The global antibiotic resistance crisis, driven by antibiotic overuse and misuse, is multifaceted. This study aimed to assess the microbiological and genetic characteristics of raw retail pork meat, including the isolation, antibiotic susceptibility testing (AST), whole genome sequencing (WGS) of selected indicator bacteria, antibiotic residue testing, and metagenomic sequencing. Samples were purchased from 10 randomly selected retail stores in Gauteng, South Africa. Samples were aseptically separated, with a portion sent to an external laboratory for isolating indicator bacteria and antibiotic residue testing. Identification of the isolated bacteria was reconfirmed using matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS). AST was performed using the Microscan Walkaway system. WGS and metagenomic sequencing were performed using the Illumina NextSeq 550 instrument. The isolated E. coli and enterococci exhibited little phenotypic resistance, with WGS revealing tetracycline resistance genes. Isolated bacteria and meat samples all harboured tetracycline resistance genes, and the antibiotic residue concentrations were within acceptable limits for human consumption. In the metagenomic context, most identified bacteria were of food/meat spoilage and environmental origin, with the resistome analysis primarily indicating beta-lactam, tetracycline and multidrug resistance genes. Further research is needed to understand the broader implications of these findings on environmental health and antibiotic resistance.

The quality of healthcare services is a very important indicator of social welfare in developed and emerging countries. Good quality levels are critical to ensuring patient safety, improving health outcomes, increasing patient satisfaction, optimizing resource utilization, and meeting regulatory requirements. The stable and sustainable operation of medical institutions urgently requires the establishment of a reliable and effective medical quality performance evaluation platform. However, the complexity of the evaluation process, involving numerous evaluators and the consideration of different subjective and objective criteria, poses significant challenges and essentially constitutes a group multi-criteria decision-making problem. This article uses the overall medical environment of the institution, medical service attitude, medical security, administrative service measures, etc. as measurement standards to deal with this challenge. It proposes a medical service quality measurement model suitable for both qualitative and quantitative analysis. In view of the heterogeneity of information, the two-tuple fuzzy language calculation method is introduced to enable evaluators to skillfully manage diverse information and effectively avoid potential information omission problems in the subjective evaluation integration process. The effectiveness and feasibility of the model were demonstrated by applying it to the operational framework of a medical institution in central Taiwan.

Prostate cancer is the second leading cause of death in males in America, with advanced prostate cancers exhibiting a 5-year survival rate of only 32%. Castration-resistance is often developed during the course of treatment, though its influences require further understanding. This study explores the human microbiome for its implications in castration-resistance and metastasis in prostate cancer. RNA sequencing data was downloaded for bone and soft tissue biopsies of patients with metastatic castration-resistant prostate cancer. These sequences were mapped to bacterial sequences to yield species-level abundance approximations. Numerous species were found to correlate to the expression of known markers of castration-resistance, including AR, PI3K, and AKT. Castration-resistance-associated signaling pathways were also enriched with these species, including PI3K-AKT signaling and endocrine resistance. For their implications in cancer aggression and metastasis, cancer stem cell markers were further explored for relation to these species. EGFR and SLC3A2 were widely downregulated with greater abundance of most species. Our results suggest that the microbiome is heavily associated with castration-resistance and stemness in prostate cancer. By considering the microbiome’s importance in these factors, we may better understand the highly aggressive and highly invasive nature of prostate cancer, allowing for needed improvement in the treatment of this disease.

Three autonomous communities have been the ones that, in the 2022-2023 season, anticipated the document approved by the Public Health Commission, recommending influenza vaccination for all children aged 6 to 59 months. The main objective of this work is to evaluate the attitude of healthcare professionals towards the first universal vaccination campaign in our region, as well as the acceptability of the vaccines used and the attitude towards the piloting of school vaccination. Cross-sectional, survey-based, descriptive study. All healthcare professionals involved in the campaign were invited to participate. The 91.9% of surveyed professionals thought that flu vaccination from 6 to 59 months was important or very important. 89.8% had previous experience regarding the intramuscular vaccine. The professionals valued the intranasal vaccine significantly more positively; however, there were no differences when asking for each of the vaccines without comparison. The inhaled vaccine was preferred by 97.5% for the following campaign. Piloted school vaccination showed 75% acceptance. The inhaled vaccine was preferred by most professionals and the piloted school vaccination was highly accepted, and independently associated to the importance of vaccination as considered by physicians, being a medical doctor, and participation in the pilot program.

Dogs population increased exponentially in the past decade while the birth rate decreased gradually, especially in the developed countries. Due to dogs’ characteristics of loyalty and obedience, most pet owners treated their dogs as their family members or companions, therefore they are willing to select and purchase safe, high quality and nutrition dog food to their dogs. However, there is lack of regulation or standard to reinforce the production or distribution of dog food in Hong Kong. Consequently, this paper will first review the relationship between high dog population and declining birth rate, types of dog food and typical ingredients. Secondly, the potential health implications of various “toxic” food ingredients for dog, hazard analysis of dog food and its testing methods will be investigated. Lastly, this paper will summarize worldwide existing standards and regulations, quality and hygiene management system related to dog food safety to provide insights and suggestions to Hong Kong government about the importance and urgency of implementing regulations and policies to oversee the imported and local manufactured dog food.

A novel determination method using flow-through cartridge purification and ultra-high-performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS) was developed for the identification and quantification of 30 mycotoxins (aflatoxin B1, B2, G1, G2, sterigmatocysin, T-2 toxin, diacetoxyscirpenol, roquefortine C, methylergonovine, ergocornine, lysergol, enniatin A, enniatin A1, enniatin B, enniatin B1, beauvericin, deoxynivalenol, 3-acetylDeoxynivalenol, 15-acetylDeoxynivalenol, patulin, verruculogen, neosolaniol, gliotoxin, HT-2 toxin, wortmannin, zearalenone, α-zearalenol, β-zearalenol, α-zearalanol, and β-zearalanol) in feedstuffs. Mycotoxins were extracted from sample by 0.1% formic acid aqueous solution/acetonitrile (16/84 v/v), then purified by a Cleanert® MC clean-up column. As a result, the pigments and other matrices were efficient removed from the sample extract solution. The purified eluate was collected, then evaporated and redissolved by 0.1% formic acid aqueous solution/acetonitrile (70:30 v/v) for UPLC-MS/MS detection. A BEH Shield RP18 chromatographic column was employed for separation of 30 mycotoxins in a total of 14 min. Multiple-reaction monitoring (MRM) mode was applied for qualitative and quantitative analysis, and matrix calibration curves obtained with the external-standard method was used for quantitation of target analytes. Under optimized conditions, the linearity range was from 2 to 1000 ng/g, and the limit of quantification of the developed method was from 2 to 50 ng/g. The recoveries of 30 mycotoxins spiked in urine samples were from 72.0% to 118.5%, and the relative standard deviation was below 20%. The method was also well approved by certified reference sample, and applied on the real feedstuff samples testing successfully.

Complex atypical endometrial hyperplasia (CAH) carries a high probability of cancer. Intraoperative evaluation of endometrial cancer in cases of CAH has not been reliable. The safety and sensitivity of sentinel lymph node (SLN) sampling has been validated. We aim to evaluate the efficacy and safety of SLN sampling in CAH managed by the da Vinci robotic platform. A total of 113 patients with a preoperative diagnosis of CAH were included in this retrospective cohort study. All underwent a robot assisted total laparoscopic hysterectomy and bilateral salpingo-oophorectomy with 69 patients undergoing SLN sampling. Statistical analysis calculated the probability of cancer, SLN map rate, and surgical complications. Predictors of cancer were evaluated. Forty-seven percent of the entire cohort were diagnosed with endometrial cancer. Median age was 63 years in the SLN cohort (N = 69) and 61 in the No SLN cohort (N = 44) (p= 0.363).  Median BMI was 34 Kg/m2 in the SLN cohort and 40 in the No SLN cohort (p= 0.004). Bilateral SLN map was 92.8% and unilateral SLN map rate was 7.2%. There were no grade 3-4 complications in the SLN cohort, and 4 grade 3-4 complications in the No SLN group (p=0.021). A preoperative diagnosis of CAH bordering on or cannot rule out cancer was the only predictor of cancer.

Introduction: Type 1 diabetes mellitus is a chronic disease of autoimmune etiology that is highly prevalent in childhood. In the last decade, the possibility of using the Bacillus Calmette-Guérin vaccine for the treatment of this disease has been studied thanks to its immunomodulatory action . Objectives: The objective of this work is to carry out a systematic review of the available scientific evidence on the relationship between the tuberculosis vaccine and the treatment of diabetes in childhood. Secondarily, the aim is to study the incidence of Type 1 Diabetes Mellitus in a cohort of children from the Basque Country according to whether or not they have received the vaccine. Methods: An exhaustive bibliographic search has been carried out on the evidence available to date. For the epidemiological study in Euskadi, a comparison of accumulated incidences between vaccinated and unvaccinated population groups was made. Results: According to the literature analyzed, There is more and more evidence about the possible use of the tuberculosis vaccine in Type 1 Diabetes Mellitus. The results of our study were not conclusive, but we believe that it is necessary to continue with long-term studies to eliminate biases. Conclusions: The Bacillus Calmette-Guérin vaccine could be used for the treatment of autoimmune, allergic, infectious or oncological processes, although more studies are still necessary in this regard.

The conformity assessment of products or a measured value with the given standards is carried out based on the global risk of producers and consumers calculation. A product may conform to specifications but be falsely rejected as non-conforming. This is about the producer's risk. If a product doesn't meet the requirements but is falsely accepted as conforming, that poses a risk to the consumer. The conventional approach to risk assessment, which yields only a single numerical value for the global risk of producers and consumers, is naturally extended, and utilized for assessing risk in measurement models with linear regression. The outcomes of the two-dimensional extension, along a moderate scale, are the parabolas with an opening upwards. Risk surfaces were obtained through three-dimensional extension over the area limited by the moderate scale and guard band axes. Four models with different ranges of tolerance intervals were used to test this innovative method of risk assessment in linear regression. The corresponding standard measurement uncertainties are determined by applying a simplified measurement model with the use of comprehensive data on the measurement performance and by determining measurement uncertainty derived from consideration of the functional relationship obtained by linear regression analysis. Models that utilize information from linear regression analysis to determine measurement uncertainty are biased towards risks at the edges of the moderate scale. Testing the model's performances with metrics related to the confusion matrix, such as the F1 score, further substantiated this assertion. The diagnostic odds ratio has been proven to be extremely effective in identifying the curve along the guard band axis, along which the global risks of producers and consumers are at their lowest.

Abstract: Background: Gender dimorphism and marital status on colorectal cancer mortality have 9 been previously documented, but the relationship between these factors and DNA mismatch repair 10 protein (MMRP) expression status is unknown. Methods: Colectomy specimens were reviewed ret- 11 rospectively for patients between 2018 to 2023 with demographics including race/ethnicity, gender, 12 marital status, faith, body mass index, pathologic staging, and MMRP expression status. Statistical 13 analyses were performed by using baseline characteristics tables and various programs in R-pack- 14 age. Results: A total 1018 colectomies were reviewed, and the tumor stages were significantly higher 15 in right colon (stage 3 and 4) than those in left colon and rectosigmoid colon (p<0.01). Marital status 16 was significantly associated with patients’ gender, age, tumor size and tumor stages (all p<0.01). 17 MMRP status were available in 775 cases, and 139 (17.9%) were MMRP deficient, and 636 (82%) 18 MMRP proficient. MMRP deficiency was significantly associated with older female patients, larger 19 tumor in size, higher tumor stages, higher histologic grade and more common in right colon (all 20 p<0.01). In addition, MMRP deficiency was statistically associated with higher percentage of di- 21 vorced and widowed patients (p<0.01). Multivariate linear regression analysis revealed persistent 22 association of MMRP deficiency with tumor size, tumor grade, tumor stage and nodal metastasis, 23 but the associations with gender and marital status no longer existed. Conclusion: The differences 24 in prevalence of CRC by gender and marital status and tumor MMRP status illustrate the im- 25 portance of these factors on tumor stages and nodal metastasis but these associations were more 26 complex with other confounding factors.

In this study, a basic study was performed to analyze the seasonal temperature status of a research room in the Global Environment Research Building where ceiling-embedded indoor units are installed to study the room temperature status of the building as well as to improve its thermal environment. In addition, a direction for improvement of the indoor thermal environment in the winter was proposed through a CFD (computational fluid dynamics) simulation and was proven by an additional experiment. Through the results of this study, it appeared that if the ceiling-embedded indoor unit was installed in the small indoor space without considering the thermal vulnerability of its perimeter boundary, the air temperature of the upper part was greatly different from that of the bottom part in the winter. Hence, in this study, as a means to improve it, convectors were installed to minimize the effect of the external thermal environment and angle-controllable air flowing fans were installed to mitigate the stratification distribution. With such result, it was intended to present the essential data for improvement of the thermal environment as well as conservation of heating energy in the winter for buildings by reviewing the use of the ceiling-embedded indoor unit in the future.

Escherichia coli is an indicator microorganism in One Health antibiotic resistance surveillance programmes. The purpose of the study was to describe and compare E. coli isolates obtained from pigs and human contacts from a commercial farm in South Africa using conventional methods and whole genome sequencing (WGS). Porcine E. coli isolates were proportionally more resistant phenotypically and harboured a richer diversity of antibiotic resistance genes, as compared to human E. coli isolates. Different pathovars, namely ExPEC (12.43%, 21/169), ETEC (4.14%; 7/169), EPEC (2.96%, 5/169), EAEC (2.96%, 5/169) and STEC (1.18%, 2/169) were detected at low frequencies. Sequence type complex (STc) 10 were the most prevalent (85.51%, 59/169) among human and porcine isolates. Six STcs (STc10, STc86, STc168, STc206, STc278 and STc469) were shared at the human-livestock interface according to multilocus sequence typing (MLST). Core genome MLST and hierarchical clustering (HC) showed that human and porcine isolates were overall genetically diverse, but some clustering at HC2 to HC200 were observed. In conclusion, even though the isolates shared a spatio-temporal relationship, there were still differences in the virulence potential, antibiotic resistance profiles, and cgMLST and HC according to the source of isolation.

The adulteration of goat milk powder occurs frequently, cattle-derived and soybean-derived ingredients are common adulterants in goat milk powder. However, simultaneously and rapidly detecting cattle-derived and soybean-derived components is still a challenge. high throughput and efficient screening method for adulteration detection is need. In this study, a rapid method was developed to detect the adulteration of common cattle-derived and soybean-derived components simultaneously in goat milk powder by combining the CRISPR/ Cas12a system with recombinant polymerase amplification (RPA). A dual DNA extraction method was employed, primers and crRNA for dual detection were designed and screened, and a series of condition optimizations were carried out in this experiment. The optimized assay can rapidly detect cattle-derived and soybean-derived components in 40 min. The detection limits of both cattle-derived and soybean-derived components were 1% (w/w) for the mixed adulteration models. The established method was applied into a blind survey of 55 commercially available goat milk powder products. The results showed that 36.36% of the samples contained cattle-derived or soybean-derived ingredients, which revealed the noticeable adulteration situation in the goat milk powder market. This study realizes a fast flow of dual extraction, dual amplification and dual detection of cattle-derived and soybean-derived components in goat milk powder for the first time. It can be used for high-throughput and high-efficiency on-site primary screening of goat milk powder adulterants, and provide a technical reference for combating with food adulteration.

Artificial intelligence (AI) is increasingly being used to improve the quality control of point-of-care diagnostics. This is caused by a number of factors, including the following: 1. AI can accelerate and improve testing accuracy. In comparison to humans, AI technology can review data more quickly and precisely, reducing errors and improving overall quality assurance. 2. When it comes to improving POC test findings on healthcare issues such as infectious diseases or medical crises such as heart attacks, AI can be used for sophisticated predictive analytics and modeling that aid in better decision-making. 3. Artificial intelligence facilitates process automation, increasing productivity and lowering labor costs in labor-intensive tasks such as testing and analyzing samples collected at point-of-care facilities. 4. The use of AI enables organizations implementing these solutions to gain insights from large volumes of raw diagnostic data generated faster and more accurately, allowing them to build solid frameworks around preventive care initiatives and significantly influence public health outcomes.5. Artificial intelligence (AI) has been demonstrated to be a useful tool for real-time monitoring systems that identify any problems with test results early so that they can be corrected before affected patients receive inaccurate diagnoses or treatment plans based on false information provided by diagnostic tests performed at points of care such as clinics or hospitals.Using these technologies would allow healthcare organizations to spend less on labor while still receiving exact diagnoses and rapid treatment delivery at a fraction of the cost that manual approaches required earlier.

This study investigates how customers’ technological readiness affects service quality and the adoption of self-service banking by developing an empirical model. The model was proposed to explore the relationships between technology readiness, self-service quality, and customer satisfaction. The hypotheses and stability of the model were tested using structural equation modeling. The findings revealed that technology readiness, including the optimism, innovation, and insecurity dimensions, had a significant positive impact on self-service quality. In addition, service quality fully mediated the relationship between technological readiness and customer satisfaction. These results suggest that when customers are ready to embrace and use new technology, their evaluation of service quality is high. Thus, bank managers should drive customer perceptions of the quality of self-service banking by improving their technological readiness through various measures. Furthermore, based on the mediating effect of self-service quality, banks must be aware that improving service quality can enhance customer satisfaction and maintain a competitive advantage.

The circular economy is one of the main strategies for mitigating the environmental impacts of civil construction, due to the generation of construction and demolition waste (CDW). In this transition, evaluating alternatives for using buildings as material banks is a way to make the process of reusing construction components more efficient. Thus, the article aimed to evaluate the state of the art of publications on the relationship between the circular economy in civil construction and the conceptual model of buildings as material banks, to mitigate the environmental impacts of CDW. The authors chose the methodological design of Systematic Literature Review, using the Scopus and Web of Science databases for research, with the following search strings: ("construction" or "civil construction" or "built environment" or "construction industry" ) and ("circular economy" or "circular construction") and ("material banks" or "BAMB" or "buildings as material banks" or "building stocks" or "building materials") and ("construction waste" or "demolition waste" or "CDW" or "construction and demolition waste" or "environmental impacts"). After a screening in which only articles published in journals were selected, from 2013 to 2023, inclusion and exclusion criteria were applied, to evaluate only those that had a direct relationship with CDW management through circular economy strategies and buildings such as banks of material. As a result, 93 articles remained, which were analyzed using quantitative and qualitative approach. The quantitative results showed an increase in publications since 2020, which are concentrated in European countries and China. The predominance of applied studies was also noted, through case studies that evaluate the management of materials and waste in the urban environment. The qualitative analysis, carried out using a SWOT Matrix, highlighted the strengths of the buildings, such as material banks, the potential reduction of resource extraction and urban mining, promoting the circulation of construction products. However, the recycling of waste, such as aggregates, still stands out as the main end-of-life strategy adopted, even without occupying the top of the waste hierarchy.

Two new dimacrolide sesquiterpene pyridine alkaloids (DMSPAs), dimacroregelines A (1) and B (2), were isolated from the stems of Tripterygium regelii. The structures of both compounds were characterized by extensive 1D and 2D NMR spectroscopic analyses, as well as HRESIMS data. Compounds 1 and 2 are two rare DMSPAs possessing unique 2-(3′-carboxybutyl)-3-furanoic acid units forming the second macrocyclic ring, representing the first example of DMSPAs bearing an extra furan ring in their second macrocyclic ring system. Compound 2 showed inhibitory effects on the proliferation of human rheumatoid arthritis synovial fibroblast cell (MH7A) at a concentration of 20 μM.

Background: The workplace burnout syndrome is often associated with particular aspects of certain job positions, especially those which entail working with people with special needs. The burnout syndrome in healthcare jobs is a serious problem which has grown into an epidemic among healthcare workers and associates. Objectives: The aim of this research is to assess the presence of stress and burnout syndrome at work with healthcare workers, expert workers, professional associates and associates in social service institutions in Belgrade. Material and Methods: This research has been conducted in the form of a cross-sectional study of a representative sample in social institutions in Belgrade. It has been conducted from March to the end of June of 2023. The sample of the study had 491 participants. The questionnaires used were a structured instrument with social-demographic and social-economic characteristics, workplace characteristics, life style characteristics, and the following questionnaires: DASS-21, Copenhagen, Brief Resilience Scale, and Brief Resilient Coping Scale. Results: The end results indicate the following to be significant risk factors for the occurrence of workplace burnout syndrome: overtime (OR=2.62; CI=1.50-4.56), BRS average score (OR=0.28; CI=0.17-0.44), DASS21 D heightened depression (OR=2.09; CI=1.1-4.04), DASS21 A heightened anxiety (OR=2.38; CI=1.34-4.21), DASS21 S heightened stress (OR=2.08; CI=1.11-3.89). The only protective risk factor which stood out was the self-assessment of health levels (OR=0.60; CI=0.42-0.85). Conclusion: Overtime is a significant predictor of workplace burnout. Apart from it, other significant predictors of workplace burnout were heightened depression, anxiety, and stress levels.

The role of foods is shifting from focusing on the provision of energy and basic nutrients to also include bioactive compounds that prevent the development of chronic age-related diseases. Mi-croalgae offer a source of nutritional compounds with important health effects, and have the po-tential for production of health-promoting products, without increasing agricultural land use and negatively impacting the environment. Here we investigate the health effects of microalgal ex-tracts with high levels of the colourless carotenoid phytoene. Phytoene is widely available from dietary sources and can be detected across different tissues in the human body. However, it is usually regarded as a precursor for the synthesis of other carotenoids, rather than a bioactive molecule. We utilised the model organism C. elegans to show that phytoene-rich extracts from Chlorella sorokiniana and Dunaliella bardawil have anti-ageing properties. The extracts protect against oxidative damage and amyloid-β42 proteotoxicity (a major pathology of Alzheimer's disease), and extends lifespan. We show that pure phytoene also has these anti-ageing effects, suggesting that phytoene is a bioactive molecule with positive effects on ageing and longevity.

The use of the voice of the customer as a main input to guide decision making towards customer centricity strategies has become a necessity for companies. This research proposes a structured method of textual processing using the KDD (Knowledge Discovery Databases) methodology applied to the tweets of users of Colombian public sector companies, through the analysis of temporal sentiments and topic modeling to identify the areas in which actions should be taken to improve the perception of service. To fulfill such purpose, tweets from January to June 2022 are processed, followed by a temporal analysis of the evolution of the sentiment based on 3 enriched dictionaries; after, the LDA (Linear Discriminant Analysis) algorithm is implemented to find the areas with ailment for the user, in addition to propose a method to homologate the CIER (Comisión de Integración Energética Regional) survey. Finally, metrics are detailed to follow up the perception of the service. It is concluded that for the Acueducto the topic with the highest number of complaints is related to "Water truck request", for Enel "Servide Outages" and for Vanti: " Case solution and request information". Also, the homologation of 3 of the 5 pillars on which the CIER survey is based is presented.

A hybrid fuzzy MADM method is proposed in this paper for evaluating airline service quality. Fuzzy set theory is used since it helps in measuring the ambiguity of concepts associated with human being’s subjective judgment. After reviewing service quality evaluation models especially in airline industry, SSQAI model was adopted as a construct for evaluating airline service quality in Iran. Fuzzy DEMATEL was applied to determine the degree of influence and impact of criteria on each other and extract cause and effect relations between them that helped in ranking criteria based on degree of relationship. Then, ANP network map was constructed based on the relation map generated from Fuzzy DEMATEL analysis. Fuzzy ANP approach assisted in prioritizing criteria based on the need for improvement and enabled in a more accurate measurement in decision making process taking the advantage of using linguistic variables. Fuzzy DEMATEL results demonstrates that expertise, Problem-solving, and conduct has the most influence on other factors and in opposite Valence, Waiting Time, Comfort are the factors which get the most impact from other factors and according to Fuzzy ANP analysis Valence, Convenience, Problem-solving, and Safety&Security are the factors with most priorities that need improvement.

Quality of Service (QoS) has a significant role in the provision of resources within service oriented distributed systems. In Quality of Service, cloud computing creates new challenges for improvements using the concept of virtualization. Currently, Cloud Computing is very emerging technology in every field of data storage and resource distribution over the network. Considering this new emerging technology, for the ease of data accessibility, price, resource use, restoration, response time and number of constraints the quality performance measures need to be upgraded. The paper highlights the research gap in providing a solution to achieve a Quality of Services in Cloud Computing. We also review the issues and challenges arising in cloud computing to guarantee quality.

As an emerging model, self-service fitness centers are reshaping the consumer fitness experience globally. Given the crucial role of customer loyalty in the sustainable operation and management of fitness service enterprises, this study constructs a structural model incorporating service quality, service convenience, customer satisfaction, word-of-mouth intentions, and repatronage intentions. The model is designed to elucidate the factors and mechanisms impacting customer loyalty at self-service fitness centers and further investigates how these relationships are affected by service methods, either with staff or without staff. The study employs PLS-SEM to empirically analyze 552 customer questionnaires from four self-service fitness centers in first-tier cities in China. The results reveal positive correlations among the constructs in the structural model, emphasizing the important position of raising service quality standards and reducing the time and effort expended by customers in the management of customer loyalty. Concurrently, service convenience was found to play a significant driving role in customers' perceived service quality. Through the chain-mediating effect of service quality and customer satisfaction, service convenience exerts a considerable positive impact on word-of-mouth intentions and repatronage intentions. Moreover, the study reveals significant differences in these relationships when considering service methods, either with staff or without staff.

Sterol homeostasis in mammalian cells and tissues involves balancing three fundamental processes: de novo sterol biosynthesis; sterol import (e.g., from blood-borne lipoproteins); and sterol export. In complex tissues, composed of multiple different cell types (such as the retina), import and export also may involve intra-tissue, inter-cellular sterol exchange. Disruption of any of these processes can result in pathologies that impact the normal structure and function of the retina. Here, we provide a brief overview of what is known currently about sterol homeostasis in the vertebrate retina and offer a proposed path for future experimental work to further our understanding of these processes, with relevance to the development of novel therapeutic interventions for human diseases involving defective sterol homeostasis.

Background/Objectives: PEMF therapy has gained significant attention due to its potential benefits in promoting tissue repair and improving overall well-being. Recent publications in the field of exercise physiology, showed that pulsed electromagnetic fields (PEMFs) enhanced the velocity and the quantity of muscle O2 available and the rate of muscle oxygen extraction and utilization, in semi-professional cyclists, during a heavy constant-load exercise. In this paper, we investigate the effect of stimulation on muscular activation, in sedentary young people, during a constant-load exercise, performed at moderate intensity. Methods: Nine male sedentary young people, partic-ipated in this study. The response of the muscle activity, was recorded by surface EMG and assessed measuring the root mean square (RMS) normalized to the peak of the maximum voluntary con-traction. Data were collected in the right vastus Medialis (RVM) and right Biceps Femoris (RBF) at the baseline (standstill sitting), on warm-up (unloaded cycling) and during 30 minutes of con-stant-load exercise, in two experimental conditions (PEMF ON vs PEMF OFF). Results: The mul-tivariate analysis of variance performed on RVM showed a significant effect of PEMF in both warmup and exercise, while on RBF showed a significant effect of PEMF and warmup. Conclusions: PEMF strongly enhanced the amplitude of muscle activity in young sedentary people. The increase in the amplitude of the muscular response may lead to a higher oxygen consumption and release.

In the foodservice industry, clients judge not only the product standard but also the service quality they receive during their restaurant experience. Therefore, when the importance of the dining experience is strongly regarded by consumers in terms of intellectual and motivational attributes, they are happier to suggest the establishment to others. The main objective of this research is to study the influence of different service quality factors in restaurants and their impact on customer satisfaction. This research is also undertaken to evaluate the identification of important factors for the restaurant industry and the levels of service quality among customers satisfaction with the services offered by restaurants in India. As factor analysis, correlation, and regression research, this study was conducted using a modified IBM SPSS Statistics 24 and AMOS instrument among the 630 randomly selected customers. A weighted mean was used to describe the levels of service quality and customer satisfaction. Multiple regressions were used to determine the predictors of customer satisfaction. The results reveal the main 12 service quality factors, which are: 1. Process-related factors: system for take-away orders, order tracking system, and time for food preparation 2. People-related factors: focus on customers' special requests, peer group influence, and making you feel special. 3. Physical Environment: Walking Space, Architecture of the Restaurant, and Signals for Direction 4. Performance-related factors: food served at an appropriate temperature; food presentation; portion size of food in the restaurant. The researchers have developed one model on service quality factors that is described in the research paper.

Transportation electrification has been identified as a crucial shift to be made for achieving energy security and emission reduction targets. Electric Vehicles (EVs) play a significant role in achieving these targets; therefore, there is a growing trend to develop new EV technologies and associated infrastructure. Along with these developments, EVs' Quality of Service (QoS) aspects should be enhanced to increase the number of EVs on the road. Various QoS factors are defined to assess the QoS of EVs, and one of the two aims of this paper is to provide a comprehensive review of these factors. The other aim is to review recent developments of associated communication technologies which are essential for exchanging information between EVs and charging stations. This paper serves as a comprehensive review and useful reference for researchers working on QoS aspects of EVs and associated communication systems aiming to enhance the QoS.

Preeclampsia (PE) is a complex and multifaceted obstetric syndrome characterized by several distinct molecular subtypes. It complicates up to 5% of pregnancies and significantly contributes to maternal and newborn morbidity, thereby diminishing the long-term quality of life for affected women. Due to the widespread dissatisfaction with the effectiveness of existing approaches for assessing PE risk, there is a pressing need for ongoing research to identify newer, more accurate predictors. This study aimed to investigate early changes in the maternal serum proteome and associated signaling pathways. The levels of 125 maternal serum proteins at 11-13 weeks of gestation were quantified using liquid chromatography-multiple reaction monitoring mass spectrometry (LC-MRM MS) with the BAK-125 kit. Ten serum proteins emerged as potential early markers for PE: Apolipoprotein M (APOM), Complement C1q subcomponent subunit B (C1QB), Lysozyme (LYZ), Prothrombin (F2), Albumin (ALB), Zinc-alpha-2-glycoprotein (AZGP1), Tenascin-X (TNXB), Alpha-1-antitrypsin (SERPINA1), Attractin (ATRN), and Apolipoprotein A-IV (APOA4). Notably, nine of these proteins have previously been associated with PE in prior research, underscoring the consistency and reliability of our findings. These proteins play key roles in critical molecular processes, including complement and coagulation cascades, platelet activation, and insulin-like growth factor pathways. To improve the early prediction of PE, a highly effective Support Vector Machine (SVM) model was developed, analyzing 19 maternal serum proteins from the first trimester. This model achieved an Area Under the Curve (AUC) of 0.91, with 87% sensitivity and 95% specificity, and a hazard ratio (HR) of 13.5 (4.6 - 40.8) with p&lt;0.001. These findings demonstrate that serum protein-based SVM models possess significantly higher predictive power compared to the routine first-trimester screening test, highlighting their superior utility in the early detection and risk stratification of PE.

The utilization of Artificial Intelligence (AI) in biotechnology is widespread, addressing challenges such as elucidating disease pathophysiology and novel therapeutic approaches. AI plays a critical role in tasks such as drug manufacturing, chemical analysis, RNA and DNA sequencing, and enzyme studies by automating processes and expediting data collection and analysis. AI has particularly transformed the analysis of omics data for researchers, providing tools to handle complex and multifaceted datasets effectively. Through AI, integrative analysis of multi-omics data can be conducted in efficient ways. This article discusses the application of multi-omics and AI technologies in studying various diseases related to infection (COVID-19), mutation (cancer), and senescence (alopecia) to understand their pathophysiology. The applications of AI were performed as the aspect of the diagnosis, prognosis, and treatment for each disease. We introduce AI-driven analysis of pathophysiology can overcome traditional limitations in pathology, with diverse features showing potential in defining the causes of diseases, and potentially enhancing primary omics data in the distinguish the subtype of diseases. In this context, integrated approaches using multi-omics data and AI technology could provide fresh biological insights by comprehending the molecular mechanism of diseases and is instrumental in advancing precision medicine. We anticipate that the rapidly advancing AI-based multi-omics data analysis will significantly contribute to promoting healthy longevity.

Diffuse midline gliomas are among the deadliest human cancers and have had little progress in treatment in the last 50 years. Cell cultures of these tumors have been developed recently, but it is unknown the degree to which such cultures retain the characteristics of the source tumors. DNA methylation profiling offers a powerful tool to look at genome-wide epigenetic changes that are biologically meaningful and can help assess the similarity of cultured tumor cells to their in vivo progenitors. Paraffinized diagnostic tissue from three diffuse intrinsic pontine gliomas with H3 K27M mutations was compared with subsequent passages of neurosphere cell cultures from those tumors. Each cell line was passaged 3-4 times and analyzed with DNA methylation arrays and standard algorithms that provided comparison of diagnostic classification and cluster analysis. All samples tested maintained high classifier scores and clustered within the reference group of H3 K27M-mutant diffuse midline gliomas. There was a gain of 1q in all cell lines, with two cell lines initially manifesting the gain of 1q only during culture. In vitro cell cultures of H3 K27M-mutant gliomas maintain high degrees of similarity in DNA methylation profiles to their source tumor, confirming their fidelity even with some chromosomal changes.

Background: IoT and Big Data are newer technologies that can provide substantial support for healthcare systems and help overcome their shortcomings. The aim of this paper was to analyze literature production descriptively, thematically, and chronologically from an interdisciplinary perspective in a holistic way to identify the most prolific research entities and themes. Methods: The synthetic knowledge synthesis qualitatively and quantitatively analyzes the production of literature through a combination of descriptive bibliometrics, bibliometric mapping and content analysis. For this analysis the Scopus bibliometric database was used. Results: In the Scopus database, 2272 publications were found, which were published between 1985 and June 10, 2024. The first article in this field was published in 1985. Until 2012 the production of literature was steady increasing, after that exponential growth began, which reached its peak in 2023. The most productive countries were the USA, India, China, the United Kingdom, South Korea, Germany and Italy. The content analysis resulted in 8 themes (four from the perspective of computer science and four from the perspective of medicine) and 21 thematic concepts (eight from the perspective of computer science and 13 from the perspective of medicine). Conclusions: The results show that IoT and Big Data have become key technologies in preventive health. The study outcomes might represent a starting point for the further development of research that combines multidisciplinary aspects of healthcare.

Steel structures, such as bridges, must be continuously maintained. Due to increasing trac loads, design and execution shortcomings, many steel bridges are subject to various types of damage, such as cracks. The bridges must be maintained by crack removal and re-welding the cracks. During this work, the bridge is closed for trac in order to suppress the crack ank movement during welding. As a result, trac loads on other routes are higher, which increases further damage on detour routes and subsequently additional welding work and costs on theses structures. Therefore, the aim is to provide a method that allows welding work on steel structures under running trac, respectively under cyclic loads. First, measurements at a representative steel bridge were conducted to derive gap opening parameters of amplitude and frequency for welding tests under cyclic loads. In a test setup for reproducible and comparable welding tests, specimen were welded under cyclic loads. Deep grinding of the root layer allowed defect-free welding within the range of 0.1 mm amplitude at a frequency of 2 Hz loadings. For such welds, the weld quality and the fatigue strength was comparable to the standard requirements.

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

Patients with a psychotic disorder frequently report oral health problems, while mental health nurses (MHNs) seem not to be fully aware of these problems and the risk factors. Therefore, this study aims to develop supportive tools for MHNs regarding oral health to increase sensitization among MHNs and to provide MHNs with knowledge to recognize (potential) oral health problems in patients with a psychotic disorder. We used a human-centered design in which the user, MHNs as well as experts by experience, were placed in the centre of the research process. Problems and needs in MHNs working with patients with a psychotic disorder were addressed. To identify key issues of problem as well as the needs in terms of resources, we started with focus groups (n = 9). We analysed the data thematically based on context of patients and MHNs in practice regarding oral health, preferred oral health tools focused on MHN, and intended outcomes of tools. A Multi Criteria Decision Matrix was developed and analysed (n = 9) to identify the most optimal and viable solution based on established criteria and issues that are prevalent in the work of MHNs. Most promising result was the development of a brochure with an awareness screener. The brochure with awareness screener was developed as a low-fidelity prototype for MHNs regarding oral health in patients with a psychotic disorder, based on the latest scientific evidence. After testing it, the feasibility was tested through semi-structured interviews (n=19). MHNs and experts by experience were satisfied with the tool and provided recommendations for adjustments to the content. Significant augmentations to the brochure include a clinical lesson and a toothbrush with toothpaste for patients. We can conclude that a brochure with an awareness screener is feasible for MHNs. Future steps aiming to further refine and optimize care processes for oral health tools in MHNs, should take refining eligibility criteria for psychiatric populations and the language level of the target group of a tool into account.

This paper deals with the service performance analysis and improvement using discrete event simulation has been used. The simulation of the heath care has been done by arena master development 14-version software. The performance measurement for this study are patients output, service rate, service efficiency and it is directly related to waiting time of patients in each service station, work in progress, resource utilization.Simulation model was building for Bahir Dar clinic and then, prepared the proposed model for the system. Based on the simulation model run result, the output of the existing healthcare service system is low due to presence of bottlenecks on the service system. Moreover, the station with the largest queue and high resource utilization are identified as a bottleneck. The bottlenecks, which have identified are reduced by using reassigning the existing resources and add new resources and merging the similar services, which has under low resource utilization (nurses). Finally, the researchers have proposed a developed model from different scenarios. Moreover, the best scenario is developed by combining scenario 2 and 3. And then, service efficiency of the healthcare has increased by 9.86 percent, the work in progress (WIP) are reduced by 3 patients from the system and the service capacity of the system is increased 34 to 40 patients per day due to the reduction of bottleneck stations.

Bacteriophages (phages) are potential alternatives to chemical antimicrobials against pathogens of public health significance. Understanding the diversity and host specificity of phages is important for developing effective phage biocontrol approaches. Here, we assessed the host range, morphology, and genetic diversity of eight Salmonella enterica phages isolated from a wastewater treatment plant. The host range analysis revealed that six out of eight phages lysed more than 81% of the 43 Salmonella enterica isolates tested. The genomic sequences of all phages were determined. Whole genome sequencing data (WGS) data revealed that phage genome sizes ranged from 41 to 114 kb with GC contents be-tween 39.9 and 50.0 %. Two of the phages SB13 and SB28 represent new species Epsep-timavirus SB13 and genera Macdonaldcampvirus, respectively as designated by the In-ternational Committee for the Taxonomy of Viruses (ICTV) as per genome based taxonomic classification. One phage (SB18) belonged to the Myoviridae morphotype while the re-maining phages belonged to the Siphoviridae morphotype. The gene content analyses showed that none of the phages possessed virulence, toxin, antibiotic resistance, type I-VI toxin-antitoxin modules or lysogeny genes. Three (SB3, SB15 and SB18) out of the eight phages possessed tailspike proteins. Whole genome-based phylogeny of the eight phages with their 113 homologs revealed three clusters A, B, C and seven subclusters (A1, A2, A3, B1, B2, C1 and C2). While cluster C1 phages were predominantly isolated from animal sources, cluster B contained phages from both wastewater and animal sources. The broad host range of these phages highlights their potential use to control the presence of S. enterica in foods.

Lately, the Critical Pathway(CP) of Electronic Medical Record(EMR) is used to the guideline for a treatment in the public hospital. We propose a healthcare promotion service using disease pattern with lifestyle risk factors. We classify a medical historical patient data with disease codes with lifestyle risk factors (hypertension, diabetes, smoking, overweight, excessive alcohol intake, and low physical activity) to make the lifestyle risk factors through the classification. We finally make the clusters of disease code with lifestyle risk factors using the medical historical data based on EMR's electronic discharge summary data. As the result of that, we do a healthcare recommending service based on the disease pattern with lifestyle risk. We can build a medical help desk of a public hospital to support people as we check into the public hospital; how to get the procedure of curing, the desired curing clinical method for the healthcare promotion service by each disease code, and how to be better our healthcare. We evaluate the performance of the proposed system by experimenting with the datasets collected at the medical center to measure performance and report some experimental results.

Background: The laryngeal mask airway Vision Mask (LMA VM) is a supraglottic airway device (SAD) with vision guidance system. The ideal head and neck position for direct laryngoscopy is known, but the ideal position for placing a LMA is not. The objective of this study is to evaluate and compare the optimal position for placement of a video laryngeal mask airway. Methods: This was a prospective observational, transversal and analytical study of 72 consecutive patients. In the same patient, laryngeal vision was first assessed with the head and neck in the sniffing position and then with the head in the neutral position. Procedures were filmed and performed by the same investigator. Assessment of the laryngeal view was performed using two classifications: modified Cormack-Lehane classification and Brimacombe classification. Device placement was considered adequate when the Cormack-Lehane rating was scored from 1 to 2 and the Brimacombe rating was from 2 to 4. Results: 72 patients were included in this study. In the assessment of the glottis using the Cormack Lehane classification for fiberoptic view, laryngeal visibility was adequate in 64 (88.89%) patients in the neutral position and in 65 (90,28%) patients in the sniffing position (p>0,05). In the fiberoptic view of the glottis, assessed using the Brimacombe classification, laryngeal visibility was adequate in 68 (93%) patients in the neutral position and in 69 (95%) patients in the sniffing position, (p>0,05). There was no statistically significant difference in the rate of success between the sniffing position (70 patients, 97.22% success rate) and the neutral position (67 patients, 93.06% success rate) during the first insertion attempt. Two patients required a second attempt in the sniffing position, while five patients required a second attempt in the neutral position. Conclusion: An adequate sniffing position did not result in a better glottic view than neutral position, and the number and type of additional maneuvers were equal in both positions.

(1) Background: Ectopic pregnancy (EP) is when fertilized ovum implanted outside of uterine cavity. The incidence was 1.5% to 2.0% of all pregnancies [1, 2]. EP decreases fertility ability [3]. This study focused on the pregnancy rate after EP and various parameters influencing pregnancy. (2) Methods: The data was extracted from National Health Insurance Research Database (NHIRD) during 2000-2013. The study group enrolled women with one EP history. Those who did not have EP was put into the control group. Chi-square/Fisher exact test was performed on category variable and t-test was used on continue variables. (3) Results: The EP group had a higher cumulative rate of conceive, 41.55% than control group, 37.14% and 1.16 times higher risk in developing pregnancy (P&lt;0.001). The conceiving rate was lower than the control group in the first 5 years, but higher than the control group in the 10th to 14th years. (4) Conclusions: The fecundability after EP is lower at the beginning, but regained after long term follow.

Epilepsy is one of the most prevalent and serious brain disorders, affecting 70 million people worldwide. Antiseizure medications (ASMs) though relieve symptoms and prevent the occurrence of future seizures in epileptic patients have limited effect on epileptogenesis. Addressing the multifaceted nature of epileptogenesis and its association with Nod-like receptor family pyrin domain containing 3 (NLRP3) inflammasome-mediated neuroinflammation requires a comprehensive understanding of the underlying mechanisms for development of targeted therapeutic strategies beyond conventional antiseizure treatments. Several types of NLRP3 inhibitors have been developed and their effect has been validated both in vitro and in vivo models of epileptogenesis. In this review, we discuss the advances in understanding the regulatory mechanisms of NLRP3 activation as well as progress made and challenges facing in the development of NLRP3 inhibitors for the treatment of epilepsy.

Pulmonary sarcoidosis is a multisystem granulomatous interstitial lung disease (ILD) with a variable presentation and prognosis. Early accurate detection of pulmonary sarcoidosis may prevent progression to pulmonary fibrosis, a serious and potentially life-threatening form of the disease. However, the lack of a gold-standard diagnostic test and specific radiographic findings pose challenges in diagnosing pulmonary sarcoidosis. Chest computed tomography (CT) imaging is commonly used but requires expert, chest-trained radiologists to differentiate pulmonary sarcoidosis from lung malignancies, infections, and other ILDs. In this work, we developed a multichannel, CT and radiomics-guided ensemble network (RadCT-CNNViT) with visual explainability for pulmonary sarcoidosis vs. lung cancer (LCa) classification using chest CT images. We leverage CT and hand-crafted radiomics features as input channels, and a 3D convolutional neural network (CNN) and vision transformer (ViT) ensemble network for feature extraction and fusion before a classification head. The 3D CNN sub-network captures localized spatial information of lesions, while the ViT sub-network captures long-range, global dependencies between features. Through multichannel input and feature fusion, our model achieved the highest performance with accuracy, sensitivity, specificity, and combined AUC of 0.93±0.04, 0.94±0.04, 0.93±0.08 and 0.97 respectively in a 5-fold cross-validation study with pulmonary sarcoidosis (n=126) and LCa (n=93) cases. The model offers promising potential for improving the diagnosis of pulmonary sarcoidosis. A detailed ablation study showing the impact of CNN+ViT compared to CNN or ViT alone, and CT+radiomics input, compared to CT or radiomics alone, is also presented in this work.

Bats are natural hosts for a wide variety of viruses and could therefore be the reservoir, source and spillover for several mammalian viruses, including adenoviruses. We examined faecal samples from 12 bats (five species of the family Vespertilionidae) from central Russia (Moscow Region) and found that two of them (16%) were positive for mastadenoviruses. One of the identified viruses was isolated from faeces of Nyctalis noctule and named BatAdV/MOW15-Nn19. The genome of the BatAdV/MOW15-Nn19 was 37,915 bp in length. Comparative studies have shown significant divergence of the nucleotide sequence of the BatAdV/MOW15-Nn19 genome from European mastadenoviruses, the highest genome sequence similarity was to isolate WA3301 from an Australian bat. Phylogenetic analysis, as well as a comparative analysis of the protein coding genes to homologous available from public database, showed evidence of novel species within Mastadenovirus genus (preliminary named «K»). Analysis of the short part of the DNA polymerase gene of BatAdV/MOW15-Nn19 reveals few NCBI records from Europe with high identity to the new virus, i.e. mastadenoviruses related to the new species are circulating in European bats. The partial genome of another mastadenovirus from Pipistrellus nathusii was identified, it represented bat adenovirus species B, which is widely distributed in European Vespertilionidae bats. New data on the genetic diversity of bat adenoviruses may help to better understand how they evolved in mammals and spread across Europe.

Chronic lymphocytic leukemia (CLL) is the most common form of leukemia in adults, characterized by abnormal growth of mature B cells in the blood, bone marrow, and lymphoid tissues. Although CLL primarily affects the hematopoietic system and lymph nodes, renal involvement is exceptionally rare and presents diagnostic and treatment challenges. Potential causes of renal failure in CLL patients include sepsis, dehydration, tumor lysis syndrome (TLS), compression of the ureter by enlarged lymph nodes, and side effects of cancer therapy. This report presents a case of CLL with renal infiltration leading to severe renal failure, discussing the clinical presentation, diagnostic workup, and management of this condition.

Correlations among estrus cycle, pyometra, and canine diabetes mellitus (CDM) have been described since the late 1950s, and substantial progress in understanding mechanisms beyond was achieved nowadays. Progesterone-related diabetes mellitus (PRDM) in dogs is known for its particular potential for diabetes remission. Thus, a deep understanding of the physiopathological aspects involved is crucial to postulate treatment guidelines to improve the PRDM remission rate, as well as to inform preventive measures. This narrative review aims to provide relevant detailed information on 1) canine estrus cycle and its impact on CDM etiology and management, 2) the role of pyometra as a further cause of insulin resistance, and 3) useful individual therapeutic and preventive strategies. Pharmacological annulment of progesterone effects, as well as inflammatory and progesterone-related conditions resolution in association with adequate exogenous insulin therapy, and residual beta cell function, are key aspects to achieve remission, or at least to improve diabetic clinical control. In this way, spaying should be considered mandatory in most PRDM cases. Preventive measures against CDM can include spaying recommendations; however, individual-based recommendations should be considered since castration may be associated with some long-term health issues.

An observational cohort study of patients diagnosed with endometrial cancer (EC) stage IA G1, or atypical endometrial hyperplasia (AHE), undergoing organ-preserving treatment, was conducted. Objective of the study: to determine CDO1, PITX2, and CDH13 gene methylation levels in early endometrial cancer and atypical hyperplasia specimens obtained before organ-preserving treatment in the patients with adequate response and with insufficient response to hormonal treatment. Materials and methods: 41 endometrial specimens obtained during diagnostic uterine curettage in women with EC (n=28) and AEH (n=13), willing to preserve reproductive function, were studied; 18 specimens of endometrial cancer IA stage G1 from peri- and early postmenopausal women (comparison group) were included in the study. The control group included 18 endometrial specimens from healthy women obtained by diagnostic curettage for missed abortion and/or intrauterine adhesions. Methylation levels were analyzed using the modified MS-HRM method. Results: All 13 women with AEH had complete response (CR) to medical treatment. In the group undergoing organ-preserving treatment for uterine cancer IA stage G1 (n=28), 14 patients had complete response (EC CR group) and 14 had not (non-CR). It was found that all groups had statistically significant differences in CDO1 gene methylation levels with the control group (p&lt;0.001) except for the EC CR group (p=0.21). The p-value of difference between EC CR and EC non-CR groups was &lt;0.001. The differences in PITX2 gene methylation levels between the control and study groups were also significantly different (p&lt;0.001), except for AEH group (p=0.21). For the difference between EC CR and EC non-CR groups, the p-value was 0.43. For CDH13 gene methylation levels, statistically significant differences were found between the control and EC non-CR groups (p&lt;0.001), and the control and EC comparison groups (p=0.005). When comparing the EC CR group with EC non-CR group, the p-value for this gene was &lt;0.001. Simultaneous assessment of CDO1 and CDH13 genes methylation allowed to accurately distinguish between EC CR and EC non-CR groups (AUC=0.96). Conclusion: Assessment of CDO1 and CDH13 gene methylation in endometrial specimens from patients with endometrial cancer (IA stage G1), planned for medical treatment, can predict the treatment outcome.

Obesity is a highly prevalent chronic disease characterized by excessive weight gain and fat accumulation. There is growing evidence that Lactiplantibacillus plantarum strains with bile salt hydrolase (BSH) activity are effective in preventing and alleviating obesity. However, few of them has confirmed the anti-obesity effect of BSH by gene deletion. In this study, 23 BSH-positive Lp. plantarum strains were screened by bile salt precipitation halo assay. Among these strains, Lp. plantarum Lp20 showed the highest BSH activity with a hydrolysis rate to glycodeoxycholic acid (GDCA) by 91.62%. Genomic sequencing and bioinformatics analysis indicated that gene bsh1 was associated with BSH activity of Lp. plantarum Lp20 and gene deletion of bsh1 confirmed the role of Bsh1 in GDCA hydrolysis. To investigate if the Bsh1 from Lp. plantarum Lp20 could alleviate obesity, the wild type and bsh1 deletion mutant strains were administered daily for 8 weeks to diet-induced obese mice, respectively. Compared with mutant strain, the wild type strain Lp20 significantly reduced body weight gain, inguinal white adipose tissue and mesenteric fat mass in obese mice. In addition, Lp20 also reduced serum total cholesterol levels and LDL-C by 20.8% and 33.3%, respectively. Furthermore, the recovered liver steatosis was only observed in Lp. plantarum Lp20 treated mice. Taken together, the bile salt hydrolase Bsh1 from Lp. plantarum Lp20 was a key functional factor on ameliorating HFD-induced obesity by reducing cholesterol levels and suppressing adipogenesis in mice.

A new model for international bed numbers is applied to local area populations for English Clinical Commissioning Groups (CCGs) where the Age Standardized Mortality Rate (ASMR) is used as a measure of population health and hence for total occupied hospital bed demand (elective plus emergency admission types, including acute, rehabilitation, mental health, and maternity), rather than simple bed availability. A 100-unit increase in ASMR (European Standard population) leads to a 15.3 – 30.7 (feasible range) unit increase in occupied beds per 1,000 deaths. ASMR shows why the Australian states of the Northern Territory and Tasmania have an intrinsic higher bed demand than the other states – although in both cases the bed planning methodologies failed to indicate this need and both states show a large bed deficit. Due to the high volatility in bed demand the average bed demand for 2019 was determined by a linear trend using data for 2014/15 to 2019/20 — as the pre-COVID-19 baseline. The slope of the relationship between occupied beds per 1,000 deaths and deaths per 1,000 population shows a power law function. As is to be expected there is scatter around the trend line which will partly arise from uncertainty in the expected occupied beds in 2019, fluctuations in both ASMR and deaths per 1,000 population from one year to another, changes in the number of persons on the elective, outpatient and diagnostic waiting lists, and local area variation in births and consequently upon maternity, neonatal and pediatric bed demand. Additional variation in bed demand will arise from differences in the level of funding for social care, especially elderly care, and to a lesser extent upon patients using private health care, and charitable hospices for palliative care. However, after including the change in bed demand arising from ASMR the model is sufficiently accurate to identify gross differences in bed demand as a prelude to further investigation. The model requires further extension to cover specialty-level demand, and perhaps segregation between elective and emergency types of inpatient demand. A method for benchmarking the whole hospital’s average bed occupancy is given which enables them to run at optimum efficiency and safety. Using this method English hospitals can be shown to operate at highly disruptive and unsafe levels of bed occupancy leading to deleterious ‘turn-away’. Turn-away implies bed unavailability for the next arriving patient. The problems associated with crafting effective bed planning are illustrated using the English NHS as an example.

Macrophages as a source and target of GDF-15

Bus services play a significant role as the main public transportation, especially in urban areas throughout the years. Since bus services compete greatly with other types of public transportation, such as e-hailing service and private vehicles, they have recently attracted scholars to conduct many relevant studies. However, most past research studies in the Asian region were not focused on engineering, social science, and Internet of Things (IOT). This present study concentrated on the service quality of bus services in Asia by using systematic literature review of articles. This study conducted a review based on previous studies, specifically on the service quality of performance. Several previous studies were selected by using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRIMSA) approach. SCOPUS and Science Direct were chosen as the main journal database. By using this method, 41 articles were selected for further analysis. This study was merely focused on three primary themes, such as study approach, stakeholder, and service quality attributes. Advanced analysis on these primary themes was used to formulate another 18 sub-themes. All themes and sub-themes which reflected the significant impacts of service quality towards bus services were discussed in detail. This study had addressed several qualities of bus services of bus performance towards improvement of urban transportation polices. Lastly, several recommendations that could provide necessary knowledge and information for future research were presented.

This purpose of the study presented in this article is to comparing different service quality measurements between Kano and TRIZ that plays the critical roles in the catering industrial. Data collected from a DINESERV questionnaire comprises service-quality standards to increase customer satisfaction of mobile dining car. Finally, the TRIZ is standardized measure designed to improve the idealization of strategy for selecting the most appropriate service quality model. In addition, the preferences of more than one decision maker are internally aggregated into the TOPSIS procedure. All these things provide several important theoretical and practical implications for developing a successful mobile catering app.

We present a case report of a young patient with pectus carinatum who experienced a small right apex pneumothorax and exhibited Brugada patterns on electrocardiogram tracing. This is the first clinical case reporting Brugada pattern presentation in both a patient with pectus carinatum and a small pneumothorax. We conducted a clinical, anatomical, and electrocardiographic analysis to explore a physiopathological explanation for these findings, considering our patient had no history or clinical signs of Brugada Syndrome. We conclude that: 1. Pectus carinatum may create a window that facilitates the less resistive measurement of cardiac action potentials; 2. Small pneumothoraces can induce modifications in the cardiac electrical signal detected by surface electrodes, and pectus carinatum could unmask these modifications; and 3. Surface electrodes may measure subepicardial potentials that include and are modified by adjacent pericardial tissues, potentially resulting in alterations in transmural potential differences, thus producing fictitious Brugada patterns. Similarly, there is a possibility that the right ventricular outflow tract may be included within the subendocardial potentials.

In this study, it was analyzed that the characteristics of ammonia and their effects on secondary particulate matter (PM) formation by region in Korea during 2020. The NH3 concentration was high in GJ (11.4 ppb) neighboring agricultural area followed by DJ (9.0 ppb) and SE (8.6 ppb) locating in the urban area. On the other hand, BI (2.6 ppb) and JI (4.5 ppb), which are background regions, were lower than other area. Seasonally, ammonia was high in spring and summer, and it generally increased when human activities are active. Therefore, it is believed that ammonia in the atmosphere changes depending on not only local emissions but also temperature-dependent phase distribution characteristics. For SE and GJ, regions with relatively high ammonia concentrations, the effect of ammonia on secondary PM formation was conducted. In both regions, the ammonium-to-sulfate mole ratio tended to increase with an ammonia or PM2.5 concentration increasing. It can be assumed that PM2.5 concentration increases as nitrates are formed under the ammonia sufficient condition. The adjusted gas ratio is generally greater than 4, indicating that there is a lot of free ammonia. Thus, it is estimated that reduction of ammonia would not effective to restrain the nitrate formation.

Cotton fiber, a crucial and sustainable resource for global textile production, undergoes a complex five-stage developmental process, encompassing initiation, elongation, transition, secondary cell wall biosynthesis, and maturation. These elongated single-cell fibers originate from the outer ovule epidermis. The development of cotton fibers involves intricate changes in gene expression and physiological processes, resulting in a nearly pure cellulose product vital for the global cotton industry. Decoding genes associated with fiber development enhances our understanding of cotton fiber mechanisms and facilitates the cultivation of varieties with enhanced quality. In recent decades, advanced omics approaches, including genomics, transcriptomics, and proteomics, have played a pivotal role in identifying genes and gene products linked to cotton fiber development, including the MYB transcription factor family which coordinates cotton fiber development. Molecular studies have revealed transcription factors like MYB, WRKY, Homeodomain Leucine Zipper (HD-ZIP) and basic Helix-Loop-Helix (bHLH) influencing fiber initiation and elongation. The intricate interplay of phytohormones like auxin, gibberellic acid (GA), brassinosteroid (BR), jasmonic acid (JA), ethylene, abscisic acid (ABA), and cytokinin is explored, providing a comprehensive perspective on shaping cotton fibers. Numerous candidate genes and cellular processes affecting various aspects of fiber development hold promise for genetic engineering or marker-assisted breeding to improve fiber quality. This review presents a comprehensive overview of key achievements in cotton molecular biology, with a specific emphasis on recent advancements in understanding transcription factors and phytohormones involved in cotton fiber initiation and elongation.

BackgroundIntracranial hemorrhage (ICH) in pregnancy, estimated at 1 in 10,000 cases, presents significant diagnostic challenges prenatally despite advanced imaging techniques such as ultrasound (US) and MRI. Detecting ICH is crucial for pregnancy management and future treatment decisions aimed at improving fetal survival and reducing brain damage. This report presents the diagnosis and outcomes of two cases of prenatal ICH.Cases presentationThe first case involves a 30-year-old pregnant woman with irregular prenatal care diagnosed with ICH at 32 weeks of gestation via US and MRI. She chose to continue the pregnancy, delivering a 3160g male infant at 36 weeks via cesarean section. Following NICU care including resuscitation and ventriculoperitoneal shunt placement, the infant was discharged. Subsequent examinations showed a reduction in ventricle size. In the second case, a 27-year-old woman taking acenocoumarol for a mechanical heart valve developed fetal subdural hemorrhage detected by US and MRI. She opted to terminate the pregnancy, resulting in a stillborn male infant weighing 1530g.ConclusionFetal ICH presents with varying severity and prognostic implications, diagnosed and graded using US. Fetal cranial MRI may help clarify the etiology. Management remains controversial, with termination of pregnancy potentially warranted in severe cases due to poor prognosis. Further research is needed to refine management and improve outcomes in fetal ICH.

Introduction: The association between epilepsy and myasthenia gravis has rarely been reported, and only in small case series. Objective: To report the frequency of epilepsy and myasthenia gravis and to describe a case series of patients with myasthenia gravis and epilepsy, focusing on their clinical characteristics and searching for a possible physiopathological mechanism. Methods: A retrospective, observational, adult center study was conducted in 2022. Patients were recruited from the database of the outpatient clinic of the Myasthenia Gravis unit and Epilepsy unit. Results: Five patients were included. Frequency of epilepsy in the myasthenia gravis cohort was 5/469 (1.1%), and of myasthenia gravis in the epilepsy cohort was 5/1432 (0.35%). All patients suffered focal epilepsy, mainly fronto-central, and drug-resistant in half of them. Myasthenia gravis was generalized and with exacerbations in half of them. Three patients were thymectomized. Other autoimmune diseases were found in 2 (40%). Epilepsy onset preceded myasthenia gravis onset in all patients. Both diseases were considered autoimmune-related in 3/5 (60%). Conclusion: Epilepsy and myasthenia gravis are only infrequently associated. In adult patients, epilepsy onset precedes myasthenia onset in most cases. In some cases, epilepsy has an autoimmune aetiology and coexists with other autoimmune conditions.

Proactive deprescribing is the process of stopping a medicine before harm occurs. This study aimed to specify and validate with an international sample of healthcare professionals, a proactive deprescribing process of steps and constituent activities. We developed a proactive deprescribing process framework of steps which we populated with literature-derived activities required to be undertaken by healthcare professionals. We distributed a survey to healthcare professionals in-ternationally requesting for each activity; the frequency of its occurrence in practice and whether it was important. Extended response questions invited barriers and enablers to deprescribing. The 263 survey respondents were from 25 countries. A proactive deprescribing process was developed comprising four steps: (1) Identify a patient for potential stop of a medicine, (2) Evaluate a patient for potential stop of a medicine, (3) Stop a medicine(s), (4) After a medicine has been stopped, and 17 activities. All activities were considered important by ≥70% respondents. Nine activities re-quired healthcare professionals to undertake in direct partnership with the patient and/or care-giver, of which seven were only sometimes undertaken. Deprescribing interventions should focus on addressing the barriers and enablers of healthcare professionals undertaking the activities that require direct partnership with the patient and/or caregiver.

Background: A Morel–Lavallée lesion (MLL) is a traumatic, internal closed degloving injury that results from shearing of subcutaneous tissue away from underlying fascia, usually associated with high-velocity trauma. Case presentation: A 52-year-old man was transported to hospital for further follow-up of a superficial femoral artery injury. Examination on admission showed bruising seen around the left thigh. Contrast-enhanced computed tomography of the left thigh revealed hematoma with extravasation from a branch of the left superficial femoral artery, but no apparent aneurysms or femoral fractures. The patient was treated with compression bandages and discharged on hospital day 6. He left hospital able to walk unaided. He subsequently complained of left thigh pain with swelling and visited the hospital several times. He was treated at another outpatient clinic and was diagnosed with MLL. Single-use disposable portable negative pressure wound therapy (NPWT) was applied for about 2 months, achieving a stable wound site. Conclusion: We encountered a case of MLL successfully treated with single-use portable NPWT. This report presents the case of a patient with isolated MLL without fracture in the left thigh, in which the diagnosis was missed on initial admission. Finally, the patient received minor interventions including drainage along with tissue debridement and portable NPWT. We reviewed the relevant literature and summarize the pathogenesis, clinical manifestations, and treatment strategies for MLL. Emergency physicians require an increased understanding of MLL to avoid misdiagnosis and missed diagnosis.

Endometriosis is a prevalent chronic inflammatory disease characterized by a considerable delay between initial symptoms and diagnosis through surgery. The pressing need for a timely, non-invasive diagnostic solution underscores the focus of current research efforts. This study examines the diagnostic potential of the menstrual blood lipidome. The lipid profile of 39 samples (23 women with endometriosis and 16 patient of control group) was acquired using reverse-phase high-performance liquid chromatography-mass spectrometry with LipidMatch processing and identification. Profiles were normalized based on total ion counts. Significant differences in lipids were determined using the Mann-Whitney test. Lipids for the diagnostic model, based on logistic regression, were selected using a combination of variance importance projection filters and Akaike information criteria. Levels of ceramides, sphingomyelins, cardiolipins, triacylglycerols, acyl- and alkenyl-phosphatidylethanolamines, and alkenyl-phosphatidylcholines increased, while acyl- and alkyl-phosphatidylcholines decreased in cases of endometriosis. PE P-16:0/18:1 and CL 16:0_18:0_22:5_22:6 serve as marker lipids in the diagnostic model, exhibiting a sensitivity of 81% and specificity of 85%. The diagnostic approach based on dried spots of menstrual blood holds promise as an alternative to traditional non-invasive methods for endometriosis screening.

Silver ion (Ag+) are recognized for their potent antibacterial properties; however, their utilization in food preservation is restricted by factors such as inadequate stability, a transient antibacterial impact, and the potential for human absorption. Hydrogel-based antibacterial agents are capable of exerting their antibacterial effects by establishing appropriate microenvironments, which facilitate the efficient delivery of antimicrobial molecules to the contaminated regions of food. In previous studies, we observed that chitosan (CS) and silver nitrate (AgNO3) were able to reduce Ag+ to silver nanoparticles (AgNPs) with enhanced antibacterial properties. This not only significantly extended the stability of the antibacterial agent but also demonstrated exceptional inhibitory capabilities against pathogenic bacteria, including common grape contaminants such as P. expansum, A. niger, and B. cinerea. Utilizing ultrasound-induced complexation technology, this study has successfully synthesized a chitosan-silver (CS-AgNPs) hydrogel. The efficacy of this hydrogel against the pathogenic fungus responsible for jujube black spot disease has been thoroughly investigated. The morphology structures of CS-AgNPs hydrogels were characterized by TEM, FTIR and UV-vis. The results indicated that AgNPs ranging from 80 to 110 nm were uniformly dispersed within the gel matrix and remained stable for extended periods at room temperature. In vitro antibacterial assays and fractional inhibitory concentration index (FICI) studies revealed that the pronounced antibacterial efficacy of the CS-AgNPs hydrogel was primarily attributed to the additive antibacterial effect of CS and AgNPs. These insights underscore the significant potential of CS-AgNPs hydrogels in combating fungal diseases of jujube, offering innovative strategies and materials for the management of agricultural pathogens.

Background: Physiotherapy and chronic low back pain (CLBP) form a broad and fast developing research area. The aim of the article was to holistically, thematically and chronologically analyze and synthesise literature production and identify most prolific research entities and research themes. Methods: The article quantitatively and quantitatively analyzed research literature production harvested from the Scopus bibliometric database. using a triangulation of bibliometric and thematic analysis. For this, Excell and VOSwiever software were used. Results: In the Scopus database, 2843 data sources were found, which were published between 1974 and February 26, 2024. The growth trend has been linearly positive since the beginning of publication, and after 2018, exponential growth began. A review of the most prolific entities showed that the most literature was published in America, Europe and Australasia. The thematic analysis of the information sources identified six main themes, while the chronological analysis revealed three main areas of developments: assessment tools, CLBP processing and study methodology. Conclusions: The results of the bibliometric study presents a good starting point for further research providing Taxonomy and research landscapes as a holistic framework offering multidisciplinary knowledge about CLBP, while chronological analysis provides a basis for identifying prospective research trends.

We document for the first time epsilon waves on the electrocardiogram of a patient with Dravet syndrome (DS) who does not exhibit structural cardiac pathology. DS, a severe form of pediatric epilepsy, involves mutations in the SCN1A gene, which disrupt sodium ion flow and increase the risk of sudden unexpected death in epilepsy. The epsilon waves, typically associated with arrhythmogenic right ventricular dysplasia, may also suggest a link between neuronal and cardiac dysfunctions. In our case, the epsilon waves appear to originate from abnormalities in sodium channels rather than structural changes in the myocardium. This finding underscores the importance of assessing both neurological and cardiac manifestations in patients with severe epilepsy, opening new avenues for the research and treatment of these interactions in DS.

Asthma is a chronic inflammatory disease for which the main anti-inflammatory drugs for better disease control are steroids or corticosteroids. The use of steroids in asthma patients, in particular in uncontrolled asthma patients, is associated with an increased risk of osteoporosis and fragility fractures. A single oral corticosteroids course increases the risk of osteoporosis and continual use of inhaled corticosteroids is correlated over time to an increased risk for both bone conditions. With the use of new, available biologic therapies for asthma, perhaps even anticipating the times of their use in what are the steps of therapeutic management, in the current guidelines and with targeted strategies of prevention it may be possible to improve asthma management, preventing some comorbidities, such as osteoporosis.

The need for new technologies into healthcare services has been stressed. However, little is known about the effectiveness of digital interventions integrated in psychosomatic rehabilitation processes. Data from 724 patients from psychosomatic rehabilitation clinics were analyzed for effectiveness of digital trainings examined by a change in symptoms related to depression, anxiety, stress and loneliness from pre- to post-rehabilitation. Rehabilitation satisfaction was examined in association with reaching rehabilitation goals and satisfaction with communication. Mixed repeated measures analysis of covariances, analysis of covariances, and hierarchical stepwise regression analyses were performed. Results indicated a superior effectiveness for the intervention group receiving all offered digital treatments in addition to the regular face-to-face rehabilitation program with regard to symptoms of depression, F(2,674)=3.93, p<.05, ηp2=.01), and anxiety, F(2,678)=3.68, p<.05, ηp2=.01), post-rehabilitation with large effect sizes for both depression (d=1.28) and anxiety (d=1.08). In addition, rehabilitation satisfaction was positively associated with reaching rehabilitation goals and perceived communication with healthcare workers. Digital interventions appeared effective in supporting mental health of psychosomatic rehabilitation patients post-rehabilitation. This finding supports the inclusion of multidisciplinary and interdisciplinary digital and face-to-face treatment programs and call for more implementations of new technologies in a context of complexity to improve health and healthcare service.

Maintaining sufficient levels of plant nutrients in the soil and controlling certain heavy metals, which can be toxic to the environment, are critical to ensure sustainable agricultural production. The study aimed to assess the linkage of crop-specific agricultural practices established by farmers in the Kvemo Kartli region (Georgia) with metal accumulation in soils of agricultural lands being subject to influence from polluted irrigation water in the past. In particular, we tried to identify the primary sources of micronutrients, including iron (Fe), copper (Cu), manganese (Mn), nickel (Ni), and zinc (Zn), and toxic elements such as cadmium (Cd) and lead (Pb), and share of the contaminated irrigation water and other factors related to agricultural practices under different land uses, such as intensive and extensive arable farming, vineyards, orchards, and permanent pastures having the least disturbed soil. Based on principal component analysis, five primary sources were identified and categorized according to farmers' interviews and previous studies conducted in the region. The results showed that increased concertation of plant-available Cu, Zn, Cd and Pb were mainly associated with irrigation water and intensive use of fungicides; Fe, Mn, and Ni were closely linked to several factors, such as the mineralogical composition of soils, mineral and organic fertilizers inputs, and atmospheric deposition from diffuse sources, where exhausts from transport are probably the primary source. During our study, we attempted to differentiate irrigation water inputs from fungicides using simulation based on irrigation pattern and irrigation water quality on the one hand and fungicide application rate and their metal content on the other. The simulation revealed that the intensive application of fungicides, especially in vineyards, is more significant in enriching soils with Cu and Zn than irrigation water. Identification of factorial dependences was supported by statistical analysis and application of a number of contamination assessment methods: Contamination Factor (CF), Pollution Load Index (PLI), single-factor Pollution Index (PI), Nemerow’s comprehensive pollution index (PIN), Enrichment Factor (EF), and Geo-Accumulation Index (Igeo). Applied environmental indices indicate that the soils under the former and existing vineyards are the most enriched with Cu and Zn, highlighting the significance of agricultural practices on heavy metals accumulation in soils of agricultural lands.

Pardosa pseudoannulata is one of the most common wandering spiders in agricultural fields and a potentially good bioindicator for heavy metal contamination. However, little is known about the mechanism by which spiders respond to heavy metals at the molecular level. In this study, high-throughput transcriptome sequencing was employed to characterize the de novo transcriptome of the spiders and to identify differentially expressed genes (DEGs) after cadmium exposure. We obtained 60,489 assembled unigenes, 18,773 of which were annotated in the public databases. Ultimately, 3450 cDNA simple sequence repeats were identified and validated as potential molecular markers in the unigenes. A total of 2939, 2491 and 3759 DEGs were detected among the three libraries of two Cd-treated groups and the control. Functional enrichment analysis revealed that metabolism processes and digestive system function were predominately enriched in response to Cd stress. At the cellular and molecular levels, significantly enriched pathways in lysosomes and phagosomes as well as replication, recombination and repair demonstrated that oxidative damage resulted from Cd exposure. Based on the selected DEGs, certain critical genes involved in defence and detoxification were analysed. These results may elucidate the molecular mechanism underlying spiders' responses to heavy metal stress.

With increasing air and sea temperatures, the thermodynamic environments over the oceans become more favourable for the development of intense tropical cyclones (TCs) with rapid intensification (RI). In fact, the number of TCs undergoing RI is rising (Zhao, et al., 2018; Bhatia, et al., 2019; Song, et al., 2020; Hong & Wu, 2021; Liu, et al., 2022). RI over coastal sea areas before landfalling is particularly impactful and threatening to coastal lives and properties. There have been studies showing that offshore areas within 400 km of the coastline have experienced a significant increase in RI events with the count tripling from 1980 to 2020 (Li et al., 2023). The south China coastal region consists of highly densely populated cities especially the Pearl River Delta (PRD) region. Intense TCs maintaining its strength or RI of TCs close to the coastal region presents substantial forecasting challenges. This study investigates the effect of sea surface and subsurface temperature and salinity on the intensification of five TCs, namely Super Typhoons Hato in 2017 and Mangkhut in 2018, Typhoon Talim, Super Typhoon Saola and Severe Typhoon Koinu in 2023, which significantly affected the south China coastal region and triggered high TC warning signals in Hong Kong. The analysis utilized the Hong Kong Observatory (HKO) TC track and intensity data, along with the sea temperature and salinity profiles generated using the China Ocean ReAnalysis version 2 (CORA2) of the National Marine Data and Information Service (NMDIS) of China. While high sea surface temperature (SST) of 30°C or above, low surface sea surface salinity (SSS) of 34 psu or below, and strong salinity stratification of at least 0.8 psu per 100 m depth may offer useful hints for predicting RI, they are part of a broader set of contributing factors. This study represents the initial documentation of sub-surface salinity's impact on intense TCs over the South China Sea (SCS) in recent years and will encourage further research to refine forecasting RI of TCs before making landfall near PRD taking into account the effect of freshwater from the Pearl River.

Functional copy number alterations (fCNAs) are DNA copy number changes with concordant differential gene expression. These are less likely to be bystander genetic lesions and could serve as robust and reproducible tumor biomarkers. To identify candidate fCNAs in neuroendocrine tumors (NETs), we integrated chromosomal microarray (CMA) and RNA-seq differential gene expression data from 31 pancreatic (pNET) and 33 small bowel neuroendocrine tumors (sbNET). Tumors were resected from 47 early disease progression (24 months) patients. Candidate fCNAs that accurately differentiated these groups in this discovery cohort were then replicated using fluorescence in situ hybridization (FISH) on formalin-fixed, paraffin-embedded (FFPE) tissues in a larger validation cohort of 60 pNETs and 82 sbNETs (52 early and 65 late disease progression samples). Logistic regression analysis determined the predictive ability of these biomarkers as well as the assay performance metrics of sensitivity, specificity, and area under the curve. Our results indicate that copy number changes at chromosomal loci 4p16.3, 7q31.2, 9p21.3, 17q12, 18q21.2, and 19q12 may be used as diagnostic and prognostic NET biomarkers. This involves a rapid, cost-effective approach to determine primary tumor site for patients with metastatic liver NETs and to guide risk stratified therapeutic decisions.

Coronavirus disease-19 (COVID-19) has disproportionately affected certain demographics in England, exacerbating existing health disparities. Effective therapeutics are a critical line of defence against COVID-19, particularly for patients at elevated risk for severe disease. Surveillance systems were established to monitor usage of COVID-19 therapeutics in hospital and community settings and inform stewardship. Three antiviral therapies: nirmatrelvir plus ritonavir (Paxlovid®), remdesivir (Veklury®), and molnupiravir (Lagevrio®); and two neutralising monoclonal antibody therapies (nMAbs): sotrovimab (Xevudy®) and casirivimab with imdevimab (Ronapreve®); were in use in England between July 2020 to April 2023. This paper aims to illuminate trends in the utilisation of COVID-19 therapeutics treatment in both hospital and community settings, stratified by the Index of Multiple Deprivation (IMD) in England. Chapter 3 of the English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) report 2022 to 2023 also discusses the epidemiological surveillance of these five directly-acting antiviral COVID-19 therapeutics use in England between 2022 to 2023.

The purposes of this study are to introduce the concept of Service Quality (SQ) in E-Supply Chain Management (E-SCM) and its impact on increasing Customer Satisfaction (CS) and provide insightful enhancements to the literature. In addition, the paper also examines the influence of SQ of E-SCM on CS in online shopping. After a comprehensive literature review, four key factors for measuring the E-Supply Chain (Process Control, Interaction with Supplier, Management Support, and Focus on Customers), four key factors for measuring CS (Informing Customers, Attention to Customers’ Needs, Staff Performance Accuracy, and Easy Access to Services), and four factors for measuring the quality of identification services (Assurance, Accountability, Tangibility and Reliability) were selected. The proposed conceptual model was then presented. This model was validated by data collected through a survey of 150 respondents in order to identify customer satisfaction, including that of customers of online websites in Iran. The sample data was analyzed using SPSS21, after which the interrelationships between the model and factors were examined based on the Partial Least Square-Structural (PLS). Model fit indices were then calculated for the dataset. The proposed model was validated using factor analysis and structural equation modeling techniques. The results indicated that E-SCM has a direct impact on CS. The effect of SQ was also confirmed. A positive and significant relationship was identified between E-SCM and CS, E-SCM and SQ, as well as SQ and CS (P> 0.05). The first limitation was to convince respondents to cooperate with the researchers. The second one was the lack of research-related background due to the subject being relatively new. This study, to the best of the authors’ knowledge, is the first empirical analysis on the CS assessment of SQ of E-Supply Chain in online shopping. This important link to online shopping has rarely been explored. It is expected that by filling this gap, this study will help in strengthening online shopping, which needs a change in the marketing area.

Dams fragment stream habitat and fishways around dams typically serve few species that are strong swimmers or jumpers. We test a prototype wetted ramp designed to allow upstream passage of small-bodied fishes while blocking upstream movement of invasive sea lamprey in the Laurentian Great Lakes. We tested short, smooth ramps with 5-10 mm water depth in various combinations of ramp angle, water flow and swim channel width with the aim to selectively block adult migrating sea lamprey while passing sub-adult white suckers (Catostomus commersonii) and creek chubs (Semotilus atromaculatus). Sea lamprey easily passed a 0.75 ramp at 5 angle, but very few individuals passed a similar ramp at 10 angle and none passed a longer ramp at the 5 angle. Limiting the amplitude of tailbeats in a narrow channel did not hamper lamprey or the other species. Greater water flow, and thereby greater immersion depth on the ramp fostered passage for all species. Smaller-bodied individual of creek chubs and white suckers performed best on the ramp. We show that wetted ramps could be incorporated into fishways at low-head dams to aid passage of smaller-bodied fishes while also blocking the spawning migration of adult sea lamprey.

To improve carbon efficiency for urban logistics service system composed of a third-party logistics service provider (3PLs) and an e-business enterprise, low-carbon operation game between them was studied. Considering low carbon technology investment cost and sales expansion effect of low carbon level, profit functions for both players were constituted. Based on their different bargaining capabilities, totally 5 types of game scenarios were designed. Through analytical solution, Nash Equilibria under varied scenarios were obtained. By analyzing these equilibria, 4 major propositions were given, in which, some key variables and system performance index were compared. Results show that the best system yields could only be achieved under the fully cooperative situation; limited cooperation only for carbon emission reduction would not benefit the system performance improvement; E-business enterprise-leading game’s performance overtook 3PLs-leading ones.

This study evaluated batch fermentation modes, namely, separate hydrolysis and fermentation (SHF), Quasi-simultaneous saccharification and fermentation (Q-SSF), and simultaneous saccharification and fermentation (SSF), and fermentation conditions, i.e., enzyme and yeast loadings, nutrient supplementation and sterilization, on high titer bioethanol production from SPORL-pretreated Douglas-fir forest residue without detoxification. The result indicated Q-SSF and SSF were obviously superior to SHF operation in terms of ethanol yield. The enzyme loading showed a strong positive correlation between enzyme loading and the ethanol yield. The nutrient supplementation and sterility was not necessary for ethanol production from SPORL-pretreated Douglas-fir. The yeast loading showed no significant influence on the ethanol yield for typical SSF conditions. The terminal ethanol titer of 43.2 g/L, or 75.1% theoretical based on glucose, mannose, and xylose theoretical was achieved when SSF was conducted at the condition of following: whole slurry solids loading of 15%, enzyme loading of 20 FPU/g glucan, 1.8 g/kg (wet) yeast loading, without nutrition supplementation and sterilization, at 38°C, on shake flask at 150 rpm for 96h. It is believed that with mechanical mixing, enzyme loading can be substantially reduced with affect ethanol yield by using a long fermentation time.

Background/Aim: Baricitinib (BAR) is the first oral selective Janus kinase inhibitor approved in Europe for rheumatoid arthritis (RA). Real-world data are still needed to clarify its long-term benefit/risk profile. This study aimed to evaluate the effectiveness, persistence, adherence, and safety of BAR in a real-world setting. Methods: An ambispective study was conducted between October 2017 and December 2021 in RA patients starting BAR. Effectiveness was evaluated by change from baseline in the Disease Activity Score using 28-joint counts-C reactive protein (DAS28CRP), and achievement of low disease activity/remission. Drug persistence was evaluated by Kaplan-Meier analysis. Adherence was estimated by medication possession ratio (MPR) and the 5-item Compliance Questionnaire for Rheumatology. Safety was assessed by global incidence proportion and adjusted incidence rates of adverse events. Results: 61/64 recruited patients were finally analyzed, 83.6% female, 78.7% seropositive, mean age of 58.1 (15.4) years, and disease duration of 13.9 (8.3) years. 32.8% were naïve to biologics and 16.4% received BAR on monotherapy. After a median exposure to BAR of 12.4 (6.6-31.2) months (range 3.1-51.4), a significant change in DAS28CRP was observed (difference -1.2, p=0.000). A total of 70.5% and 60.7% patients achieved low disease activity or remission, respectively and 50.8% (31/61) patients remained on BAR during follow-up with a median persistence of 31.2 (9.3-53.1) months. The average MPR was 0.96 (0.08) and all patients were “good adherents” by questionnaire. 21.3% patients discontinued baricitinib due to toxicity. Conclusion: In our real-world practice, BAR demonstrated effectiveness, large persistence, high adherence to treatment and acceptable safety profile.

Holistic care in the nursing care consists of physical, psychological, socio-cultural, developmental and spiritual aspects. However, the spiritual has received less attention than the other four aspects. The aim of this study was to review paper related to spiritual care in nursing care practices. The method in this study is a review using the CINAHL database. CINAHL was used because the articles focus on nursing topics. The keywords used were "Spirituality" OR "Spiritual care" OR "Spiritual" AND "Nurse". The inclusion criteria for the article were English language and published from 2019-2021, for adult range between 18-44 years old. Exclusion criteria were article not in English language, not full paper article, not in Human and not psychometric study also master thesis. This study recorded 64 articles, screened according to the topic, then the final results recorded 19 articles. This article focuses on the use of spiritual care in patients, nurses and caregivers, as well as both of patients and caregivers. The results of the review showed that spiritual care was important for mental health, physical health, and well-being, quality of life, increasing expectations for patients, nurses or caregivers. The significance of the study was spiritual care should be addressed in nursing care practices and it must include in the nursing curriculum, because spiritual care has many benefits for patients and nurses.

This research investigates the application of Fused Filament Fabrication (FFF) in producing WC-10Co hardmetals, focusing binder formulations and understanding its influence on extrusion force and the influence of printing variables on green density of the samples. By examining the interplay between different binder compositions and backbone contents, the study aims to enhance the mechanical properties of the sintered parts while reducing defects inherent in the printing process. Evidence suggested that formulated feedstocks influenced the hardness of the sintered hardmetal, not due to microstructural changes but to macrostructural responses like macro defects introduced during printing, debinding and sintering of the samples. The results demonstrate the critical role of PP-MA content in improving part density and sintered hardness, suggesting the need for specific thermal debinding protocols tailored to each feedstock. The study provides insights into the formulation of feedstocks for hardmetal FFF, proposing a path toward refining manufacturing processes for better quality and performance of 3D printed hardmetal components.

Protected areas serve as an effective mechanism usually supported by a statute to conserve and protect wildlife-rich areas worldwide. Such extensive external management needs elaborate planning, regular monitoring, and periodic assessment of results. Thus, management effective evaluation (MEE) has emerged as one of the major tools for quantifying the performance of any protected area, globally since 2006. India has successfully conducted a complete round of management effectiveness evaluation of all its terrestrial protected areas (except conservation reserves and community reserves), with 25 such areas already undergoing a repeat assessment. Simultaneously, India biennially carries out a country-wide status of forest cover in all its states and union territories. This study has correlated the trend in change of forest cover for the states that contain those 25 repeat evaluated protected areas with their change in MEE scores over the same period. Our study found a positive correlation between the change in forest cover and the change in management effectiveness score from 2005-06 to 2018-19. Owing to increased protection regimes in the PAs including the degraded areas if they make part of such areas, the habitat often shows recovery. Effective habitat conservation is thus intertwined with the monitoring and preserving the wildlife populations in the protected areas, thereby, reduction in forest cover equally impacts the management scores. However, in states where the loss in forest cover has been reported, more protected areas need to be assessed to plan complementary strategies for both habitat and species conservation.

Thunderstorms endager life and infrastructure. Accurate and precise prediction of thunderstorms are therefore helpful to enable protections measures and to reduce the risks. This manuscript presents the latest developments to improve thunderstorm forecasting in the first few hours. This includes the description and discussion of a new Julia-based method (JuliaTSnos) for the temporal extrapolation of thunderstorms and the blending of this method with the numerical weather prediction model (NWP) ICON. The combination of ICON and JuliaTSnow attempts to overcome the limitations associated with the pure extrapolation of observations wit Atmospheric Motion Vectors (AMVs) and thus increase the prediction horizon. For the blending the operational ICON-D2 is used, but also the experimental ICON-RUC, which is performed with a higher data assimilation update cycle. The blended products are evaluated against lightning data. The Critical Success Index (CSI) for the blended RUC product is higher for all forecast time steps. This is mainly due to higher resolution of the AMVs (prediction hours 0-2) and the rapid update cycle of ICON-RUC (prediction hours 2-6). The results demonstrate the potential of the rapid update cycle to improve the short term forecasts of thunderstorms. Also the transition between AMV driven nowcasting to NWP is much smoother in the blended RUC product, which points to the advantages of fast data assimilation for seamless predictions. The CSI is well above the critical value of 0.5 for the 0-2 hour forecasts. However, also with RUC the CSI drops below 0.5 as soon as the last forecast is more than 3 hours away from the last data assimilation, indicating the lack of the model physics to accurately predict thunderstorms. This lack is simply a result of chaos theory. Within this scope the role of NWP in comparison with Artificial Intelligence (AI) is discussed and it is concluded that AI could replace physical short term forecasts in the near future.

This paper focuses on evaluating airline service quality from the perspective of passengers view. Until now a lot of researches has performed in airline service quality evaluation in the world but a little research has been conducted in Iran, yet. In this research a framework for measuring airline service quality in Iran is proposed. After reviewing airline service quality criteria, SSQAI model was selected because of its comprehensiveness in covering airline service quality dimensions. SSQAI questionnaire items were redesigned to adopt with Iranian airlines requirements and environmental circumstances in the Iran's economic and cultural context. This study includes fuzzy decision-making theory, considering the possible fuzzy subjective judgment of the evaluators during airline service quality evaluation. Fuzzy TOPSIS have been applied for ranking airlines service quality performances. Three major Iranian airlines which have the most passenger transfer volumes in domestic and foreign flights, were chosen for evaluation in this research. Results demonstrated Mahan airline has got the best service quality performance rank in gaining passengers' satisfaction with delivery of high quality services to its passengers, among the three major Iranian airlines. IranAir and Aseman airlines placed in the second and third rank, respectively, according to passenger's evaluation.Statistical analysis have been used in analyzing passenger responses. Due to abnormality of data, Non-parametric tests were applied. To demonstrate airline ranks in every criterion separately, Friedman test was performed. Variance analysis and Tukey test were applied to study the influence of increasing in age and educational level of passengers' on degree of their satisfaction from airline's service quality. Results showed that age has not significant relation with passenger satisfaction of airlines, however increasing in educational level demonstrated a negative impact on passengers' satisfaction from airline's service quality.

Robotic-assisted hip and knee arthroplasty represents significant advancements in orthopedic surgery. Artificial intelligence (AI) - driven chatbots, such ChatGP, plays a significant role in healthcare education. This study aims to evaluate the quality of responses provided by ChatGPT to the top 20 questions concerning robotic-assisted hip and knee arthroplasty.We have asked ChatGPT to select the top 20 questions on Google concerning robotic hip and knee arthroplasty and to provide a detailed answer to each of them. The accuracy of the information provided were examined by three orthopedic surgeons with scientific and clinical experience in hip and knee replacement surgery. The accuracy was assessed through a 5-point Likert scale (from 1 – completely incorrect to 5 – correct); the completeness through a 4-point Likert scale (from 0 – comprehensiveness not assessable for completely incorrect answers to 3 – exhaustive information) on two different occasions to ensure the consistency of the assessment. Our analysis reveals that ChatGPT provides a relatively high degree of accuracy, moreover the explanations can be considered satisfy, especially for factual questions. The findings suggest that ChatGPT can serve as a valuable initial resource for general information on robotic hip and knee arthroplasty but the integration with human expertise remains essential.

Innovation development in healthcare has paved the path towards the improvement in system efficiency, patient care and cost-effective healthcare services, increasing the overall efficiency of the healthcare system in a significant manner. Electronic medical record system has fostered interoperability and collaboration in healthcare departments by enabling different systems to exchange and use patient data. This trend has been accelerated dominantly by the pandemic, leading to increased use of telemedicine, referring specifically to the use of electronic communication to provide healthcare services remotely. Moreover, an increased prevalence towards the use of artificial intelligence and machine learning in healthcare has contributed effectively towards the rigorous and informed analysis of large amounts of data as well as to identify patterns or trends that may be useful for improving care delivery or identifying potential issues. A unified electronic medical record System that will generate competitive opportunities and success prospects with reference to enhanced interoperability in US healthcare departments, can contribute towards the improvement in the quality and efficiency of care by making it easier for healthcare providers to access and share patient information as well as reducing the risk of errors in effective patient care.

In this study, 10%PTFE/PEEK blend were modified by potassium titanate whisker (PTW) and chopped glass fiber (GF), respectively. The blends were prepared by three-screw extruder. Through the investigation of thermal stability, tribological properties, mechanical properties and rheological behavior, the effects of reinforcing agents were determined. The results illustrated that the mechanical properties of 10%PTFE/PEEK blend can be dramatically improved by adding reinforcing agent of PTW or GF, and the reinforcing effect of GF was especially obvious. As for tribological properties, 1% addition was the best proportion. The friction coefficient and wear rate of the blend with 1% PTW were 0.283 and 4.97 × 10^-6 mm³/N · m, which decreased by 7.2% and 21% compared with those of the blend without reinforcing agent.

This review provides a comprehensive and updated information on chalcones, presenting their sources, methods of identification and properties putting emphasis on applications in agricultural industry. Vast exploitation of synthetic pesticides led to the weed and pest resistance issue, causing economic loss but more importantly health risk due to pesticide overuse. Because one of the aim of the European Green Deal 2030 is the Farm to Fork strategy which targets on reducing by 50% the use of chemical pesticides by 2030, and push towards natural pesticides which are more environmentally friendly and restore natural resources, chalcones and their derivatives seem to fit perfectly. They have herbicidal, fungicidal, bactericidal and antiviral properties. Moreover, chalcones are naturally occurring substances, known for their favorable health effect for years, working on many areas. This review is complementary to the previous ones describing chalcones use in agriculture, updates them but additionally shows methods of detection.

The recent mountain pine beetle outbreaks have caused widespread mortality among lodgepole pine trees in western North America, resulting in a reduced population of surviving trees. While previous studies have focused on the cascading impacts of these outbreaks on the physiology and growth of the surviving trees, there remains a need for a comprehensive study into the interactions among various physiological traits and the growth in post-outbreak stands. Specifically, the relationship between chemical (primarily terpenes) and anatomical (mainly resin ducts) defences, as well as the allocation of non-structural carbohydrates (NSCs) to support these defence modalities, is poorly understood. To address these gaps, we conducted a field survey of surviving lodgepole pine trees in post-mountain pine beetle outbreak stands in western Canada. Our retrospective analysis targeted to determine correlations between the post-outbreak concentrations of monoterpenes, diterpenes, and NSCs in the phloem, and the historical resin duct characteristics and growth traits before and after the outbreak. We detected strong correlations between post-outbreak concentrations of monoterpenes and historical resin duct characteristics, suggesting a possible link between these two defence modalities. Additionally, we found a positive relationship between NSCs and the total concentrations of monoterpenes and diterpenes, suggesting that NSCs likely influence the production of these terpenes in lodgepole pine. Furthermore, historical tree growth patterns showed strong positive correlations with many individual monoterpenes and diterpenes. Interestingly, while surviving trees had enhanced anatomical defences after the outbreak, their growth patterns did not vary before and after the outbreak conditions. The complexity of these relationships emphasizes the dynamics of post-outbreak stand dynamics and resource allocation in lodgepole pine forests, highlighting the need for further research. These findings contribute to a broader understanding of conifer defenses and their coordinated responses to forest insect outbreaks, with implications for forest management and conservation strategies.

The Saudi Vision 2030 is critical to boosting national development, notably in the construction industry. The construction industry is getting a lot of attention in a variety of ways, the most visible of which is the promotion of best practices, including project management office (PMO) applications. Hail province, like others, is experiencing project delivery issues. Thus, the purpose of this research is to explore the suitable PMO model for Hail public construction projects. A literature review included the drive factors for establishing PMO in construction firms, as well as PMO models and typologies that describe functions. Therefore, those drive factors and PMO models were subjected to a focus group to explore their suitability in the context of Hail. The research findings reveal that the Enterprise PMO is the main for Hail public construction pro-jects, followed respectively by the Program Management Office model and the Project Management Center of Excellence (PMCOE). This method of selection a PMO model is driving construction companies and related businesses to change in order to improve the sector while also ad-dressing construction project delivery challenges in Hail province.

Quality control (QC) may be a lengthy and tedious process. As a result, most data users use data from meteorological services without performing data quality checks. The South African Weather Service (SAWS) re-established the national solar radiometric network comprising of 13 new stations within the six climatic zones of the country. This study reports on the performance results of the Baseline Surface Radiation Network (BSRN) QC procedures applied to the solar radiation data within the SAWS radiometric network. The overall percentage performance of the SAWS solar radiation network based on BSRN QC methodology is 97.79%, 93.64%, 91.6% and 92.23% for Long Wave Downward Irradiance (LWD), Global Horizontal Irradiance (GHI), Diffuse Horizontal Irradiance (DHI) and Direct Normal Irradiance (DNI) respectively with operational problems largely dominating the percentage of bad data. The overall average performance of the Surface Solar Radiation Dataset – Heliosat (SARAH) data records for the GHI estimation for all the stations showed a Mean Bias Deviation (MBD) of -8.28 Wm^-2, a Mean Absolute Deviation (MAD) of 9.06 Wm^-2 and the Root Mean Square Deviation (RMSD) of 11.02 Wm^-2. The correlation (quantified by R²) between ground-based and SARAH-derived GHI time series was ~ 0.98. The established network has the potential of providing high quality minute solar radiation data sets (GHI, DHI, DNI and LWD) and auxiliary hourly meteorological parameters vital for scientific and practical applications in renewable energy technologies in South Africa.

Anxiety disorders, characterized by excessive fear and anxiety, are increasingly recognized as significant comorbidities in chronic diseases such as Chronic Obstructive Pulmonary Disease (COPD). This study aimed to evaluate the prevalence of anxiety in COPD patients referred from primary care centers to pulmonology services and identify predictive factors for anxiety. Conducted as a multicentric, observational, and prospective study, 293 COPD patients were recruited, undergoing comprehensive respiratory and smoking histories, spirometry, and anxiety assessments using the Hospital Anxiety and Depression Scale (HADS). These results show: a diagnosis of suspected anxiety in in 85 patients (29.0%): 17 possible and 68 with a strong suspicion. The study found significant associations between anxiety and factors such as gender (women showed a risk 3.5 times higher than men), weight, and body mass index (BMI). Disease severity, smoking status, and clinical manifestations did not significantly influence anxiety prevalence. The findings underscore the need for systematic psychological evaluations in COPD management, advocating for the use of simple diagnostic tools like the HADS to facilitate referrals to mental health services. Addressing anxiety in COPD patients could potentially improve their quality of life and disease outcomes. The study highlights the importance of a multidisciplinary approach involving family medicine, pulmonology, and psychiatry to optimize COPD patient care and suggests future research should focus on the impact of anxiety treatment on COPD progression. These insights call for integrating psychological assessments into routine clinical practice for comprehensive COPD management.

Knowing the number of cases of an epidemic is the first function of epidemiological surveillance. An important underreporting of cases was observed in many places during the first wave of COVID-19 pandemic. To estimate this underreporting in the COVID-19 outbreak of Borriana (Valencia Community, Spain), during “Falles” mass gathering events in March 2020, a cross-sectional study was performed in June 2020 querying public health register. Logistic regression models were used. From a total of 468 symptomatic COVID-19 cases diagnosed in the outbreak by anti-SARS-CoV-2 serology, 36 cases were reported (7.7%), thus an underreporting of 92.3% (95% Confidence Interval [CI] 89.5%-94.6%), 13 unreported cases for every reported case. Only positive SARS-CoV-2 polymerase chain reaction cases were predominantly reported due to a limited testing capacity and following a national protocol. Significant factors associated with underreporting were no medical assistance for COVID-19 disease, adjusted odds ratio [aOR] 10.83 (95% CI 2.49-47.11), no chronic illness, aOR=2.81 (95% CI 1.28-6.17), middle and lower social classes, aOR=3.12 (95% CI 1.42-6.85), younger age, aOR=0.97 (95% CI 0.94-0.99), shorter duration of illness, aOR=0.98 (95% CI 0.97-0.99). To improve surveillance, studies of representative population samples are necessary to estimate the magnitude of future epidemics, and novel approaches are recommended.

Live-streaming commerce (LSC) is a new shopping method that combines the characteristics of social commerce and e-commerce. Since the global coronavirus disease 2019 (COVID-19) outbreak, the number of branded platforms is growing rapidly, and their competition is fiercer than ever. Understanding consumer needs and improving service quality become the key issue for survival. This study aims to develop and empirically validate a multi-dimensional hierarchical model for measuring service quality on LSC platforms. A hierarchical reflective construct was proposed to capture dimensions based on literature on e-retail and social commerce service quality. The pro-posed model was rigorously tested using two waves of survey data through the partial least squares method. Results showed that the service quality of LSC is a third-order, reflective con-struct and includes five primary dimensions (the streamer’s interaction quality, physical envi-ronment, website quality, outcome quality and ordering process) and twelve sub-dimensions (trustworthiness, expertise, responsiveness, telepresence, consumption scenarios, information quality, system operation quality, fulfillment and refund/compensation, privacy/security, contact and ease of use). Findings also supported the hypothesis that service quality has a significant impact on customers’ satisfaction and their behavioral intentions. Furthermore, we tested an al-ternative model, and the results showed that the relationship between dimensions and overall assessment is reflective rather than formative. We offered directions for further research on LSC service quality and discussed managerial implications stemming from the empirical findings.

The aim of this study was to evaluate the nature of relationship between service quality and customers’ satisfaction thorough SERVQUAL model. This study can be considered as an applied research, from purpose point of view and descriptive-survey, with regards to the nature and method. Passengers of Kaveh and Sofeh terminal in Isfahan have been considered as research population. Sample size included 200 passengers witch was determined by Cochran formula. Spss 19 was used to analyze collected data. Results show that there is a significant positive relationship between service quality and customers’ satisfaction. It is also proved that in terms of the importance of satisfactions’ dimensions, assurance is the most important aspect and then reliability, empathy, equipment appearance and responsiveness in sequence are the most important dimensions.

Weather conditions appear to be undergoing significant deviations from the long-term average, marked by pronounced extremes of heat, prolonged droughts, and heightened rainfall occurring with greater frequency worldwide. Consequently, new patterns of extreme weather are emerging, like the unusual and unorganized tropical cyclone called "Yaku", that influenced the extreme amount of rain that between March 6th to 10th, 2023 hits more than 1000 districts in the northwestern of Peru. One of the district more affected was Íllimo, in the Lambayeque province, due to the river that pass through the city, so called “La Leche”, after the continuous and intensive rain overflow devastating his surrounding areas and causing victims and damage. This emergency provided and excellent opportunity to apply, on the aforementioned areas, the “change detection” technique, that allows identifying areas of change between data obtained before and after of emergency events. In this research, optical data (Sentinel-2, Landsat, MODIS Terra and Aqua, and PeruSAT-1) and synthetic aperture radar (SAR) data (Sentinel-1 and COSMO SkyMed) were analyzed. A benchmark could also be carried out between open-source and commercial spatial analysis tools. The results indicated that in an extreme rain event the optical data are obscured by clouds and do not allow their use, while SAR data overcome clouds, and can be used for this research. The benchmark indicated that using the Jaccard index score, the Sentinel-1A set showed a 33% of correlation, while COSMO SkyMed demonstrated a 38% of match between the maps. The results obtained could be used to sensitize the population and develop a better management of future emergency events (floods) in different areas of Peru.

Groundwater is becoming increasingly important in the Pacific Northwest of the USA due to declining snowpack volumes and shifts in precipitation type and timing, all connected with climate change. The Upper Williamson Basin of the Klamath Watershed is a groundwater dominated watershed with massive fluctuations in year-to-year streamflow volumes over the past four decades, including the complete absence of any live flow for several years. The precise relationship between groundwater and streamflow in the basin has been difficult to assess due to a limited number of monitoring wells and significant gaps in the water level time history. To address this challenge, we use a novel imputation technique that leverages Earth observations and machine learning to impute gaps in water level records. We use these more complete datasets to compute a groundwater storage change time series for the basin. We show that groundwater storage is highly correlated to streamflow and that groundwater storage is correlated to rainfall with a three- to four-year delay that appears variable depending on groundwater storage volumes. The tools and relationships we present make it possible for water managers to estimate when streamflows will return to the basin and be more informed to support better management.

Grain quality, cooking quality and nutritional quality traits are some of the major attributes that enhance uptake and utilisation of improved cowpea varieties. Therefore, there is need for a better understanding of the genetic variation and inter-relationships among these quality traits in cowpea to integrate them in cowpea breeding programs. The study was conducted to determine genetic variability among 306 cowpea genotypes for grain quality, cooking quality and nutritional quality traits and to understand the interrelationships among these traits for exploitation in breeding programs. The results showed highly significant differences (P

Inequality of health service for different specialty categories not only occurs in different areas inequality of health service for different specialty categories in the world, but also happens in the online service platform. In the online health community (OHC), health service was often of inequality for different specialty categories, including both online views and medical consultation for offline registered service. Moreover, how the factor city-level impacts the inequality of health service in OHC is still unknown. We designed a causal inference study with data on distributions of serviced patients and online views in over 100 distinct specialty categories on one largest OHC in China. To derive the causal effect of the city-levels (two levels inducing 1 and 0) on the Gini coefficient, we matched the focus cases in cities of rich healthcare resources with the potential control cities. For the Gini coefficient of serviced patients in over 100 specialty categories, the average treatment effect of level-1 cities is 0.470, which is 0.029 higher than that of the matched group. Similarly, for the Gini coefficient of online views, the average treatment effect of Level-1 cities is 0.573, which is 0.016 higher than that of the matched group. For each of the specialty categories, we also estimated the average treatment effect the specialty category’s Gini coefficient ( ) with the balanced covariates. The results support the argument that the total Gini coefficient of all the doctors in OHC shows that the inequality of health service is still very serious. This study contributes to the development of the theoretically grounded understanding of the causal effect of city-level on the inequality of health service in an online to offline healthcare service setting.

Attention to the work-related musculoskeletal disorders (WMSDs) involve also statistical surveys showing an increasing trend in the incidence of WMSDs. Technological development retrieves new tools and methods for the assessment of physical load at work. In addition to the conventional questionnaires and scaling assessment systems, these methods are mostly based on the direct sensing of appropriate parameters, which allows more precise quantification. The aim of this paper is to compare the assessment of ergonomic risk through current legislative regulations. A Captiv wireless sensor system was used at a car headlight quality control assembly workplace for sensing, data acquisition and data processing. During the evaluation of the postures and movements at work, we discovered differences in the applicable standards: Decree 542/2007 Coll. (Slovak legislation), STN EN 1005-4+A1, French standards default in the Captiv system. Standards define the thresholds for hazardous postures with significant differences in several evaluated body segments, which also affects the final evaluation of the measurements. Based on the results of our research, we found that respondents were in an acceptable position for approximately 63% of the total duration of the work activity in terms of the Legislative method, 44% with Captiv and 27% with Standards method.

Infrared thermography is a contactless imaging technique, useful to measure surface temperature at distance which has been widely applied in animal production. The possible applications within the pig husbandry include sow heat detection, reduction of the incidence of neonatal mortality, recognition of febrile state caused by pathogens, study of metabolic efficiency, evaluation of stress caused by heat, by constraints, or by aggressive interaction and meat quality prediction. Even if this technique could be easily influenced by environmental factors, the continuous improvement in the procedures and the decrease in the cost of the equipment will allow in the next future new and more applications in swine farming.

In recent decades, organizational research has given special attention to the mechanisms promoting the health and wellbeing of nursing professionals. In this context, self-esteem is a personal resource which influences wellbeing at work and psychological wellbeing of nurses. The purpose of this study was to analyze the mediating role of eating in the effect of sleep quality on self-esteem in nursing professionals. The sample of 1073 nurses were administered the Rosenberg General Self-Esteem Scale, the Pittsburgh Sleep Quality Index and the Three-Factor Eating Questionnaire-R18. The results show that poor sleep quality and type of eating directly and indirectly affect self-esteem. More so, poor sleep quality deteriorated self-esteem through emotional eating, and even though emotional eating facilitated disinhibited eating, this relationship had no significant effects on self-esteem. The findings of this study suggest that hospital management should implement employee health awareness programs on the importance of healthy sleep and design educational interventions for improving the quality of their diet.

Low Power Wide Area Networks (LPWAN) enable a growing number of Internet-of-Things (IoT) applications with large geographical coverage, low bit-rate, and long lifetime requirements. LoRa (Long Range) is a well-known LPWAN technology that uses a proprietary Chirp Spread Spectrum (CSS) physical layer, while the upper layers are defined by an open standard - LoRaWAN. In this paper, we propose a simple yet effective method to improve the Quality-of-Service (QoS) of LoRa networks by fine-tuning specific radio parameters. Through a Mixed Integer Linear Programming (MILP) problem formulation, we find optimal settings for the Spreading Factor (SF) and Carrier Frequency (CF) radio parameters, considering the network traffic specifications as a whole, to improve the Data Extraction Rate (DER) and to reduce the packet collision rate and the energy consumption in LoRa networks. The effectiveness of the optimization procedure is demonstrated by simulations, using LoRaSim for different network scales. In relation to the traditional LoRa radio parameter assignment policies, our solution leads to an average increase of 6% in DER, and a number of collisions 13 times smaller. In comparison to networks with dynamic radio parameter assignment policies, there is an increase of 5%, 2.8%, and 2% of DER, and a number of collisions 11, 7.8 and 2.5 times smaller than equal-distribution, Tiurlikova's (SoTa), and random distribution, respectively. Regarding the network energy consumption metric, the proposed optimization obtained an average consumption similar to Tiurlikova's, and 2.8 times lower than the equal-distribution and random dynamic allocation policies. Furthermore, we approach the practical aspects of how to implement and integrate the optimization mechanism proposed in LoRa, guaranteeing backward compatibility with the standard protocol.

During the COVID-19 pandemic, antibody-based vaccines targeting the SARS-CoV-2 spike glycoprotein were the key focus for development because neutralizing antibodies were associated with protection against the SARS-CoV-2 infection in pre-clinical models and human trials. While deploying these spike-based vaccines saved millions of lives worldwide, it has become clear that the immunological mechanisms of protection against severe disease are multifaceted and involve non-neutralizing antibody components. Here, we describe a novel pan-sarbecovirus T-cell vaccine, ChAdOx1.COVconsv12, designed to complement and broaden the protection of spike vaccines. The vaccine immunogen COVconsv12 employs the two regions in the viral proteome most conserved among sarbecoviruses delivered by replication-deficient vector ChAdOx1. It focuses T cells towards epitopes shared among sarbecoviruses including evolving SARS-CoV-2 variants. Here, we show that ChAdOx1.COVconsv12 induced broad T-cell responses in the BALB/c and C57BL/6 mice. In the Syrian hamster challenge model, ChAdOx1.COVconsv12 alone did not protect against the SARS-CoV-2 infection, but when co-administered with 1/50th of the ChAdOx1 nCoV-19 spike vaccine protective dose, faster recovery and lower oral swab viral load were observed. Induction of CD8+ T cells may decrease COVID-19 severity and extend the T-cell response coverage of variants to match the known (and as yet unknown) members of the beta-coronavirus family.

This study addresses the influence of working conditions on Work-Related Quality of Life (WRQOL) among Spanish healthcare professionals. The research seeks to elucidate the mediating roles of job engagement and burnout, and the moderating effects of resilience and self-efficacy, in this relationship. Methods: The study included 374 healthcare workers from Spain, encompassing physicians, nurses, and nursing assistants. It employed a methodological approach using validated instruments to assess psychosocial risks, work-life quality, job engagement, burnout, and resilience. Data were gathered through self-reported questionnaires. Results: Key findings indicate a negative association between working conditions and WRQOL. Job engagement and burnout significantly mediated this relationship, accounting for 19% to 33% of the variance in WRQOL. Notably, lack of support emerged as a strong negative factor for work-related quality of life. Additionally, resilience moderated the relationship between lack of support and burnout. Conclusions: The study concludes that improving working conditions could increase WRQOL. Interventions aimed at enhancing engagement and addressing burnout may be effective. The moderating role of resilience suggests that strategies to enhance resilience could also be beneficial. These findings hold significant implications for policy formulation and human resources planning in healthcare, emphasizing the need for enhanced workplace support and the development of resilience among health workers.

Network Function Virtualization (NFV) allows for the dynamic provisioning of Virtualized Network Functions, adapting services to the complex and real-time network environment for enhanced network performance. Despite the benefits of NFV, virtual network functions (VNFs) migration and the energy consumption pose significant challenges due to the dynamic nature of the physical network, especially in the edge-cloud continuum network. Currently, people tackle this challenge by predicting the network traffic and then proactively migrating the VNFs using the predicted values. There are two challenges here. First, when SFCs belong to different network service providers, the historical network traffic data is held by the service providers, and they are reluctant to share the historical data due to privacy concerns. Without the historical network traffic data of each SFC, the resource provider that owns the underlying network cannot effectively predict the network traffic; in addition, without the feedback of the migration results of the underlying physical network, the network traffic prediction will be difficult to match the needs of the physical network. In this manuscript, we solve the problem of network traffic prediction in the NFV-based edge-cloud continuum network for multiple network service providers. We aim to improve migration performance and reduce energy consumption while ensuring resource and latency requirements. To protect the privacy of each network service provider, we apply an FL algorithm. After that, to improve the migration performance, we tailor the loss function. In the loss function, factors such as the number of migrations, the number of migration failures, and the energy consumption of the NFV-based edge-cloud continuum network are added. Additionally, to obtain the results of the SFC migration, we develop a mathematical model for the problem of multiple network service providers in the NFV-based network. The effectiveness of our algorithm is evaluated through extensive simulations, and the results show a significant reduction in the number of migrated nodes and energy consumption while improving the SFC acceptance ratio compared to state-of-the-art schemes which only use the difference between predicted and actual flows to define the loss function.