non-traditional approaches with tools characterised by flexible non-hierarchical structures. Conventional models using group decision-support systems have been applied; however, when used in smart urban environments, emergency response services have limitations in their ability to identify unobstructed paths (routes) in dynamic operating environments. In this paper we introduce a novel path planning method for autonomous vehicle control in emergency situations. The proposed model uses self-organizing maps in an integrated Spiral STC algorithm termed the: Hybrid SOM-Spiral STC model which uses hedge algebras and \emph{Kansei} evaluation in group decision-support. The proposed model has been designed to quantify qualitative factors using sensor derived data processed with human sensibilities and preferences in emergency decision support. The experimental results show that the proposed model achieves significant improvements in group decision-support under dynamic uncertainty. We posit that our novel approach holds the prospect of improvements in the provision of emergency services.

Breast cancer (BC) is a prevalent malignancy with various subtypes, each presenting unique diagnostic and therapeutic challenges. Triple-negative breast cancer (TNBC), which comprises 12-17% of breast cancers, is particularly aggressive due to its lack of estrogen receptor (ER), progesterone receptor (PR), and HER2 expression. This case report details the management of a 64-year-old woman with TNBC. Initially presenting with a left breast nodule, she underwent a biopsy that confirmed triple-negative infiltrating ductal carcinoma. Despite negative BRCA genetic testing, her significant family history of cancer and a newly detected right breast lesion led to a bilateral mastectomy. Post-surgery imaging revealed multiple hypodense nodules and a spiculated pulmonary nodule, prompting further investigation. An endoscopic lung biopsy identified a primary pulmonary carcinoma with histological features similar to the breast cancer, indicating the lung as the primary source. This case underscores the complexity of TNBC, the importance of comprehensive diagnostic evaluations, and the need for considering extramammary origins in metastatic cases. The findings emphasize the role of multidisciplinary teams in managing such rare and challenging cases and highlight the necessity for thorough and repeated evaluations in atypical BC presentations.

The rapid spread of African swine fever virus (ASFV), causing severe and often lethal disease in domestic pigs and Eurasian wild boar, continues to be a threat for pig populations and dependent industries. Despite scientific achievements that deepen our understanding of ASFV pathogenesis, alternative transmission routes for ASFV remain to be elucidated. We previously demonstrated the efficient transmission of ASFV from infected boars to naïve recipient gilts via artificial insemination, thereby highlighting the importance of surveillance in boar semen prior to shipment. Since accurate and reliable detection of even low amounts of ASFV in boar semen is key for disease prevention and control, we established a suitable diagnostic pipeline to efficiently detect ASFV genome in boar semen. Here, we assessed sensitivity, specificity and overall performance of various routine nucleic acid extraction kits as well as qPCR protocols in detecting ASFV genome in blood and semen of boars. Feasibility of respective kits and methods for future use in boar studs was also considered. Variability in sensitivity mostly concerned samples with low to very low amounts of ASFV genome. Ultimately, we defined a well-suited pipeline to precisely detect ASFV genome in boar semen, as early as 2 days post ASFV infection.

The focus of this article is the evaluation of the quality and the degree of community engagement in an expert-based, public-health communicative intervention for Alcohol Use Disorder (AUD). In 2023 the Canadian Alcohol Use Disorder Society collaborated with a grass-roots community health group, a regional health authority, and an academic participatory researcher to organize a working group to mount a social-marketing campaign to increase community support for AUD medical treatment in family-practice settings in a rural community in British Columbia. The partnership working group conducted a series of activities in the school system, the town council, and the community. This article covers the formative evaluation and the summative evaluation of the working group's effectiveness. The formative evaluation ("lessons learned" and "recommendations") consists of consensus evaluations of the quality of each activity using a variety of data sources. The formative evaluation followed improvement science methods and used consensus meetings to provide and reflect on formal and informal feedback. Formative results reflect the consensus of the participants in the working group and they record the reactions in the community. The summative evaluation measures evidence of community engagement found in transcribed text from meeting minutes. The summative evaluation used theory-based frameworks and text data visualization to assess the engagement dynamics of the working group. The summative evaluation helps to put the formative evaluation into perspective as communicative action. The summative evaluation validates the formative evaluation by revealing the communicative dynamics of engagement which resulted in the community’s increased capacity to understand and support Alcohol Use Disorder Treatment options. The working group and the entire intervention was seen by the participants and the public as a success and capable of replication. In a small community, it instilled new understandings and attitudes, bringing an emerging awareness of medication as an optional health mitigation strategy for Alcohol Use Disorder. Our study furthers this overall assessment by using theoretical constructs and analysis of communicative records to trace engagement characteristics of interest to researchers, societies, and community groups contemplating similar interventions in the future. The study also validates the effectiveness of communicative analysis as a measure of social-marketing for expert-based public health interventions.

INTRODUCTION : In this scoping review, we delve into the transformative potential of artificial intelligence (AI) in addressing challenges inherent in whole genome sequencing (WGS) analysis, with a specific focus on its implications in surgical oncology. METHODS: Scoping review of whole genomic sequencing and artificial intelligence.DISCUSSION : Unveiling the limitations of existing sequencing technologies, the review illuminates how AI-powered methods emerge as innovative solutions to surmount these obstacles. The evolution of DNA sequencing technologies, progressing from Sanger sequencing to next-generation sequencing, sets the backdrop for AI's emergence as a potent ally in processing and analyzing the voluminous genomic data generated by these technologies. Particularly, deep learning methods play a pivotal role in extracting knowledge and discerning patterns from the vast landscape of genomic information. In the context of oncology, AI-powered methods exhibit considerable potential across diverse facets of WGS analysis, including variant calling, structural variation identification, and pharmacogenomic analysis. CONCLUSIONS : This review underscores the significance of multimodal approaches in diagnoses and therapies, highlighting the imperative for ongoing research and development in AI-powered WGS techniques. Integrating AI into the analytical framework empowers scientists and clinicians to unravel the intricate interplay of genomics within the realm of multi-omics research, paving the way for more personalized and targeted treatments in surgical oncology and perhaps beyond.

Thromboprophylaxis of hospitalized patients at risk of venous thromboembolism (VTE) presents challenges owing to patient heterogeneity and lack of adoption of evidence-based methods. Intuitive practices for thromboprophylaxis have resulted in many patients being inappropriately prophylaxed. Multiple interventions for thromboprophylaxis have been tested, including use of multifaceted approaches such as national VTE prevention programs with audits, use of passive alerts (either human or electronic), and more recently use of active clinical decision support (CDS) tools incorporated into electronic health records (EHRs). Multifaceted health-system interventions have shown mixed results in their ability to increase appropriate thromboprophylaxis and reduce VTE, unless mandated through a national VTE prevention program, though the latter approach is potentially costly, effort- and time-dependent. Studies utilizing passive human or electronic alerts have also shown mixed results in increasing appropriate thromboprophylaxis and reducing VTE. The use of active CDS tools holds the greatest promise, especially with further refinement and widespread implementation within various EHRs and clinical workflows. Recent-ly a universal cloud-based and EHR-agnostic CDS VTE tool revealed high adoption and effectiveness in increasing appropriate thromboprophylaxis and reducing major thromboembolism. This narrative review summarizes the literature on system-wide thromboprophylaxis interventions in hospitalized patients, with a focus on CDS tools.

Intelligent systems are increasingly present in various areas of society, gaining special relevance in healthcare environments. In this work, grounded on previous developments proposed by the authors, the evolution and improvement of a novel intelligent system focused on the diagnosis of obstructive sleep apnea (OSA) is addressed. To do this, starting from two packages of information of a heterogeneous nature, and deploying a set of Machine Learning classification algorithms, focused each of them on different levels of the apnea-hypopnea index (AHI), as well as a set of cascaded expert systems, it is possible to obtain a series of risk metric pairs (Statistical Risk, Symbolic Risk) for each AHI level, understood as a warning forecast associated with the early detection of the pathology. The risk indicators of each pair are subsequently aggregated by means of a symbolic inference system, whose knowledge base was determined using the automatic rule generation approach proposed by Wang and Mendel. At the output of each inference system, a risk indicator is obtained for each AHI level, the Apnea Risk, whose interpretation makes it possible to discriminate between patients who could suffer OSA and those who do not, as well as to generate the appropriate recommendations. For the initial tests of the system, the design and development of a specific software artifact was carried out using data from 4,400 patients from the Álvaro Cunqueiro Hospital in Vigo, obtaining when applied to the test set AUC values within the range 0.74–0.88, which invites optimism and points to the benefits expected from the architecture of the proposed intelligent system.

This paper presents an interpretable support vector machine (SVM) and its application to rehabilitation assessment. We introduce the concept of nearest boundary point to standardize the one-class SVM decision function and determine the shortest path for data from abnormal cases to become those from normal cases. This analytical approach is computationally simple and provides a unique solution. The nearest boundary point of abnormal data can also be used to analyze the cause of abnormal classification and indicate countermeasures for normalization. These properties render the proposed interpretable SVM valuable for medical assessment applications and other problems that require careful consideration of classification results for treatment. Simulation and application results demonstrate the feasibility and effectiveness of the proposed method.

The rising challenge of polyethylene terephthalate (PET) waste necessitates efficient collection methods to mitigate environmental impacts. The Analytic Hierarchy Process (AHP) is one of the Multi-Criteria Decision Analysis (MCDA) approaches utilized in this study. The Technique for Order of Preference by Similarity to the Ideal Solution (TOPSIS) was used to rank each alternative according to the objective weight that AHP had produced. Also, sensitivity analysis was performed to determine how robust the findings were when considering equal weights and entropy weights to maximize PET waste collection techniques. The alternative achieved the objective of obtaining the best collection method, Threshold Plastic Bottle Waste Collection (Tpbw), out of all the three alternatives considered. Another MCDA approach, VIseKriterijumska Optimizacija I Kompromisno Resenje (VIKOR), was used to compare the results and validate the ranking result achieved by the TOPSIS method. The VIKOR technique's validation of the TOPSIS approach showed that the outcomes were highly consistent. Data for the study were gathered from the archives of waste management companies on possible practices of plastic waste collection addressing costs, environmental impacts, social acceptance, feasibility, and efficiency. The findings provide a prioritized framework for enhancing PET waste collection strategies, contributing to sustainable waste management. Many criteria are considered when deciding the best collecting method for PET waste recycling, making it challenging. By using criteria importance, multi-criteria decision analysis (MCDA) was applied in this study, and the objective weight of the criteria was determined using the analytic hierarchy process (AHP). The five criteria considered in this study are Initial investment cost, Operational cost, Transportation cost, Environmental risk, Employment potential, and the objective weights allocated to them. AHP results 0.4952, 0.1997, 0.1565, 0.0870, and 0.0616 are respectively determined.

Selenium is essential for the synthesis and function of various selenoenzymes, such as glutathione peroxidases, selenoprotein P, and thioredoxin reductase, which play an important role in both antioxidant defense and limiting oxidative damage. Associations between serum selenium concentration and obstetric complications as well as pregnancy outcomes has been reported in many studies. The aim of this study was to determine whether the dietary intake of selenium, its concentration in serum and the activity of glutathione peroxidase in subsequent trimesters of pregnancy affect the birth condition of newborns assessed on the basis of the Apgar score in the 1st and 5th minute of life, birth weight, body length and head and chest circumference in physiological and complicated pregnancy course. Twenty-seven pregnant women at a mean age 29.6 ± 4.8 years from the Lower Silesia region of Poland were recruited to the study, 55% of studied group had pregnancy complications. The mean reported Se intake and serum selenium content for Polish pregnant women was in the first trimester – 56.53 μg/day and 43.75 μg/l, the second trimester – 61.79 μg/day and 41.77 μg/l and the third trimester – 58.37 μg/day and 42.13 μg/l, respectively. In the subgroup of pregnant women with a physiological pregnancy course, a weak, although statistically significant, positive correlation was found in the first trimester between Se intake and the length (R=0.48, p=0.019) and birth weight of newborns (R=0.472, p=0.022), and in the second trimester with the APGAR score at 1 (R=0.680, p=0.005) and 5 minutes (R=0.55, p=0.033), as well as in the third trimester with th APGAR score at 1 minut (R=0.658, p=0.019). The GPX value had a strong positive correlation with the APGAR score at 1 min. (R=0.650, p=0.008) in the second trimester and with the birth weight of the newborns (R=0.598, p=0.039) in the third trimester. There was no correlation between newborns' birth measurements and serum selenium concentration. In the subgroup of pregnant women with pregnancy complications, a strong, statistically significant, negative correlation was found between Se intake in the second trimester and gestational age (R=-0.618, p=0.032), and in the third trimester, a positive correlation between Se concentration in serum and head circumference (R=0.587, p=0.021). The obtained results indicate that there is a relationship between the maternal selenium status during pregnancy, both in terms of the intake of this element, its serum concentration as well as the glutathione peroxidase activity, and the anthropometric parameters of the newborn, such as birth weight, length and APGAR score, especially in the group with physiological course of pregnancy, but when pregnancy complications occur, these relationships lose their importance.

Background: A new access technique was developed to reduce postoperative adverse events after the extraction of impacted maxillary wisdom teeth. Hence, this study aimed to assess the occurrence of adverse events after extraction of maxillary impacted wisdom teeth using traditional or modified access. Methods: Two different surgical incision designs were used for bilateral wisdom tooth extractions in 30 patients. The traditional incision was performed distal to the second molar in the center of the tuberosity, followed by a buccal releasing incision. After tooth extraction the wound was secured by sutures. The new technique consists of an oblique incision from the distal palatal aspect of the tuberosity towards the buccal aspect of the second molar. After tooth extraction, cyanoacrylate glue was used on the wound. Results: Lower pain was reported by patients at the site treated with the new technique (p&lt;0.01). Edema, postsurgical bleeding, and hematoma were similar in both groups. The surgical time was shorter for the new technique (p&lt;0.01). Conclusions: The new technique applied for the extraction of impacted maxillary wisdom teeth reduced postsurgical pain and the duration of surgery.

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

Pain diagnosis remains a challenging task due to its subjective nature, the variability in pain expression among individuals, and the difficult assessment of the underlying biopsychosocial factors. In this complex scenario, artificial intelligence (AI) can offer the potential to enhance diagnostic accuracy, predict treatment outcomes, and personalize pain management strategies. This review aims at dissecting the current literature on computer-aided diagnosis methods. It also discusses how AI-driven diagnostic methods can be integrated into multimodal models that combine various data sources, such as facial expression analysis, neuroimaging, and physiological signals, with advanced AI techniques. Despite the significant advancements in AI technology, its widespread adoption in clinical settings faces crucial challenges. Ethical considerations related to patient privacy, biases, and lack of reliability and generalizability are the main issues. Furthermore, there is a need for high-quality real-word validation as well as the development of standardized protocols and policy rules to guide the implementation of these technologies in diverse clinical settings.

Background: Although several studies have been conducted on the use of Artificial Intelligence (AI) in mammography (MG), research focusing on the diagnosis of metachronous bilateral breast cancer (BC), which is typically more challenging to diagnose, remains limited. This study assessed whether AI could enhance the detection of BC, achieving earlier or more accurate diagnoses than radiologists in cases of metachronous contralateral BC. Methods: The study included patients who underwent unilateral BC surgery and subsequently developed contralateral BC during follow-up. We evaluated the capability of the AI-supported MG diagnostic system FxMammo™ (FathomX Pte Ltd, Singapore) to diagnose BC more accurately or earlier than radiologists' assessments. This evaluation was supplemented by reviewing MG readings by radiologists. Results: Out of 1,101 patients who underwent surgery, 10 patients who had initially received a partial mastectomy and later developed contralateral BC were analyzed. The AI system identified malignancies in 6 cases (60%), while radiologists identified 5 cases (50%). Notably, two cases (20%) were diagnosed solely by the AI system. Additionally, for these cases, the AI system had identified malignancies a year prior to the conventional diagnosis. Conclusions: This study highlights the AI system's effectiveness in diagnosing metachronous contralateral BC via MG. In some cases, the AI system consistently diagnosed cancer at earlier than radiological assessments.

This study presents an advanced data augmentation framework to enhance diagnostics in centrifugal pumps using vibration data, with a focus on practical industrial applications. Initially, Gaussian noise and signal stretching were employed to generate synthetic data, addressing the common issue of insufficient defect data in industrial settings. These methods simulate varied operating conditions and different rotating speeds. Recognizing the limitations of traditional approaches, we further integrated advanced models—Long Short-Term Memory (LSTM), Autoencoder (AE), and Generative Adversarial Networks (GANs) to augment the dataset comprehensively. This enhanced approach increases the robustness and accuracy of machine-learning models for fault detection and classification. Experimental results show significant improvements in diagnostic algorithm performance, reducing false positives and increasing fault detection rates. The study offers a complete framework for incorporating both traditional and advanced data augmentation techniques into predictive maintenance protocols, ensuring reliable operation of centrifugal pumps in diverse industrial environments.

D-dimer testing in combination with clinical assessment is commonly used to diagnose suspected DVT and pulmonary embolism. However, as D-dimer levels are physiologically higher in elderly patients, this test loses clinical specificity in the setting of geriatric patients. The aim of our study was to investigate the changes in D-dimer levels with age and the specificity of the D-dimer test in the diagnosis of pulmonary embolism. 1617 elderly patients consecutively admitted to the Geriatric Emergency Care Department of the INRCA-IRCCS hospital between January 2013 and February 2014 and for whom D-dimer results were available were included. The D-dimer immunoturbidimetric assay was performed on a cs-2100i Sysmex Siemens using a conventional cut-off level of 500 µg/L. The median D-dimer level was 1200 [550-2990] µg/L FEU, and the percentage of patients with D-dimer levels below the conventional cut-off was only 22.1%. As expected, there was a significant age-related increase in D-dimer, even when sex was considered, and a significant decrease in the specificity of D-dimer assay with age. The most established use of D-dimer testing is in the diagnosis of deep vein thrombosis or pulmonary embolism. Our study confirms the need for an age-adjusted cut-off for D-dimer testing in geriatric patients.

The leaves of Nicotiana glauca (Solanaceae) plant, are known for its major cause of health concern. This study investigated the antioxidant activity and polyphenols composition of aerial parts of N.glauca collected from its wild habitat in Jordan, using Methanol-Conventional (MC) and deep eutectic solvents (DESs) extraction methods in addition to nicotine content determination using UHPLC. The results have shown that the MC extract contains fewer total phenols and flavonoid content than the DES extract at ratio of 90% (0.1194 ±0.009 and 0.311± 0.020 mg/mL equivalent to gallic acid) and (0.01084±0.005 and 0.928 ± 0.09 mg/mL equivalent to rutin), respectively. Moreover, the study showed that the MC extract contains 635.07 ppm nicotine compared to the DES extraction method, which contains 1194.91 ppm. Both the MC and the DES extracts exhibited weak antioxidant activities with the highest was 33%inhibition equivalent to ascorbic acid was found for DES at (90%) ratio. The UHPLC-MS/MS analysis revealed the presence of variations in the detected compounds between the two extraction methods used. This study found that en-vironmentally friendly DES extraction of N. glauca produced higher phenol and flavonoid content than MC method, highlighting green chemistry methods' superior efficiency and environmental benefits for extracting valuable phytoconstituents.

Livestock management is challenging for resource-poor (R-P) farmers due to unavailability of quality feed, limited professional advice and rumor-spreading about animal health condition in a herd. This research seeks to improve animal health in southern Africa by promoting sericea lespedeza (Lespedeza cuneata), a nutraceutical fodder legume. An automated geospatial model for precision agriculture (PA) can identify suitable locations for its cultivation. Additionally, a novel approach of radio frequency identifier (RFID) supported telemetry technology can track animal movement, and the analyses of data using artificial intelligence can determine sickness of small ruminants. This RFID-based system is being connected to a smartphone app (under construction) to alert farmers of potential livestock health issues in real-time so they can take immediate corrective measures. An accompanying Decision Support System (DSS) site is being developed for R-P farmers to obtain all possible support on livestock production, including the designed PA and RFID-based DSS.

Fractional flow reserve (FFR) is regarded as the gold standard for assessing the functional significance of coronary artery lesions, yet it remains underutilized in clinical practice. Our objective was to investigate whether FFR results have the potential to alter treatment decisions for coronary lesions compared to visual assessments of angiographic images made by three operators at a high-volume interventional center. In this retrospective study, we aimed to reassess the angiographic images of 63 patients presenting with chronic coronary syndrome (n=39, 61.9%) and acute coronary syndrome (n=24, 38.1%) who underwent FFR. Three experienced interventional cardiologists (with >300 PCI procedures per year) reevaluated, blinded to FFR results, 105 ambiguous lesions in 63 patients to determine angiographic significance and treatment strategy. The observers reached a concordant agreement (≥2 operators made the same decision) to perform PCI in 60 (57.1%) of the lesions based on angiographic evaluation. Interestingly, 9 (15%) of these lesions were functionally non-significant (FFR &gt;0.80). The observers agreed to defer PCI in 45 (42.9%) of the lesions; however, 4 (8.9%) of these were functionally significant (FFR ≤0.80) and required PCI. Thus, inter-observer concordance in visual-guided therapeutic decision-making is variable and not always confirmed by the functional significance of coronary lesions.

The shift towards autonomous excavators in construction and mining is a significant leap towards enhancing operational efficiency and ensuring worker safety. However, it presents challenges such as the need for sophisticated decision-making and environmental perception due to complex terrains and diverse conditions. Our study introduces the E-GTN framework, a novel approach tailored for autonomous excavation that leverages advanced multisensor fusion and a custom-designed convolutional neural network to address these challenges. Results demonstrate that GridNet effectively processes grid data, enabling the reinforcement learning algorithm to make informed decisions, thereby ensuring efficient and intelligent autonomous excavator performance. The study concludes that the E-GTN framework offers a robust solution for the challenges in unmanned excavator operations, providing a valuable platform for future advancements in the field.

Age-related brain deterioration and Alzheimer's disease (AD) pose major challenges as misfolded proteins are deposited in the brain, leading to a decline in cognitive abilities and disruption of neural networks crucial for memory. This article addresses the impact of disrupted spike-timing-dependent plasticity (STDP) mechanisms in Alzheimer's disease and highlights the role of Transcranial magnetic stimulation (TMS) in the study of cortico-cortical spike-timing-dependent plasticity. Amidst this adversity, the role of STDP emerges as a key player in memory formation by synchronizing neural activity. Progressive neuronal dysfunction decreases neural plasticity and impairs manual dexterity and speed, echoing more general problems in elderly people. The findings highlight the potential of neurally-driven cortico-cortical paired associative stimulation (ccPAS) to revitalize neural plasticity and improve motor performance in elderly people, bridging the gap between age-related challenges and Alzheimer's research. This work opens a door to potential rehabilitation strategies for aging populations by unlocking the aging brain's ability to improve motor performance.

The ongoing SARS-CoV-2 pandemic has raised concerns surrounding immunological protection against the virus, particularly for people with inborn errors of immunity (IEI). While COVID-19 vaccination induces robust antibody, memory B-cell, and T-cell responses in healthy individuals, how well vaccination protects people with IEI against infection and severe disease remains unclear – especially in the context of new viral variants and vaccine formulations – leading to anxiety, ongoing self-isolation, and repeated vaccination with limited evidence of increased efficacy. Whilst most people with IEI generate some level of cellular and/or humoral immunity to COVID-19 vaccination, the level of protection and durability of the response are unclear. Alongside vaccination, antibody-based therapeutics are aimed at limiting infection and severe disease in this cohort. Immunoglobulin replacement therapy (IgRT) provides passive immunity in antibody-deficient individuals. However, to successfully prevent SARS-CoV-2 infection, a sufficient number of neutralizing antibodies must be present in product. While antibodies against circulating variants are eventually present in IgRT products (both from natural infection and vaccination of the donors), evidence of their capacity to recognize new variants is limited. Furthermore, while antibody-based pre- and post-exposure prophylaxis can be effective, they are susceptible to decreased efficacy in the context of variant evolution. This review provides an in-depth overview of current knowledge about COVID-19 vaccine efficacy in IEIs, the efficacy of SARS-CoV-2-specific antibody products, and knowledge and technological advances required for continued protection of people with IEI.

Schistosomiasis, acquired by skin-penetrating cercariae of dioecious digenean schistosomes during freshwater contact, afflicts nearly 260 and 440 million people with active infections and residual morbidity, respectively; about 10 million women at reproductive age contract schistosomiasis during gestation every year. Acute schistosomiasis is characterized by pre-patent pro-inflammatory CD4+ T-helper 1 or CD4+ Th1/T-helper 17 reactivity against immature schistosomulae. Chronic schistosomiasis is dominated by post-patent anti-inflammatory CD4+ T-helper 2 reactivity against ova epitopes; flukes co-exist in immunocompetent definitive hosts as they are capable of evading their defense mechanisms. Preventive measures should be complemented by vaccination, inducing long-term protection against transmission, infection, and disease recurrence, given the latest advancements in schistosomal vaccines. Transmission models incorporating vaccination available in PubMed, Embase and Web of Science up to December 31, 2023 are presented. Besides conceptual model differences, predictions meant to guide decision- and policymaking reveal continued worm harboring facilitating transmission besides residual infections, and increased susceptibility to re-infection and rebound morbidity, both shifted to later life stages following the intervention. Consequently, a vaccination schedule is pivotal considering the optimal age for initial immunization, i.e., pre-schoolchildren or schoolchildren, in a cohort-based or population-based manner while incorporating potential non-adherers promoting ongoing transmission; longevity over magnitude of vaccine protection to antigenic schistosomal moieties is crucial including accounting for existing pre-acquired immunity from natural exposure, in utero priming besides herd immunity, and induced by chemotherapy. Combining as one multi-component approach long-term effects of vaccination with short-term effects of chemotherapy as regular repeated vaccine-linked therapy in contrast to a single-component intervention seems most promising for achieving WHO’s endpoints of transmission elimination and morbidity control.

Big Data and blockchain technology are coming together to revolutionize how decisions are made in a decentralized way across various industries. This review looks at how these technologies, along with distributed systems, can improve data security, transparency, and real-time processing, making decision-making more efficient and informed. The integration enhances data security with unchangeable records, increases transparency and traceability, and supports real-time data analysis. However, there are challenges to overcome, including scalability, data privacy, interoperability, regulatory compliance, and high costs. By examining case studies such as Estonia's healthcare system, IBM and Walmart's Food Trust, and the Brooklyn Microgrid project, we explore the practical applications and benefits of combining Big Data with blockchain. Despite these hurdles, the review finds that the ongoing advancements and innovative solutions in these technologies offer significant promise. They are set to drive the adoption and effectiveness of decentralized decision-making, ultimately leading to better efficiency and outcomes across multiple sectors.

Breast cancer remains a major public health concern, and early detection can result in more treatment options, which are crucial for improving survival rates. Metabolomics offers the potential to develop blood-based screening and diagnostics tools that are less invasive and more cost-effective. However, the inherent complexity of metabolomic datasets makes identifying the most diagnostically relevant biomarkers a difficult task, with multiple studies demonstrating lim-ited agreement on the specific metabolites and pathways involved. This study aims to identify a set of biomarkers for early diagnosis of breast cancer using metabolomics data. Plasma samples from 185 breast cancer patients and 53 controls (CHTN) were analyzed. We utilized univariate Naïve Bayes, L2-regularized Support Vector Machines, and Principal Component Analysis (PCA), along with feature engineering techniques, to select the most informative features. Multiple ma-chine learning models, including Support Vector Machines, Multidimensional Scaling, Logistic Regression, and Ensemble Learning were utilized for classification. The best-performing feature set comprised 4 biomarkers and 2 demographic variables, achieving an accuracy of 98%, demon-strating the potential for a robust, cost-effective, non-invasive breast cancer screening and diagnostic tool.

A crop-weed simulation model is presented to compare and evaluate Integrated Weed Management (IWM) strategies. Specifically, the model was parameterized for soybean crops in competition with Euphorbia davidii Subils. We used both, weed and crop demographic data surveyed in agronomic fields of the central zone of the Buenos Aires province, Argentina, throughout two crop cycles (2011/2012 and 2013/2014). The proposed model underwent a calibration process and subsequent validation with 70/30 % data split respectively (N=37). Two annual-based and one multiannual-based case studies were simulated to demonstrate the performance of the model. Different IWM strategies were compared under both, operational and tactical planning horizons through the evaluation of different model outcomes (i.e. crop yield, interspecific competition, economic return, and environmental impact). Our case studies results suggest that the inclusion of cultural management practices could reduce weed interspecific competition by 46 to 97 % and weed seed production by 40 to 89%. An increment in both expected crop yield, by 6 to 20%, and annual gross margin, by 44 to 199 US$.ha-1, were obtained in silico for similar levels of environmental impact.

The introduction of social commerce ushered in a new era in business-consumer interaction. As a result, more power has passed from the vendor to the buyer, primarily fueling e-commerce acceptance. As a result, understanding consumer behaviour in the context of social commerce adoption has become essential for businesses looking to persuade customers by using the power of social ties and support.Furthermore, such social ties will facilitate trust as the most promising benefit while reducing perceived risk, which has always been a critical problem with online commerce. This study proposes a paradigm for understanding the impact of social commerce on the stages of the consumer decision-making process: need recognition, information search, alternative evaluation, purchase decision, and post-purchase behaviour, with a focus on social support. In this respect, relevant literature in the subject of social commerce either (1) lacks an adequate explanatory model, (2) has a solid theoretical base, or (3) contains practically complex theories with insufficient empirical data. The research model applies the Social Commerce Constructs (SCC): recommendations and referrals, forums and communities, and ratings and reviews to study the respective influence on the consumer decision-making process phases. This paper aims to understand the influence of social commerce on an integrative model that incorporates all customer choice phases while expecting new knowledge. Furthermore, it is advised that this conceptual model be empirically verified to evaluate the practical consequences.