This paper presents an optimized energy management strategy for Li-ion power batteries used on electric vehicles (EVs) at low temperatures. Under low-temperature environments, EVs suffer a sharp driving range loss resulted from the energy and power capability reduction of the battery. Simultaneously, because of Li plating, battery degradation becomes an increasing concern as temperature drops. All these factors could greatly increase the total vehicle operation cost. Prior to battery charging and vehicle operating, preheating battery to a battery-friendly temperature is an approach to promote energy utilization and reduce total cost. Based on the proposed LiFePO4 battery model, the total vehicle operation cost under certain driving cycles is quantified in the present paper. Then given a certain ambient temperature, a target temperature of preheating is optimized under the principle of minimizing total cost. As for the preheating method, a liquid heating system is also implemented on an electric bus. Simulation results show that the preheating process becomes increasingly necessary with a decreasing ambient temperature; however, the preheating demand declines as driving range grows. Vehicle tests verify that the preheating management strategy proposed in this paper is able to save total vehicle operation cost.

: Tunnel instability and lining integrity are intimately tied to the creep properties of the surrounding rock. The acquisition of rock mass creep parameters is critical in ascertaining the appropriate timing for lining construction. Nevertheless, creep tests on rock specimens conducted in a controlled setting cannot be straightforwardly extrapolated to rock mass creep analysis. This study performs laboratory-based creep tests on mudstone samples and establishes the corresponding creep constitutive model. Integration of a Mohr-Coulomb element with the Burgers model in series serves to characterise the yield creep behaviour of the rock mass. Additionally, the research outlines a series of 100 orthogonal experiments utilising randomised creep parameters, and formulates a GA-BP neural network inversion model. Employing long-term deformation measurements from the crown and sidewalls of the project site, this study deduces the creep parameters of the mudstone in the investigated tunnel section and examines the prolonged deformation traits of the surrounding rock. Drawing on the deformation traits of the surrounding rock and the forces impacting the primary support and lining structures, this paper evaluates the earliest and latest viable lining casting periods and pinpoints an optimal timing interval for lining implementation. The methodologies employed herein can serve as a benchmark for analogous endeavors internationally.

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.

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.

A sustainable low cost activated carbon substitute was produced based on pretreated lignocellulosic biomass, especially spruce sawdust. A harmful liquid waste, desalination brine was used for the treatment of a solid wood industry waste, spruce sawdust. This approach is in the circular economy theory and aims to the decarbonization of the economy. The pretreated sawdust was tested as an adsorbent appropriate for the removal of a commonly used pollutant, methylene blue, from industrial wastewater. The adsorption capacity of the pretreated material was found to increased four times comparing to the untreated one in the case that the Freundlich equation was fitted to the isotherms’ data. The treatment experimental conditions with desalination brine that gave maximum adsorption capacity correspond to 1.97 combined severity factor in logarithmic form value. The same adsorption capacity was found to increase five to six times comparing to the untreated spruce sawdust in the case that the Langmuir isotherm model was applied at the same data. Moreover, kinetic experiment was cried out as regards the methylene blue adsorption process. The desalination brine pretreated sawdust adsorption capacity increased 1.4 times comparing to the untreated one, in the case of the Lagergren kinetic equation fitting. Furthermore, the adsorption capacity of the same material was increased 1.6 times when the second order kinetic model was applied to the same data. Industrial scale applications can be based on the kinetic data findings as they have to do with a very shorter adsorption period comparing to the isotherm data.

Large-scale hydrological modeling in China is challenging given the sparse meteorological stations and large uncertainties associated with atmospheric forcing data.Here we introduce the development and use of the China Meteorological Assimilation Driving Datasets for the SWAT model (CMADS) in the Heihe River Basin(HRB) for improving hydrologic modeling, by leveraging the datasets from the China Meteorological Administration Land Data Assimilation System (CLDAS)(including climate data from nearly 40000 area encryption stations, 2700 national automatic weather stations, FengYun (FY) 2 satellite and radar stations). CMADS uses the Space Time Multiscale Analysis System (STMAS) to fuse data based on ECWMF ambient field and ensure data accuracy. In addition, compared with CLDAS, CMADS includes relative humidity and climate data of varied resolutions to drive hydrological models such as the Soil and Water Assessment Tool (SWAT) model. Here, we compared climate data from CMADS, Climate Forecast System Reanalysis (CFSR) and traditional weather station (TWS) climate forcing data and evaluatedtheir applicability for driving large scale hydrologic modeling with SWAT. In general, CMADS has higher accuracy than CFRS when evaluated against observations at TWS; CMADS also provides spatially continuous climate field to drive distributed hydrologic models, which is an important advantage over TWS climate data, particular in regions with sparse weather stations. Therefore, SWAT model simulations driven with CMADS and TWS achieved similar performances in terms of monthly and daily stream flow simulations, and both of them outperformed CFRS. For example, for the three hydrological stations (Ying Luoxia, Qilian Mountain, and ZhaMasheke) in the HRB at the monthly and daily Nash-Sutcliffe efficiency ranges of 0.75-0.95 and 0.58-0.78, respectively, which are much higher than corresponding efficiency statistics achieved with CFSR (monthly: 0.32-0.49 and daily: 0.26 – 0.45). The CMADS dataset is available free of charge and is expected to a valuable addition to the existing climate reanalysis datasets for deriving distributed hydrologic modeling in China and other countries in East Asia.

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.

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.

Background: Simulation plays a crucial role in health studies, as it helps medical students apply their theoretical knowledge in real-life situations. Moulage is one of the techniques that helps in making simulation more realistic or high-fidelity. It uses special effects to emulate wounds for a better understanding of what the wound is like visually. Still, moulage is expensive, time-consuming, resource-intensive, and requires the training of staff, which is why we need to find low-cost substitutes for moulage materials. Method: When searching the database “PubMed” for the terms “Low-cost and Medical moulage”, we retrieved 222 studies, out of which when excluding results not related to low-cost, we obtained 62 studies, from which when removing studies that do not contain information regarding moulage, we found two papers, after referring to citations and cited articles of those papers, we ended up with six studies. Based on the selected articles and additional articles sourced from their reference list, a total of 11 studies were included in the review. Results: We understand that moulage is a technique that helps make simulations come alive, but the resources required to use it are at times, expensive, which is why we need to find methods to do low-cost moulage, and many studies address that it can be as simple as using homemade ingredients. Students from a previous study have talked about their opinions regarding the realistic component of moulage and whether if it is any different from other moulages. Most of the students agreed that the moulage ranked well in face and content validity. However, further innovations must be introduced in the field to be widely spread and lead to newer opportunities. Conclusion: Although the research done under moulage is limited, it is accepted that moulage is helpful for simulation-based studies and that low-cost moulage can help make medical studies a better experience for students studying it. Students have a favorable opinion on the realistic aspect of the low-cost moulage applied to them. Newer methods can be introduced to moulage, and it can be implemented in low-income countries.

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.

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.

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.

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.

Crop production in Afghanistan suffers from limited phosphorus (P) availability, which severely hinders national agriculture sustainability. This present study hypothesized that deep fertilizer placement could significantly enhance uptake of immobile P and thus tissue P accumulation and crop yield. A two-year pot experiment growing two maize (Zea mays) hybrid cultivars (Xida-789 and Xida-211) was therefore conducted to test these hypotheses under three contrasting fertilizer placement methods (broadcast, side band, and deep band). In doing so, P concentrations in both maize tissues and soils were compared at 45, 60, and 115 days after sowing (DAS) under nine combinations of nitrogen (N) and P fertilizer rates (kg ha-1: N112P45, N112P60, N112P75, N150P45, N150P60, N150P75, N187P45, N187P60, N187P75). Results have shown that deep band placement significantly increased P uptake efficiency, leading to greater P concentration and accumulation in maize tissues compared to other two fertilization methods. This improved P uptake was attributed to several factors associated with deep placement, including reduced P fixation, enhanced root access to P, and moisture availability for P uptake. Additionally, deep band placement combined with higher N application rates (N187 and N150) further enhanced plant P uptake by promoting P availability and utilization mechanisms. Deep band placement also resulted in significantly higher total soil P, Olsen-P, and P use efficiency than broadcast and side band methods, indicating a more efficient P fertilization strategy for maize that can improve growth and yield. This present study also found positive correlations between P concentration in plant organs and soil Olsen-P, highlighting the importance of adequate soil P levels for optimal plant growth. Overall, our results have showed that deep band fertilizer placement emerged as a superior strategy for enhancing P uptake efficiency, utilization, and maize productivity compared to broadcast and side band placement. This approach can potentially optimize P fertilizer utilization, improve maize growth and yield, while minimizing environmental P losses associated with broadcast applications.

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.

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.

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.

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.

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.

Conditions under which compositions of component systems form a well-defined system-of-systems here are formulated at a fundamental level. Statement of what defines a well-defined composition and sufficient conditions guaranteeing such a result offers insight into exemplars that can be found in special cases such as differential equation and discrete event systems. For any given global state of a composition, two requirements can be stated informally as: 1) the system can leave this state, i.e., there is at least one trajectory defined that starts from the state, and 2) the trajectory evolves over time without getting stuck at a point in time. Considered for every global state, these conditions determine whether the resultant is a well-defined system and if so, whether it is non-deterministic or deterministic. We formulate these questions within the framework of iterative specifications for mathematical system models that are shown to be behaviorally equivalent to the Discrete Event System Specification (DEVS) formalism. This formalization supports definitions and proofs of the afore-mentioned conditions. Implications are drawn at the fundamental level of existence where the emergence of a system from an assemblage of components can be characterized. We focus on systems with feedback coupling where existence and uniqueness of solutions is problematic.

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.

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.

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.

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.

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.

The rapid advancement of large language models (LLMs), such as ChatGPT, has revolutionized natural language processing, enabling these models to generate coherent and contextually relevant text. These capabilities hold significant potential for various applications, particularly in the medical field. LLMs can assist healthcare professionals by providing accurate information, supporting diagnostic processes, and enhancing medical education. However, the implementation of LLMs in clinical settings faces several barriers, including technical limitations, ethical concerns, regulatory constraints, and practical challenges. Ensuring accuracy, reliability, and interpretability is crucial, along with addressing biases, ensuring data privacy, and establishing ethical guidelines. Future research should focus on improving training techniques, developing explainable AI methods, and creating efficient, resource-saving models. Expanding applications through domain-specific models and multi-modal integration can further unlock the potential of LLMs. By addressing these challenges and prioritizing responsible development, LLM technology can be safely and effectively integrated into various domains, driving innovation and improving outcomes. This paper explores the current state of LLM technology, its medical applications, barriers to implementation, and directions for future research and development

Estimating ground surface PM2.5 with fine spatiotemporal resolution is a critical technique for exposure assessments in epidemiological studies of its health risks. Previous studies have utilized monitoring, satellite remote sensing or air quality modeling data to evaluate the spatiotemporal variations of PM2.5 concentrations, but such studies rarely combined these data simultaneously. We develop a three-stage model to fuse PM2.5 monitoring data, satellite-derived aerosol optical depth (AOD) and community multi-scale air quality (CMAQ) simulations together and apply it to estimate daily PM2.5 at a spatial resolution of 0.1˚ over China. Performance of the three-stage model is evaluated using a cross-validation (CV) method step by step. CV results show that the finally fused estimator of PM2.5 is in good agreement with the observational data (RMSE = 23.00 μg/m^3 and R2 = 0.72) and outperforms either AOD-retrieved PM2.5 (R2 = 0.62) or CMAQ simulations (R2 = 0.51). According to step-specific CVs, in data fusion, AOD-retrieved PM2.5 plays a key role to reduce mean bias, whereas CMAQ provides all-spacetime-covered predictions, which avoids sampling bias caused by non-random incompleteness in satellite-derived AOD. Our fused products are more capable than either CMAQ simulations or AOD-based estimates in characterizing the polluting procedure during haze episodes and thus can support both chronic and acute exposure assessments of ambient PM2.5. Based on the products, averaged concentration of annual exposure to PM2.5 was 55.75 μg/m3, while averaged count of polluted days (PM2.5 > 75 μg/m3) was 81, across China during 2014. Fused estimates will be publicly available for future health-related studies.

The healthcare situation in Africa is characterized by limited resources and a high burden of disease, presenting significant challenges to the healthcare systems in the region. The integration of Artificial Intelligence (AI) technologies in African healthcare holds immense potential for addressing these challenges and improving health outcomes. This paper aims to provide a comprehensive understanding of the current healthcare landscape in Africa and the urgent need for AI-driven solutions.In addition to discussing the potential applications of AI in African healthcare, such as disease diagnosis, treatment planning, and medical imaging analysis, this manuscript seeks to shed light on the specific challenges hindering the implementation of AI in the region. By providing detailed examples and case studies, we aim to offer insights into the obstacles that need to be overcome and potential solutions that can be pursued.By leveraging AI technologies, Africa has the opportunity to revolutionize its health systems, bridging the gap in access to quality healthcare across the continent. The objective of this review article is to not only highlight the potential benefits that AI can bring to African healthcare but also to emphasize the urgent need for action and collaboration in implementing and scaling up AI innovations in the region. By doing so, African countries can pave the way for improved health outcomes and ensure that their populations receive the healthcare services they deserve.

Using numerical simulation method, combined with the pre-branch material characteristics of the measurement results, based on the LS-DYNA software to simulate the branch crushing process, the analysis found that not only the existence of the cutter cutting in the branch destruction process, there is also the cutting of the opposing surface of the bending fracture, with the increase in the speed of the knife rollers, the cutter cutting resistance increases, the cutting resistance reaches 2690 N when the cutter at 2500 r/min, the cutter cutting resistance is the smallest in the cutting simulation at the blade angle of 55°, the blade angle is more suitable for the cutting of the branch. In the cutting simulation under different cutting edge angles, the cutting resistance of the tool is the smallest when the edge angle is 55°, which is 1860 N. This edge angle is more suitable for branch crushing and cutting. Using Fluent software to analyse the airflow characteristics of the crushing device, it was found that with the increase of the knife roller speed, the inlet flow and negative pressure of the crushing chamber are increasing, the speed of 2500 r/min, the inlet flow and negative pressure were 1.92 kg/s and 37.16 Pa, which will be conducive to the feeding of branches, but the speed is too high and it will also lead to the enhancement of the vortex of part of the area in the crushing device, which will affect the feeding of branches and the throwing of the crushed material. affect the feeding of branches and the throwing out of crushed materials, and finally determined the speed range of the crushing knife roller is 1800 ~ 2220 r/min. Based on ANSYS/Model module modal analysis of the crushing knife roller, the knife roller of the first six orders of the intrinsic frequency and vibration pattern, crushing knife roller of the lowest order of the modal intrinsic frequency of 137.42 Hz, much larger than the crushing knife roller operating frequency of 37 Hz, the machine will not resonate during operation.

Mortality rates in sub-Saharan Africa remains unacceptably high, and disproportionately affecting economically disadvantaged communities. And healthcare delivery which is considered a major contributor to this is challenged by the limited resources and high service costs, prompting many patients to opt for outpatient department services. This study addresses the need for a data-driven approach to healthcare policy formulation by proposing a model for the implementation of a data warehousing system that integrates outpatients into the national healthcare framework. By leveraging data warehousing, healthcare delivery can be made more efficient through a robust repository that supports decision-making and policy formulation. The research focuses on the outpatient department in resource-scarce settings, proposing a novel multidimensional data model and practical framework implementation. The benefits include improved patient experiences, cost-effective service delivery, and enhanced patient management through electronic health records. Additionally, mobile apps are explored for patient navigation and reminders to enhance treatment adherence. The study’s results indicate that data warehousing can significantly improve healthcare delivery by consolidating critical data and facilitating better planning, resource allocation, and policy formulation. Ultimately, this approach offers valuable insights for optimizing healthcare systems in resource-constrained environments, enabling data-driven policies, and improving health outcomes across sub-Saharan Africa.

The origin of a product, consumer familiarity, and purchasing identity are factors that affect perception of cheese consumption. The present study aims at identifying consumers’ conceptualizations and attitudes towards local Greek cheeses of the North-Aegean Sea islands, such as Ladotyri, Graviera, Kasseri, Kaskavali, Melichloro, and Kalathaki, some of which have a Protected Designation of Origin (PDO) status, as opposed to cheeses of non-Greek origin, such as Cheddar, Regatto, and Gouda. Sensory and emotional attributes of local, local PDO, and imported cheeses, and drivers associated with consumers’ choice and acceptance above and beyond their sensory attributes were studied, using three methods: a) Flash Profile to gain insight into the sensory positioning of products and description of samples, b) qualitative analysis of focus groups to pinpoint consumer knowledge, preference, and consumption criteria, and c) a new methodology for natural language processing and sentiment analysis of social media posts to determine consumer conceptualizations. Social media posts have proven to be a valuable source of linguistic and cultural data for cheeses. Local cheeses, including PDO products, were found to be linked to village life and family gatherings, home, tradition, and childhood memories, with saltiness and hardness being their main sensory attributes. Imported cheeses were linked to fast food, pizza, and snacking, with elasticity and gumminess as prominent sensory qualities. The main criterion of purchase was intended usage and versatility, taste and texture, price, and familiarity. The findings provide key sensory attributes, information about consumer purchasing criteria, and relevant vocabulary for the promotion of cheeses as agri-food and gastronomic identity key products.

Large Language Models (LLMs) have demonstrated promising capabilities to solve complex tasks in critical sectors such as healthcare. However, LLMs are limited by their training data which is often outdated, the tendency to generate inaccurate ("hallucinated") content and a lack of transparency in the content they generate. To address these limitations, retrieval augmented generation (RAG) grounds the responses of LLMs by exposing them to external knowledge sources. However, in the healthcare domain there is currently a lack of systematic understanding of which datasets, RAG methodologies and evaluation frameworks are available. This review aims to bridge this gap by assessing RAG-based approaches employed by LLMs in healthcare, focusing on the different steps of retrieval, augmentation and generation. Additionally, we identify the limitations, strengths and gaps in the existing literature. Our synthesis shows that proprietary models such as GPT-3.5/4 are the most used for RAG applications in healthcare. Also, there is a lack of standardized evaluation frameworks for RAG-based applications. In addition, the majority of the studies do not assess or address ethical considerations related to RAG in healthcare. It is important to account for ethical challenges that are inherent when AI systems are implemented in the clinical setting. Lastly, we highlight the need for further research and development to ensure responsible and effective adoption of RAG in the medical domain.

Healthcare professionals constantly face situations that reflect ecosystems’ degradation. These can negatively affect their mental health. Research suggests that hope and resilience can play an important role in this scenario, since they are related to/predict mental health in highly heterogeneous samples (considering geography, age, profession, health, etc.). In this context, the aims of the present study are: to characterize and explore the relationship between hope, resilient coping and mental health of Portuguese healthcare professionals. Using Google Forms, 276 healthcare professionals answered to the GHQ-28, the (adult) Trait Hope Scale, and the Brief Resilient Coping Scale (cross-sectional study). The minimum and maximum possible scores were reached, with the exception of the maximum score of GHQ-28-Total. Regarding Hope, 19.6% scored below the midpoint (M=43.46, SD=11.97); 29.3% revealed low resilience (M=14.93, SD=4.05); and the average of 4 of the 5 Mental Health scores (exception: Severe Depression) indicates the probability of a psychiatric case. Hope correlated with Social Dysfunction and GHQ-28-Total; resilient coping proved to be a (weak) predictor of 4 of the 5 GHQ-28 indicators (exception: Severe depression). The results support the need to promote the sample's mental health, hope and resilient coping. They also suggest that stimulating resilient coping may contribute to improving healthcare professionals’ mental health.

To conduct high-precision and high-resolution numerical simulation of complex flow structures in turbomachinery, a high-order finite volume weighted essentially non-oscillatory (WENO) scheme for the large eddy simulation (LES) is improved and embedded into the three-dimensional viscous unsteady CFD solver NUAA-Turbo. Firstly, the spectral characteristics and unsteady convergence of the improved WENO scheme are studied. Compared with the classical WENO scheme, the improved WENO scheme has better dissipation and dispersion characteristics and faster convergence speed. Then, the coefficient CW of the Wall-Adapting Local Eddy-viscosity (WALE) model is calibrated by decaying homogeneous isotropic turbulence (DHIT) test case. Finally, the scheme is applied to conduct high-precision LES calculations of turbulent boundary layer flow, supersonic compression corner flow, and low-pressure turbine cascade separation flow. The numerical simulation results show that this WENO scheme has excellent shock wave capture ability and turbulence resolution and can capture more flow field details with less mesh size, greatly reducing the computational cost and laying a foundation for large-scale engineering application of LES.

Academics in healthcare grapple with the challenge of efficiently managing time while addressing diverse roles and responsibilities, leading to heightened levels of anxiety and stress within the academic community. The primary objective of this study is to offer a sustainable and systemic solution to the prevalent time-management challenges in healthcare academia, through the development of a predictive model. Employing systemic analysis software and adopting a systemic management approach, we crafted a model to address academic time-management concerns. The dynamics of time allocation for academicians are governed by three fundamental pillars: teaching, research, and administrative tasks. Significantly prioritizing administrative tasks depletes valuable academic time, making time management within academia excessively costly. This occurs as highly skilled individuals find themselves diverted towards administrative duties at the expense of their academic roles diminishing resilience levels. The proposed Timebooster Academic Systemic Model (TASM) advocates for the cultivation of soft skills in academia, en-compassing prioritization, seeking assistance, and addressing tendencies of perfectionism and procrastination. Additionally, TASM recommends the implementation of full automation, delegation of administrative responsibilities, and the mitigation of both overt and covert time-consuming elements. Furthermore, TASM reports on the pivotal role of the academic resilient manager-leaders, who actively contribute to their own satisfaction and academic growth by enhancing collaboration and teamwork. Time-management challenges emerge as a critical determinant of academic well-being and resilience. Systemic models, exemplified by TASM, offer a valuable framework for investigating prioritization concerns, identifying administrative impediments in academic processes, and managing low-value time-consuming elements. The TASM model, along with the systemic philosophy underpinning its design, presents an avenue for advancing the exploration of time-management phenomena within the context of healthcare academia.

One of the industries with the fastest rate of growth is healthcare, and this industry's enormous data requires extensive cloud storage. The cloud may offer some protection, but there is no assurance that data owners can rely on it for refuge and privacy amenities. Therefore, it is essential to offer security and privacy protection. Increased customer satisfaction with security and privacy preservation is crucial since healthcare big data and its sources are stored in the cloud and contain increasingly private and sensitive information. However, maintaining privacy and security in an untrusted green cloud environment is difficult, thus the data owner should have complete data control. A new work SecPri-BGMPOP(security and privacy of Boost graph Convolutional Network -Pinpointing-Optimization Performance) is suggested that can offer a solution that involves several different steps in order to handle the numerous problems relating to security and protecting privacy. Initially Boost Graph Convolutional Network Clustering (BGCNC) algorithm, which reduces computational complexity in terms of time and memory measurements, is first applied to the input dataset to begin the clustering process. Second, enlarge by employing a piece of the magnifying bit string to generate a safe key, pinpointing based encryption avoids amplify leakage even if a rival or attacker decrypts the key or asymmetric encryption. Finally, to determine the accuracy of the method, an optimal key was created using a meta-heuristic algorithmic framework called Hybrid fragment horde bland lobo Optimization (HFHBLO). Our proposed method currently kept in a cloud environment, allowing analytics users to utilize it without risking their privacy or security.

(1) Background: Second Victims are health care workers negatively affected by adverse events and are prone to developing dysfunctional coping strategies compromising not only their own, but also patient safety. An effective way to address this issue is the implementation of peer support programs. This paper reports on the effectiveness of a peer support program at the Austrian Hietzing Clinic (KHI). (2) Methods: Telephone interviews were carried out after peer support sessions using a questionnaire. Descriptive analysis was carried out reporting frequencies and proportions for nominal variables, means with standard deviations for ordinal and interval-scaled variables. (3) Results: So far, 45 peer supporters have completed telephone interviews after a peer support session. The main reasons for the session were bad news from the private sphere and death of a patient. The peer supporters rated the helpfulness of the sessions for their colleagues as very high while not feeling very burdened themselves afterwards. (4) Conclusions: Underutilization of the program is probable. However, the high rating of helpfulness of the carried-out sessions by the peer supporters in combination with them not feeling very burdened, shows that the program is safe for the peer supporters and an upscaling is warranted.

While digitization can make the health industry faster and more efficient, there are many financial, social and organizational obstacles and barriers to its implementation. This article offers a systematic review of the main troubles detected from the literature review. Also there is a proposal of new kind of restrictions to pay attention. Finally, its offer an heterodox reading about the problem analyzed.

This paper presents a co-designed solution aimed at improving community healthcare assistance management. To enhance patients’ self-awareness of their health status, encouraging active participation in care process, and to support nurses in delivering patient-centered care, we have developed an innovative platform with a highly customized app. This platform was designed using a multi-disciplinary bottom-up approach. Patient data collection and processing facilitate the automation of care timeline planning, based on real time patients’ needs and the available resources. To achieve this goal different components have been considered: real-time health data collection and processing, patient care planning, decision support for nurses, secure communication for data transmission, and user-friendly interfaces to ensure easy access to platform functionalities.

Understanding the dynamics of teamwork and communication among healthcare professionals is crucial in the face of evolving healthcare challenges. This study assessed relational coordination among healthcare professionals in the South Tyrolean healthcare system in Italy, focusing on communication and teamwork dynamics in a cross-sectional survey. Using the validated Relational Coordination Survey (RCS) instrument and 525 completed online responses, the questionnaire aimed to understand the implications of different levels of relational coordination ratings by general practitioners, hospital physicians, nurses, and administrative personnel (response rate 26%). The demographics of the participants revealed a predominance of female professionals (64%), with an average age of 50 and 18 years of service. The resulting RCS scores varied significantly across professional groups, with nurses reporting the highest within-group scores, indicating moderate coordination, and administrators reporting the lowest scores, reflecting areas of weak coordination. Between-group relational coordination was generally perceived as weak across professional groups, with the least weakness observed between general practitioners and nurses. German or Italian language and health district affiliation emerged as significant factors influencing relational coordination ratings, highlighting the need for differentiated understanding and strategies in multilingual and diverse regional settings. Assessments of interdisciplinary feedback and referral practices highlight the variation in teamwork and communication weaknesses and underscore the need for targeted interventions to improve relational coordination. This study provides insights into the complexity of relational dynamics in health care settings. It suggests that improving relational coordination through tailored strategies could significantly improve team effectiveness, quality of patient care, and overall system efficiency.

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.

The development of virtual models has recently been generalized in the field of complex mechatronic product design. Virtual models have various advantages such as: the systemic design approach, most often parametric, the implementation of extreme, expensive, and perhaps risky scenarios for the operation of the designed product, the testing of a large number of variants, etc. The main contribution of the paper consists of the development of an interface family called DeSeRoI (Dedicated Serial Robot Interface). Each member of the interface family integrates Simulink libraries and is created by the programmer in accordance with user requests. It follows that the interfaces composing the DeSeRoI family can have different levels of complexity depending on user needs and constraints. We are implementing a MATLAB-based application with user-provided configuration for serial robots in order to automatically visualize the kinematics data and simulation. Within MATLAB, two scripts are created responsible for generating Simulink models that compute the kinematics problem. One of the scripts (Main) saves information about the configuration of the robot and the other one (Generates_Simulink_Models) computes the kinematics problem. Different types of functions (software module) have been developed. Using these functions, the Simulink models result as modular entities. The automated approach eases user’s interaction and understanding of serial robots’ kinematics by performing the simulation procedure in a shorter amount of time and with higher efficiency, assuring a precise outcome despite the chosen parameters.

This study examines geothermal energy extraction potential from the basement rock within the Denver-Julesburg (DJ) Basin, focusing on flow performance and heat extraction efficiency of different geothermal well configurations. It specifically compares U-Shaped, V-Shaped, Inclined V-Shaped, and Pipe-in-Pipe configurations against Enhanced Geothermal Systems (EGS) setups. Through numerical modeling, we evaluated the thermal behavior of these systems under various operational scenarios and fracture conditions. Results suggest that while closed-loop systems offer moderate temperature increases, EGS configurations show substantial potential for high-temperature extraction. This underscores the importance of evaluating well configurations in complex geological settings like the DJ Basin. The insights from this study aid in strategic geothermal energy planning and development, marking significant advancements in geothermal technology and setting a foundation for future explorations and optimizations.

Driven by the growing interest of the scientific community and the proliferation of research in this field, cranial implants have seen significant advancements in recent years regarding design techniques, structural optimisation, appropriate material selection and fixation system method. Custom implants not only enhance aesthetics and functionality but are also crucial for achieving proper biological integration and optimal blood irrigation, critical aspects in bone regeneration and tissue health. This research aims to optimize the properties of implants designed from triply periodic minimal surface structures. The gyroid architecture is employed for its balance between mechanical and biological properties. Experimental samples were designed varying three parameters of the surface model: cell size, isovalue and shape factor. Computational simulation tools were used for determining the relationship between those parameters and the response variables: the surface area, permeability, porosity and Young modulus. These tools include computer aided design, finite element method and computational fluid dynamics. With the simulated values, the corresponding regression models were fitted. Using the NSGA-II, a multi-objective optimisation was carried out, finding the Pareto set which includes surface area and permeability as targets, and fulfil the constraints related with the porosity and Young modulus. From these non-dominated solutions, the most convenient for a given application was chosen, and an optimal implant was designed, from a patient computed tomography scan. An implant prototype was additively manufactured for validating the proposed approach.

Large language models (LLMs) have recently garnered significant attention due to their remarkable ability to assimilate vast amounts of information and effectively process natural language. In healthcare, natural language constitutes a substantial portion of medical data, rendering LLMs highly promising for various healthcare applications. This study seeks to explore the potential of LLMs in healthcare and clinical decision support (CDS), following PRISMA guidelines for reviews. The analysis encompasses 44 LLMs, each influenced by several factors impacting their performance. Notably, the datasets utilized for pretraining and finetuning processes play a crucial role in determining the model’s domain specificity. Furthermore, distinct model architectures are tailored for specific tasks, while prompting strategies are frequently employed to refine and enhance the model’s performance. LLMs exhibit considerable promise for a wide array of healthcare applications. For instance, LLMs possess the potential to handle and analyze medical information efficiently, facilitate contextual understanding among clinicians and patients, as well as automate the documentation of clinical notes and reports. Presently, however, their implementation within the field remains limited. Notable improvements have been witnessed in the performance of current healthcare-oriented LLMs, with some achieving expert-level competence in medical question-answering (MQA). However, these LLMs face prominent challenges, encompassing ethical concerns, issues related to accountability, and a lack of appropriate regulations. Nevertheless, this study reveals numerous promising applications in healthcare where LLMs could significantly augment the efficiency, accessibility, and manageability of healthcare delivery. Addressing the challenges LLMs encounter is essential for their seamless integration into practical healthcare applications. As a relatively new technology, the development of LLMs is still in its early stages, but their potential is evident through this study. Consequently, fostering collaboration among healthcare professionals, developers, regulators, and other stakeholders is imperative to cultivate dependable LLMs that align with the demands of the healthcare sector.

The role of Physician Assistant emerged in 1960s America and their number has increased to become a significant component of the health care workforce in that country. On the eve of a new policy regulating Physician Associates in the United Kingdom, the role of key actors in shaping the development of regulatory policies in the two countries is critically compared against a backdrop of very different political contexts and health care systems, to reveal the factors that might help or hinder the deployment of Physician Associates/Assistants and ameliorate workforce shortages.

In this paper, we first discuss the research status and application progress of the finite element method and the smoothed particle method. By analyzing the advantages of the smoothed particle method and the finite element method, a new coupling algorithm, namely FEM-SPH algorithm, is proposed. By the method of comparison, it shows that finite element method and SPH method in the simulation of large deformation problems each have advantages and disadvantages, the finite element method smoothed particle coupling algorithm is effective to achieve the performance of high computational efficiency and can naturally simulate large deformation problems across. In the process of calculation, the large deformation unit can be freely into an algorithm to facilitate the calculation accuracy and efficiency of three methods of numerical simulation. Through the study found, FEM-SPH algorithm not only overcome the defect of smooth particle tensile instability, but also overcomes the problem of low efficiency of finite element computation. To further test the FEM-SPH algorithm has advantages in the practical engineering, we have carried out the actual test to the example of the super high speed collision, concluded that, since the target of most of the computational domain is always finite element, smoothed particle focused only in contact with the projectile and target of local area, particle number is not much, the whole calculation process just ten minutes, computational efficiency has been greatly improved, at the same time in the simulation of large deformation, the advantage is very obvious .This provides a criterion for the actual project, depending on the specific material deformation mode and choose a more appropriate conversion algorithm.

In this paper we report a new development on the numerical model for aluminum-steam combustion. This model is based on diffusion flame of continuum regime and the thermal equilibrium between the particle and the flow field, which can be used to calculate the aluminum particle combustion model for two phase calculation conditions. The model prediction is in good agreement with the experimental data. A new type of vortex combustor was proposed for the combustion of aluminum and steam, and the mathematical model of the two phase reacting flow with in this combustor was established. The turbulence effects are modeled using the Reynolds Stress Model (RSM) with Linear Pressure-Strain approach, and the Eddy-Dissipation model is used to simulate the gas phase combustion. Aluminum particles are injected into the vortex combustor and form a swirling flow around the chamber and their trajectories are traced using the Discrete Phase Model (DPM). The simulation results show that the vortex combustor can achieve high efficient combustion of aluminum and steam. The influencing factors, such as the eccentric distance of the inlet of aluminum particles, particle size and steam inlet diameter, etc., are studied. The work described in this paper represents an attempt to the design of a vortex combustor in order to increase aluminum combustion efficiency.

The majority of existing numerical simulations of the effect of bridge piers on water movement are based on a limited number of bridge piers at a laboratory scale. Furthermore, some 2D numerical simulations for actual bridge projects have deficiencies, including the use of overly large mesh sizes and an inadequate treatment of bridge piers. In this study, we compare three methods of structural mesh encryption, suspension mesh, and nonstructural mesh based on Delft3D, and apply the optimization scheme to a real bridge project. It is demonstrated that optimal results can be achieved by utilising a grid size comparable to the pier diameter (Dp) in the region away from the piers. In the vicinity of the piers, the grid cell size should be no larger than 1/9 Dp. The suspended grid technique (DD Boundary) can yield results consistent with those obtained using a full-area high-resolution grid, provided that the total number of grids can be reduced and the computational time is considerably reduced. In this study, the unstructured mesh (Deflt3D Flexible Mesh) scheme was unable to capture the oscillations of the wake flow behind the bridge piers. However, the application of the optimized scheme in bridge engineering has demonstrated its practical value. The findings of this study on mesh resolution and suspension mesh scheme can be applied to the Delft3D software and are also useful for other numerical simulation work.

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.

The control of the fine particle emission from the coal-fired power plants has been a big challenge in china. Either the conventional electrostatic precipitator or the fabric filter has some shortages. The electrostatic precipitator is hard to keep high efficiency for the submicron particles. The fabric filter could keep high efficiency but with very high pressure drop. One solution is to combine them together. Several types of hybrid particle collectors (HPC) combining the electrostatic precipitator and the fabric filter together have been developed and applied in a number of projects in China. In recent years, numerical simulation technology has been widely used in the design of the collectors. In this paper, an unsteady numerical model is used to investigate the particle deposition characteristics in a scale hybrid collector. The fluid field is modeled by using incompressible Navier-Stokes equations with the RNG turbulence equations. The corona discharge is solved by using a finite volume method. The particle charging is modeled by using a filed-diffusing combined model. And an unsteady cake formation model is used to simulate the filtration process.

Frontal Polymerization (FP) is recognized as a polymer synthesis method capable of generating a highly localized and self-propagating exothermic front, considered a more rapid and energy-efficient manufacturing scheme for polymer-based fiber-reinforced composite materials. This study conducts a numerical investigation based on the Finite Element Method into the initiation and propagation of frontal polymerization of acrylamide. Utilizing Differential Scanning Calorimetry (DSC) experiments, the study phenomenologically tests the curing kinetics reactions of acrylamide (AM) in deep eutectic solvent (DES)-based polymerizable systems, thereby establishing a curing kinetics model for the autocatalytic reaction of polyacrylamide. By coupling the heat conduction diffusion equation of the frontal polymerization reaction, the Finite Element Method is employed to solve the reaction-diffusion model, aiming to explore the evolution of temperature and degree of curing during the manufacturing process. The results demonstrate the reliability and accuracy of the nth-order autocatalytic model in the study of curing kinetics for DES-based synthesis, indicating that the front propagation speed of the AM-based FP reaction is influenced by the activation temperature, duration of activation temperature, and initial temperature of the solution. Experimental validation of the polyacrylamide manufacturing through frontal polymerization corroborates the accuracy and reliability of the model predictions, providing a reference for the numerical model study and temperature control in the synthesis of acrylamide composite hydrogels via FP.

Background: Virtual care adoption accelerated during the COVID-19 pandemic, highlighting the need for healthcare professionals to develop relevant competencies. However, limited evidence exists on the core competencies required for quality virtual care delivery. Objective: This study aimed to identify the critical competencies physicians, nurses, and other health professionals need for adequate virtual care provision in Saudi Arabia using a Delphi method. Methods: A 3-round Delphi technique was applied with a panel of 42 experts, including policymakers, healthcare professionals, academicians, and telehealth specialists. In round 1, an open-ended questionnaire elicited competencies needed for virtual care. Competencies were distilled and rated for importance in rounds 2 and 3 until consensus was achieved. Results: Consensus emerged on 151 competencies across 33 domains. The most prominent domains were communication (15 competencies), professionalism (13), leadership (12), health informatics (5), digital literacy (5) and clinical expertise (11).

The healthcare system is crucial to the development, standard of living, and sustainability of any country. Amid the pandemic, most developed countries are experiencing varying levels of difficulty managing their healthcare systems. Overloading of healthcare services is common, leading to prolonged waiting times for medical services; thus, the wastage of hospital resources must be addressed seriously. In this paper, we examine the problem of no-shows in outpatient clinics. Through a review of the literature and practical industrial experience, we identify the processes of these clinics. We then propose a robust optimisation approach for overbooking using a traditional overbooking model and a robust system. This model aims to mitigate the significant parameter uncertainties encountered during the pandemic. Considering risk aversion, the optimal policy for overbooking can be established while accounting for the costs associated with overbooking. The main contribution of this paper is the introduction of an alternative method to address the uncertainty of no-shows using an overbooking technique.

Despite the importance of influenza vaccination for healthcare workers (HCWs), their uptake remains challenging. This study aimed to measure influenza vaccine hesitancy among HCWs in Nakhon Phanom province, Thailand. A representative cross-sectional survey was conducted at six hospitals during August – September 2020 using a self-administered questionnaire. HCWs delaying getting influenza vaccines, accepting but unsure, or refusing with doubts were categorized as hesitant. Those accepting without any doubts were classified as non-hesitant. Vaccine hesitancy determinants were identified by multivariable logistic regression analysis. A total of 338 participants (97%) completed the questionnaires; most were female nurses working at district hospitals without pre-existing chronic medical conditions. Nearly 60% of participants (197/338) exhibited influenza vaccine hesitancy, and significant factors included age above 50 years adjusted odds ratio [aOR] 3.2, 95% CI 1.3-8.5), fair knowledge of influenza/vaccination (aOR 0.4, 95% CI 0.2-0.8), and negative influence of other HCW (High level– aOR 2.3, 95% CI 1.1-4.8; Moderate level- aOR 2.1, 95% CI 1.1-4.4). Imparting updated information to the HCW combined with positive guidance from influential peers may help reduce this hesitancy.

This research addresses a gap in the literature by conducting a comprehensive analysis of patients’ level of satisfaction with dental care. Methods: By combining quantitative and qualitative survey methods with the PSQ questionnaire this study aims to augment ongoing initiatives to enhance dental patients’ experiences by painting a more comprehensive depiction of patients' level of satisfaction; Results: When asked about their overall level of satisfaction 77,1% of the patients said they received excellent services from the office personnel and 72,2% said they trust their doctors; Conclusions: Assessing patient satisfaction in the realm of dental services quality is crucial for enhancing service quality and accuracy, benefiting both patients and dentists, and ultimately improving public health.

This review article focuses on the role of Artificial Intelligence (AI) in transforming healthcare in Africa, specifically in combatting infectious diseases, neglected tropical diseases (NTDs), and antimicrobial resistance. We provide a comprehensive overview of the significance of AI in the healthcare industry, highlighting its urgency and importance in addressing these specific health challenges in Africa. We begin by discussing the role of AI in infectious disease surveillance and outbreak detection. We explore how AI technology can be employed for real-time tracking and prediction of outbreaks, providing examples of successful AI applications in infectious disease surveillance within the African context.Next, we examine the potential of AI-enabled diagnosis and treatment for faster and more accurate diagnoses of infectious diseases and NTDs. We highlight specific examples of AI applications in diagnosing and treating these diseases in Africa, showcasing the potential of AI to improve clinical outcomes and save lives.Furthermore, we focus on how AI-driven drug discovery and development can expedite the search for new treatments for infectious diseases and combat antimicrobial resistance. We present examples of AI applications in drug discovery within the African context, illustrating the potential for AI to revolutionize the development of effective therapeutics.In addition, we delve into how AI-powered public health interventions can enhance the design and implementation of targeted interventions. We explore how AI can optimize resource allocation and facilitate data-driven decision-making processes, providing examples of AI applications in public health in Africa.Finally, we address the challenges and limitations of implementing AI in combatting infectious diseases, NTDs, and antimicrobial resistance in Africa. We discuss potential barriers and ethical concerns surrounding AI applications in healthcare, aiming to encourage informed and responsible utilization of AI technologies.Overall, this review emphasizes the importance and potential of AI in combatting infectious diseases, NTDs, and antimicrobial resistance in Africa. It positions AI as a catalyst for revolutionizing healthcare in the region, leading to more effective disease surveillance, diagnosis, treatment, drug discovery, and public health interventions.

Antimicrobial resistance (AMR) is a major public health threat linked to increased morbidity and mortality. It has the potential to return us to the pre-antibiotic era. Antimicrobial stewardship (AMS) programs are recognized as a key intervention to improve antimicrobial use and combat AMR. However, implementation of AMS programs remains limited in Africa, particularly in Rwanda. This qualitative study, conducted at King Faisal Hospital (KFH) in Rwanda, aimed at assessing current prescription practices to identify areas for improvement and promote adherence to AMS principles. The interviews were recorded, transcribed, and thematically analyzed, revealing four emerging themes. First, emerged on AMS activities that were working well which includes availability of microbiology laboratory results, and prescription guidelines as factors influencing antibiotic prescription adjustments. Second, Implementations challenges to AMS which identified the prescription of broad-spectrum antibiotics, limited local data on AMR patterns, stock-outs of essential antibiotics, Thirdly, the importance of adhering to AMR management guidelines at KFH was underscored. Lastly, participant recommendations centered on regular training for healthcare workers, widespread dissemination of AMR findings across departments, and the enforcement of antibiotic restriction policies. These actions can improve prescription behaviors, upholding the highest standards of patient care, and strengthening the nascent AMS program.

Urban rail transit hub platform is the most important area for passenger flow distribution. In order to calculate passenger flow volume in platform and evaluate platform service level during rush hours, this paper presents a method for modeling and simulation of passenger flow distribution in platform. Passenger flow distribution model (PFDM) is proposed based on the basic analysis and the superposition principle of passenger flow. Simulation design for PFDM is proposed by Anylogic, which contains simulation process and simulation model. Experiment results show that PFDM and simulation design are effective and accordant with the reality scenario, and the simulation precision is comparatively ideal. This research could provide a beneficial reference for train scheduling and operation management under the viewpoint of traffic safety and service level.

Shear dynamics simulation under extreme pressure was used to optimise the composition of ester-based lubricant base oil and extreme pressure additives. As a result, the ester-based lubricant in the weak-gel drilling fluid achieves reduction and increases the efficiency in drilling construction, and the field operation efficiency improves. The results of base oil lubrication simulation show that three base oils, namely, methyl oleate, ethyl oleate and butyl oleate, can be stably adsorbed on the surface layer of the shear surface. Methyl oleate has the lowest system temperature after shear stabilisation and has a high load-bearing capacity. The shear stress of methyl oleate decreases by changing the initial shear temperature and speed. It increases by 6.36 MPa when the speed increases from 10 m/s to 30 m/s. At this time, the shear stress of butyl oleate increases by 10.11 MPa. The results of the four-ball friction experiments show that the radius of the abrasion spot of methyl oleate is 179.83 μm, which is smaller than that of the other two base oils. Moreover, the friction coefficient of methyl oleate is 0.0018, which is approximately 1/3 of that of butyl oleate. Methyl oleate has better lubrication efficiency. The shear simulation results are consistent with the experimental results. The simulation can be used for the molecular design of lubricant materials. The oleic acid amide–containing amine group and the glyceride oleic–containing hydroxyl group were selected as the extreme pressure functional components for shear simulation. Results show that the shear stress of oleic acid amide is much lower than that of oleic acid glyceride when the initial shear temperature and speed change. The extreme pressure lubrication component–containing amine group is better than the extreme pressure lubrication material–containing hydroxyl group. The effects of different oleamide contents in the two-component mixtures on the lubricating properties were investigated through shear simulation, with methyl oleate as the base oil and oleamide as the extreme pressure functional component. The simulation results show that the lubricant has the optimal shear stress when 10% oleamide is added to the lubricant. The base properties of the lubricant were tested using a mixture of 90% methyl oleate and 10% oleamide, formulated as a lubricant. Results show that the friction coefficient can be reduced to 0.03 when 0.5% of the lubricant is added to the base mud. Moreover, the lubricant film formed shows high strength. Then, 1% lubricant was added to the weak-gel drilling fluid to evaluate the effect of the lubricant on the gel structure of the drilling fluid. Results show that adding lubricant does not affect the rheological properties of the drilling fluid. The gel structure of the system also remains stable even after 7 days of continuous ageing. The results of the field experiments in Hua3-01 well show that adding 1% ester-based lubricant to the field drilling fluid reduces the drilling friction by 33%. Thus, the efficiency of directional side drilling can be effectively improved, complicated accidents, such as poor starting and stopping of drilling and stuck jamming, can be avoided, and the goals of reducing quantity and increasing efficiency can be completed.

Two coupled climate models which participated the CMIP6 project (Coupled Model Intercomparison Project Phase 6), the Earth System Model of Chinese Academy of Sciences version 2 (CAS-ESM2-0) and the Nanjing University of Information Science and Technology Earth System Model version 3 (NESM3), were assessed in terms of the impact of four new sea ice parameterization schemes. These four new schemes are related to air-sea heat flux, radiation penetration and absorption, melt ponds, ice-ocean flux, respectively. To evaluate the effectiveness of these schemes, key sea ice variables with and without these new schemes, such as sea ice concentration (SIC) and sea ice thickness (SIT), were compared against observation and reanalysis product from 1980 to 2014. The simulations followed the design of historical experiments within the CMIP6 framework. The results revealed that both models demonstrated improvements in simulating Arctic SIC and SIT when the new parameterization schemes were implemented. The model bias of SIC in some marginal sea ice zones of Arctic was reduced, especially during March. The SIT was increased and the transpolar gradient of SIT was reproduced. The changes of spatial pattern of SIC and SIT after adding new schemes bear similarities between the two coupled models. This suggests that the new schemes have potential for broad application in climate models, especially for those with underestimated SIT.

Modern automotive systems should must satisfy strict reliability requirements. Most of the real vehicle systems and safety-critical networks have complex interconnections. Sensitivities and probabilistic uncertainties of reliability of System with Complex Interconnections (SwCI) can be investigated by the Monte-Carlo Simulation (MCS). The paper focuses on sensitivities and parametrical uncertainties of SwCIs reliability. The proposed method can be used forimplemented in the investigation of uncertainties of SwCIs reliability – in other wordsi.e., for in the determination of critical system elements and to estimateion of the Required Number of Spare Parts (RNSP) of the system, which depends on the probability of allowable spare equipment shortage.

The Roma population constitutes the largest ethnic minority in Europe, however, data regarding the prevalence of non- communicable diseases are still scarce in the medical literature. The aim of this study was to assess the clinical and metabolic particularities of a Roma population with diabetes, in comparison with a group of Romanian Caucasians. We conducted an observational, transversal study and evaluated 808 adult patients with diabetes mellitus, from a tertiary hospital providing diabetes care, aged between 18 and 89 years old, of whom the majority were men (52.84%). Most of them had type 2 diabetes mellitus (T2DM), reaching 95.1% the Caucasian group and 87.8% among the Roma patients. 81.1% of the Caucasian patients had hypertension, approximately 15% higher than the Roma group, while more than half of the patients in both groups had obesity. There were no differences concerning myocardial infarction, however, the number of patients with history of stroke was 2.1 times higher in the Roma group compared to Caucasians. Chronic kidney disease was present in 22.1% of the Roma patients, 33.25% had retinopathy, and 72.7% presented polyneuropathy. The prevalence of cardiovascular risk factors, cardiovascular disease and microvascular complications among the study Roma population are quite significant, underscoring the importance of ethnic disparities in approaching healthcare management strategies.

This study presents the design and comprehensive 3D multiphysics simulation of a novel microfluidic immunosensor for real-time, non-invasive monitoring of pro-inflammatory biomarkers in human sweat. The patch-like device, designed using COMSOL Multiphysics, integrates magnetofluidic manipulation with direct-field capacitive sensing. The sensor comprises two distinct units: an immunocomplex enhancement unit, employing a series of microcoils to optimize the binding efficiency, reaction kinetics, and homogeneity of biomarker-magnetic nanoparticle (MNP) interactions, thereby enhancing the sensor's specificity; and a layered capacitive sensing unit, designed to concentrate and detect biomarker-tagged MNPs, thus amplifying sensitivity. Simulations of the capacitive sensing unit revealed a substantial sensitivity increase of up to 42.48\% at an 85\% MNP concentration within the detection zone. These findings highlight the potential of the proposed immunosensor for efficient and precise real-time biomarker monitoring, which may facilitate early disease diagnosis and enable personalized healthcare interventions.

Electrical contacts are important circuit components with diverse industrial applications, and their failure can lead to multiple unwanted effects. Hence, the behavior of electrical contacts is a widely studied topic in scientific literature based on various approaches, tools, and techniques. The present study proposes a numerical modeling and simulation approach based on the Holm contact theory to study the dependence between the electric potential and the temperature within an electrical contact. Structured in 5 sections, the research was conducted using COMSOL Multiphysics software and its solid-state mechanics, electric current, and heat transfer modules in order to highlight contact behavior from mechanical, electrical and thermal points of view: the von Mises stress, contact force, the electric field amplitude, the variation of the electrical potential along the current path, the temperature gradient, and dependence of temperature along the contact elements edges were obtained by simulation and graphically represented. The results are in line with the expectations and with past research that was studied in the literature review.

Advanced Finite Element (FE) modeling and simulations were performed on vehicular crashes into a Three-bar Metal Bridge Rail (TMBR). The FE models of a sedan, a pickup truck, and a TMBR section were adopted in the crash simulations subject to Manual for Assessing Safety Hardware (MASH) Test Level 2 (TL-2) and Test Level 3 (TL-3) requirements. The test vehicle models were first validated using full-scale physical crash tests conducted on a two-bar metal bridge using a sedan and a pickup truck with similar overall physical properties and sizes to their respective vehicles used in the simulations. The validated vehicular models were then used to evaluate the crash performance of the TMBR using MASH Evaluation Criteria for structural adequacy, occupant risk, and post-impact trajectory. The TMBR met all MASH TL-2 requirements but failed to meet the MASH TL-3 Criteria H and N requirements when impacted by the sedan. The TMBR was also evaluated under in-service conditions (behind a 1.52-m wide sidewalk) and impacted by the sedan under MASH TL-3 conditions. The simulation results showed that the TMBR behind a sidewalk met all safety requirements except for the occupant impact velocity in the longitudinal direction, which exceeded the MASH limit by 3.93%.

We assessed depression, anxiety, and stress in healthcare workers (HCWs) in 2023 and the evo-lution of depression in 2023 compared with 2022. In September-November 2023, 181 HCWs from the Infectious Diseases Hospital, Cluj-Napoca, Romania, completed the Depression, Anxiety, and Stress 21 Scale (DASS-21 R), the Patient Health Questionnaire-9 (PHQ-9), and the Hamilton Anxiety Rating Scale (HAM-A). The prevalence of moderate-to-severe levels was 13.81% for DASS-Depression, 18.79% for DASS-Anxiety, 16.02% for DASS-Stress, 19.89% for PHQ-9, and 12.16% for HAM-A. Moderate-to-severe PHQ-9 clinical depression was found in 19.89% of respondents, and moderate-to-severe HAM-A clinical anxiety in 12.16%. Moderate-to-severe PHQ-9 depres-sion was significantly lower in the 2023 study group (19.89%, N=181) compared with 2022 (30.60%, N=114) (p=0.036), also within the 2022-2023 follow-up study group (N=88) (p=0.026). We did not find significant statistical differences between those infected vs. non-infected, vaccinated vs. non-vaccinated, working with vs. non-working with SARS-CoV-2 infected patients. Males were significantly more stressed (p=0.018) and anxious (p=0.034), and physicians in training had the highest prevalence of moderate-to-severe depression (31.60%), followed by physicians (25.64%). In 2023, depression, anxiety, and stress symptoms decreased but remained within a concerning range. By addressing these psychological issues, we can prevent professional crises in the healthcare system.

Background: Mental capacity is a fundamental aspect that enables patients to fully par-ticipate in various healthcare procedures. To assist healthcare professionals (HCPs) in assessing patients' capacity, especially in the mental health field, several standardized tools have been developed. These tools include the MacArthur Competence Assessment Tool for Treatment (MacCAT-T), the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR), and the Competence Assessment Tool for Psychiatric Advance Directives (CAT-PAD). The core dimensions explored by these tools include Understanding, Appreciation, Reasoning, and Expression of a choice. Objective: This meta-analysis aimed to investigate potential differences in deci-sion-making capacity within the healthcare context among groups of patients with bi-polar disorder (BD) and schizophrenia spectrum disorder (SSD). Methods: A systematic search was conducted on Medline/Pubmed, and Scopus. Addi-tionally, Google Scholar was manually inspected, and a manual search of emerging re-views and reference lists of the retrieved papers was performed. Eligible studies were specifically cross-sectional, utilizing standardized assessment tools, and involving pa-tients diagnosed with BD and SSD. Data from the studies were independently extracted and pooled using random-effect models. Hedges g was used as a measure for outcomes. Results: Six studies were identified, with three studies using the MacCAT-CR, two studies the MacCAT-T, and one the CAT-PAD. The participants included 189 individuals with BD and 324 individuals with SSD. The meta-analysis revealed that patients with BD performed slightly better, and the difference was statistically significant, compared to patients with SSD, particularly in the domain of Appreciation (ES=0.23, 95% CI: 0.01 to 0.04, p=0.037). There was no statistically significant difference between the two groups for Understanding (ES=0.09, 95% CI: - 0.10 to 0.27, p=0.352), Reasoning (ES=0.18, 95% CI: - 0.12 to 0.47, p=0.074), and Expression of a choice (ES = 0.23, 95% CI: - 0.01 to 0.48, p=0.60). In the sensitivity analysis, furthermore, when considering only studies involving patients in symptomatic remission, the difference for Appreciation also resulted in non-significant (ES=0.21, 95% CI: -0.04 to 0.46, p=0.102). (ES=0.21, 95% CI: -0.04 to 0.46, p=0.102). Conclusions: These findings indicate that there are no significant differences between patients with BD and SSD during remission phases, while differences are minimal during acute phases. The usefulness of standardized assessment of capacity at any stage of the illness should be considered, both for diagnostic-therapeutic phases and for research and advance directives. Further studies are necessary to understand the reasons for the overlap in capacity between the two diagnostic categories compared in this study.

This study explores the role of inflammation and oxidative stress, hallmarks of COVID-19, in accelerating cellular biological aging. We investigated early molecular markers—DNA methylation age (DNAmAge) and telomere length (TL)—in blood leukocytes, nasal cells (NC), and induced sputum (IS) one-year post-infection in pauci- and asymptomatic healthcare workers (HCWs) infected during the first pandemic wave (February-May 2020), compared to COPD patients, model for "aged lung". Data by questionnaires, Work Ability Index (WAI), blood analyses, autonomic cardiac balance assessments, heart rate variability (HRV), and pulmonary function tests were collected. Elevated leukocyte DNAmAge significantly correlated with advancing age, male gender, daytime work, and an aged phenotype characterized by chronic diseases, elevated LDL and glycemia levels, medications affecting HRV, and declines in lung function, WAI, lymphocyte count, hemoglobin levels, and HRV (p&lt;0.05). Increasing age, LDL levels, job positions involving intensive patient contact, and higher leukocyte counts collectively contributed to shortened leukocyte TL (p&lt;0.05). Notably, HCWs exhibited accelerated biological aging in IS cells compared to both blood leukocytes (p≤0.05) and NC (p&lt;0.001), and were biologically older than COPD patients (p&lt;0.05). These findings suggest the need for monitoring aging in pauci- and asymptomatic COVID-19 survivors, who represent the majority of the general population.

A power factor correction (PFC) rectifier is compulsory for any electronic circuitry connected to the electrical grid. The majority of PFCs that are utilized are based on a step-up converter that supplies high DC voltage at its output terminal. Electric vehicle battery voltage varies from a few hundred to almost a thousand volts. Thus, an additional conversion step is obligatory when designing an all-brand universal charger. This paper presents a new type of front-end versatile step up / down three voltage level PFC. The rectifier can operate in continuous conduction mode or discontinuous conduction mode. First, the rectifier’s principle of operation is described, and then an innovative rectifier is analyzed for continuous and discontinuous conduction modes. Finally, the proposed theory is experimentally validated in a multiplier-less dual loop mode at discontinuous conduction modes. It was shown that although there is no multiplier use in the control circuitry, the power factor is near unity. It was revealed that the rectifier could swing the output voltage from 50 V to 900 V while the input voltage was 230 Vrms. The innovative topology suits any standard PFC rectifier, three-level voltage supplement, and dual-stage low-voltage power supply.

Addressing the significant challenge in high-speed cotton dibbling operations in Xinjiang—specifically, the duck bill’s ("Duck bill" is a type of duck-billed bunch planting mechanism or component). shortened opening duration leading to seed throwing and floating—a new crawler-type delayed hole-forming mechanism has been designed. This mechanism extends the duck bill horizontally, thereby prolonging its opening time, enabling cotton sowing speeds of up to 6 km/h. Following agronomic principles for cotton planting, the overall layout of the crawler-type hole-forming mechanism, the structural parameters of the key components and the trajectory of the hole-forming are determined. We use the Discrete Element Method (DEM) and multi-body dynamics coupling method to simulate and analyze the motion process of the device. The fixed the tilt angle of the duck bill α(A), the depth of the duck bill hole-forming into the soil h(B), and the angle of rotation of the moving duck bill β(C) were taken as the experimental factors, with the longitudinal length of cotton seed hole (Y1) and the hole-forming depth of cotton seed hole (Y2) as the response values. The parameter range of each factor and the preliminary influence on the response value were determined through pre-experiments and single-factor simulation test. Based on RecurDyn-EDEM coupling, a quadratic regression orthogonal rotation combination simulation test was carried out. The results show that the order of the primary and secondary factors affecting the Y1 of the time-lapse hole-forming device was: A > C > B. The order of primary and secondary factors affecting the Y2 of the delayed hole forming device was: B > C > A. When the A was 2.4 °, the B was 42.4 mm, and the C was 30.5 °, the performance of the hole-forming was the best, and the Y1 was 26.4 mm, and the Y2 was 25.0 mm. The bench verification test results show that under the optimized combination of operating parameters, the average Y1 was 29.1 mm, and the average Y2 was 23.2 mm. Compared with the results of the previous coupled simulation model, the average relative errors of the two are 7.23 % and 4.36 %, respectively, indicating the accuracy and effectiveness of the established DEM simulation model and virtual test analysis. The hole-forming area and the opening time of the duck bill after the stable operation of the machine were recorded and measured. The calculated hole dislocation rate Hc was 4.33 %, which did not exceed the national standard requirement of 6 %. The qualified rate of hole distance Hx was 94.33 %, which was much higher than the national standard requirement of 80 %. The average opening time of the duck bill at a speed of 6 km/h is 0.45 s, which is much longer than the time required for cotton seeds to fall from the duck bill 0.11 s. It meets the requirements of high-speed cotton planting in China and facilitating advancements in future high-speed planter technology.

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.

The fractional advection-dispersion equation FADE plays an important role, especially in explaining the process of solute-transport in natural porous media with different degrees of heterogeneity. However, studies of the flow and transport of contaminants in the underground environment are based on the knowledge of many functional parameters of the subsoil. The delay factor caused by nonlinear absorption is one of these parameters inheriting significant ambiguities in its estimation in heterogeneous media. In the study, a fractional advection-dispersion FADE model was developed by the implicit Euler method, based on a Grunwald and Caputo-Liousville approximation to explicitly evaluate and simulate the transport mechanism of contaminants in media with unsaturated porous materials subjected to a nonlinear sorption model. Better solute mass retention was observed for fractional advection-dispersion FADE model. Moreover, the absorption parameter of the retardation coefficient has a better impact on the motion of the solute in a saturated porous medium. In other words, it has a significant effect on the dispersion of pollutants in aquifers. This study highlights the need to characterize the aquifer to predict solute transport in porous media.

This paper proposed a three-layer distributed simulation network architecture: 1. Distributed virtual simulation network, 2. Perception and control sub-network, and 3. Collaborative communication service network. This simulation architecture runs on a distributed platform. The platform can provide a unique virtual scenario and several simulation services to verify the individual robot system's basic perception, control, and planning algorithms and the distributed collaborative algorithms of heterogeneous multi-robot systems. Furthermore, we designed a simulation experiment scenario for classical heterogeneous robot systems such as unmanned aerial vehicles (UAVs) and unmanned ground vehicles (UGVs). At last, We gave a rough estimation model of the bandwidth.

The shear stress generated by wall turbulence is the main cause of wall friction resistance in turbulent flow through pipes. This paper investigates the impact of inserting rest periods (regions of constant Reynolds number) within the pulsating operating cycle of velocity on the fully turbulent flow at large time-averaged Reynolds numbers, using the Large Eddy Simulation (LES) method. The study aims to explore the effect of increasing rest periods within pulsations on drag resistance. The dimensionless shear stress and drag reduction rates during different time periods of rest were analyzed. Numerical simulation results indicate that the pulsating velocity operation mode does not necessarily lead to drag reduction; it may even result in increased resistance. Inserting rest periods within the pulsation cycle can achieve drag reduction effects, with the maximum drag reduction rate reaching 21.8\%. Comparisons with experimental data and Direct Numerical Simulation (DNS) from the literature validate the feasibility of using the LES method for pipe pulsating operation modes.

Tinnitus is a common phantom auditory percept, believed to be related to plastic changes in the brain due to hearing loss. However, tinnitus can also occur in absence of any clinical hearing loss. Then, since there is no hearing loss, the mechanisms that drive plastic changes remain largely enigmatic. Previous studies showed subtle differences in sound-evoked brain activity associated with tinnitus in subjects with tinnitus and otherwise, normal hearing, but the results are not consistent across studies. Here, we aim to investigate those differences using monaural rather than binaural stimuli. Sound-evoked responses were measured using functional magnetic resonance imaging (MRI) in participants with and without tinnitus. All participants had clinically normal audiograms. The stimuli were pure tones with frequencies between 353 and 8000 Hz, presented monaurally. A Principal Component Analysis (PCA) of the response in the auditory cortex revealed no difference in tonotopic organization, which confirmed earlier studies. A GLM analysis showed hyperactivity in the lateral areas of the bilateral auditory cortex. Consistent with the tonotopic map, this hyperactivity mainly occurred in response to low stimulus frequencies. This may be related to hyperacusis, which was associated with tinnitus found in the parahippocampus. This may reflect an interference between tinnitus and spatial orientation.

In the recent years, tubular nanostructures have been related with immense advances in various fields of science and technology. Considerable research efforts have been centered on the theoretical prediction and manufacturing of non-carbon nanotubes (NTs), which meet modern requirements for the developing of novel devices and systems. In this context, diatomic inorganic nanotubes formed by atoms of elements from the 13th group of the periodic table (B, Al, Ga, In, Tl) and nitrogen (N), have received much research attention. In the present work, the elastic properties of single-walled boron nitride, aluminium nitride, gallium nitride, indium nitride and thallium nitride nanotubes were numerically evaluated using the nanoscale continuum modelling approach (also called molecular structural mechanics). The elastic properties (rigidities, surface Young´s and shear moduli, and Poisson´s ratio) of nitride nanotubes are discussed with respect to the bond length of the corresponding diatomic hexagonal lattice. The results obtained contribute to a better understanding of the mechanical response of nitride compound-based nanotubes, covering a broad range from the well-studied boron nitride NTs to the hypothetical thallium nitride NTs.

Taking due account of users' perspectives is crucial for improving the quality of healthcare services. This study aimed to analyse the representations and evaluation criteria that users of a public health agency express towards care and treatment services and to explore whether and how the content and meaning of their communications varied according to pre-pandemic, pandemic or post-pandemic periods. 501 communications (73.4% complaints, 16% appreciations, 10.6% enquiries) sent to the public relations office of an Italian health agency were collected. An automatic content analysis procedure (ACASM) was applied to the textual corpus. Four main thematic cores were identified concerning the request for care and respect, the value of the doctor-patient relationship and the difficulties in contacting services and accessing care. Two main latent dimensions of meaning were identified, which capture the dialectic between the demand for relationships and the demand for access to care, and between attention to the relational competence of health workers and attention to the needs and rights of users. Communications collected during the pre-pandemic and post-pandemic periods mainly concern the difficulty of access to care; those collected during the pandemic period mainly concern the doctor-patient relationship. Interpersonal aspects and timely access to care appear to be crucial in users' assessment of the quality of care.

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.

Although, promotion of urbanization culture in recent decades has made inevitable development of cities in the world, however, the development can be guided in a direction that leave, to the extent possible, minimum socioeconomic and environmental impacts. For this, it is required to first forecast auto-spreading orientation of cities and suburbs in rural areas over time and then avoid shapeless growth of cities. This paper is an attempt to develop a dynamic hybrid model based on logistic regression (LR), Markov chain (MC), and cellular automata (CA) for prediction of future urban sprawl in fast-growing cities. The model was developed using 12 widely-used urban development criteria, whose significant coefficient was determined by logistic regression, and validated by relative operating characteristic (ROC) analysis. The validated model was run in Guilan, a tourist province in northern Iran with a very high rate of urban development. For this, changes in the area of urban land use were detected over the period of 1989 to 2013 and then, future sprawl of the province was forecasted by the years 2025 and 2037. The analysis results revealed that the area of urban land use was increased by more than 1.7 % from 36012.5 ha in 1989 to 59754.8 ha in 2013, and the area of Caspian Hyrcanian forestland was reduced by 31628 ha. The results also predicted an alarming increase in the rate of urban development in the province by the years 2025 and 2037, during which urban land use is predicted to develop 0.9 % and 1.38 %, respectively. The development pattern is expected to be uneven and scattered, without following any particular direction. The development will occur close to the existing or newly-formed urban basements as well as around major roads and commercial areas. This development, if not controlled, will lead to the loss of 13863 ha of Hyrcanian forests and if the trend continues, 21013 ha of Hyrcanian forests and 20208 ha of Barren/open lands are expected to be destroyed by the year 2037. In general, the proposed model is an efficient tool for the support of urban planning decisions and facilitates the process of sustainable development of cities by providing decision-makers with an overview on future development of cities where the growth rate is very fast.

In this work, two plasmonic structures with two different periodic nanostructures (nanodisk and nanostrip arrays) separated from the gold layer by an ultrathin dielectric Al2O3 layer are proposed, and their optical properties are simulated as 3-dimensional models using COMSOL Multiphysics software tool. The optical responses, such as the amplification of the electric field and the scattering, absorption and extinction cross sections of the two structures, are investigated and compared. The results show that both structures show strong field enhancement in their gap layer, and the structure with the periodic array of metal nanodisks shows stronger field enhancement and larger absorption, extinction, and scattering cross sections in its dipole resonance wavelength, which is defined as a bright plasmonic mode. In addition, some weaker resonant modes are observed for both structures and the reason for their generation is dis-cussed. The analysis of different possible modes in such structures is crucial for their application in various fields.

Ambulatory heart rate (HR) monitors that acquire electrocardiogram (ECG) or/and photoplethysmographm (PPG) signals from the torso, wrists, or ears are notably less accurate in tasks associated with high levels of movement compared to clinical measurements. However, reliable estimation of HR can be obtained through data fusion from different sensors. These methods are especially suitable for multimodal hearable devices, where heart rate can be tracked from different modalities, including electrical ECG, optical PPG, and sounds (heart tones). Combined information from different modalities can compensate for single source limitations. In this paper, we evaluate the possible application of data fusion methods in hearables. We assess data fusion for heart rate estimation from simultaneous in-ear ECG and in-ear PPG, recorded on eight subjects while performing 5-minute sitting and walking tasks. Our findings show that data fusion methods provide a similar level of mean absolute error as the best single-source heart rate estimation but with much lower intra-subject variability, especially during walking activities. We conclude that data fusion methods provide more robust HR estimation than a single cardiovascular signal. These methods can enhance the performance of wearable devices, especially multimodal hearables, in heart rate tracking during physical activity.

Gas and power networks are tightly coupled and interact with each other due to physically interconnected facilities. In an integrated gas and power network, a contingency observed in one system may cause iterative cascading failures, resulting in network wide disruptions. Therefore, understanding the impacts of the interactions in both systems is crucial for governments, system operators, regulators and operational planners, particularly, to ensure security of supply for the overall energy system. Although simulation has been widely used in the assessment of gas systems as well as power systems, there is a significant gap in simulation models that are able to address the coupling of both systems. In this paper, a simulation framework that models and simulates the gas and power network in an integrated manner is proposed. The framework consist of a transient model for the gas system and a steady state model for the power system based on AC-Optimal Power Flow. The gas and power system model are coupled through an interface which uses the coupling equations to establish the data exchange and coordination between the individual models. The bidirectional interlink between both systems considered in this studies are the fuel gas offtake of gas fired power plants for power generation and the power supply to LNG terminals and electric drivers installed in gas compressor stations and underground gas storage facilities. The simulation framework is implemented into an innovative simulation tool named SAInt (Scenario Analysis Interface for Energy Systems) and the capabilities of the tool are demonstrated by performing a contingency analysis for a real world example. Results indicate how a disruption triggered in one system propagates to the other system and affects the operation of critical facilities. In addition, the studies show the importance of using transient gas models for security of supply studies instead of successions of steady state models, where the time evolution of the line pack is not captured correctly.

In this paper, the boiling flow inside a nanochannel with 700000 argon particle has been simulated by molecular dynamics (MD) simulation. This approach has been employed to analysis the superheated flow and its heat transfer pattern as well. For all simulations an external thrust force varying from 1 PN to 12 PN is exerted on inlet nanoparticles along the channel to have the forced annular boiling flow. Computations reveal that saturation condition and superheat degree have significant impacts on the liquid-vapor interface. Furthermore, because of the major influence of surface tension throughout a nanochannel, the x-velocity of liquid film and vapor core has not considerable fluctuations and stay smooth. All provided results show the behaviors completely similar to the available outcomes in the literature.

Background: This study aimed to evaluate the burden and impact of cardiac and cerebrovascular disease (CCD) on hospital inpatients with type 1 diabetes mellitus (T1DM). Methods: This is a retrospective nationwide cohort study of people with T1DM with or without CCD in the US National Inpatient Sample between 2016 to 2019. The in-hospital mortality rates, length of stay (LoS) and healthcare costs were determined. Results: A total of 59,860 T1DM patients had a primary diagnosis of CCD and 1,382,934 did not. The median LoS was longer for patients with CCD compared to no CCD (4.6 vs. 3 days). Patients with T1DM and CCD had greater in-hospital mortality compared to those without CCD (4.1% vs. 1.1%, p&lt;0.001). The estimated total care cost for all patients with T1DM with CCD was approximately US $326 million. The adjusted odds of mortality compared to patients with non-CCD admission was greatest for intracranial hemorrhage (OR 17.37, 95%CI 12.68-23.79), pulmonary embolism (OR 4.39, 95%CI 2.70-7.13), endocarditis (OR 3.46, 95%CI 1.22-9.84), acute myocardial infarction (OR 2.31, 95%CI 1.92-2.77) and stroke (OR 1.47, 95%CI 1.04-2.09). Conclusions: The burden of CCD in patients with T1DM is substantial and significantly associated with increased hospital mortality and high healthcare expenditures.

Surgical simulators are crucial in early craniofacial and plastic surgical training, necessitating synthetic materials that accurately replicate tissue properties. Recent critiques of our lab’s currently deployed silicone surrogate have highlighted numerous areas for improvement. To further refine our models, our group's objective is to find a composition of materials that is closest in fidelity to native oral mucosa during surgical rehearsal by expert craniofacial surgeons. Fifteen platinum silicone-based surrogate samples were constructed with variable hardness and slacker percentages. These samples underwent evaluation of tactile sensation, hardness, needle puncture, cut resistance, suture retention, defect repair, and tensile elasticity. Expert craniofacial surgeon evaluators provided focused qualitative feedback on selected top-performing samples for further assessment and statistical comparisons. Evaluation revealed surrogate characteristics with satisfactory to good performance. Sample 977 exhibited the highest performance, and comparison with the original surrogate (sample 810) demonstrated significant improvements in critical areas, emphasizing the efficacy of the refined composition. The study identified a silicone composition that directly addresses the feedback received by our team’s original silicone surrogate. The study underscores the delicate balance between biofidelity and practicality in surgical simulation. The need for ongoing refinement in surrogate materials is evident to optimize training experiences for early surgical learners.

Surgical simulators are crucial in early craniofacial and plastic surgical training, necessitating synthetic materials that accurately replicate tissue properties. Recent critiques of our lab’s currently deployed silicone surrogate have highlighted numerous areas for improvement. To further refine our models, our group's objective is to find a composition of materials that is closest in fidelity to native oral mucosa during surgical rehearsal by expert craniofacial surgeons. Fifteen platinum silicone-based surrogate samples were constructed with variable hardness and slacker percentages. These samples underwent evaluation of tactile sensation, hardness, needle puncture, cut resistance, suture retention, defect repair, and tensile elasticity. Expert craniofacial surgeon evaluators provided focused qualitative feedback on selected top-performing samples for further assessment and statistical comparisons. Evaluation revealed surrogate characteristics with satisfactory to good performance. Sample 977 exhibited the highest performance, and comparison with the original surrogate (sample 810) demonstrated significant improvements in critical areas, emphasizing the efficacy of the refined composition. The study identified a silicone composition that directly addresses the feedback received by our team’s original silicone surrogate. The study underscores the delicate balance between biofidelity and practicality in surgical simulation. The need for ongoing refinement in surrogate materials is evident to optimize training experiences for early surgical learners.

To address the requirements of sonar imaging, such as high receiving sensitivity, wide bandwidth, wide receiving angle, an AlN PMUT with an optimized ratio of 0.6 for the piezoelectric layer diameter to backside cavity diameter is proposed in this paper. A sample AlN PMUT is designed and fabricated with SOI substrate-based bulk MEMS process. The characterization test result of the sample demonstrates a -6 dB bandwidth of approximately 500 kHz and a measured receiving sensitivity per unit area of at 1.37 V/μPa/mm2, which significantly surpasses the performance of previously reported PMUTs. The -6 dB horizontal angles of the AlN PMUT at 300 kHz and 500 kHz are measured 68.30° and 54.24°, respectively. To achieve an accurate prediction of its characteristics when being packaged and assembled in a receive array, numerical simulations with the consideration of film stress are conducted. The numerical result shows a maximum deviation of ±7% in the underwater receiving sensitivity across the frequency range of 200 kHz to 1000 kHz and a deviation of about 0.33% in the peak of underwater receiving sensitivity comparing to the experimental data. By such good agreement, the simulation method reveals its capability of providing theoretical foundation for enhancing the uniformity of the AlN PMUTs in future studies.

This study investigates the impact of vertical greenery systems (VGS) applied to heavyweight walls on indoor thermal conditions in a building module situated in the Mediterranean climate of Catania, Italy. Using dynamic simulations in TRNSYS, the research compares the thermal behavior of walls constructed from hollow clay blocks (Poroton) and lava stone blocks with a lightweight wall setup already in place at the University of Catania. The primary focus is on evaluating the VGS’s effect on reducing peak inner surface temperatures and moderating heat flux fluctuations entering the building. The findings indicate that adding a vertical greenery layer to heavyweight walls can decrease the peak inner surface temperature by up to 1.0°C compared to the same wall without vegetation. However, the greenery’s impact on mitigating heat flux fluctuations is less pronounced than in the case of the lightweight wall. This research underscores the potential of green facades in enhancing indoor thermal comfort in regions with climates similar to the Mediterranean, providing valuable insights for sustainable building design and urban planning.

Toll-like receptor 4 (TLR4) is a member of the TLR family. Members of the TLR family play an important role in innate immune responses and are induced by recognition of pathogen-associated molecular patterns. They are also involved in cell proliferation and apoptosis in cancer. We investigated the role of TLR4 in apoptotic cell death in gynecological cancer cells; gynecological cancer is associated with infertility and spontaneous abortion. To examine the effect of TLR4 activation on apoptotic signaling in cancer cells, cultured primary cancer cells were treated with the TLR4 agonist lipopolysaccharide (LPS). The morphology of cancer cells was compared with normal myometrial cells. Enhanced growth rate and loss of contact inhibition with cellular overlap was observed in the cancer cells. The molecular mechanism analysis revealed differential expression of tumor suppressor genes in LPS-treated cancer cells. The expression of apoptosis-related caspase-3 was increased significantly in cancer cells with TLR4 activation after exposure to LPS. Taken together, these results suggest the pro-apoptotic activity of TLR4 as a potential therapeutic target for the treatment of gynecological cancers.

This paper proposed three-dimensional numerical simulation method by coupling of electrostatic and fluid fields to evaluating the performance of electrical sensor in the concentration measurement of gas/solid two-phase flow. Compared with the static numerical simulation, this real-time dynamic 3-D simulation method can research on a designed capacitance sensor combining the dynamic characteristics of the two-phase flows for concentration measurement. Several fluid-electrostatic models of transmission pipes with different sensor structures are built. Under different test positions and different particle concentrations, the flow characteristics and the corresponding electric signals can be obtained, and the correlation coefficient between the concentration values and the capacitance values are used for performance evaluation of the sensors. The effects of flow regimes on concentration measurement are also been investigated in this paper. To validate the results of simulation, an experimental platform with horizontal straight pipe for phase volume concentration measurement of solid/air two-phase flow is built, and the experimental results agree well with simulation conclusions. The simulation and test results show that the coupling models can give constructive reference opinions for the sensor design and collection of installation position in different transmission pipelines, which are very important for the practical process of pneumatic conveying system.

: In this paper we present an optimization of the planar manufacturing scheme for stretch-free, shape induced metal interconnects to simplify the fabrication with the aim of maximizing the flexibility in the structure regarding to stress and strain. The Formation of trenches between silicon islands are actively used in the lithographic process to create arc shape structures by spin coating resist into the trenches. The resulting resist form is used as a template for the metal lines, which are structured on top. Because this arc shape is beneficial for the flexibility of these bridges. The trench depth as a key parameter for the stress distribution is investigated by applying numerical simulations. The simulated results show that the increase in penetration depth of the metal bridge into the trench increases the tensile load which is converted into a shear Force Q(x), that usually leads to increased strains the structure can generate. For the fabrication the filling of the trenches with resist is optimized by varying the spin speed. Compared to the theoretical resistance, the current-voltage measurements of the metal bridges show a similar behavior and almost every structural variation is capable of functioning as a flexible electrical interconnect in a complete island-bridge array.

Hydraulic fracturing has enabled production from unconventional reservoirs in the U.S., but production rates often decline sharply, limiting recovery factors to under 10%. This study optimizes the CO2 huff-n-puff process for multistage-fractured horizontal wells in Wolfcamp A formation in the Delaware Basin. The potential for enhanced oil recovery and CO2 sequestration simultaneously was addressed using a coupled geomechanics-reservoir simulation. Geomechanical properties were derived from a 1D mechanical earth model and integrated into reservoir simulation to replicate hydraulic fracture geometries. The fracture model was validated using a robust production history matching. Fluid phase behavior analysis refined the equation of state, and 1D slim tube simulations determined a minimum miscibility pressure of 4300 psi for CO2 injection. After the primary production phase, various CO2 injection rates were tested from 1 to 25 MMSCFD/well, resulting in incremental oil recovery ranging from 6.3% to 69.3%. Different injection, soaking, and production cycles were analyzed to determine the ideal operating condition. The optimal scenario improved cumulative oil recovery by 68.8% while keeping the highest CO2 storage efficiency. The simulation approach proposed by this study provides a systematic workflow for evaluating and optimizing CO2 huff-n-puff in hydraulically fractured wells, enhancing the recovery factor of unconventional reservoirs.

Artificial Intelligence (AI) is revolutionizing decision-making procedures in healthcare information systems (HIS), increasing the efficacy, accuracy, and personalization of healthcare. Notwithstanding remarkable progresses, yet there remain gaps in the holistic comprehension and implication of AI-driven technologies across various HIS scenarios. These gaps, consisting limited integration of AI across a variety of HIS parts and inadequate emphasize on interpretability and privacy, motivate our study to conduct a structured evaluation of recent AI applications in this domain. In this study, we present a novel taxonomy for the AI implication in medical decision-making. We analyzed 30 articles and categorized them into six groups including: Clinical Decision Support Systems (CDSS), Predictive Analytics, Natural Language Processing (NLP), Computer-Aided Diagnostics (CAD), Robotic-Assisted Surgery, and Virtual Health Assistants (VHAs/chatbots). Our study aims to propose a holistic perspective of the fast evolving perspective of AI in HIS. The majority of the investigated studies were published from 2023 and 2022, with Springer as the leading publisher (33%). Python and MATLAB were the most well-known simulation languages, applied in 48% and 20% of the papers, respectively, reflecting the technical trends in the area. By emphasizing on pivotal criteria like interpretability, accuracy, and privacy, this research aims to elucidate the crucial issues and development driving AI-driven decision-making in HIS.

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.

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.

Utilization of wasted heat instead of fuel combustion is effective to reduce primary energy consumption for mitigating global warming problem. Because wasted heat sources are not necessarily located close to areas of heat demand, one of the difficulties is that wasted heat has to be transferred from heat source side to heat demand side, which may require heat transportation over long distance. From this point we proposed and have examined new idea of heat transportation using ammonia-water as the working fluid which system is named Solution Transportation Absorption chiller, in short STA. Our previous studies of STA were mainly the experimental investigation with STA facility which cooling power was 25RT (90kW). As a result, the COP of STA was found almost same value 0.65 with the conventional absorption chiller without depending on the transportation distances. The simulation using AspenHYSYS also examined with same experimental condition. The experimental data showed good agreement with the simulation calculation. In this study, we examined the large-scale cooling power STA on simulation. The examination cooling powers were from 90 kW(25RT) to 3517 kW(1000RT). All cooling power achieved around COP 0.64 including pump power consumptions. In addition, we performed the dynamic simulation. As the results, there was no effect of pipeline size on the cooling capacities and mass flow rates. Furthermore, the stability time of the cooling capacities and mass flow rates were almost same regardless of the pipeline size and cooling capacity. In other words, STA may be achieved the same COP even though having various complex conditions compared with the conventional absorption chiller.