Over the past decade and a half, dynamic functional imaging has revolutionized the neuroimaging field. Since 2009, it has revealed low dimensional brain connectivity measures, has identified potential common human spatial connectivity states, has tracked the transition patterns of these states, and has demonstrated meaningful alterations in these transition and spatial patterns in neurological disorders, psychiatric disorders, and over the course of development. Recently, researchers have begun to analyze this data from the perspective of dynamic system and information theory in the hopes of understanding how these dynamics support less easily quantified processes, such as information processing, cortical hierarchy, and consciousness. Consciousness, in particular, appears to be strongly linked to entropy production in the brain. Little attention has been paid to the effects of psychiatric disease on entropy production in the human brain, however. Even disorders characterized by substantial changes in conscious experience have not been widely analyzed from this perspective. We begin to rectify this by examining the complexity of subject trajectories in state space through the lens of information theory. Specifically, we identify a basis for the dynamic functional connectivity state space and track subject trajectories through this space over the course of the scan. The dynamic complexity of these trajectories is assessed along each dimension of the proposed basis space. Using these estimates, we demonstrate that schizophrenia patients display substantially simpler trajectories than demographically matched healthy controls, and that this drop in complexity concentrates along specific dimensions. We also demonstrate that entropy generation in at least one of these dimensions is linked to cognitive performance. Overall, results suggest great value in applying dynamic systems theory to problems of neuroimaging and reveal a substantial drop in the complexity of schizophrenia patients’ brain function.

Background: Endovascular treatment of popliteal aneurysms (PA) has increased in the last few years, quickly becoming the main treatment in many vascular centers, based on the acceptable and promising outcomes reported in the literature. However, endograft infections are the most dangerous complication as a serious local compromise and usually require open surgical conversion and device explantation to preserve the affected extremity. Case report: We reported two patients admitted to the emergency room for pain and edema in the lower leg. Both patients have undergone exclusion of ruptured PA a few years before by endovascular graft. CTA showed a significant volume of fluid-corpuscular collection related to perianeurysmal abscess collection in both cases. Blood cultures and drained material cultures were positive for Staphylococcus Capitis in the first case and S. Aureus in the second. The antibiotics prophylaxis was performed for 10 days, then, patients underwent an open surgical conversion with a complete explantation of endovascular material and a femoro-popliteal bypass using an autologous vein in the first case and biological bovine pericardium prosthesis in the other case. Furthermore, we have questioned the literature and found eight more cases described in case report article referred to popliteal graft infections by different microorganisms, mostly presenting acute limb ischemia as the first symptom and suggesting endograft explantation with open conversion and autologous vein bypass as the commonest therapeutic choice. Conclusions: Open surgical conversion of popliteal endograft infection is the best strategy to manage peripheral infection of the popliteal stent.

This research is dedicated to a comprehensive examination of the strengths and weaknesses inherent in the legal and institutional measures designed to protect cultural heritage in the Republic of Serbia from the adverse effects of natural disasters, including earthquakes, landslides, rockfalls, floods, torrents, storms, hail, and forest fires. The study aims to identify the primary challenges and shortcomings within the existing legal and institutional framework, while also pinpointing and analyzing best practices and potential improvements for the protection system. This research posits a preliminary hypothesis suggesting that challenges may exist within the legal and institutional framework for the protection of cultural heritage in the Republic of Serbia, potentially limiting effective response and recovery following natural disasters. This hypothesis will be further developed and adapted based on the analysis of available data. Data collection for this research was conducted through semi-structured interviews with experts and an in-depth analysis of existing documentation. By conducting interviews with experts in the field, the research seeks to gather critical data and insights that will enhance the understanding of these issues and contribute to formulating viable solutions. The analysis and processing of data were carried out using ATLAS.ti software, which facilitated a comprehensive and systematic examination of the collected qualitative information. Furthermore, an assessment of the current capacity of institutions to respond rapidly and effectively to natural disasters that pose a threat to cultural heritage is a key component of the study. The ultimate goal is to develop recommendations that will fortify the legal and institutional framework, thereby bolstering the resilience of cultural heritage sites in Serbia against future natural disasters. The results of the research, highlight significant deficiencies in the legal framework, inadequate institutional capacities and resources, as well as a lack of proper training for crisis response. The need for improved inter-institutional cooperation and the development of technical-logistical resources is emphasized. This paper represents a significant contribution to the understanding and enhancement of the cultural heritage protection system, providing a foundation for further research and strategy development in this area.

Debates regarding human capital disclosure (HCD) emphasise the usefulness of people-related information in stimulating investor confidence and building stakeholder trust. Despite this, human capital (HC) information is interwoven in most international sustainability reporting standards such as the global reporting initiative (GRI), thereby concealing the impact of human resource (HR) practices in shareholder value creation. The aim of this study is to develop a taxonomy to assess HCD in the sustainability reports to capture the true value of HC distinctively. A content analysis-based study with a deductive approach was followed by utilising the GRI standards to isolate and classify people-related information into an HCD sustainability taxonomy. 40% HC metrics were extracted from the GRI standards and subsequently classified into 7 dimensions, namely, human capital allocation, human capital wellbeing, human capital investment, human capital network, human capital governance, human capital risk and human capital earnings. Furthermore, 40 GRI content indexes of the companies listed in the Johannesburg Stock Exchange (JSE) revealed that most disclosures are covered in the human capital governance and human capital earnings categories. HCD sustainability provides investors and HR professionals with a useful tool to assess people-related information from the sustainability reports for isolating the true value of HC.

We previously reported our initial experience of subxiphoid single-port robotic-assisted thoracic surgery (SRATS) thymectomy using the single-port robotic surgical system (SPS). However, the potential benefits of this technique remain unknown. Thus, this study examined the multi-institutional experience of SRATS thymectomy and compared perioperative outcomes of this technique with those of subxiphoid single-port video-assisted thoracic surgery (SVATS) thymectomy. Data of patients who underwent subxiphoid SRATS and SVATS thymectomy performed by three thoracic surgeons at three institutions between September 2018 and May 2024 were retrospectively collected. In total, 110 patients were included, with 85 and 25 undergoing SRATS and SVATS thymectomy, respectively. No significant differences were noted in the total operative time (154.46±74.06 vs. 146.76±67.07 min, P=0.674) and conversion rate to median sternotomy (0% vs. 4 %, P=0.227) between the two groups. The SRATS group was associated with a lower conversion rate to multi-port surgery (2% vs. 20%, P=0.006), shorter chest tube drainage duration (1.40±0.94 vs. 2.00±1.29 days, P=0.001), and shorter postoperative hospital stay (2.87±1.26 vs. 5.08±5.20 days, P=0.007). Subxiphoid SRATS thymectomy using the SPS is feasible and can be a good alternative to conventional minimally invasive thymectomy. Further large-scale randomized controlled studies are needed to confirm its benefits.

Environmental, social, and governance (ESG) investment has become a common trend in capital markets, and many institutional investors have publicly declared their long-term ESG investment target (ESGIT). This study focuses on investors who conduct strategic asset allocation (SAA) using composite indices but establish their ESGIT outside the SAA process. A mismatch could arise between investors’ planned and actual portfolios because they must pursue their ESGIT by asset selection, which inevitably makes the constituents of their portfolios different from those of composite indices. To scrutinize the potential existence of a misalignment between their SAA and ESGIT, this study analyzes actual stock and bond indices over the past decade using traditional mean-variance optimization. The results reveal significant differences between the expected and realized performances, and the misalignment is more significant when the analysis period is divided into two sub-periods: stable and volatile. Specifically, the results indicate that the efficient frontier constructed using ESG indices significantly differs from that constructed using composite indices, and that the difference between these two efficient frontiers becomes more significant during volatile periods. Furthermore, the results show that investors cannot meet their targets if their ESGIT is established outside the SAA process.

The transition to sustainable energy systems in the Middle East and North Africa (MENA) region addresses critical challenges of environmental protection, energy security, and socio-economic resilience. Using neo-institutional theory, this paper examines the intricate relationship between formal and informal institutions and their significant impact on the region’s energy transition. Despite the MENA region’s abundant renewable energy resources, numerous institutional barriers, such as governance inefficiencies, regulatory inconsistencies, and entrenched socio-cultural norms, significantly hinder this transition. Through a review of existing literature, this study presents a comprehensive analytical framework designed to overcome these barriers, with a focus on the Just and Sustainable Energy Transition model. This strategic model emphasizes equity, sustainability, and inclusive governance as pillars for reform. The study offers detailed recommendations for institutional change and underscores the importance of collaborative efforts among governments, industry stakeholders, and international partners to unlock the MENA region’s renewable energy potential, advance global sustainability goals, and ensure a more secure and resilient energy future.

Effective water resources management requires assessments of water availability within a framework of complex institutions and infrastructure employed to manage extremely variable stream flow shared by numerous often competing water users and diverse types of use. The Water Rights Analysis Package (WRAP) modeling system is fundamental to water allocation and planning in the state of Texas in the United States. Integration of environmental flow standards into both the modeling system and comprehensive statewide water management is a high priority for continuing research and development. The public domain WRAP software and documentation are generalized for application any place in the world. Lessons learned in developing and implementing the modeling system in Texas are relevant worldwide. The modeling system combines: (1) detailed simulation of water right systems, interstate compacts, international treaties, federal/state/local agreements, and operations of storage and conveyance facilities; (2) simulation of river system hydrology; and (3) statistical frequency and reliability analyses. The continually evolving modeling system has been implemented in Texas by a water management community that includes the state legislature, planning and regulatory agencies, river authorities, water districts, cities, industries, engineering consulting firms, and university researchers. The shared modeling system contributes significantly to integration of water allocation, planning, system operations, and research.

In recent years, Ethiopia's number of returnee entrepreneurs has increased dramatically, significantly contributing to personal financial achievement and the nation's economic development and transformation. However, their businesses are typically smaller and less profitable than non-migrant entrepreneurs. This study explores factors affecting the success of these returnee migrant entrepreneurs, including individual characteristics, entrepreneurial skills, and experience, financial resources, as well as the mediating role of government policies and institutional support. Data was collected from 390 returnee migrants who started their businesses and analyzed using a robust theoretical foundation and PLS-SEM to understand the impact of success factors. The results show that entrepreneurial skills, experience, and financial resources positively and significantly influence the success of returnee migrant entrepreneurs. Furthermore, social networks, while not directly significantly influencing the entrepreneurial success of returnee migrants are mediated by government policies and institutional support. Professional guidance and counseling provided by experts and mentors of the accelerator program were found to be essential for entrepreneurial success but did not improve the effectiveness of the policy. Financial resources, although crucial, did not significantly impact policy efficacy. These findings underscore the need for tailored policy interventions addressing the challenges faced by returnee migrants, including economic self-sufficiency, socio-psychological support, and effective social networks to boost the success of returnee migrants. Experienced returnee entrepreneurs play a key role in developing a vigorous and supportive entrepreneurial ecosystem through community engagement and policy advocacy. Additionally, personal traits are crucial for entrepreneurial success, while practical experience influences government policies for substantiated policy development in returnee migrant entrepreneurship and its benefits.

Accurate stock market predictions following earnings reports are crucial for investors. Traditional methods, particularly classical machine learning models, struggle with these predictions because they cannot effectively process and interpret extensive textual data contained in earnings reports and often overlook nuances that influence market movements. This paper introduces an advanced approach by employing Large Language Models (LLMs) instruction fine-tuned with a novel combination of instruction-based techniques and quantized low-rank adaptation (QLoRA) compression. Our methodology integrates ‘base factors’, such as financial metric growth and earnings transcripts, with ‘external factors’, including recent market indices performances and analyst grades, to create a rich, supervised dataset. This comprehensive dataset enables our models to achieve superior predictive performance in terms of accuracy, weighted F1, and Matthews correlation coefficient (MCC), especially evident in the comparison with benchmarks such as GPT-4. We specifically highlight the efficacy of the llama-3-8b-Instruct-4bit model, which showcases significant improvements over baseline models. The paper also discusses the potential of expanding the output capabilities to include a ‘Hold’ option and extending the prediction horizon, aiming to accommodate various investment styles and time frames. This study not only demonstrates the power of integrating cutting-edge AI with fine-tuned financial data but also paves the way for future research in enhancing AI-driven financial analysis tools.

Objective Ovarian pregnancy is a rare but well-known pathology. However, pathophysiology, diagnosis and treatment are not clearly established. Data sources. All case reports published in Pubmed from Nov 2011 till Nov 2022. Study eligibility criteria. A systematic review and 2 case reports of ovarian pregnancy Study appraisal and synthesis methods. Not applicable Results Ovarian pregnancies occur in 8% of women without or blocked oviducts and in 23% on the other side than the corpus luteum and the symptoms of ovarian pregnancies are not specific. Therefore ovarian pregnancy has to be suspected in all women with abdominal bleeding. As for extrauterine pregnancies, the presence of an intrauterine pregnancy does not rule out an ovarian pregnancy. Surgical excision is the preferred treatment. Important is that in women with both an intra-uterine and an ovarian pregnancy, care should be taken not to damage the corpus luteum. Conclusions Ovarian pregnancies can occur in women with blocked tubes, on the other side of the corpus luteum, in the presence of an intrauterine pregnancy, and even when pregnancy tests or tranvaginal ultrasonography are negative. The diagnosis being difficult to exclude, a laparoscopy is indicated in all women with intra-abdominal bleeding, keeping in mind that an intra-uterine pregnancy cannot be exluded and that a corpus luteum need to be respected.

The hypothesis posed was whether participation in LaLiga Genuine Santander (competitive football) influenced the quality of life (QL) of the people who participated in it, since their perception of themselves is enhanced by all the aformentioned factors (self-determination, social inclusion, emotional well-being, physical well-being, material well-being, rights, personal development, interpersonal relationships). The objective was to evaluate the QL of people with Down's Syndrome (DS) using their self-perception (n=39) and the perception of the informants (family members, teachers) (n=39). The KidsLife-Down Scale, with a few modifications was used. In general, differences of opinion between the subgroups of participants with DS and informants showed that results were higher in terms of perception for participants in the DS subgroup. Scores for all variables were higher for those participants with DS who said they did engage in practicing competitive football. Despite the perception of informants provides a great deal of information regarding the QL of participants with DS, the latter should be involved in the evaluation process and their self perceptions taken into account. Our research shows that participation in the league modifies the perceptions of the participants with Down's Syndrome regarding their quality of life. However, these perceptions are not shared by the informants.

This study presents a strategic approach to developing applications focused on implementing Large Language Models using the Langchain framework in Python. Three language models are highlighted: GPT-3.5 (turbo mode), LLaMA 2, and Vicuna 7B, each with their distinctive features and capabilities. The methodology used is described in detail, including data extraction from medical reports using zero-shot prompting data extraction techniques, interaction with language models, and structured storage of results. The performance of the models in data extraction is evaluated, presenting metrics such as precision, recall, and F1 score. The results demonstrate high model capability in extracting information, although areas for improvement are identified, particularly in data extraction precision. In conclusion, the efficacy of the models in extracting information from medical histories is not considerably acknowledged, with an emphasis on the importance of improving precision and increasing the volume of trained data for future research in healthcare digitalization.

Crisis environments, which are becoming systemic, pose significant challenges to smart government strategies. The paper aims to contribute to academic debate by proposing an analytical framework for examining the institutional capacities of smart government systems in addressing local crises. The paper focuses on the recent approach of robust governance and highlights a set of variables that promote effective smart government: contingency planning capacity, analytical capacity, organizational management capacity, and collaborative capacity. The study presents an analytical model for evaluating the robustness and effectiveness of local smart government systems in crises. One of the significant findings of this study has been the identification of critical indicators that inform institutional capacities of smart government systems. By analyzing these indicators, the proposed analytical framework provides a comprehensive approach to assess the preparedness of smart government systems in dealing with crises. Moreover, it can be used to benchmark the performance of local smart government systems in similar contexts and identify best practices for improving crisis management.

The Science-Sustainability poses an interdisciplinary paradox. On the one hand, the science for sustainability has increased in OECD economies in and in China as well as in the US in particular; on the other hand; the sustainability situation has worsened (Co2 emission has risen). On the face value, the adverse correlation shows a paradox. However, without explicating the science-sustainability relationship, it leads to a premature conclusion. In this study, we have drawn on three concrete questions for concrete answers. First, whether and how interdisciplinary sciences—energy science and environmental science—contribute to the sustainability. Second, whether and how the Sino-US inter-institutional analysis varies in the science-sustainability paradox. The empirical analysis from a panel data in the interdisciplinary and inter-institutional context show mixed patterns in three ways. First, the increase in the environmental science shows an improvement in the sustainability; the energy science shows a decline in the sustainability. Second, the Chinese environmental science has a comparative advantage to American environment science for the sustainability development, and the Chinese energy science has a comparative disadvantage to the US in the sustainability development. Third, the environmental science mediates the energy science in the science-sustainability relationships. Standing alone, the increase in the energy science harms sustainability; mediated by environmental science, it benefits sustainability. The study explains the adverse role of energy science in Jevons Paradox. The study also offers some policy paths for further research how capitalisms differently innovate, form strategies, and implement the practice.

During public health events, Active Mobility (walking and cycling) plays an important role in securing residents' travel. To enhance the resilience of urban transportation, this article integrates the travel environment elements for walking and cycling and constructs a travel environment for Active Mobility evaluation index system. This article uses survey data from the main urban area of Harbin in the context of the COVID-19 pandemic in May 2022, and combines the Gradient Boosting Decision Tree (GBDT) and Impact-Asymmetry Analysis (IAA) methods to analyze the satisfaction of the travel environment for Active Mobility. It proposes strategies for optimizing the travel environment for Active Mobility, ensuring residents' travel during public health events, guiding them to adopt Active Mobility, and improving urban transportation resilience. This research shows that Active Mobility can enhance urban transportation resilience. In addition, there are differences in resident demand for walking and cycling environments in the travel environment for Active Mobility. Residents are more concerned about the comfort of the walking environment, while they prioritize the convenience of the cycling environment.

Background: DICER1, cancer predisposition syndrome (CPS), seems to escape timely diagnosis in pediatric patients. Case report 1: A 16-year-old female patient was referred to the endocrinology ward due to a large goiter. Her medical history indicated normal sexual maturation, with menarche occurring at 13.5 years. Over the past 2.5 years, she developed pronounced androgenic symptoms, including a deepened male voice, facial, back and neckline acne, hirsutism, and menstrual irregularities leading to secondary amenorrhoea. A thyroid ultrasound identified a multinodular goiter with cystic-solid lesions containing calcifi-cations. An abdominal ultrasound identified a 5.7x6.9 cm solid mass in the right adnexal region, displacing the uterus to the left. Histopathological examination confirmed a Sertoli-Leydig cell tumor. The patient was subjected to total thyroidectomy. Histopathology revealed benign follicular cell-derived neoplasms. Thyroid follicular nodular disease was diagnosed bilaterally. DNA analysis using NGS, confirmed by the Sanger method, revealed a pathogenic heterozygotic variant c.2953>T [p.Gln985*] in exon 18 of DICER1 gene. Case report 2: A 12-year-old male patient was admitted to the pediatric surgery unit due to a 33 ml goiter. A month prior to admission, the patient discovered a palpable nodule in his neck, accompanied by hoarseness. An ultrasound revealed a multinodular goiter. Molecular analysis revealed a pathogenic heterozygotic variant c.2782C>T [p.Gln928Ter] in exon 17 of DICER1 gene. Subsequently, a total thyroidectomy was performed, and histopathological examination revealed thyroid follicular nodu-lar disease bilaterally. Conclusion: Multinodular goiter, although rare in pediatric population, when accompanied by characteristic ultrasound and histopathological features, and by additional features such as androgen excess, warrants exclusion of DICER1 syndrome.

The corporate strategic planning of businesses in sub-Saharan Africa (SSA) largely focuses on immediate financial performances with minimal credence to social sustainability. Thus, studies on the linkage between corporate governance and sustainability reporting have focused on developed economies. This study therefore investigated the role of institutional ownership in the impact of board committee characteristics on social sustainability reporting. The study involved strongly balanced panel data with 1,969 observations of 275 publicly listed non-financial firms in SSA within the timeframe of 2012 to 2021. Data was analyzed using STATA 14.1. The hypotheses were tested using the two-step system of the generalized method of moment (GMM) using the Arellano-Bond dynamic panel-data estimation method. The rate of social sustainability reporting was 39.4%. Relatively, Mauritius and South African firms had the most effective board committee characteristics and higher levels of social sustainability reporting. Institutional ownership had no significant effect on social sustainability reporting. Institutional ownership moderated the effect of sustainability committee independence and sustainability committee gender diversity on social sustainability reporting negatively. The paper presents a new perspective on corporate governance and social sustainability literature by examining the effect of institutional ownership on board committee characteristics and social sustainability reporting in SSA.

Land and property development process include a series of multifaceted activities ranging from purchasing to converting it for development purposes and everything in between. The process itself encompasses multiple stakeholders, drivers, and contributions from diversified public and private actors and transaction cost arises out of their complex interaction. Transaction costs incurred during any kind of human interactions (i.e. transactions). Every actor involved in the process wishes to maximize his achievement under various constraints and hence institutional arrangement (i.e. set of humanly devised rules to administer the constraints) is necessary for efficient management of the development process. Therefore, to devise an optimum outcome out of economic and social transactions in the property development process, cooperative and competitive relationships between individuals should be understood from a broader socio-political and governance structure. In this research, it is critically argued that land and property development process should implicate a multifaceted set of formal and informal rules or institutional arrangement to govern the intrinsic interaction, action and thereby reducing the related transaction cost. The argument is further reproachfully evaluated and implicated in the urban development process through the myopic lens of Transit-oriented development (TOD) pathway. A vigilant combination of descriptive and explanatory research approach is adopted to analyze the connection between theory and practice.

Advanced persistent threat (APT) attacks are sophisticated and organized attacks commonly motivated by political, financial, and strategic objectives. In order to comprehend their tactics, techniques, and procedures (TTP) and indicators, APT reports are valuable sources. While blue teams typically rely on server logs, firewall rules and user authorizations managed in database tables, attackers have a graph-based mindset. In this work, we propose a framework for discovering and evaluating APTs using graph-based algorithms. Cyber threat intelligence (CTI) was extracted from 40,358 pages of APT reports and transformed into a graph. Centrality, community, and similarity analyses were executed on the graph. As a result, critical and influential APT groups and indicators of compromise (IoC) were discovered. Similar attacks and APT groups were revealed. Analysis results were interpreted to create new strategic CTI that can be utilized in future security operations.

Lahpet-ye-hsain, known as a “tea shop” or teahouse, is where the people of Myanmar conduct their daily social activities besides its economic orientation. They are private establishments and informal gathering places serving tea and food at different times of the day for various clients. They can be small snacks, large open-aired, or covered restaurants with extensive menus. Patrons sit around small square tables on footstools. A diverse range of characters goes to tea shops. They have a reputation for welcoming people from all backgrounds and walks of life, but the role of women is hardly seen and unclear. They provide a space for men to share a cup of tea and food and exchange ideas, opinions, problems, hopes, and aspirations. They provide not only space but also to get ‘good taste and cheap food.’ A cup of tea at a tea shop is an opportunity to share knowledge amongst old and new friends. Such shops are abundant over the country. This paper examines the social, political, and economic role of these ubiquitous features of Myanmar society. The barriers to women's participation and inroads in some locales are discussed.

The dynamic nature of international business necessitates a strategic approach to achieve sustainable value creation. This paper supports the hypothesis that understanding institutional constraints and leveraging organizational resources provides the foundation for sustainable value creation during international expansion. These elements provide a solid foundation for firms seeking to expand internationally by enabling them to effectively navigate the complexities of foreign markets. Using the context supplied by Peng (2023), the subsequent sections and subsections delve into critical facets of international expansion, including market integration, the role of entrepreneurial firms, entry strategies, supply chain establishment, multinational strategies, and the impact of global trade and foreign direct investment (FDI).

Cyclic neutropenia is a rare hematological condition characterized by periodic fluctuations in neutrophil counts, with a 21-day periodicity. Clinical presentation varies from mild to severe forms of the disease, with the onset of recurrent fever, painful oral ulcers, recurrent bacterial infections, peritonitis and septic shock. The availability of granulocyte colony-stimulating factor (G-CSF) has revolutionized the management and natural history of this disease, regulating the proliferation, differentiation and maturation of the progenitor cells, reducing the duration of neutropenia. Inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a group of chronic pathologies with involvement of the gastrointestinal tract. Symptoms include diarrhea, abdominal pain, fever, weight loss and extraintestinal manifestations (EIMs). In recent years, the focus of IBD therapy, including conventional therapies and biological therapies, has moved from treatment of symptoms to "deep remission" of the disease. The association between cyclic neutropenia and CD is rarely reported in the literature. Here, we describe two case reports of patients who underwent surgery because of diagnosis of complicated CD. After surgery, because of persistent neutropenia, the hematologist consultant confirmed suspicions of cyclic neutropenia and therapy with G-CSF was started with benefits, underlining the crucial importance of proper differential diagnosis.

probiotics. However, these bacteria caused rare infections mostly in diabetic and immunocompromised subjects in presence of risk factors such as prosthetic hearth valves and dental procedures or caries. The scope of this survey was re-assessing the pathogenic potential of lactobacilli based on the infection case reports published in the last three years. In 2019, 2020 and 2021 17, 15 and 16 cases, respective-ly,.including endocarditis, bacteremia and other infections, were reported. These annual numbers are higher than observed previously. Lacticaseibacillus rhamnosus (13 cases), comprising strain GG (ATCC 53103) with established applications in healthcare, L. paracasei (7 cases), Lactobacillus acidophilus (5 cas-es), L. jensenii (5 cases), Lactiplantibacillus plantarum (3 cases), L. paraplantarum, L. delbrueckii subsp. del-brueckii, L. gasseri, L. paragasseri, Limosilactobacillus fermentum and L. reuteri (1 case each) were involved. Virulence characterization of two strains that caused infections, a derivative of L. rhamnosus GG and L.paracasei LP10266, indicated that increased biofilm forming capacity favors pathogenicity and it is determined by variable genetic traits. This survey highlighted that strains of lactobacilli able to cause infections were little characterized genet-ically. Instead, to avoid that these bacteria become a hazard, genetic stability should be periodically re-evaluated by whole genome sequencing (WGS) to ensure that only non-pathogenic variants are ad-ministered to vulnerable individuals.

Aims: This study aimed at examining coach-athlete violence based on the retrospective reports of adults who had been athletes as children and adolescents; predict variables that contribute to the existence of such violence; describe difficulties that the participants encountered as young athletes following such violence; and reveal the outcomes of such violence on their emotions and behaviors, in the past and present. Methodology: The applied mixed-methods comprised quantitative self-reporting questionnaires and qualitative interviews. The former included 440 participants (mean age 27.6) who had trained for at least one year in a sports union youth department; the latter included 14 participants (aged 23-37). These competitive athletes came from eight branches of sports. The interviews were analyzed based on the Narrative Approach. Results: According to the quantitative study, all participants had experienced coach violence at least once during their career, mainly psychological violence and neglect, followed by physical violence. Sexual violence was least reported. The age of their retirement from sports and the number of coaches that they had had were significant predictors of violence. Thematic analysis of the qualitative interviews resulted in six types of coach-athlete violence: (1) psychological violence; (2) verbal violence; (3) starvation and food fattening; (4) non-proportional punishing; (5) physical violence; and (6) sexual violence. Conclusions: It is vital that coach-athlete violence is addressed in public discourse, that the topic of of young athletes’ safety is introduced into coaching education, and that a position holder is nominated to be in charge of such safety in all sports organizations.

Hereditary hemochromatosis (HH) is an inherited iron metabolism disorder. It is caused by an autosomal recessive disorder resulting from a C28Y8 HFE gene mutation. Mutations in the HFE gene may result in iron accumulation and oxidative stress in the retina, resulting in macular degeneration. This article describes two patients with HH who developed vision difficulties. Both patients were subjected to a retinal exam, multimodal imaging, and electrodiagnostic techniques, which revealed structural and functional degeneration of the central macula. Fundus photography, fluorescein angiography (FA), and fundus autofluorescence (FAF) revealed changes at the level of the retinal pigment epithelium (RPE) in the center of the macula, while optical coherence tomography (OCT) revealed subfoveal accumulation of hyperreflective material at and below the RPE. The multifocal electroretinogram (mfERG) confirmed a decreased cone response, whereas the full-field electroretinogram (ERG) revealed no pathological findings. In addition, patients underwent genetic testing, which ruled out the possibility of hereditary macular dystrophy. Considering macula findings and the nature of the patients' primary illness, we believe that the higher concentration and accumulation of iron and photoreceptor metabolic products have led to dysfunction in the RPE, which has led to morphological and functional changes in the macula.

Commercial banks usually classify customers according to their credit reports when making loans. In this study, we put our focus on classifying customers based on their credit reports from the People's Bank of China (PBC). Since there are no target labels of users in the credit report of the People's Bank of China, we put forward the fuzzy clustering method for the initial label, and then Construct ant colony search to optimize intelligent recognition. Finally, this study uses SVM, BP neural network, and random forest to classify users and compare their results. The research re-sults indicate that using ant colony clustering algorithm and random forest for classification is the most effective method with the PBC credit reports.

There is a strong need and demand from the United Nations, public institutions, and private sector for classifying government publications, policy briefs, academic literature, and corporate social responsibility reports according to their relevance to the Sustainable Development Goals (SDGs). It is well understood that the SDGs play a major role in the strategic objectives of various entities. However, linking projects and activities to the SDGs has not always been straightforward or possible with existing methodologies. Natural language processing (NLP) techniques offer a new avenue to identify linkages for SDGs from text data. This research examines various machine learning approaches optimized for NLP-based text classification tasks for their success in classifying reports according to their relevance to the SDGs. Extensive experiments have been performed with the recently released Open Source SDG (OSDG) Community Dataset, which contains texts with their related SDG label as validated by the community volunteers. Results demonstrate that especially RoBERTa achieves very high performance in the attempted task, which is promising for automated processing of large collections of sustainability reports for detection of relevance to SDGs.

Recent policies’ changes in sustainability reporting, such as the ones related to the new European Directive on non-financial disclosure, the standards issued by the American Sustainability Accounting Standard Board (SASB), the G4 guidelines issued by the Global Sustainability Standard Board (GSSB-GRI) and the framework of the International Integrated Reporting Council (IIRC) are stressing about the importance of extending the disclosure of ethical, social and environmental risks within social and environmental reporting. Institutional pressure has notably increased among organizations, in setting-up risk management tools to understand sustainability risks within managerial and reporting practices. Given such institutional pressure, the corporate reaction in providing additional sustainability risk disclosure call for attention and scrutiny. Therefore, this study aims at addressing such issues from an exploratory perspective. We based our analysis on a sample of organizations that issued sustainability disclosure in accordance with the GRI G4 guidelines, and we tested the relationship between risk disclosure and other relevant variables. Consistently with the literature, we found that “experienced” sustainable reporters provide a significant volume of disclosure, and that disclosure quality on risk is positively influenced by their international presence and reporting experience. However, when accounting for specific risk-related areas of disclosure, only few of them seems to adopt a management accounting perspective linking strategy, risk metrics and disclosure.

Dreams and positive symptoms of schizophrenia are similar in many aspects, such as bizarre-ness, impairment of reality testing, intense emotional participation. Hallucinations, delusions, and disorganized thoughts have been proposed to be an intrusion of the dreaming state in wake-fulness: conversely, psychotic patients’ abnormal cognitive and behavioral features could over-flow into sleep, transferring peculiar features to their dreams which would differ, in quantity and quality, from those of healthy people. Here we assess this latter hypothesis by analyzing the dreams of 46 patients, hosted in a residential facility or in a day-treatment center, affected by disorders of the schizophrenic spectrum with psychotic symptoms, versus those of 28 healthy controls, in terms of several quantitative and qualitative characteristics. In patients, we also in-vestigated whether dream variables correlated with the severity of symptoms assessed via the Brief Psychiatric Rating Scale. Overall, patients reported fewer and shorter dreams than controls, with a reduction of many ele-ments like characters and settings. The greatest differences regarded emotions, which were less frequent in patients and inversely correlated with symptoms’ severity. This evidence supports the hypothesis that dreams are crucial for emotion regulation during wakefulness and that this func-tion could be totally or partially ineffective in psychoses.

Energy and institutional quality are two factors that determine economic output, but these two factors are often neglected in the search for economic output. Therefore, this study examines the relative importance of energy use and its interaction with institutional quality for economic output. We employ a robust econometric estimation technique on a panel sample of 21 African countries between 2002-2019. Our results show that energy use is significant and negatively related to economic output while moderating terms of institutional quality are significantly associated with economic output, but the direction of the association depends on the specific quality. We find the moderating term control of corruption and government effectiveness to be negative and significantly associated with economic output, whilst political stability, regulatory quality, rule of laws, voice, and accountability positively impact. Our results imply that improved economic output is possible when there are specific institutional strategies.

The novel COVID-19 pandemic prompted an unprecedented Institutional reaction to aggregate existing capacity from silos of research laboratories to establish a multidisciplinary research laboratory for COVID19 testing. In less than two weeks, resources were mobilized from the community to strengthen public health response and epidemic control. Such strengthening of institutional research capacity to support public health response contributes to a natural knowledge transfer, facilitates collaboration, and generates new frontiers for knowledge production that should ultimately lead to professional development and retention of skilled human resources. This report describes the pre-established mechanisms and involvement of the authors that made it possible to set-up a multidisciplinary laboratory in a remarkably short period of time. We also discuss the opportunities and sustainability of multidisciplinary laboratory research post-COVID19. Existing institutional capacity can be repurposed to establish multidisciplinary research laboratories to support the strengthening of basic and clinical translational research capacity in resource limited settings and impact on public health and scientific knowledge for socioeconomic development.

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.

Colonoscopy is used for colorectal cancer (CRC) screening. Extracting details of the colonoscopy findings from free text in electronic health records (EHRs) can be used to determine patient risk for CRC and colorectal screening strategies. In this study, we developed and evaluated the accuracy of a deep learning model framework to extract information for the clinical decision support system to analyze relevant free-text colonoscopy reports, including indications, pathology, and findings notes. The Bio-Bi-LSTM-CRF framework was developed using Bidirectional Long Short-term Memory (Bi-LSTM) and Conditional Random Fields (CRF) to extract several clinical features from these free-text reports, including indications for the colonoscopy, findings during the colonoscopy, and pathology of the resected material. We then trained the Bio-Bi-LSTM-CRF and existing Bi-LSTM-CRF models on 80% of 4,000 manually annotated notes obtained from the colonoscopy reports of 3,867 patients. The clinical notes were from a group of patients aged over 40 years old enrolled in four Veterans Affairs Medical Centers. A total of 10% of the remaining annotated notes were used to train hyperparameter, while the remaining 10% were used to evaluate the accuracy of our model (Bio-Bi-LSTM-CRF) and to compare the results with the outcomes obtained using Bi-LSTM-CRF. The results of our experiments showed that the bidirectional encoder representations by integrating dictionary function vector from Bio-Bi-LSTM-CRF and strategies character sequence embedding approach is an effective way to identify colonoscopy features from EHR-extracted clinical notes. Therefore, the Bio-Bi-LSTM-CRF model is concluded to be capable of creating new opportunities to identify patients at risk for colon cancer and to study their health outcomes.

Ensuring banking stability is essential for economic resilience and the prevention of financial crises. Financial Stability Reports (FSRs) provide critical data on the financial system. This study advocates for the use of text mining tools to enhance the analysis of FSRs. Text mining offers a systematic method for extracting insights from unstructured data, allowing analysts to uncover detailed information on capital adequacy, risk management, and regulatory compliance. Additionally, this approach identifies emerging trends and vulnerabilities that may not be apparent through traditional analysis methods. The paper examines the application of text mining techniques to FSR analysis within the Republic of Armenia.

The Safe Drinking Water Act Amendments of 1996 require community water systems in the United States to send consumers Consumer Confidence Reports (CCRs). CCRs contain information on detected contaminants and required educational information about drinking water. The authors of this study developed a survey to evaluate how utilities track consumer feedback, understanding, and the role of the CCR in shaping consumer perceptions about water quality. Responses from this survey indicate it is common for utilities to indirectly track the effectiveness of their CCRs, but few utilities indicated directly evaluating consumer understanding or the effect of CCRs on consumer perceptions.

Background: Hospital accreditation has become ubiquitous in developing countries. Although studies recognize that accreditation can improve healthcare quality, efficiency, and safety, there are doubts about how hospitals deal with conflicts caused by the different institutional logics that inhabit this process. Therefore, this study aimed to investigate how professional and market logics, as well as the conflict between institutional demands, affect compliance with hospital accreditation. Methods: To this end, we developed a multiple case study in four Brazilian hospitals through in-depth interviews with sixteen participants (managers, physicians, nurses, physiotherapist) and on-site observation by the triangulation between the analysis of the narratives and the results of the multiple correspondence analysis. The interpretation and subsequent categorization of the interviews were guided by the study's analytical categories: institutional logics (professional and market); adoption objectives (legitimacy and efficiency); strategic responses to adoption (conformity, non-conformity, and customization); nature of demands (origin in the means and in goal). Results. The data showed that when professional logic is prominent, there is a greater tendency to customize activities, as there are conflicts in the means by which activities can be developed. When market logic stands out, there is a risk of non-conformity, mainly because the focus falls exclusively on goals. Finally, the data point to the absence of conflicts between justifications related to efficiency and legitimacy. Conclusion. We conclude the study by highlighting the theoretical and practical implications of recognizing the conflict between logics, contributing to a deeper understanding of how logic influences the attention given to specific demands and, more significantly, how they affect compliance with hospital accreditation standards, expanding the body of knowledge in the area.

Background: The incidence of spinal metastatic disease has risen with improved cancer survivorship. Separation surgery, the current standard surgical treatment, does not fully address spinal deformity. Advances in operative management warrant reevaluating maximal tumor resection and anterior column reconstruction with corpectomy. Methods: An IRB-approved retrospective single-center review of 63 patients was performed. Demographics, tumor characteristics, clinical and radiographic data, treatments, and neurological and survival outcomes were analyzed. Results: The mean age at presentation was 63.5 ± 9.6 years (range, 37-84 years) and 28 patients (44.4%) were female. Functional outcomes, measured by KPS, RAND-36 survey scores and Oswestry Disability Index all improved postoperatively (pre- vs postop: 70 to 80 (p=0.0056), 26.5 to 46.4 (p=0.0081), and 28.9 to 16.9 (p=0.0613), respectively). Spinal alignment also improved, with Cobb angle measurements showing a reduction in spinal kyphosis from -5 to 0 (p=0.021). Nine patients (14.5%) had non-fatal postoperative complications. The median OS for this cohort was 14.4 months (range, 0.6-145.0 months) with median follow-up time of 15.5 months. Conclusion: In oligometastatic spinal disease patients with good functional status, corpectomy for decompression of neural elements, deformity correction, and spinal stabilization is associated with improvements in pain and functional outcomes without overwhelming morbidity.

We introduce the Transformation Flower Approach (TFA), a Theory of Change that attends to multiple value creation and institutional change as a dual design challenge. We highlight how the TFA integrates social scientific theories and models relevant for transformative change (in particular focusing on pathways, leverage points, governance, power, and values) and demonstrate its practical value by an application to the ongoing transformation of the Dutch food system. By providing a holistic, transdisciplinary and practically relevant approach that aims to support new social contract formation, the TFA goes beyond other transformative change approaches. Based on the notion of pathways, it offers a toolbox that aids in working towards desired futures, involving both incumbents and challengers in an effort to harness untapped yet proximal potentials in a forward-looking way. By embracing an innovation approach, it not only promises to circumvent resistance to change, but also serves as a step-by-step approach to identify options for multiple value creation and effective cooperation. We demonstrate the analytical and practical value of the TFA by discussing action perspectives at various levels and scales in the context of the Dutch food system transition, including (1) area-oriented approaches, (2) acceleration agendas for specific transformation pathways, and (3) actor-specific transformation flowers. In developing these, we emphasize the importance of interdependencies between leverage points. Our approach helps to identify opportunities to link transformative options (the what), actors (the who) and levers (the how) in dynamic interaction to embark on transformative pathways.

The study investigated roles of institutional types and ethnic/racial background on academic credit among the traditionally underrepresented population of the U.S. study abroad program. Using archival data, the study sampled the student’s enrollment and academic credit information spanning a period of 20 years (2003 - 2022). Data analysis Using One-Way Analysis of Variance (ANOVA) indicates significant main influence of institutional type (p<.001) and significant main influence of ethnic/racial identity (p<.001) on students’ academic credit. The result was discussed in terms of its relevance in educational policy re-evaluations, improvement of the study conditions of the underrepresented students, and enhancement of the enrollment opportunities of these minority population across all U.S. institutions of learning.

Background: Monogenic Alzheimer's disease (AD) has severe health and socioeconomic repercussions. Its rarest cause are presenilin 2 (PSEN2) gene mutations. We present two new cases with presumed PSEN2-AD, with unusual clinical and neuroimaging findings in order to provide more information on the pathophysiology and semiology of these patients. Methods: Women aged 69 and 62 years at clinical onset, marked by prominent behavioral and language dysfunction, progressing to severe dementia within three years. Neuroimaging, laboratory study, genetic testing. In addition, a systematic review of the PSEN2-AD were performed. Results: Neuroimaging revealed pronounced frontal white matter hyperintensities (WMH) and frontotemporal atrophy/hypometabolism. The genetic study unveiled PSEN2 variants: c.772G>A (p.Ala258Thr) and c.1073-2_1073-1del. Both cerebrospinal fluid (CSF) and experimental blood biomarkers shouldered AD etiology. Conclusions: Prominent behavioral and language dysfunction suggesting frontotemporal dementia (FTD) may be underestimated in the literature as a clinical picture in PSEN2 mutations. Thus, it may be reasonable to include PSEN2 in genetic panels when suspecting FTDL. PSEN2 mutations may cause striking WMH, arguably related with myelin disruption induced by amyloid accumulation.

(1) Background: Spontaneous isolated intramural hematoma of the superior mesenteric artery (SIHSMA) is a rare entity often considered as a subset of spontaneous isolated dissection of the superior mesenteric artery (SIDSMA). It is characterized by a completely thrombosed false lumen with or without ulcer-like projection with computed tomography (CT) imaging. The recent literature describes few reports with a relatively short-term follow-up. The natural course, prognosis, and treatment options for SIHSMA still lack consensus. We present two cases of acute abdominal pain in a young man due to IMH of the superior mesenteric artery with an extensive literature review. (2) Case report: A 46-year-old male patient was submitted to an urgent CTA for acute abdominal pain, showing the presence of an isolated dissection of the superior mesenteric artery, determining significant stenosis of the vessel with collateral vessel patency. The patient referred to a recent COVID-19 infection, whose course was paucisymptomatic. He was treated conservatively with antiplatelet therapy and corticosteroid treatments, and, after a few days, the symptomatology completely regressed; also, 2-month- control CTA showed the complete IMH regression and the absence of any signs of residual stenosis. The second patient is a 61-year-old male patient who was submitted to an urgent CTA for acute abdominal pain, showing the presence of an isolated dissection of the superior mesenteric artery, not determining significant vessel stenosis. He was treated conservatively with antiplatelet therapy and corticosteroid treatment, and after a few days, the symptomatology completely regressed, and the radiological control showed a complete dissection regression. (3) Conclusion: SISHSMA is a rare entity of vascular pathology, and conservative management represents the best medical strategy. We propose corticosteroid treatment as one of the most appropriate tools in the conservative treatment of SISHSMA.

Snakebite envenomation, cognized as a neglected tropical disease, is a dread public health concern with the most susceptible groups being herdsmen, the elderly, active farmers, hunters, fishers, firewood collectors, 10 to 14-year old working children and individuals with limited access to education and health care. Snakebites are fragmentarily documented in Uganda primarily because most occur in rural settings where traditional therapists end up being the first line defence for treatment. Ethnobotanical surveys in Uganda have unveiled that some plants are used to antagonize the activity of various snake venoms. This review was sought to compile the sporadic information on the vegetal species reported as antivenins in Uganda. Electronic data indicate that no study entirely reported on antivenin plants in Uganda. A total of 77 plant species belonging to 65 genera, distributed among 42 botanical families claimed as antiophidic in Uganda are used for treatment of snakebites. Majority of these species belong to family Fabaceae (30.9%), Euphorbiaceae (14.3%), Asteraceae (11.9%), Amaryllidaceae (9.5%) and Solanaceae (9.5%). The antiophidic species listed are shrubs (40.5%), trees (32.9%) and herbs (17.7%), usually found in the wild and uncultivated. Antivenin extracts are primarily prepared from roots and leaves, through decoctions, infusions, powders and juices and administered orally or topically. The most frequently encountered therapeutically important species are Allium cepa L., Carica papaya L., Securidaca longipedunculata Fres., Harrisonia abyssinica Oliv. and Nicotiana tabacum L. Baseline epidemiological data on snake envenomation and antivenin plants in Uganda remain incomplete due to inadequate research and diverse ethnic groups in the country. There is a dire need to isolate and characterize the bioactive compounds in the claimed plants to enable their adroit utilization in handling the plague of snake envenomation. More baseline data should be collected on snake ecology and human behaviour as well as antivenin plants in Uganda. Indigenous knowledge on the use of plant preparations in traditional medicine in Uganda is humongous, but if this is not quickly researched and appropriately documented, indications as to the usefulness of this vegetal treasure house will be lost in the not so distant future.

Caveolin-1 (Cav-1) is 22 kDa caveolae protein, acts as a scaffold within caveolar membranes. It interacts with alpha subunits of G-protein and thereby regulates their activity. Earlier studies reported elevated or up-regulated levels of caveolin-1 in the serum of prostate cancer patients. Secreted Cav-1 promotes angiogenesis, cell proliferation and anti-apoptotic activities in prostate cancer patients. Cav-1 upregulation is mainly related to prostate cancer metastasis. Keeping above facts in view, the present study was designed to explore Cav-1 as a target for prostate cancer therapy using computational approach. Molecular docking, structural base molecular modelling and molecular dynamics simulations were performed to investigate Cav-1 inhibitors. A predictive model was generated and validated to establish a stable structure. ZINC database of biogenic compounds was used for induced fit docking (IFD) and high throughput virtual screening. The H-bond interactions of the compounds with active site residues of Cav-1 were estimated by IFD and 100 ns long molecular dynamic simulations. The reported compounds showed significant binding and thus can be considered as potent therapeutic inhibitors of Cav-1. This study provides a valuable insight into biochemical interactions of Cav-1 for therapeutic applications and warrants for experimental validation of the predicted ‘active(s)’.

A The present investigation was undertaken in foothill regions of Uttarakhand from July-2016 up to December-2018. A total of thirty four different sites ranging from the roadside areas, grasslands to forests were studied and Mushroom fruiting bodies were collected. A total of One Hundred sixty six fruiting counts were obtained and 68 mushroom genera belonging to 15 orders and 43 families were identified. During collection visits mushroom were apparent from organic debris of diversified habitats ranging from humid soil; grassland; leaf litter; living tree trunk; dead wood log of forest zone. Maximum fruiting bodies (75%) were obtained between July to September and minimum i.e. 6% between November – February. Among the collected mushroom Stereum rugosum, Crepidotus variabilis, Laccaria laccata, Schizophyllum commune, Ganoderma applantum, Cantharellus cibarius were more prevalent. Out of all collected mushroom sample the frequency of Mushroom belonging to order Agaricales was 45.18% followed by Polyporales i.e., 27.7%. The collected mushroom were cultured on PDA medium and their mycelial forms were preserved for further studies.

Protozoa and helminths are responsible for several intestinal parasite infections (IPIs). Generally helminth infections are very unsafe but scarcely reported in high-income countries, while protozoa and helminth co-infections are usually reported in children living in inadequate hygienic-sanitary conditions and in rural areas. However, the impact of growing globalization, intense travelling, international adoptions and high levels of immigrants and refugees has significantly incremented the incidence of oro-faecal parasitosis in non endemic areas. Although most IPs clear without treatment when population, even children, emigrate from endemic to different geographical areas, some IPIs such as strongyloidiasis may persist for decades as subclinical infections or as low-grade disease with nonspecific clinical manifestations, unless to reappear under impairment conditions. Herein we report an unusual case of Giardia lamblia and Trichuris spp. chronic asymptomatic co-infection in a healthy adopted Romanian child, living in a Central Italy rural area, and an hidden case of Strongyloides stercoralis in an adopted Burundian child, resident in South Italy, long misdiagnosed as a recurrent undefined dermatitis. Our report suggests the need to review primary care practitioner guidelines and children's hospital procedures for appropriate IPIs screening and follow-up, hence providing new screening and prevention strategies, in agreement with international guidelines.

This study delves into the transformative growth of private higher education in China, highlighting the rapid and diverse expansion following the COVID-19 pandemic. Although previous studies have reported expansion and difficulties, a thorough examination of the relationship between institutional adaptation and the development of human capital remains unexplored. This study examines how private higher education institutions modify their job-related courses to suit the demands of the job market, evaluates the effect on the employability of graduates, and investigates ways to control costs without sacrificing academic quality. This study analyzes data from the Ministry of Education, Wind Information, and Shenwan Hongyuan Research to gain insights into the impact of human capital theory and institutional theory on private higher education in China. Enrollment trends, program alignment, financial sustainability, and quality enhancement activities are all examined using detailed analysis. Private higher education institutions play a critical role in developing a skilled labor force by filling skill gaps and meeting the demands of an evolving job market. The findings also emphasize the importance of quality assurance procedures, strategic program development, and collaborations with businesses. In conclusion, the study emphasizes the imperative for more research and policy action. This is crucial to securing the lasting effectiveness and influence of private higher education institutions on China's socioeconomic progress and human capital development in the post-pandemic era.

The use of improved agricultural technologies has been reported as the major strategy to increase agricultural production, increased household incomes and addressing poverty. However, adoption of such improved technologies by smallholder coffee farmers has been slow and this has contributed to the low coffee productivity in the country and the poor performance of the coffee sub sector. The study was meant to examine the effect of institutional factors including extension services, access to market and access to credit on technology adoption among smallholder coffee farmers in Kanungu District, Uganda. The study collected both quantitative and qualitative data from 289 smallholder coffee farmers and 8 key informants respectively in major coffee growing sub counties in Kanungu district. The study revealed that access to extension services and access to market have a positive significant influence on agricultural technology adoption while access to market has no significant influence on agricultural technology adoption. The study concluded that there is a positive significant relationship between institutional factors and technology adoption among smallholder coffee farmers in Kanungu district.

In Thailand, thousands of children living with perinatal HIV have been exposed to HIV-related stigma/discrimination but its frequency and expressions have been little studied. Our objective was to assess stigma/discrimination prevalence, associated risks factors and its expressions among adolescents. All caregivers of adolescents aged 12-19 years living with perinatal HIV and receiving antiretrovirals in 20 hospitals throughout Thailand were invited to complete a face-to-face questionnaire on their adolescent’s life and medical history. Of the 572 adolescents living in family settings, 464 had their HIV-status known in the community. The overall stigma/discrimination prevalence was 46%. Factors associated included living in the north-east region (OR: 2.80, 95%CI: 1.19-4.96), having a low intellectual ability (OR:2.68, 95%CI: 1.45-5.16), a lower Body Mass Index (BMI) (OR BMI &gt; 18.5: 0.61, 95%CI: 0.37-0.98), conflicts with caregivers (OR: 1.86, 95%CI: 1.26-2.76) and caregivers being members of a support group (OR: 2.34, 95%CI: 1.58-3.48). Expressions of stigma/discrimination included bullying, social isolation, behavioral discrimination and public disclosure. The prevalence of stigma/discrimination among adolescents living with perinatal HIV is high. Despite existing policies, stigma eradication remains necessary to normalize their life as they grow into adulthood.

Liver cancer is the fourth leading cause of cancer-related death worldwide. In Mexico, there is a high burden of liver cancer mortality in rural states, which affects both women and men equally. Thus, we aimed to describe the demographic and clinical characteristics of hepatocellular cancer (HCC) by sex in Mexico. Demographic and clinical information were extracted retrospectively from the medical records of patients with HCC initially treated (2015-2022) at participating institutions of a national survey across the country. The male-to-female ratio was calculated at the national and regional levels and the results were stratified by sex. Among 697 HCC patients, the age at diagnosis was 65.4±11.9y and 20% were diagnosed at ≥75y. The male-to-female ratio was 1.4:1, ranging from 1:1 in the northwestern and southwestern regions to 2.1:1 in the western region. The proportion of cirrhosis was similar between sexes; however, the etiologies for cirrhosis differed: cryptogenic cirrhosis was higher in women and alcohol consumption was higher in men. Men had a higher proportion of advanced HCC, poor/undifferentiated tumors, and ≥4 nodules than women. HCC in the Mexican population affects men and women at a 1.4:1 male-to-female ratio. This unique proportion by sex could be explained by the differences in the prevalence of risk factors across our heterogeneous country.

Land management and community involvement are two main elements in ensuring the absence of conflict between landowners and agencies. Disputes between owners and agencies will be the biggest obstacle in the land development effort. Therefore, this article aims to address the cause of landowners’ objections against land alienation using the institutional approach. To enable the researchers to understand the root causes of landowners' objections against the alienation of land using the Communal Grant method, the institutional approach has been adopted to identify the issue of the objection. Therefore, questionnaires for 100 landowners were distributed in two villages in Semporna district in Sabah. The purpose is to obtain their views on the cause leading to the dispute of land alienation using the Communal Grant method. The Likert scale was used to enable community rankings on issues that can be understood according to the level of seriousness of the population's views on the issue of using Communal Grants in native customary land alienation. The study results explain that there are four factors that drive objection of the Communal Grant land alienation which involves the formal factors. The findings explained that there are 4 formal provisions which lead to the community's objection against Communal Grants, namely the native customary lands (NCR) act, provision of Communal Grants, provisions in the land ownership and land allocation in Sabah Land Ordinance.Due to numerous objections among native customary peoples concerning the native customary land alienation using Communal Grants, the government has acted in substitution with a fair method of individual ownership for the native customary peoples. This situation explains that disputes in land ownership can be a threat to the country if it cannot be resolved in ways and methods acceptable to the native customary community. This study will benefit the government and NGO’s to alert and focusing on barriers in the context of local community land laws. Communal grants are intended to address land issues in Sabah.

Contrast-enhanced ultrasonography (CEUS) is useful for evaluation of the hemodynamics of hepatic tumors and surrounding he-patic parenchyma in real time. CEUS with intravenous contrast administration is well established for evaluation of hepatocellular carcinoma (HCC). On the other hand, intra-arterial (transcatheter) CEUS (IAUS) is an emerging technique that allows more selective evaluation of the arterial supply to the tumor. IAUS was performed by administration of Sonazoid® through the microcatheter and imaging of the area of the target lesion with a dedicated, contrast-specific technique. Sonazoid® (0.5 ml diluted with 49.5 ml of distilled water) was used as the contrast medium in IAUS. The diluted Sonazoid® was introduced into the feeding artery by in-termittent injection of 0.3-1.0 ml through a microcatheter placed in the artery and flushing with saline at the same flow rate. We report the three cases in which IAUS was useful in transarterial chemoembolization (TACE) for HCC. Two cases were performed TACE for hepatic metastasis. In any cases, plain computed tomography (CT) after TACE showed accumulation of Lipiodol® only in the metastases. One case was suspected having HCC rupture and urgent abdominal angiography was performed. IAUS was performed frequently to reduce the amount of iodinated contrast agent as much as possible because of renal failure. Concomitant use of IAUS enabled reduction of the amount of contrast agent.

An exhaustive list of thirteen instances of reports confirming experimentally the relativistic Doppler relation, are examined. For those involving longitudinal Doppler, the non-relativistic relation is seen to be confirmed, within the reported experimental accuracies, to the same degree as the standard relativistic relation. Higher values of the speed of the emitter would be required to examine further the claimed confirmations. For those reports involving saturation spectroscopy, there is much confusion over the appropriate Doppler relation to be used, together with some serious analytical flaws. For the two cases that involve transverse Doppler, there are seen to be either serious faults in the theoretical part, or intrusion from the first order effect. Therefore, the reported conclusions - that the results for the experiments confirm the relativistic SR relation - cannot be justified by any of the experimental works.

A case study is presented which demonstrates the value and validity of a novel approach to the use of consolidated amateur (‘ham’) radio reception reports as indicators of the presence of intense ionospheric sporadic E (Es). It is shown that the use of amateur data can provide an important supplement to other techniques, allowing the detection and tracking of Es where no suitable ionosonde or other measurements are available. The effectiveness of the approach is demonstrated by reference to ionosonde data, and the advantages and limitations of the technique are discussed.

The full impact of COVID-19 on policing, crime and disorder is slowly being fully unraveled. However, there remains a number of areas of policing that are yet to be examined in detail. Two of these areas include the impact on the intrinsically linked, volume of police recorded intelligence reports, and the use of stop and search. In this study we examine them symbiotically and frame them in the context of the intelligence led policing model, in particular in an effort to understand how national lockdowns in the United Kingdom affected both proactive policing approaches and the underpinning intelligence cycle. To achieve this, we use data from freedom of information requests regarding the annual levels of recorded police intelligence over a 10-year period for 20 police services. To supplement this, we examine overall national monthly volumes of stop and search activity over a 5-year period. Finally, we then use a case study approach of 3 police services to further explore changes in the conduct of stop and search such as the officer defined ethnicity, grounds for search and disposal outcomes. The findings indicate that both recorded intelligence reports and stop and search increased dramatically during periods of lockdown, despite widespread decreases in crime and social mobility. Changes in proportional impact are identified for White and Black citizens, searches for controlled drugs and the no further action disposal, but these are not consistent across police services. Potential causes and implications are then discussed and again, framed within the context of the impact on the intelligence led policing model and wider policing environment.

Modern advances in technology have increased the demand for traditional accounting systems to be upgraded for real-time data processing, security, and standardized reports. Thus, this paper proposes a new accounting information system that integrates IoT, blockchain, and XBRL. The proposed system aims to automate the accounting process by using IoT to collect data and send it automatically to a blockchain, which acts as a database that will generate journal entries automatically through smart contracts. XBRL will then be used as an output method for standardized financial reports based on the data transferred from the blockchain. This paper uses a qualitative research design based on semi-structured interviews with 13 industry experts from IT engineering, academia, and financial systems analysis. NVivo software was used to conduct a thematic analysis of interview transcripts. The findings revealed the technical feasibility, challenges, and benefits of the proposed integration and identified the most efficient mechanism for data transmission across the three technologies. The paper concluded that while integration complexity and user adoption are challenging, this integrated system can revolutionize accounting by enabling real-time data capture, automation of essential operations, data security, and integrity improvements. To our knowledge, this is the first paper to develop a comprehensive accounting information system framework using IoT, blockchain, and XBRL to automate data collection, improve data security, and streamline financial reporting. The study's potential to impact accounting systems and financial reporting research and practice emphasizes its importance.

Rheumatoid arthritis (RA) is a complex illness with both hereditary and environmental compo-nents. Globally, in 2019, 18 million people had RA. RA is characterised by persistent inflammation of the synovial membrane that lines the joints, cartilage loss, and bone erosion. Phenolic molecules are the most prevalent secondary metabolites in plants, with a diverse spectrum of biological ac-tions that benefit functional meals and nutraceuticals. These compounds have received a lot of at-tention recently because they have antioxidant, anti-inflammatory, immunomodulatory, and anti-rheumatoid activity by modulating tumour necrosis factor, mitogen-activated protein kinase, nu-clear factor kappa-light-chain-enhancer of activated B cells, and c-Jun N-terminal kinases, as well as other preventative properties. This article discusses dietary polyphenols, their pharmacological properties, and innovative delivery technologies for the treatment of RA, with a focus on their possible biological activities. Nonetheless, commercialization of polyphenols may be achievable only after confirming their safety profile and completing successful clinical trials.

Granulomatosis with polyangiitis (GPA), formerly known as Wegener’s granulomatosis, is a rare form of necrotizing granulomatous inflammation that predominantly affects medium and small size vessels. Generally respiratory tracts and kidneys are the most affected organs. Neurological manifestations of GPA usually involve the peripheral nervous system causing mononeuritis multiplex or and cranial nerve palsies. Central nervous system (CNS) involvement is rare and characterized by cerebral vasculitis, meningeal inflammation, or mass lesions. The CNS involvement is often linked to Ear Nose Throat (ENT) system disease. In this report, we present two cases of patients diagnosed with GPA who exhibit CNS involvement as first symptom. In the first one with an ischemic stroke while in the second with an atypical headache. In the first patient, a positive medical history indicating involvement of the Ear, Nose, and Throat (ENT) facilitated a precise diagnosis through the prompt execution of autoimmune screening. This, in turn, enabled a timely commencement of treatment, resulting in neurological improvement. In the second case, the significance of ENT involvement was initially overlooked in the context of pathological definition, leading to a substantial delay in diagnosis and an ultimately grim prognosis for the patient. The ENT involvement could be an easy marker to suspect GPA in patient with atypical CNS presentation and could help to make a prompt diagnosis.

Alveolar bone atrophy after tooth extraction presents significant difficulties when planning delayed-immediate implant treatment to replace a lost tooth. Socket augmentation is an effective therapy that limits the post extraction volumetric changes and facilitates implant placement whilst reducing the need for staged grafting. However, socket augmentation and osteoconductive graft conversion is a slow process that could take 4-6 months. PRF and its variants have significant bio-enhancement effect on wound healing and regeneration through release of platelet drived growth factors, bioactive substances, cytokines. Leukocytes in PRF also play a significant role in enhancing tissue regeneration as part of osteo-immune response. Use of PRF during socket augmentation is highly effective in enhancing extraction site healing and graft integration by angiogenesis, cell proliferation, recruitment, and differentiation through release of growth factors and bioactive substances mediated by platelets and leukocytes. PRF with SA is recommended as an adjunct to SA as a sole biomaterial or in combination with xenograft or allograft bone substitutes to enhance tissue regeneration and to reduce risk of infection, osteitis and postoperative pain in extraction sockets

Although domestic cats are susceptible to infection with SARS-CoV-2, the role of the virus in causing feline disease is less well defined. We conducted a large-scale study to identify SARS-CoV-2 infections in UK pet cats, using active and passive surveillance. Remnant feline respiratory swab samples, submitted for other pathogen testing between May 2021 and February 2023, were screened using RT-qPCR. In addition, we appealed to veterinarians for swab samples from cats suspected of having clinical SARS-CoV-2 infections. Bespoke testing for SARS-CoV-2 neutralising antibodies was also performed, on request, in suspected cases. One RT-qPCR-positive cat was identified from the active surveillance (1/549, 0.18 %), during the Delta wave (1/175, 0.57 %). Passive surveillance detected one cat infected with the Alpha variant, and two of ten cats tested RT-qPCR-positive during the Delta wave. No cats tested RT-qPCR-positive after the emergence of Omicron BA.1 and its descendants although 374 were tested by active and eleven by passive surveillance. We describe four cases of SARS-CoV-2 infection in pet cats, identified by RT-qPCR and/or serology, that presented with a range of clinical signs, as well as their SARS-CoV-2 genome sequences. Our results demonstrate that, although uncommon, clinical infections in cats can and do occur.

The deep neural network - BERT model (Bidirectional Encoder Representations from Transformers) and the stocks cumulative abnormal return is used in this article to analyze the sentiment of financial texts. The proposed approach, unlike those used so far, does not require the creation of dictionaries, takes into account the broad context of words and their meaning in financial texts, eliminates the problem of ambiguity of words in various contexts, does not require manual labelling of data and is free from the subjective assessment of the researcher. The sentiment of financial texts in the meaning presented in this paper is directly related to the market reaction to the information contained in these texts. For texts belonging to one of the two classes (positive or negative) with the highest probability the BERT model gives the results of predictions with a precision level of 62.38% for the positive class and 55% for the negative class. The results at this level can be used in event study, market efficiency research, investment strategy development or support of investment analysts using fundamental analysis.

DNS is a necessary infrastructure for accessing the Internet. Until now, privacy protection in domain name resolution has mainly focused on end user privacy (communication encryption between clients and DNS full-service resolver). For this reason, communication between DNS full-service resolver and authoritative DNS servers is still done in plaintext. A DNS request from a DNS full-service resolver to an authoritative DNS server does not pose a privacy issue because the source IP address that comes from is the DNS full-service resolver. However, in recent years, there have been reports of specific techniques for identifying the privacy of previously unknown institutions by analyzing the logs of authoritative DNS servers. In order to further strengthen privacy in DNS communication, we proposed an architecture to encrypt all DNS communication in DoH, created a prototype environment, and investigated performance evaluation. The main contributions of this paper are threefold. First, we proposed the Full-DoH DNS architecture. This is a domain name resolution framework designed specifically for institutional privacy. Second, we evaluated the proposed architecture through a prototype implementation. Finally, we discussed related issues to the proposed architecture.

We investigate how formal institutional distance (FID) moderates the relationship between cul-tural distance (CD) and the financial performance of foreign subsidiaries firms. Following recent research, we estimate the asymmetric effects of CD by considering its size and direction towards host countries on the opposite poles of each cultural dimension` scale. We propose that a limited understanding of the formal institutions in the host country, as measured by the magnitude and direction of the FID, can have a positive moderating effect, increasing the impact of CD on finan-cial performance. This is mainly because foreign subsidiary firms may be more reliant on their ca-pacity to navigate the less formal (and more implicit) aspects of the host country's institutional environment, such as their ability to cope with the CD. We use foreign subsidiary data from the Orbis database including 22 developed and 22 developing home countries and over 1400 foreign subsidiaries during a period of 3 consecutive years operating in 10 of the largest economies (host countries) in Latin America including: Argentina, Brazil, Colombia, Chile, Ecuador, Mexico, Panama, Peru, Uruguay, and Venezuela. Findings confirm the asymmetric effects of CD, howev-er, by considering the direction of FID, our findings reveal that the higher the FID towards less developed host countries, the more significant the effects of CD on the financial performance. These findings contribute to the knowledge of how formal and informal institutional distances in-teract by showing that the greater the FID towards less developed host countries, to higher the impact of CD on the financial performance of foreign subsidiary firms.

The term “medical error” is quite often used to refer to any mistake committed in the provision of healthcare services which has caused harm to a patient. Objective: To analyze civil lawsuits involving medical errors in pediatrics by evaluating: 1) causal link; 2) type of medical error; 3) conviction of the court and its legal basis; 4) correlation between medical expert understanding and legal understanding. Materials and Method: Retrospective analysis of 60 pediatric forensic medical examinations carried out by a pediatric expert between April 2009 and February 2014 at the Institute of Medicine and Criminology of the State of São Paulo (IMESC). The expert’s reports were analyzed according to age, gender, type of forensic medical report (direct or indirect), conclusion of the expert’s report (causal link between the medical conduct and complaint or not), type of medical error (negligence, recklessness, malpractice), judgment in the first instance (if in accordance with the expert’s report or not), and basis of judgment as objective or subjective (type of law). Results: Most expert’s examinations (65%) were indirect (death). In 27 reports (45%), the expert’s conclusion determined that there was a causal link between medical care and the damage inflicted to a patient. Of the 27 reports with causal link, the judge was not in accordance with the expert’s report in one case, thus not considering medical error. The vast majority of sentences (55) were in accordance with the expert’s conclusion (91.6%). Subjective law was mostly used to support the judge’s ruling (61.70%), followed by objective law (23.30%). All lawsuits claimed moral damages (100%). In the statistical analysis of distribution of nominal variables (frequency), an excellent agreement (kappa= 0.86), with statistical significance, was verified between the expert’s report and the court ruling. Conclusion: Expert evidence supported 91.6% of the sentences and was considered to be highly valuable evidence. Expert evidence had a major impact on the legal proceedings and has proven statistically significant (p<0.005). Subjective law was used to assess medical error in all cases in which healthcare professionals were involved. Claims for moral damages was requested in all lawsuits, and was fully or partially granted in 100% of the cases.

This study aims to understand the global environment of COVID-19 management and guide future policy directions after the pandemic crisis. To this end, we analyzed a series of the World Economic Forum’s COVID-19 response reports through text mining and network analysis. These reports, written by experts in diverse fields, discuss multidimensional changes in socioeconomic situations, various problems created by those changes, and strategies to respond to national crises. Based on 3,897 refined words drawn from a morphological analysis of 26 reports (as of the end of 2020), this study analyzes the frequency of words, the relationships among words, the importance of specific documents, and the connection centrality through text mining. In addition, network analysis helps develop strategies for sustainable response to and management of national crises through identifying clusters of words with a similar structural equivalence.

Background: The incidences of COVID-19 related suicide among adolescents and youths have been reported across the world. There is no cumulative study focusing on nature, patterns, and causative factors that lead to the present investigation. Methods: A purposive sampling of google news between 15 February to 6 July was performed. After excluding duplicate reports, the final list comprised a total of 37-suicide cases across 11 countries. Results: More male suicides were reported (21-cases, i.e., 56.76%), and the mean age of the total victims was 16.6±2.7 years (out of a total of 29-cases). About two-thirds of the suicides were from three countries named India (11-cases), United Kingdom (8-cases), and the USA (6-cases). Out of 23-student victims, 14 were school-going students. Hanging was the most common suicide method accounting in 51.4% of cases. The most common suicide causalities were related to mental sufferings such as depression, loneliness, psychological distress, etc., whereas either online schooling or overwhelming academic distress was placed as the second most risk factors followed by TikTok addiction-related psychological distress, and tested with COVID-19. Conclusion: The finding of the temporal distribution of suicides concerning lockdowns may help in exploring and evolving public measures to prevent/decrease pandemic-related suicides in young people.

There is growing adoption of corporate sustainability practice in both for-profit and not-for-profit organizations. This proliferation is largely due to the increasing concerns for social, environmental and economic factors in which we assume shared responsibility. Despite the growing attention of researchers and practitioners, several corporations failed to meet their sustainability responsibilities. Several reasons could be associated to this phenomenon such as lack of regulatory mechanism, accountability, etc. This review, however, seeks to examine how nongovernmental organizations (henceforth, NGOs) influence corporate sustainability adoption (i.e. sustainability reporting). In the review of prior research, we leveraged the institutional-legitimacy and corporate governance theories. The findings suggest that NGOs have greater potential in sustainability discourse through two salient actions, namely (1) collaborative partnership, and (2) confrontational tactics. While the former promotes stakeholder involvement in corporate decision making through dialogue, joint-projects on CSR, sustainability reporting, the latter, however, is the last resort – involving “naming and shaming” corporations for poor social and environmental performance through public and social media. The objective of such action is to cause reputational damage to businesses. Finally, it is also observed that crucial to NGO power and influence is the collaboration with government and civil society organizations in the fight for environmental sustainability and accountability.

The community of farmers in land tenure have different institutional in terms of mastery of the land. In Indonesia there were generally institutional governing the utilization of land for mastery permanently, but there were also institutional governing dominion land in turn. This research aimed to chart institutional pattern characteristic mastery of the land inheritance system passes in, andanalyzeits contribution to sustainability of agriculture in the economic, social and ecological. Research method using case studies, with unit case a subdistrict in Gowa, South Sulawesi province, Indonesia. The results showed that institutional land pattern mastery system passes the inheritance patterns of alternation that has in effect hereditary, pattern rotation established by the heir land management patterns, depending on the number of beneficiaries, as well as not having managed to land fragmentation, so the scale of farming land, conditions can be maintained , the land was slanted so given a terracing, planting process was carried out by means of mutual. Neither found that institutional land pattern mastery system passes the inheritance had been contributing the sustainability of agriculture in social and ecological, but have yet to fully contribute to the sustainability of agriculture in economy.

Background: To our knowledge, the sudden onset of symptomatic pulmonary hypertension after COVID-19 vaccination has not been described. Both cases presented here resulted in functional limitations and likely permanent organ damage. Case Summary: We report two cases of acute onset pulmonary hypertension in previously healthy adult males within three weeks of receiving the second dose of the Pfizer (BNT162b2) mRNA COVID-19 vaccine from different lots. Both patients experienced the sudden onset of severe fatigue and dyspnea on exertion with negative COVID-19 PCR testing. The diagnosis was made by serial transthoracic echocardiography in the first case and by both transthoracic echocardiography and right heart catheterization in the second. Discussion: Pulmonary hypertension is a serious disease characterized by damage to lung vasculature and restricted blood flow through narrowed arteries from the right to left heart. The onset of symptoms is typically insidious, progressive and incurable, leading to right heart failure and premature death. The World Health Organization (WHO) classifies pulmonary hypertension into 5 categories and recently re-defined as a resting mean pulmonary artery pressure greater than 20 mmHg. Sudden onset pulmonary hypertension would only be expected in the settings of surgical pneumonectomy or massive pulmonary emboli with compromise of at least 50% of the lung vasculature.

Abstract: Fertility tracking of menstrual cycles during perimenopause with a quantitative hormone monitor is a novel undertaking. Women in regular menstrual cycles have been tracking their fertility using different biomarkers since the 1960’s [1]. Presently, there are newer electronic hormonal devices used to track fertility that provide more exact and objective data to help delineate the fertile time frame of a woman’s cycle. These devices measure quantitative levels of estrogen, luteinizing hormone, progesterone, and follicle stimulating hormone, all of which occur at varying levels during the menstrual cycle. As women advance toward menopause, their cycles vary in length and their hormones fluctuate [2]. In this retrospective analysis, forty-two women aged 40 to 50 tracked their cycles over time and eight of the forty-two women used the quantitative hormonal device. With the use of this device, the perimenopausal period has revealed distinct hormonal cycle characteristics unique to this group of women. It is the purpose of this paper to discuss those cycle characteristics during perimenopause that were found with the use of the quantitative hormonal device.

This paper investigates if Corporate Social Responsibility (CSR) reports published by a selected group of Nordic companies are aligned with the Global Reporting Initiative (GRI) standards. To achieve this goal, several natural language processing, and text mining techniques were implemented and tested. We extracted strings, corpus, and hybrid semantic similarities from the reports and evaluated the models through the intrinsic assessment methodology. A quantitative ranking score based on index matching was developed to complement the semantic valuation. The final results show that Latent Semantic Analysis (LSA) and Global Vectors for Word Representation (GloVE) are the best methods for our study. Our findings will open the door to the automatic evaluation of sustainability reports which could have a strong impact on the environment.

(1) Background: Antimicrobial resistance (AMR) requires urgent multidisciplinary solutions, and Pharmacovigilance (PV) has the potential to strengthen current antimicrobial stewardship (AMS) strategies. This study aimed to characterise AMR-relevant adverse drug reaction (ADR) reports submitted to The Netherlands Pharmacovigilance Centre (Lareb); (2) Methods: We carried out a descriptive analysis of ADR reports submitted to Lareb, coded with AMR-relevant MedDRA Preferred Terms (PTs).; (3) Results: Between 1998 and Jan 2019, 252 AMR-relevant ADR reports were submitted to Lareb. The most frequent antibiotics were tobramycin (n=89; 35%), colistin (n=30; 11,9%), ciprofloxacin (n=16; 6,35%), doxycycline (n=14; 5,5%) and aztreonam (n=12; 4,76%). The most frequently used PTs were drug ineffective (n=71; 28%), pathogen resistance (n=14; 5%) and drug resistance (n=13; 13%). A total of 119 reports (74%) suggested use-related issues. Watch antibiotics were in 54% of the reports and Reserve antibiotics were in 19%. In the Watch group, “Off label use” and “Product use in unapproved indication” were the most frequent PTs and majority of reports on Reserve antibiotics were coded as “Off label”. (4) Conclusions: Addressing AMR using the PV methods will provide an opportunity for PV expansion and could encourage further investment in both in AMS programs and PV systems.

Banking sector is generally taken out of sample while the sustainability performance, and the financial performance are compared with each other. The core aim of this study is to analyze the effect of the declarations made in the cope of sustainability reports on the financial performance in the banking sector. Seven banks were included in the study which were placed at least one time in BIST Sustainability Index in between 2010-2017 years. Environment, human resources, product liability and community involvement were determined as sustainability criteria and return on assets, return on equity and net interest margin were determined as financial performance criteria. Non-Parametric Statistic Tests and Panel Data Analysis were used for analysis and types, and the sizes of banks were selected as dummy variables. As a result, it is found that the declarations of sustainability reports have a significant effect only on return on assets and have no significant effect on return on equity and net interest margin. And also, when we analyzed the relationship of sustainability criteria and return on assets, we found that the declarations about environment and human resources have negative effects on return on assets.

The commitment of the EU to Corporate Social Responsibility (CSR) is projected in the EU law about annual reporting by businesses. Since EU member states further develop this framework by their own domestic laws, annual reporting with CSR information is not unified and just partially mandatory in the EU. Do all European businesses report CSR information and what public declaration to society do they provide with it? The main dual purpose of this paper is identifying the parameters of this annual reporting duty and studying the CSR information provided by the ten largest Czech companies in their annual statements for 2013-2017. Based on legislative research and the teleological interpretation, the current EU legislative framework with Czech particularities is presented and, via a case study exploring 50 annual reports, the data about the type, extent and depth of the CSR is dynamically and comparatively assessed. It appears that, at a minimum, large Czech businesses satisfy their legal duty and e-report on CSR in a similar extent, but in dramatically different quality. Employee matters and adherence to international standards are used as a public declaration to society more than the data on environmental protection, while social matters and R&D are played down.

Alzheimer’s disease and related dementias (ADRD) remain a public health challenge in developing counties. We developed a needs-based essential care service package (ECSP) for care planning of persons living with dementia (PLWD) using a cross-sectional survey among PLWD in institutions in six cities in China (n= 1,299). Face-to-face interviews were conducted with caregivers of PLWD by trained staff between 2018 and 2019. Care service needs and utilization by the level of cognitive impairment were summarized. The average age of PLWD was 80.7 years. 76% of participants had severe cognitive impairment. The needs-based ECSP with 30 service items would be sufficient in supporting care services of PLWD in China, of which seven items are core care. The selection plan for ECSP at different levels is designed as “General Care Services + Selective Care Services”, in which service items for low-, mid-and high-level care for PLWD are 7+3, 7+6, and 7+10, respectively. The findings provide the first large-scale data on service needs and utilization of PLWD in mainland China. The ECSP for PLWD advanced in the paper was a practicable and effective quantitative management means. It is deserved to application in a large scale.

The Multi-Faith Spaces (MFS) are a relatively new invention, and yet they quickly gained in significance. On one hand, they are a convenient solution for satisfying needs of people having diverse beliefs in the institutional context of places such as hospitals, schools, airports and the like. On the other hand, as Andrew Crompton pointed out, they are politically significant because the multi-faith paradigm “is replacing Christianity as the face of public religion in Europe” as successor of secularism (2012, p. 493). Due to their ideological entanglement, however, they are often used as the means to promote either a more privatised version of religion, or a certain denominational preference. Two diverse kinds of design are used to achieve these means: negative in the case of the former, and positive for the latter. Neither is without problems, and neither adequately fulfils their primary purpose of serving diverse groups of believers. Both, however, seem to follow the biases and main problems of secularism. In this paper, I analyse recent developments of the MFS to detail their main problems and answer the question, whether the MFS, and the underlying Multi-Faith Paradigm, can be classified as a continuation of secularism.

This research investigates the alignment of soft power and institutional skills in Montenegro's journey towards accession to the European Union (EU), with a particular focus on the environmental sector. An online survey targeting individuals employed in state institutions directly engaged in negotiation processes, notably the Ministry of Sustainable Development and Tourism and the Agency for Nature and Environmental Protection, was conducted. The research conducted an online survey, distributed before and after the summer recess to accommodate the transition of power following parliamentary elections, aimed at assessing the effectiveness of current personnel and identifying areas for improvement in staffing and negotiation strategies within Montenegro's environmental sector. Employing diverse methodologies, the survey's analysis delved into the demographic, social, and professional backgrounds of respondents. It explored their roles within institutions, involvement in environmental negotiations, and possession of relevant skills and expertise. Furthermore, respondents' knowledge of environmental issues, legislation, and challenges facing the country was assessed to gauge institutional capacity for environmental governance. Demographic data, including gender, age, education and regional origin, were collected to understand gender-specific attitudes and regional disparities in environmental perspectives. The sample of 84 individuals, comprising executives and employees from both institutions, provided insights into the age structure and regional diversity of personnel involved in negotiation tasks for Chapter 27. The selection of the Ministry of Sustainable Development and Tourism and the Agency for Nature and Environmental Protection reflects their pivotal roles in shaping Montenegro's environmental policies and addressing climate change challenges. This study aims to illuminate the dynamics of environmental governance within Montenegro's state administration, contributing to the country's path towards EU accession. The research findings highlight the critical need for Montenegro to prioritize strategic initiatives in personnel management, skill development, and institutional capacity-building within its environmental sector. The implications of this research extend beyond academia to inform policymaking and societal action, emphasizing the urgency for Montenegro to bolster its environmental sector capabilities, fostering both EU alignment and sustainable governance practices for the benefit of present and future generations.

Institutional barriers can hinder effective access and utilisation of Newcastle disease vaccines among smallholder chicken farmers. Many studies have focused on formal institutional barriers with minimal focus on informal institutions - unwritten rules and regulations that govern access and utilisation of Newcastle vaccines. However, informal institutions are more profound and encultured in individuals’ daily activities. This study sought to investigate informal institutional barriers to access and utilisation of Newcastle disease vaccines among women smallholder chicken farmers in Makueni, Kenya. The cross-sectional qualitative study employed in-depth interviews, key informant interviews and focus group discussions as data collection methods. Study informants were conveniently and purposively sampled. Informal institutional barriers to access and utilisation included: fear of Newcastle disease vaccine as a new technology, use of herbal remedies, mistrust of community vaccinators, gender division of labour, ownership of household resources and beliefs that indigenous chickens do not need vaccines. The study concludes that women chicken farmers are constrained by unwritten rules, norms, regulations and gender roles that hinder their access to and utilisation of the Newcastle disease vaccines. The need to examine informal institutions to identify and eradicate barriers to access and utilisation of Newcastle disease vaccines by farmers is recommended.

Introduction: Spinal epidural arteriovenous fistulas (SEDAVFs) are extremely rare and the pathological process still remains unclear. Nevertheless, neurofibromatosis, surgery, as well as trauma have been implicated as causes. Nevertheless, long standing chronic vertebral compression fractures (VCFs) as a cause of SEDAVFs has not been reported in literature. Case Presentation: Our cases comprised of a male and female with ages 67 and 62 year respectively. They presented with weakness of bilateral lower extremities and back pain. Their symptoms deteriorated into mild recto-bladder dysfunction as well as hypoesthesia of lower limbs. They both had history of road traffic accidents (RTAs) prior to their symptomatology. In both cases, Magnetic resonance imaging (MRI) revealed VCFs prior to the above symptomatology. Spinal digital subtraction angiography (DSA) was used to confirm SEDAVFs in both cases. We utilized the trans-arterial route with Onyx embolization agent to obliterate both fistulae and their symptom resolved after the embolization. Two-years follow-ups revealed no recurrence of their fistulae. Conclusion: The initial long standing VCFs caused by trauma resulted in perforation of the dorsal somatic branches of the radicular artery leading to the occurrences of SEDAVFs in our cases.

An outbreak of novel coronavirus(2019-nCoV) that began in Wuhan, China, is rapidly spreading to all over China, and gradually to multiple countries. Regarding to put the epidemic prevention and spread under the control, early identification and diagnosis play a critical role. Patients with initially no or mild symptoms of Novel Coronavirus Pneumonia (2019-nCoV), namely “stealth” infection, often lack of typical clinical evidence to establish the diagnosis. Based on the clinical analysis of 4 cases in stealth infection, the results of this study highlight that early diagnosis requires a combination of epidemiological history, clinical manifestations, early chest CT examination, and 2019-nCoV RNA test (nucleic acid test), with particular emphasis on definite epidemiological history and early chest CT findings when positive nucleic acid tests lag behind.

Background. Epithelial ovarian cancer (EOC) is the deadliest gynecological malignancy worldwide. Brain metastasis (BM) is quite an uncommon presentation. However, the likelihood of central nervous system (CNS) metastasization should be considered in the context of disseminated disease. The therapeutic management of BMs is an unmet clinical need, to date. Case presentation. We identified across different Cancer Centers six cases of both BRCA wild-type and BRCA-mutated EOC spreading to the CNS. They presented either with a single brain lesion or with multiple lesions and most of them had intracranial-only disease. All cases received Poly-ADP ribose polymerase inhibitor (PARPi) maintenance, as by clinical practice, for a long time within a multimodal treatment approach. We also provide an insight into the available body of work regarding the management of this intriguing disease setting, with a glimpse of future therapeutic challenges. Conclusion. Despite the lack of unanimous guidelines, multimodal care pathways should be encouraged for optimal disease control of this unfortunate patient’s subset. Albeit not being directly investigated in BM patients, the PARPi maintenance is deemed to have a valuable role in this setting. Prospective research, aimed to implement worthwhile strategies in the multimodal patient journey of BMs from EOC, is eagerly awaited.

For decades, the discoverability and visibility of a paper relied on the readership of the academic journal where the publication was issued. The public's increasing interest in scientific research, particularly in biomedicine, has led news media outlets to play a significant role in disseminating scientific advances. This investigation, which explores the potential impact of news media stories on the citations and altmetrics of a paper, was conducted with thoroughness and rigour. A total of 2020 open access biomedical research papers, all published in the same year, 2015, and in journals with an impact factor between 10 and 14, were investigated. The papers were split into two groups based on the sole criterion of receiving or not receiving news media coverage. Papers with news media coverage accounted for 44% of the total. They received, on average, 60% more citations, 104% more blogs, 150% more X posts, 106% more Facebook reports, 40% more Wikipedia references, 85% more videos, and 51% more Mendeley readers than papers without news media coverage. The correlation between news media outlets and increased citations and altmetrics is evident. However, the broader societal impact of news media coverage, in terms of bringing scientific matters or discoveries to the public eye, appears to be more robust when compared to the reactions of the scientific community.

Extreme environmental variations (EV), as a phenomenon deriving from climate change (CC), led to an exacerbated uncertainty on water availability and increased the likelihood of conflicts regarding water-dependent activities such as agriculture. In this paper, we investigate the role of conflict resolution mechanisms -one of Ostrom’s acclaimed Design Principles (DPs)- when social-ecological systems (SESs) are exposed to physical external disturbances. The theoretical propositions predict that SESs with conflict-resolution-mechanisms will perform better than those without them. We tested this proposition through a framed-field-experiment that mimicked an irrigation system. In this asymmetric setting, farmers were exposed to two (2) dilemmas: (i) how much to invest in the communal irrigation system’s (CIS) maintenance and (ii) how much water to extract. The setting added a layer of complexity: water availability did not only depend on the investment but also on the environmental variability. Our findings largely confirmed the theoretical proposition: groups with stronger institutional robustness are able to cope with EV better than those with weaker robustness. However, we also found that some groups, despite lacking conflict-resolution-mechanisms, were also able to address EV. We explored potential explanatory variables to these unexpected results. We found that subjects’ and groups’ attributes might address uncertainty and avert conflict. Thus, SESs’ capacity to respond to external disturbances, such as EV, might not only be a question of DPs. Instead, it might also be strongly related to group members' attributes and group dynamics. Our results pave the way for further research, hinting that some groups might be better equipped for mitigation measures, while others might be better equipped for adaptation measures.

Vaccination against SARS-CoV-2 has significantly contributed to the recent pandemic control. COVID-19 vaccines are available with different platforms and the primary clinical trials results presented acceptable safety profile of the approved vaccines. Nevertheless, the long-term assessment of the adverse events or rare conditions need to be investigated. The present systematic review, aimed at classification of Iranian case reports following COVID-19 immunization. To achieve this goal, the related published case reports were explored via PubMed, Web of Science and Google scholar according to PRISMA guideline and available up to 14th Dec, 2022. Out of 437 explored studies, the relevant data were fully investigated which totally led to 40 studies including 64 case reports with a new onset of a problem. The cases were then classified according to the various items such as the type of adverse event manifestations and COVID-19 vaccine. The reported COVID-19 vaccines in the studied cases included Sinopharm, AstraZeneca, and COVAXIN. The results showed that the adverse events presented in 8 different categories from which cutaneous problems accounted as the most prevalent manifestations (43.7%) in which rare diseases were also screened such as Steven-Johnson syndrome, Morphea and Toxic Epidermal Necrolysis. Notably, almost 60% of the cases had no comorbidities. Moreover, the obtained data revealed nearly half of the incidences occurred after the first dose of injection and the mean duration of improvement after the symptom onset was 18.72±24.69 days. 73% of all the cases were either significantly improved or fully recovered. Although the advantages of COVID-19 vaccination is undoubtedly significant, the high risk individuals including those with a history of serious disease or comorbidities immunodeficiency conditions should be vaccinated with the utmost caution.

The purpose of this study is to examine the relationship between the institutional investors which can affect financial performance for corporate sustainability on the income smoothing. Therefore, this study focus on the connection between the nature of stock rights and income smoothing in China. For this study, hypotheses were established on the relationship each state-controlled companies, income smoothing, and information equilibrium of individual investors, and empirical analysis was conducted through related variables. The analysis results are summarized in three categories as follows. First, this research finds that state-controlled firms (CONTs) prefer income smoothing activities compared to non-state-controlled firms for the long-term sustainable development of firms using data from 2011 to 2019. Second, this study found out that Institutional investors support the behavior of CONTs to smooth their earnings because this behavior is seen as an attempt by CONTs to convey valuable private information to other investors. Third, we was able to discover that institutional investors' monitoring effect is predominantly driven by pressure-resistant institutional investors. This research complements the lack of empirical research on income smoothing and enable to give a guideline that the type of stock rights is a critical key determinant of participation in income smoothing activities for stable growth and sustainability in the future.

Using English prison inspectorate reports the article reports a Goffmanesque-informed discourse analysis of official accounts about the younger inmates of London’s Feltham prison and the conditions characterizing their lived experiences in this prison environment. The construction of this prison estate captures dilapidation, unhygienic conditions, and endless social danger. The stigmatizing construction of the child prisoner intimates a pervasive culture of violence and bullying resulting in their aversion to purposive activities. While, at first blush, prison inspec-torate reporting is based on the policy of ensuring a safe and rehabilitative prison experience for youth it is argued that the nature of the reporting of incarceration obviates a critique of the wider political fabric that custodial interventions reproduce. The Inspectorate operates within the state’s dominant class stratified political ideology. The adoption of a generic labelling discourse in the reports minimizes the communication of harms inflicted on children by criminal ‘justice’ that can only worsen their wellbeing and reproduce the harmful intensity of their imported marginality.

Background: After allogeneic hematopoietic stem cell transplantation (allo-HSCT), acute leukemia relapse is common, and asymmetric bone marrow recurrence hasn’t been reported. Because the anatomical distribution of acute leukemia clones in the bone marrow after allo-HSCT is presumed to be diffuse, bone marrow aspirations are performed in single site. Case presentation: We identified two acute leukemia patients, whose leukemic burden in bilateral bone marrow specimens differed significantly. The first case was a 20-year-old man who was diagnosed with acute myelomonocytic leukemia and received haploidentical allo-HSCT. He had been in complete remission for two years and off immunosuppressive medications for a year, with normal peripheral blood count. Routine bone marrow biopsy of his left posterior iliac bone marrow showed 52% leukemia blasts, while the right side had 0% blasts ten days later. Due to the discordant results, the patient refused further intervention and died of high leukocyte syndrome four months later. The second case was a 23-year-old woman who was diagnosed with acute B lymphoblastic leukemia and received HLA-identical sibling allo-HSCT. Although 62% of blasts were found in her left iliac marrow on day +122, 0 % of blasts were found on a sample obtained from the right iliac crest on day +128. Whole-body 18F-FDG PET/CT scans confirmed that the leukemic infiltration in her bone marrow was asymmetric. Considering the higher leukemic burden on the left, we chose the left posterior iliac crest aspiration for further response evaluation. After chemotherapy combined with donor lymphocyte infusion, she achieved transient hematologic complete remission. She died of septic shock with heart failure at +258 days after allo-HSCT before infusion of anti-CD19 donor chimeric antigen receptor T cells. Conclusions: To our knowledge, these are the first case reports of asymmetric bone marrow infiltration of blasts in acute leukemia patients after allo-HSCT. Bilateral posterior iliac crest aspirations or 18F-FDG-PET/CT scans may help distinguish such distribution. If discordant bone marrow specimens are observed, physicians should restrict future bone marrow studies to the more involved side.

Background/Objectives: Vascular invasion, especially extramural vascular invasion (EMVI) has emerged as prognostic parameter for rectal cancer (RC) in recent years. Prediction of reccurence and metastases development poses a significant challenge for oncologists, needing markers for prediction of adverse outcome. The aim of this study was to examine the prognostic significance of pathohistologically detected EMVI in untreated rectal cancer and its implications in separate reporting. Methods: We examined 100 untreated RC patients who underwent curative resection from January 2016 to June 2018 with follow up of 5 years. Patients were divided in equal EMVI- and EMVI+ groups based on histological re-examination of H&E stained postoperative surgical samples. Results: The presence of EMVI within the selected cohort was significantly associated with female gender, T3/T4 and N1/N2 post-operative stages, positive lymph nodes, lymph node ratio LNR2 and LNR3 groups, abundant tumor-infiltrating lymphocytes, positive lympho-vascular invasion (LVI), perineural (PNI), and circumferential resection margin (CRM) (p

Digital transformation and green innovation are critical to firms’ competitive advantage and, thus, firms desire to make digital transformation enhance green innovation. However, the relationship between the digital transformation on green innovation is unclear. Drawing on digital empowerment, we delineate types of digital transformation and their impacts on green innovation in manufacturing firms. Our empirical results indicate that production digitalization and service digitalization have a significant promoting effect on both of green technological innovation and green management innovation. However, the effect of production digitalization on green management innovation is stronger than that of service digitalization. Moreover, environmental regulation enhances the positive effect of service digitalization on green technological innovation and green management innovation. While it enhances the effect of production digitalization on green management innovation. Peer firms’ green innovation strengthens the effect of service digitalization on both of green technological innovation and green management innovation.

Based on the institutional theory and resource-based theory and the "institution-strategy-performance" research paradigm, this research explores the mechanism of institutional support on the innovation performance of new ventures, focusing on the mediating role of entrepreneurs and the moderating role of innovative resource acquisition. An empirical analysis based on 278 survey samples shows that: ① (formal/informal) institutional support positively affects the innovation performance of new ventures; ② entrepreneurial orientation plays an intermediary role between institutional support and innovation performance of new ventures; ③ innovation resource acquisition not only positively regulates the relationship between entrepreneurial orientation and innovation performance of new ventures, but also enhances the mediation of entrepreneurial orientation between institutional support and innovation performance. The conclusion shows that institutional support plays an important role in the innovation practice of new ventures, and can provide guidance for the innovation management practices of new ventures.

In this study, we designed a structural model to determine the relationships among push–pull factors, institutional situations, and satisfaction during the COVID-19 pandemic. The 17 selected indicators fell under five domains, namely push factors, pull factors, institutional leadership, international strategies, and satisfaction. Structural equation modeling (SEM) was used to verify the assumptions of the model. Based on 1005 degree-seeking international students' views, this study found that push and pull factors may coincidentally exist, and their functions can be modified by institutional situations. The findings suggest pull factors will, through institutional leadership, impact students' satisfaction, while push factors will not. Moreover, the detection of institutional mediation can provide useful information for specific institutes to develop their future recruiting or retaining strategies. These findings enriched our knowledge of the field during the pandemic. For future studies, this design may be useful to interpret the phenomena of global student mobility in higher education settings.

Several treatment guidelines for sporadic, nonmetastatic nonfunctioning neuroendocrine tumors of the pancreas (NF-pNETs) have recommended resection, however, tumors ≤ 2 cm do not necessarily need surgery. This study aimed to establish a surgical treatment plan for NF-pNETs ≤ 2 cm. From 2000 to 2017, 483 patients who underwent resection for NF-pNETs ≤ 2cm in 18 institutions from Korea and China were enrolled and their medical records were reviewed. Median age was 56 (range 16- 80) years. The 10-year overall survival rate (10Y-OS) and recurrence-free survival rate (10Y-RFS) were 89.8 and 93.1%, respectively. In multivariable analysis, tumor size (> 1.5cm; p = 0.001) and nodal metastasis (p = 0.013) were independent adverse prognostic factors for OS. Perineural invasion (p = 0.008) and high Ki-67 index (≥3%; p < 0.001) were independent prognostic factors for poor RFS. NF-pNETs ≤ 2 cm showed unfavorable prognosis after resection when the tumor was larger than 1.5cm, Ki-67 index ≥ 3%, or nodal metastasis was present. NF-pNET patients with tumors ≤ 1.5cm can be observed if the preoperative Ki-67 index is under 3%, and if nodal metastasis is not suspected in preoperative radiologic studies. These findings support the clinical use to make decision about small NF-pNETs.

This paper contributes to the current debate about Benefit Corporations, presenting the development of this organisational model in Italy, the first country to introduce this hybrid form after the US. Grounded on an institutional logic perspective, it provides a picture of the institutional dynamics that have characterised the rise of this new entrepreneurial form outside the US. The analysis provides an in-depth foundational study of the Italian case and highlights the relevant influence of different institutional pressures in explaining the rise of and constraints in the diffusion of Benefit Corporations. Empirically, it combines secondary data, available from different public sources, and primary data collected through interviews with a series of knowledgeable informants. Based upon the analysis, two aspects appear peculiar for the development of Benefit Corporations in Italy: the interplay between the Benefit Corporation legal form and the certified B Corp model, and the rise of tensions between social entrepreneurship and the third sector ecosystem. This paper concludes that the peculiar institutional pressures leading to the birth of Benefit Corporations in Italy may be source of permanent tensions and of concern for the diffusion of the model.

Imatinib 400 mg is the standard of care for medical treatment of advanced GISTs. In the majority of cases, however, GISTs eventually develop resistance to imatinib. The optimal second line treatment has not been established yet and imatinib dose escalation (800 mg) or sunitinib represent two feasible options. The objective of this retrospective, multi-institutional, study is to analyze the validity of several parameters as possible predictive factors of response to sunitinib after imatinib failure. We reviewed 128 metastatic GISTs treated with sunitinib between January 2007 to June 2017. Primary tumour site, metastatic site, c-KIT/PDGFR-α mutational status, PET-FDG status and type of disease progression to sunitinib were assessed as possible predictive factors of response. This study identifies the gastric site of primary tumor as a predictive factor to sunitinib efficacy in second line setting. The mutational status (GIST WT), the site of metastasis (peritoneum) and the FDG-PET status (negative), although not statistically significant, seem to be elements of increased activity for sunitinib treatment. These results provide the rationale to drive physician for sunitinib choice in second line setting for metastatic GISTs, to improve patients selection and to maximize the benefit from the treatment, on the basis of possible predictive factors of response.

Background: The novel Coronavirus SARS-CoV-2 (COVID-19) is a global pandemic with an increasing public health concern. Due to the non-availability of a vaccine against the disease, non-pharmaceutical interventions constitute major preventive and control measures. However, inadequate knowledge about the disease and poor perception might limit compliance. Aim: This study examined COVID-19-related knowledge, practices, perceptions and associated factors amongst undergraduate veterinary medical students in Nigeria. Methods: A cross-sectional web survey was employed to collect data from 437 consenting respondents using pre-tested self-administered questionnaire (August 2020). Demographic factors associated with the knowledge and adoption of recommended preventive practices towards COVID-19 were explored using multivariate logistic regression at P ≤ 0.05.Results: The respondents’ mean knowledge and practice scores were 22.7 (SD ± 3.0) and 24.1 (SD ± 2.9), respectively with overall 63.4% and 88.8% displaying good knowledge and satisfactory practice levels. However, relatively lower proportions showed adherence to avoid touching face or nose (19.5%), face mask-wearing (58.1%), and social distancing (57.4%). Being in the 6^th year of study (OR = 3.18, 95%CI: 1.62-6.26, P = 0.001) and female (OR = 2.22, 95% CI = 1.11-4.41, P = 0.024) were significant positive predictors of good knowledge and satisfactory practices, respectively. While only 30% of the respondents perceived the pandemic as a scam or a disease of the elites (24.0%), the respondents were worried about their academics being affected negatively (55.6%). Conclusion: The study revealed good knowledge and satisfactory preventive practices towards COVID-19 among Nigerian Veterinary students; albeit with essential gaps in the key non-pharmaceutical preventive measures recommended by the WHO. Therefore, there is a need to step up enlightenment and targeted campaigns about COVID-19 pandemic.

Background: The ageing process starts in the center of the face, in the periocular region and around the mouth, with a combination of volume loss and tissue descent, wrinkles deepen, and loss of skin structure and quality. Recently, several studies proved the efficacy of therapies based on the autologous adipose tissue grafting that leverages the properties of stromal vascular fraction (SVF) and adipose derived mesenchymal stem cells (ADSCs) to accelerate the regenerative processes of the skin. This study aimed to verify the ability of the guided Superficial Enhanced Fluid Fat Injection (SEFFI) in the facial area to correct volume loss and skin aging and proved the very low rate of complications of this standardized procedure . Methods: we retrospectively collected data from 2,365 procedures performed in Italian centers between 2019 and 2021. Guided SEFFI was performed alone or combined with cosmetic treatments, including the use of hyaluronic acid filler, suspension threads, synthetic calcium hydroxylapatite, botulin toxin, and microneedling. Results: SEFFI was used alone in more than 60% of the patients, and in all face areas. In about one tenth of patients SEFFI was combined with botulin toxin treatment or hyaluronic acid filling. Other procedures were used more rarely. Ecchymosis in the donor or injection sites was the most frequent event, and yet observed in only 14.2% and 38.6% of patients, respectively. Conclusions: The SEFFI technique is standardized and minimally invasive, leading to very few complications. It can be a promising antiaging medical treatment that combines effectiveness, safety, and simplicity.

Objective: to evaluate the effects of excitatory repetitive transcranial magnetic stimulation (rTMS) of the international 10-20 system P3 point (intraparietal sulcus region) in chronic patients with a frontal lesion and parietal sparing due to stroke on the impaired upper (UL) and lower limb (LL) as measured by Fugl-Meyer Assessment (FMA). Methods: three patients (C1: 49.83/2.75, C2: 53.17/3.83, C3: 63.33/3.08 years-old at stroke/ years post-stroke, respectively) received two weeks (five days/ week) of rTMS at 10 Hz of P3. A patient was treated in similar conditions with a sham coil (S1: 56.58/4.33). No complimentary therapy was delivered during the study. Patients were evaluated before, after- and two months post-treatment (A1, A2 and A3, respectively). Results: we found increased scores for LL in motor function subsection for C1 and C3 and in sensory function for C2 by A2 that remained at A3. We also found an increased score for UL motor function for C2 and C3, but the score decreased by A3 for C2. C3 score for UL range of motion increased by A3 compared to A1 and A2. Conclusion: In a variable way, P3 excitatory rTMS increased FMA scores in different upper and lower limb subsections of our three treated patients.

The clinical significance of carbon-ion radiotherapy (CIRT) for adenocarcinoma (AC) of the uterine cervix has been assessed in several single-institutional studies. To validate the significance, we conducted a multi-institutional survey of CIRT for locally advanced AC (LAAC) of the uterine cervix. We retrospectively analyzed the clinical outcomes of patients with stage IIB–IVA LAAC of the uterine cervix who underwent chemo-CIRT or CIRT alone between April 2010 and April 2016. Patients received 74.4 Gy (relative biological effectiveness [RBE]) in 20 fractions of CIRT or 55.2 Gy (RBE) in 16 fractions of CIRT plus 3 sessions of brachytherapy. Patients aged ≤70 years with adequate bone marrow and organ function were administered cisplatin weekly (40 mg/m2 per week for up to 5 weeks). Fifty-five patients were enrolled in this study. The median follow-up period was 67.5 months. The 5-year overall survival (OS) and local control (LC) rates were 68.6% and 65.2%, respectively. Multivariate analysis showed that the initial tumor response within 6 months was significantly associated with LC and OS. The present study represents promising outcomes of CIRT or chemo-CIRT for LAAC of the uterine cervix, especially in the cases showing initial rapid regression of the tumor.

There is a great need to develop research-based models for supporting collaboration between educational institutions. Collaboration models are needed, for example, to assist the transition from lower educational level to higher education or from higher education to work life. In this research, collaboration was conducted through a joint upper-secondary school and university course that addressed global challenges by using a project-based learning approach. There is a shortage of research exploring students’ perceptions of collaboration. Therefore, the main purpose of this qualitative case study is to explore the relevance of the joint course for students and university students. The research was guided by the following research question: What kind of relevance did the students experience in the joint project-based learning course? The data was gathered using questionnaires, interviews, and reflective study reports. The data was analyzed via theory-based content analysis where research-oriented relevance model was used as the analysis framework. The analysis framework enabled categorizing experienced relevance on individual, vocational and societal dimensions. Altogether, the analysis produced 7 relevance categories for upper-secondary students and 9 for university students. According to the analysis, upper-secondary school students felt that the course offered the most on an individual relevance dimension whereas university students experienced the vocational relevance dimension most diverse. As the main conclusion, this research produced new insights on the experienced relevance of upper-secondary level and higher education cooperation from the students’ point of view. The acquired knowledge can be useful for everyone developing new cross-institutional cooperation models.

In times of water scarcity, water conservation measures from authorities are primarily directed to the residential sector—homeowners and renters who engage in individual activities to reduce water consumption. Business owners, manufacturers, and institutional workers—the ICI sector, generally, do not receive targeted information and education on water savings measures, and when they do, the information, typically, refers to indoor technologies, and behavior choice. In answer to this shortfall, this research illustrates how the ICI sector might engage in outdoor water conservation and, thus, realize water savings using the well-established Pittenger’s Simplified Landscape Irrigation Design Estimation (SLIDE) formula that estimates outdoor water conservation/savings for the lesser studied industrial, commercial, and institutional (ICI) sector. We applied the SLIDE formula five diverse climate areas in Texas to demonstrate the potential water savings in each, as well as identifying the type of water technology measures that yielded the greatest water savings for outdoor ICI landscapes. Overall, the greatest water savings for outdoor ICI landscapes was realized through smartscape design with soil moisture sensors-SMS technology, second best. Our findings will provide ICI facility owners/managers with knowledge and examples of a simplified system for quantitative decision making when considering choices among technologies and/or practices toward outdoor water conservation for their own facilities.