This paper introduces a quantitative methodology for assessing drone pilot performance, aiming to reduce drone-related incidents by understanding the human factors influencing performance. The challenge lies in balancing evaluations in operationally relevant environments with those in a standardized test environment for statistical relevance. The proposed methodology employs a novel virtual test environment that records not only basic flight metrics but also complex mission performance metrics, such as the video quality from a target. A group of Belgian Defence drone pilots were trained using this simulator system, yielding several practical results. These include a human performance model linking human factors to pilot performance, an AI co-pilot providing real-time flight performance guidance, a tool for generating optimal flight trajectories, a mission planning tool for ideal pilot assignment, and a method for iterative training improvement based on quantitative input. The training results with real pilots demonstrate the methodology’s effectiveness in evaluating pilot performance for complex military missions, suggesting its potential as a valuable addition to new pilot training programs.

Despite the recognized influence of maximum or acceleration strength on combat techniques and countermovement jump (CMJ) performance, the relationship between body segment weights and combat techniques remains unexplored. This study aimed to examine the impact of body segment weights, including striking arm weight (SAW), kicking leg weight (KLW), and trunk weight (TW), on the dynamics of direct punches (DP), palm strikes (PS), elbow strikes (ES), front kicks (FK), and CMJ performance. Sixteen male military cadets (22.3±1.8 years, 181.4±7.0 cm, 83.0±8.1 kg) performed combat techniques, with performance measured by using a force plate and body segment weights assessed by Dual-energy X-ray absorptiometry. Spearman's correlation analysis was applied. Results indicated a strong correlation between KLW and FK impulse (r = 0.64, p ≤ 0.01) and CMJ impact force (r = 0.80, p ≤ 0.01). SAW showed moderate correlations with DP impulse (r = 0.53, p ≤ 0.05) and ES impulse (r = 0.54, p ≤ 0.05). Additionally, FK peak and impact forces were strongly correlated with CMJ jump height (r = 0.74, p ≤ 0.01; r = 0.77, p ≤ 0.01), and FK peak force moderately correlated with CMJ peak velocity (r = 0.63, p ≤ 0.05). These findings suggest targeted arm strength training could enhance striking abilities, while improvements in leg acceleration strength may directly boost kicking performance and vertical jump capabilities, which are crucial in combat scenarios.

This paper explores the dynamics of political competition, resource availability, and conflict through a simulation-based approach. Utilizing agent-based models (ABMs) within an evolutionary game theoretical framework, we investigate how individual behaviors and motivations influence collective outcomes in civil conflicts. Our study builds on the theoretical model developed by Basuchoudhary et al. (2023), which integrates factors such as resource availability, state capacity, and political entrepreneurship to explain the evolution of civil conflict. By simulating boundedly rational agents, we demonstrate how changes in resource availability and state capacity can alter the nature of civil conflict, leading to different equilibrium outcomes. The findings highlight the importance of understanding individual motivations and adaptive behaviors in predicting the stability and resolution of conflicts. This research contributes to the growing body of literature on the use of agent-based models in evolutionary game theory and provides valuable insights into the complex interactions that drive civil violence.

The wealth of data obtained during the past 20 years using Laser-Induced Breakdown Spectroscopy (LIBS) indicates that the technique is very promising to detect small chemical contents of alloying elements. The potential of LIBS was looked more seriously during the past two decades or so as more data were obtained on Aluminum and steel to study the phenomena in the condition of local thermodynamic equilibrium and time-delay between a Q-switch laser and an intensified CCD camera. Since the past decade, some data on compounds were also shown to be useful in determining small concentrations of harmful elements. This manuscript is intended to show that the technique of LIBS performance is very promising in fields such as micro-machining, in alloying element analysis, surface cleaning and environmental applications even with lightweight spectrometers having a relatively low resolution, which can potentially be air-borne.

CX3CL1, also named fractalkine or neurotactin, the only known member of the CX3C chemokine family that can chemoattract several immune cells. CX3CL1 exists in both membrane-anchored and soluble forms, each mediating distinct biological activities. CX3CL1 signals are transmitted through its unique receptor, CX3CR1, primarily expressed in microglia of central nervous system (CNS). In the CNS, CX3CL1 acts as a regulator of microglia activation in response to brain disorders or inflammation. Recently, there has been a growing interest in the roles of CX3CL1 in regulating cell adhesion, chemotaxis, and host immune response in viral infection. Here, we provide a comprehensive review of the changes and function of CX3CL1 in various viral infections such as human immunodeficiency virus (HIV), SARS-CoV-2, influenza virus and cytomegalovirus (CMV) infection, to highlight the emerging roles of CX3CL1 in viral infection and the associated diseases.

The mutation in NF2 is the most common alteration associated with meningioma oncogenesis, and it is related to the loss of a suppressing protein called merlin. At the same time, alterations in energy production are visible in cancer cells where increased demand for energy is observed. Fatty acid oxidation could be one of the ways cancer cells obtain energy. This metabolic pathway uses the acylcarnitine shuttle system, which is responsible for the acylation of fatty acids and their transport through mitochondria. Therefore, this study aimed to profile acylcarnitines with short-, medium- and long-acyl chain length in meningiomas to assess their changes in tumors with different NF2 mutation statuses. For the analysis, solid-phase microextraction (SPME) coupled with liquid chromatography high resolution mass spectrometry (LC-HRMS) was used. The presented sampling method enables low invasive and easy collection of the analytes from the studied lesions, which can be crucial for future analysis of potential biomarkers in the surgery room. It was observed that higher levels of these analytes characterized meningiomas with NF2 mutation. Moreover, increased energy consumption and elevated levels of acylcarnitines show that these analytes can be considered as a marker of increased fatty acid oxidation in NF2 mutated cells.

Abstract: Background: Nurses worldwide are acknowledged for their role in health education across various settings. However, doubts often arise regarding their competence in this domain. This study aims to validate the Nurse Health Education Competence Instrument (NHECI) linguis-tically and culturally for the Italian context. Methods: Following Beaton et al.’s (2000) guidelines, we conducted cross-cultural adaptation to develop the Italian version of the questionnaire. Results: The Italian version demonstrates good internal consistency and stability, making it suita-ble for assessing nursing students during clinical internships and practicing nurses. Availability of Italian tools promotes research in healthcare, ensuring patient-centric care. Conclusions: The validity and reliability of the Italian version of the instrument for assessing health education competencies, essential for self-assessment among health education nurses, are established.

Despite the recognized influence of body mass on combat techniques, the relationship between body segment mass (BSM) and combat moves remains unexplored. This study aimed to examine the relationship between striking arm mass (SAM), kicking leg mass (KLM), and body mass (BM) with the dynamic forces of the direct punches (DP), palm strikes (PS), elbow strikes (ES), front kicks (FK), and countermovement jumps (CMJ) performance. Sixteen male military cadets (22.3 ± 1.8 years, 181.4 ± 7.0 cm, 82.1 ± 8.5 kg) performed combat techniques, with performance measured by using a force plate and body segment mass assessed by Dual-energy X-ray absorptiometry. Spearman's correlation analysis, the Wilcoxon test, and Cohen's d were applied. Results indicated the relationship between KLM or BM and FK impulse (r = 0.64, p = 0.01; r = 0.52, p = 0.04, respectively) and CMJ impact force (r = 0.80, p ≤ 0.01; r = 0.70, p ≤ 0.01, respectively). Moreover, FK peak and impact forces were moderately correlated with CMJ jump height (r = 0.74, p ≤ 0.01; r = 0.77, p ≤ 0.01). The highest relationship was found between KLM and FK impulse; however, the difference in variability explained by KLM versus body mass is only 12%. This suggests that knowledge of BSM did not provide a significantly better estimate of the dynamic forces of the punches and FK than BM.

Background Sarcopenia is a state with progressive and generalized loss of skeletal muscle mass and strength. It is a serious complication occurring in chronic kidney disease (CKD) patients which increases morbidity and mortality rate. Sarcopenia is diagnosed when loss of both compartments - muscle strength and skeletal muscle quality or quantity are present. However, there are still numerous patients, also with CKD, diagnosed as pre-sarcopenic individuals with low muscle strength and normal skeletal muscle quality or quantity and conversely, with correct muscle strength and decreased skeletal muscle mass, who are prone to develop sarcopenia in future life. It is crucial to examine numerous variables possibly associated with changes of skeletal muscle mass and muscle strength in terms of preventing the development of sarcopenia. The aim of the study was to investigate anthropometric and clinical correlates and sources of variation in both skeletal muscle mass and muscle strength in advanced stages of CKD. Methods The study sample consisted of 84 non-dialysis dependent patients of both sexes (including 45.2% of women) with eGFR < 45 ml/min/1.73m²: 26.2% with eGFR 30-44 mL/min/1.73 m², 65.5% with eGFR 15-29 mL/min/1.73 m² and 8.3% with eGFR < 15 mL/min/1.73 m². Muscle strength was estimated by measuring hand grip strength (HGS) with the use of handheld hydraulic dynamometer. Muscle quantity was measured by bioimpedance spectroscopy using Body Composition Monitor. Appendicular skeletal muscle mass (ASM) was calculated according to Lin’s formula. Serum creatinine, urea, uric acid and albumin were measured. Results In bivariate analysis we found that ASM significantly and positively correlated with anthropometric variables such as body mass (r=0.903, p<0.001), NH weight (r=0.882, p<0.001), height (r=0.694, p<0.001), body mass index (BMI) (r=0.701, p<0.001), lean tissue mass (LTM) (r=0.664, p<0.001), lean tissue index (LTI) (r=0.433, p<0.001), fat mass (r=0.614, p<0.001) and fat tissue index (FTI) (r=0.449, p<0.001), and was negatively associated with clinical variable such as hydration status (p<0.001). HGS significantly and positively correlated with anthropometric parameters such as body mass (r=0.319, p=0.003), NH weight (r=0.315, p=0.004), height (r=0.666, p<0.001), LTM (r=0.490, p<0.001), LTI (r=0.238, p=0.029), and ASM (r=0.501, p<0.001), and was negatively associated with clinical variables like uric acid (p=0.039) and urea (p<0.001). After adjustment for age, sex and height, HGS remained significantly and negatively related with uric acid (β=-1.078, p=0.041) and hydration status (β=-0.805, p=0.042). Conclusions In CKD patients, ASM is determined mainly by anthropometric parameters but HGS - both by anthropometric and clinical variables specific for CKD.

To make wind power more competitive, it is necessary to reduce turbine downtime and reduce costs associated with wind turbine Operation and Maintenance (O&amp;M). Incorporating machine learning in developing condition-based predictive maintenance methodologies for wind turbines can enhance their efficiency and reliability. This paper presents a monitoring method that utilizes Base Density for the Support Vector Machine (BDSVM) and the evolutionary Fourier spectra of vibrations. This method allows smart monitoring of the function evolution of the turbine. A complex optimal function (FO) for 5-degree order has been developed that will be the boundary function of the BDSVM to timely determine the magnitude, frequency, and place of the failure occurring in wind turbine drive.

The development of effective vaccines against SARS-CoV-2 remains a critical challenge amidst the ongoing global pandemic. This study introduces a novel approach to enhance mRNA vaccine efficacy by leveraging the untranslated region (UTR) of TMSB10, a gene identified for its significant mRNA abundance in antigen-presenting cells. Utilizing the GEO database, we identified TMSB10 among nine genes with the highest mRNA abundance in dendritic cell subtypes. Subsequent experiments revealed that TMSB10's UTR significantly enhances the expression of a reporter gene in both antigen-presenting and 293T cells, surpassing other candidates and a previously optimized natural UTR. Comparative analysis demonstrated that TMSB10 UTR not only facilitated higher reporter gene expression in vitro but also showed marked superiority in vivo, leading to enhanced specific humoral and cellular immune responses against the SARS-CoV-2 Delta variant RBD antigen. Specifically, vaccines incorporating TMSB10 UTR induced significantly higher levels of specific IgG antibodies and promoted a robust T-cell immune response, characterized by increased secretion of IFN-γ and IL-4 and the proliferation of CD4+ and CD8+ T cells. These findings underscore the potential of TMSB10 UTR as a strategic component in mRNA vaccine design, offering a promising avenue to bolster vaccine-induced immunity against SARS-CoV-2 and potentially other pathogens.

Chlorophyll-a (Chl-a), a proxy for phytoplankton biomass, is one of the few biological water quality indices detectable using satellite observations. However, models for estimating Chl-a from satellite signals are currently unavailable for many lakes. The application of Chl-a prediction algorithms may be affected by the variance in optical complexity within lakes. Using Lake Winnipeg in Canada as a case study, we demonstrated that separating models by the lake’s basins [north basin (NB) and south basin (SB)] can improve Chl-a predictions. By calibrating more than 40 commonly used Chl-a estimation models using Landsat data for Lake Winnipeg, we achieved higher correlations between in situ and predicted Chl-a when building models with separate Landsat-to-in-situ matchups from NB and SB (R² = 0.85 and 0.76, respectively; p &lt; 0.05), compared to using matchups from the entire lake (R² = 0.38, p &lt; 0.05). In the deeper, clearer waters of the NB, a green-to-blue band ratio provided better Chl-a predictions, while in the shallower, highly turbid SB, a red-to-green band ratio was more effective. Our approach can be used for rapid Chl-a modeling in large lakes using cloud-based platforms like Google Earth Engine with any available satellite or time series length.

Background: breastfeeding is the optimal nourishment for infants and recommends that children commence breastfeeding within the first hour of birth and be exclusively breastfed for the initial 6 months of life. Our objective was to determine which factors related to mothers could influence the degree of exclusive breastfeeding during hospitalization, as well as to assess breastfeeding mothers' attitudes towards breastfeeding. Methods: A multicenter cross-sectional study was undertaken in the healthcare area of Santiago de Compostela, Spain. The reduced Iowa Infant Feeding Attitude Scale (IIFAS-s) was employed to gauge maternal attitudes toward feeding their baby. Results: 64 women were studied. The overall score of IIFAS-s (mean ± standard deviation) was 36.95 ± 5.17. No use of pacifier by the newborn was associated with a positive attitude for breastfeeding. Having previous children (ORa=6,40; IC95% 1,26 – 32,51) and previous experience with breastfeeding (ORa=6,70; IC95% 1,31 – 34,27) increase the likelihood of exclusive breastfeeding during admission. Conclusions: It is important to identify the factors that contribute to increasing the probability that mothers choose exclusive breastfeeding. We must guide our training efforts to these factors.

Military Internet of Things (MIoT) has emerged as a new research area in military intelligence. The MIoT frequently has to constitute a federation-capable IoT environment when the military needs to interact with other institutions and organizations or carry out joint missions as part of a coalition such as in NATO. One of the main challenges of deploying MIoT in such an environment is to acquire, analyze, and merge huge amounts of data from many different IoT devices and disseminate it in a secure, reliable, and context-dependent manner. In this work, we present a comprehensive solution for secure data dissemination based on the integration of Hyperledger Fabric's distributed registry technology, Apache Kafka message broker, and data processing microservices implemented using the Kafka Streams API library and applying attribute-based encryption (ABE), a cryptographic approach that facilitates controlling access to information based on data and user attributes rather than traditional methods that rely on specific keys. In the work, we built an experimental setup, implemented an access control scheme designed for mobile components, and performed an evaluation of its performance. Performance tests have confirmed the suitability of the developed cryptographic method for attribute-based data access control in MIoT systems, considering the federations of military networks. The results indicate that the proposed cryptographic scheme is viable for the number of attributes typically assumed to be used in battlefield networks, offering a good trade-off between security and performance for modern cryptographic applications.

A U.S. government health agency conducted epidemiological studies to evaluate whether exposures to drinking water contaminated with volatile organic compounds at U.S. Marine Corps Base Camp Lejeune, North Carolina, were associated with increased health risks to children and adults. These health studies required knowledge of contaminant concentrations in drinking water—at monthly intervals—delivered to family housing, barracks, and other facilities within the study area. Because concentration data were limited or unavailable during much of the period of contamination (1950s–1985), the historical reconstruction process was used to quantify estimates of monthly mean contaminant-specific concentrations. This paper integrates many efforts, reports, and papers into a synthesis of the overall approach to, and results from, a drinking-water historical reconstruction study. Results show that at the Tarawa Terrace water treatment plant (WTP) reconstructed (simulated) tetrachloroethylene (PCE) concentrations reached a maximum monthly average value of 183 micrograms per liter (ug/L) compared to a one-time maximum measured value of 215 ug/L and exceeded the U.S. Environmental Protection Agency’s current maximum contaminant level (MCL) of 5 ug/L during the period November 1957–February 1987. At the Hadnot Point WTP, reconstructed trichloroethylene (TCE) concentrations reached a maximum monthly average value of 783 ug/L compared to a one-time maximum measured value of 1,400 ug/L during the period August 1953–December 1984. The Hadnot Point WTP also provided contaminated drinking water to the Holcomb Boulevard housing area continuously prior to June 1972, when the Holcomb Boulevard WTP came on line (maximum reconstructed TCE concentration of 32 ug/L) and intermittently during the period June 1972–February 1985 (maximum reconstructed TCE concentration of 66 ug/L). Applying the historical reconstruction process to quantify contaminant-specific monthly drinking-water concentrations is advantageous for epidemiological studies when compared to using the classical exposed versus unexposed approach.

Additive Manufacturing (AM) Direct Laser Fabrication (DLF) of Ti-5Al-5V-5Mo-3Cr (Ti5553) is being developed as a method for producing aircraft components. The additive manufacturing process can produce flaws near the surface, such as porosity and material voids, which act as stress raisers, leading to potential component failure. Eddy current testing was investigated to detect flaws on or near the surface of DLF Ti5553 bar samples. For this application, the objective was to develop an eddy current probe capable of detecting flaws 500 µm in diameter, located 1 mm below the component's surface. Two initial sets of coil parameters were chosen: The first, based on successful experiments that demonstrated detection of a near surface flaw in Ti5553 using a transmit-receive array probe, and the second, derived from simulation by Finite Element Method (FEM). An optimized transmit receive coil design, based on the FEM simulations, was constructed. The probe was evaluated on Ti5553 samples containing sub-surface voids of the target size, as well as samples with side-drilled holes and samples with holes drilled from the opposing inspection surface. The probe was able to effectively detect 80% of the sub-surface voids. Limitations included the probe’s inability to detect sub-surface voids near sample edges and a sensitivity to surface roughness, which produces local changes in lift-off. Multifrequency mixing improved signal-to-noise ratio when surface roughness was present on average by 22%. A probe based on that described in this paper could benefit quality assurance of additively manufactured aircraft components.

Although prior research has extensively examined the association of emotional intelligence (EI) with various job attitudes (e.g., job satisfaction), the empirical and systematic investigation of this link within military institutions has captured considerably less research attention. The present research analyzed the relationship between EI, teamwork communication, and job satisfaction among Spanish military cadets. We tested the potential unique contribution of EI to job satisfaction over and above demographics (i.e., gender and age), proactive personality, and resilience. Moreover, we also examined whether EI indirectly affects job satisfaction via its relationship with teamwork communication. A sample of 363 cadet officers of the Spanish General Military Academy completed questionnaires assessing EI, teamwork communication, proactive personality, resilience, and job satisfaction. Our results revealed that EI exhibited incremental variance in predicting job satisfaction even after accounting for demographics, proactive personality, and resilience. Additionally, we found that the effect of EI on job satisfaction was partially driven by enhanced teamwork communication. This research provides empirical evidence suggesting a pathway (i.e., effective teamwork communication) through which EI helps military cadets to experience higher job satisfaction. Implications for future academic programs including EI and teamwork communication to promote positive job attitudes among military personnel are discussed.

The emergence of antibiotic-resistant Campylobacter jejuni, a leading cause of gastroenteritis worldwide, presents a significant public health challenge requiring vigilant surveillance and disease control. This study aimed to characterize C. jejuni strains isolated in Romania from 2017-2020, focusing on genetic diversity, virulence, and antibiotic resistance determinants. The isolates underwent phenotypical testing, PCR, and antibiotic resistance assessment using Disc Diffusion Kirby–Bauer for ciprofloxacin, nalidixic acid, erythromycin, and tetracycline. Genetic analysis identified resistance and virulence genes, point mutations, and performed sequence typing (7-gene MLST) to determine genetic relatedness. Results indicated substitutions at position 86 in the amino acid sequence or position 257 in the nucleotide sequence of the gyrA gene in 47 fluoroquinolone-resistant isolates. Additionally, mutations in the rRNA23S gene at positions 2074 and 2075, associated with macrolide resistance, were found in 12 of the 66 isolates. Allelic profiles generated 38 sequence types (STs), including three new STs not present in the reference database. The sequence data analysis revealed a genetically diverse C. jejuni population with a weak clonal structure. This study provides crucial insights into the genetic diversity and antibiotic resistance of C. jejuni strains in Romania, highlighting the need for ongoing surveillance and control measures.

The increasing world steel production has contributed to the generation of million tons of mining residues. But, the huge demand of aggregates for the execution of pavements and the lack of raw material for this purpose, the research for new materials to be used in this area has become vital. The sandy residue that was studied was collected at Mariana– MG county, which was the result of the iron ore processing of the company Samarco S.A. This research has as objective the evaluation of the mechanical behaviour of asphalt mixtures utilizing residue from the processing of iron ore in substitution of the fine aggregate in the asphalt mixtures of the Asphaltic Concrete type, aiming its use in the rolling layer of a road pavement. To do so, the Marshall dosage of three asphalt mixtures and the mechanical tests characterized by the resilient modulus and fatigue life at a controlled tension were performed. It was also performed the determination of the optimum content by the Superpave dosage method conducted in two of these mixtures to obtain the Compaction Index and the mechanical behaviour by the Flow Number value. Concluded that the residue is compatible with all current standards for the use in asphalt mixtures, being able to be used in the CBUQ rolling layer, showing an improvement in the behaviour compared to the standard mixture.

Background: Clinical trails have revealed that patients with depression generally accompanied with learning and memory impairment, which critically impact on individual’s health and development. Danggui-Shaoyao-San (DSS), a famous Chinese complex prescription, significantly overcame depression and relieved cognitive disorder based on previous research and publication. However, its effectsand potential mechanism against chronic restraint stress (CRS) remained unknown. Methods: CRS animal model was established and mice were divided to six groups while they were oral administrated with Danggui-Shaoyao-San at doses of 1.25, 2.5 and 5 g/kg for 14 days. Emotional and cognitive performances were detected by behavior tests, meanwhile neural plasticity and its molecular mechanism were examined by Dil staining, western blot and immunofluorescence. Results: DSS treatment dose-dependently improved locomotion ability in open filed test, overcame depression behavior in forced swimming test and elevated plus maze test, enhanced learning and memory ability in Morris water maze test. CRS decreased number of total spines and mushroom spines, while DSS treatment dose-dependently restored these by Dil staining. Expression of BDNF and GluR1 were significantly down-regulated in CRS group, which were significantly normalized by DSS. Conclusions: DSS treatment dose-dependently reversed CRS-induced cognitive impairments by inducing structural remodeling of neurons.

Objective: Evaluation of patients with prosthetic valves who developed infective endocarditis by comparing treatment outcomes in both early- and late-onset IE episodes following prosthetic valve replacement surgery. This study sought to conduct a comprehensive assessment of the efficacy of these methodologies. The insights derived from this assessment will be utilized to enhance the quality of care for individuals with infective endocarditis who have received prosthetic valve replacement surgery. Results: During the period of investigation (January 2018 - December 2022), 78 patients diagnosed with infective endocarditis (IE) on prosthetic valve were admitted to the Infectious Diseases Department of the "Dr. Carol Davila" Central Military Emergency University Hospital in Bucharest. In 28 cases (35.8%), the onset of PVE occurred within 12 months of surgery (early onset), whereas in 50 patients (64.2%), the onset occurred more than 12 months after surgery (late onset). The mortality rate was 35.9% (53.6% among the early onset patients and 26% among the late-onset patients). Among patients who received surgical and medical therapy, the mortality rate was 29.6%, whereas among those who underwent only medical therapy, a 39.2% mortality rate was reported. According to the extracted data, antibiotic therapy was successful in 72.6% of patients. In contrast, a combination of surgical and drug-based approaches resulted in a cure in 76.1% of the patients. The most common etiological agent was Staphylococcus aureus (38.5%), followed by Enterococcus faecalis (26.9%), and Streptococcus mitis (10.3%). The mortality rate of patients with S. aureus was 29.2%, indicating the severity of this infectious agent. Conclusions: Prosthetic valve endocarditis (PVE) is a serious condition associated with a high mortality rate both in the short and long term. Regardless of the therapy used, the risk of death remains high. All patients with PVE who survived received effective early treatment, highlighting the need for prophylactic measures.

Digital technologies have changed the way supply chain operations are structured. In this article, we conduct systematic syntheses of literature on the impact of new technologies on supply chains and the related cyber risks. A taxonomic/cladistic approach is used for the evaluations of progress in the area of supply chain integration in the Industrial Internet of Things and Industry 4.0, with a specific focus on the mitigation of cyber risks. An analytical framework is presented, based on a critical assessment with respect to issues related to new types of cyber risk and the integration of supply chains with new technologies. This paper identifies a dynamic and self-adapting supply chain system supported with Artificial Intelligence and Machine Learning (AI/ML) and real-time intelligence for predictive cyber risk analytics. The system is integrated into a cognition engine that enables predictive cyber risk analytics with real-time intelligence from IoT networks at the edge. This enhances capacities and assist in the creation of a comprehensive understanding of the opportunities and threats that arise when edge computing nodes are deployed, and when AI/ML technologies are migrated to the periphery of IoT networks.

This communication is to summarize our single center experience on applications of anti-IL-1 biologic response modifiers on autoimmune and autoinflammatory conditions in children. We present our rationale for off-label utilization of Anakinra and discuss evolving treatment paradigms that warrants further research and validation. Based on our observations and successful treatment outcomes, we advocate future multilateral efforts to liberate access to anti-IL-1 medications to control inordinate and detrimental inflammation in children.

Bacillus Calmette-Guérin (BCG) immunotherapy has been a cornerstone treatment for non-muscle invasive bladder cancer for decades and still faces challenges, such as severe immune adverse reactions, which reduce its use as a first-line treatment. This review examines BCG therapy’s history, mechanisms, and current status, highlighting how nanotechnology and bioengineering are revitalizing its application. We discuss novel nanocarrier systems aimed at enhancing BCG's efficacy while mitigating specific side effects. These approaches promise improved tumor targeting, better drug loading, and enhanced stimulation of anti-tumor immune responses. Key strategies involve using functional BCG cell wall components and co-delivering BCG with chemotherapeutics to achieve synergistic effects. While most studies remain experimental, this research direction offers hope for overcoming BCG's limitations and advancing bladder cancer immunotherapy. Further elucidation of BCG's mechanisms and rigorous safety evaluations of new delivery systems will be crucial for translating these innovations into clinical practice.

With the increasing use of automatic transmissions in passenger vehicles, there is a growing need for improved gear shifting control strategies that aim to enhance performance and fuel efficiency. This paper introduces a knowledge-based fuzzy control system designed specifically for automatic transmissions in light vehicles. The proposed system utilizes a fuzzy inference system as the controller, enabling the emulation of the driver’s perceptions during the gear shifting process. Consequently, the input signal consists of variables that are either sensitive to or observable by the driver, while the output represents the selected gear. The paper evaluates three distinct control strategies, each based on different inputs. These inputs include the longitudinal velocity of the vehicle, the angular velocity of the engine, or a combination of both, along with the time-derivative of the throttle valve opening. Through the evaluation, it is observed that the combination of inputs yields significantly improved performance. Therefore, the methodology presented in this paper demonstrates that the combined input approach is more effective for gear shifting control.

(1) Background: The significant progress observed over last two decades in coherent beam combining (CBC) technology has mainly focused on its applications in high-energy physics and laser weapons. This work provides insight into the basic principles of CBC and the search for an alternative, namely optical angular momentum (OAM) generation using CBC; (2) Methods: The semi-analytical model based on the paraxial wave equation explored generating OAM-CBC beams by manipulating the tilts and phases of CBC (T&amp;P-CBC) of hexagonal architecture; (3) Results: The specially arranged T&amp;P-CBC shows typical properties of OAM, such as annular profiles for the zero diffraction order and 1-st order replicas in the far field and correlation coefficients of 1% between different OAM-CBC fields; (4) Conclusions: The differences between classical OAM beams and OAM-CBC are substantial due to hexagonal lattice properties. Moreover, applications in free space optical communications are feasible as T&amp;P CBC fulfills the main conditions and requirements for OAM generation.

In this paper we present two algorithms for computing discrete logarithms. We present some properties and show how we break the Diffie-Hellman protocol, which is considered to be very secure.

Background/Objectives: Patients with chronic kidney disease (CKD) have an increased risk of cardiovascular disease (CVD). Carotid intima-media thickness (C-IMT) is a non-invasive marker of atherosclerosis. Low omega-3 polyunsaturated fatty acids (PUFA) intake and vitamin D deficiency are potential cardiometabolic risk factors in patients with CKD. The aim of this study was to evaluate dietary intake and status of omega-3 PUFA and vitamin D in pre-dialysis and hemodialysis patients and to examine the link of dietary α-linolenic acid (ALA) and fish consumption with blood pressure and C-IMT in CKD patients. Methods: All 77 selected patients (36 pre-dialysis, 41 on hemodialysis) underwent standardized clinical, nutritional, and laboratory assessments. Repeated 24-hour recalls were performed to assess dietary intake. The fatty acid profile was determined by gas-liquid chromatography. Results: Inadequate vitamin D intake and vitamin D status were found in 95% of patients. PUFAs profiles did not differ between hemodialysis and pre-dialysis participants. Dietary intake of ALA was negatively correlated with systolic blood pressure (SBP) (p=0.007), C-IMT (p=0.002), serum CRP (p=0.044), iPTH (p=0.01) and 25(OH)D3 (p=0.006). ALA intake of more than 0.23 g/daily was associated with lower SBP (p=0.001), serum 25(OH)D3 (p=0.004), and C-IMT (p=0.002). Conclusions: This study contributes to a better understanding of the relationship between dietary ALA intake and C-IMT in CKD. The results of this study could emphasize the significant role of the high prevalence of vitamin D deficiency and inadequate omega-3 PUFA intake and status considering CVD health in CKD patients.

Over the years, Artificial Intelligence (AI) has seen a steady progress in development and evolution that can aid many sectors. Today, AI plays an essential role in the Fourth Industrial Revolution, and it is making its way into the military sector as well. Many countries are actively looking into AI military technology. Some of these innovations include image recognition, text analysis, Self-driving vehicles (SDV), gaming, robotic process automation (RPA) & Robotic and Autonomous Systems (RAS), and Autonomous Weapons Systems (AWS). In this research, we discuss the advantages of each innovation mentioned and analyze the many different cybersecurity threats that awaken due to military artificial intelligence systems. We then discuss the open research areas to better improve the current state of military artificial intelligence applications in terms of ethics, system security, proper strategy plan, accepted responsibility matrix, and introduction of relevant laws.

Combining modern thermodynamics theory branches, including finite time thermodynamics or entropy generation minimization, constructal theory and entransy theory, with metallurgical process engineering, this paper provides a new exploration on generalized thermodynamic optimization theory for iron and steel production processes. The theoretical core is to thermodynamically optimize performances of elemental packages, working procedure modules, functional subsystems, and whole process of iron and steel production processes with real finite-resource and/or finite-size constraints with various irreversibilities toward saving energy, decreasing consumption, reducing emission and increasing yield, and to achieve the comprehensive coordination among the material flow, energy flow and environment of the hierarchical process systems. A series of application cases of the theory are reviewed. It can provide a new angle of view for the iron and steel production processes from thermodynamics, and can also provide some guidelines for other process industries.

The polysaccharide-based chiral stationary phase (CSP) columns for high-performance liquid chromatography (HPLC) were applied in the separation of liquid crystalline racemic mixtures obtained based on (R,S)-2-octanol and were found to be highly effective in recognizing isomers of minor structural differences. The mobile phase (MP), which consists of acetonitrile (ACN)/water (H2O) at different volume ratios, was used. All measurements were made at room temperature. The order of the elution was also determined. The chromatographic parameters such as resolution - (Rs), selectivity - (α), and the number of theoretical plates, i.e., column efficiency - (N), were determined. The polysaccharide-based CSP columns have unique advantages in separation technology, and this study has shown the potential usefulness of the CSP columns in separating liquid crystalline racemic mixtures belonging to the same homologous series.

The work contains a detailed analysis of the electromagnetic field originating from a point source placed above the layered structure.The surface impedance of the multilayer dielectric structure was determined. Based on the boundary conditions, a method for determining the surface impedance of a layered structure with a perfectly conductive screen and or a magnetic screen is presented. The resonance conditions and the conditions for the excitation of surface waves are derived. The integral expression defining the generalized impedance was analyzed with a view to adapting it to numerical implementation. This allowed the development of a computer program based on which calculations were made of the effect of excitation of waves on multilayer dielectric substrates.

Decompression sickness (DCS) with neurological disorders is the leading cause of diving accidents. Exposure to high levels of CO2 during diving is a safety concern for occupational , groups at risk of DCS. However, the effects of prior exposure to CO2 have never been evaluated. The purpose of this study was to evaluate the effect of CO2 breathing prior to a provocative dive on the occurrence of DCS in mice. 50 mice were exposed to a maximum CO2 concentration of 70 hPa for one hour at atmospheric pressure. Another 50 mice breathing air under similar conditions served as controls. In the AIR group (controls), 22 out of 50 mice showed post-dive symptoms compared to 44 out of 50 in the CO2 group. We found that CO2 breathing is associated with a decrease in body temperature in mice and that CO2 exposure dramatically increases the incidence of DCS. More unexpectedly, it appears that a lower temperature of the animals even before exposure to the accident-prone protocol leads to an unfavorable prognosis. This study also suggests that the composition of the microbiota may influence thermogenesis and thus accidentology. Depending on prior exposure, some bacteria identified in this work could be perceived as protective or pathogenic.

Histological evidence of active prosthetic valve endocarditis (PVE) in cardiac valve tissue is widely regarded as a criterion established by Duke to confirm the presence of this condition, although the histological characteristics of mechanical prosthetic valve endocarditis have not yet been definitively established. The primary objective of this study was to determine the histologic differences in mechanical PVE in individuals with either early- or late-onset PVE, with the aim of distinguishing the unique aspects of this rare condition. Histological analysis of mechanical cardiac valve tissue was conducted in 27 patients who underwent surgical valve removal, comprising individuals with early onset and late-onset PVE. The findings were compared between the two groups. Histopathologically, PVE in individuals with mechanical heart valves is typically associated with the formation of vegetation and considerable neutrophil-rich infiltrates. In cases of early onset PVE, the affected valve tissue displays intense inflammation predominantly consisting of lymphocytes. In contrast, valve tissue samples from patients with late-onset PVE exhibit extensive fibrosis and inflammation, comprising macrophages, which are specialized immune cells and calcifications.

The use of didactic and interactive materials is essential in generating interest among students and teachers in utilizing mathematical models and digital technologies for the educational process. These materials create a dynamic and engaging learning environment that promotes a deeper understanding of complex concepts and fosters a passion for learning. Additionally, integrating interactive materials into pilot courses can assist teachers in better assessing student learning and adjusting the teaching strategies accordingly and the teachers can receive valuable insights into students' strengths and weaknesses, allowing them to provide targeted support and intervention when needed. In this context, the purpose of this paper is to introduce an approach for solving mathematics problems embedded in technical scenarios within the defense and security fields with the aid of digital technology. In this way, students can visualize abstract concepts, experiment with different scenarios, and receive instant feedback on their understanding. This paper helps to reinforce key concepts and enhance problem-solving skills, sparking curiosity, creativity, and encouraging active participation and collaboration. Throughout the development of this proposal, good practices are adopted, and advice for improvement is collected while having a wide range of users, giving feedback, discussions, and testing (pilot) short-term learning/teaching/training activities.

Earth is a complex material with a mechanical and physical behavior that differs from modern building materials. The conservation of rammed earth (RE) constructions presents specific difficulties that are challenging to overcome. The lack of knowledge about RE due to its abandonment for decades and attempts to adopt materials and repair methodologies designed for new building products has led to inadequate interventions. In the case of historic defensive constructions, the doubts and technical difficulties are even greater due to the nature of the so called military RE (with physical and mechanical characteristics significantly different from those of civil, more common, RE) and, not least, due to the historical and cultural heritage value of these constructions. Some important interventions have been carried out recently and others are underway or in the planning stage, and there is a constant lack of information and technical data on the best ways to intervene. To fill this gap, the state of conservation of the RE defensive structures and the results of interventions carried out throughout history in the southwest of the Iberian Peninsula are being assessed. This article sets out the framework of the subject, identifies the material and construction techniques, and recognizes the main causes of its deterioration and decay. With special focus on the most frequent damages detected in historic military defensive structures built with RE, it analyses and discuss the most common techniques that have been used for the repair and conservation of these particular structures.

The research question in this article concerns how a competitive environment affects the learner (officer cadet's) personal leadership development and their relationship to their team and with future civilian foundations. More specifically, what are the possible learning effects of the “hidden” curriculum? This article investigates how a more than 250 years of leadership education provides new army officers with new skills and how such an environment may affect the cadets' leadership training. The paper builds on ethnographic data gathered during the three-year education program in most of the relevant practical locations and contexts. Findings regarding trust in their learning environment, cadets have reported scores of (Mean 2.83) on a 1 (low trust) to 5 (high trust) Likert scale, underpinning interviewdata regarding the lack trust in the academy and in their fellow cadets. Cadets also point out that competition has hindered their learning (Mean 2.50). These findings are interpreted in relation to possible negative effects stemming from internal competition and the evaluation system as a whole. The overall output of this system is a zero–sum game, and thus effects evaluative practices and learning processes. This study is of relevance to higher education officers responsible for designing learning environments.

Predicting nurse turnover is a growing challenge within the healthcare sector, profoundly impacting healthcare quality and the nursing profession. This study employs the Synthetic Minority Over-sampling Technique (SMOTE) to address class imbalance issues in the 2018 National Sample Survey of Registered Nurses (NSSRN) dataset and predict nurse turnover using machine learning (ML) algorithms. Four ML algorithms, namely logistic regression (LR), random forests (RF), decision tree (DT), and extreme gradient boosting (XGBoost), are applied to the SMOTE-enhanced dataset. The data is randomly split into an 80% training set and a 20% validation set. Eighteen carefully selected variables from the NSSRN database serve as predictive features, and the machine learning model identifies feature importance concerning nurse turnover. The study includes a performance comparison based on metrics such as Accuracy, Precision, Recall (Sensitivity), F1-score, and AUC. In summary, the results demonstrate that SMOTE-enhanced random forests (SMOTE_RT) exhibit the most robust predictive power, both in the classical approach (with all 18 predictive variables) and an optimized approach (utilizing eight key predictive variables). XGBoost, decision tree, and logistic regression follow in performance. Notably, age emerges as the most influential factor in nurse turnover, with working hours, EHR/EMR usability, individual income, and region also playing significant roles. This research offers valuable insights for healthcare researchers and stakeholders, aiding in selecting suitable ML algorithms for nurse turnover prediction.

Obesity is related to the establishment of chronic inflammation and metabolic diseases, but it can be positively influenced by the regular practice of physical activity. The study aimed to compare the anthropometric, metabolic, and inflammatory parameters of physically active Military Police Officers (MPOs) with those who are less physically active. Sixty male MPOs, low activity (n=28) and physically active (n=32) participated. The following parameters were measured: plasma cytokine levels, C-reactive protein (CRP) levels, circulating glucose triglyceride (TAG) and high-density lipoprotein cholesterol (HDL-C) levels, and plasma glutamic oxalacetate transaminase (GOT), glutamic-pyruvate transaminase (GPT), and gamma-glutamyl transferase (GGT) activities. The physically active group presented lower body fat and reduced TAG and IL-8 levels compared to the low activity group. Moreover, a negative correlation between SPE and SBP, DBP, BPM was detected for the physically active group (p<0.05) but not in the low activity group. Furthermore, the physically active group's work time (WT) values were not correlated with the important metabolic markers SBP, DBP, BPM, GLU, TAG (p>0.05) but could be in the low activity group (p<0.05). These findings highlight the fundamental protective role of physical activity in controlling body composition, subclinical inflammation, and cardiovascular risk in MPOs.

The world is currently experiencing the fourth industrial revolution driven by the newest wave of digitisation in the manufacturing sector. The term Industry 4.0 (I4.0) represents at the same time: a paradigm shift in industrial production, a generic designation for sets of strategic initiatives to boost national industries, a technical term to relate to new emerging business assets, processes and services, and a brand to mark a very particular historical and social period. I4.0 is also referred to as Industrie 4.0 the New Industrial France, the Industrial Internet, the Fourth Industrial Revolution and the digital economy. These terms are used interchangeably in this text. The aim of this article is to discuss major developments in this space in relation to the integration of new developments of IoT and cyber physical systems in the digital economy, to better understand cyber risks and economic value and risk impact. The objective of the paper is to map the current evolution and its associated cyber risks for the digital economy sector and to discuss the future developments in the Industrial Internet of Things and Industry 4.0.

Prevalence of overweight and obesity are escalating globally among the general population. However, there are limited evidence on the trends and prevalence of overweight /obesity in the military setting. Increased rates of injuries, low work productivity, incurred higher healthcare costs and prematurely discharge from service are consequences of overweight/obesity among the military. Therefore, we aimed to systematically describe the trends and prevalence of overweight and obesity in the military population, by regions and military service branches. Databases including PubMed, Scopus, Web of Science and Google Scholar were used. Inclusion criteria were military population (inclusive of all service branches) with BMI reported as the overweight/obesity indicator. Population related to military but not exclusively military personnel such as the retirees, the veterans and their dependents were excluded. From the 27 included studies, 13 were published between year 2010 to 2014 and half were conducted in the United States. Overall, studies showed increasing trend in the prevalence of overweight (30% to 50%) and obesity (2% to 30%); only one study showed a decreasing trend of 0.9% and 0.6% for the prevalence of overweight and obesity respectively. However, the rates of increment differed between countries, where Asian countries demonstrated lower overweight prevalence compared to the United States and the European countries. In conclusion, the military population is not protected from overweight and obesity. Interventions should be implemented to prevent overweight / obesity among the military personnel.

Abstract: The present study seeks to investigate MNOs leadership style and how it influences their compassion competence and their personal level of compassion at work. This is a cross-sectional study carried out from December 2019 to May 2020 using the method of convenience sampling. The study involved 235 MNOs serving in Greek Military Hospitals. A single questionnaire containing Compassion at Work index, Compassion competence scale, and Multifactor Leadership Questionnaire (MLQ-5X), and socio-demographic and professional data, was used for data collection. A total of 400 printed questionnaires were distributed with a response rate of 58.75%. Data analysis was performed using the statistical package SPSS 22.0. The research showed that the transformational and transactional leadership styles coexist in the Nursing Corps of the Armed Forces with an average value of 2.72(SD=0.70)-2.95(SD=0.54) points and 2.47(SD=0.69)-2.74(SD=0.63) points respectively, while the passive style represented a very small percentage with an average subscale value of 0.88(SD=0.61)-0.94(SD=0.63) points. It was also found that both actual compassion at work and compassion ability had improved with the increase of transformational or transactional leadership style characteristics and amelioration of leadership outcome criteria. On the other side, a deterioration of these was observed with the increase of the passive leadership. Specifically, a higher score in the «Intellectual Stimulation» scale was associated with a higher level of compassion at work in the dimension «Experiencing the suffering of others» (p=0.010/SD=0.14), while higher values on the «Laissez-Faire Leadership» scale were associated with less compassion at work in the same dimension (p<0.001/SD=0.13). Also, a higher score on the «Contingent Reward» scale was associated with more compassion at work in the dimension «Takes appropriate action» (p=0.023/SD=0.16). Furthermore, higher values observed in the «Inspirational Motivation», «Individual Consideration» and «Extra Effort» scales were associated with a better communication ability (p=0.035/SD=0.09, p=0.022/SD=0.12, and p=0.042/SD=0.08 accordingly). Finally, a higher score on the «Effectiveness» scale was associated with higher sensitivity (p=0.049/SD=0.08). Teaching appropriate leadership behavior, promoting a culture of compassion, and continuing to train nurses to manage their emotions should be included in the infrastructure of nursing science.

MicroRNAs (miRNAs) are a kind of conserved small non-coding RNAs that participate in regulating gene expression by targeting multiple molecules. Early studies have shown that the expression of miRNAs changes significantly in different tumor tissues and cancer cell lines. It is well acknowledged that such variation is involved in almost all biological processes, including cell proliferation, mobility, survival and differentiation. Increasing experimental data indicate that miRNA dysregulation is a biomarker of several pathological conditions including cancer, and that miRNA can exert a causal role, as oncogenes or tumor suppressor genes, in different steps of the tumorigenic process. Anticancer therapies based on miRNAs are currently being developed with a goal to improve outcomes of cancer treatment. In our present study, we review the function of miRNAs in tumorigenesis and development, and discuss the latest clinical applications and strategies of therapy targeting miRNAs in cancer.

Sustainable water resource management in Bangladesh's Gumti River Basin faces challenges from climate change, urbanization, and population growth. This study aimed to calibrate and validate the HEC-HMS model for the Gumti River to enhance flood prediction and water resource planning. The model was set up using precipitation, temperature, and discharge data from 2019-2021, with SRTM elevation data for catchment delineation. Manual calibration was performed for 2019-2020, followed by validation for 2021, using parameters such as Muskingum routing and SCS Curve Number. Model performance was evaluated using R², Nash-Sutcliffe efficiency (NSE), RSR, and PBIAS metrics. Results showed satisfactory to good performance, with R² values of 0.64 and 0.68 for calibration and validation, respectively. NSE values were within the satisfactory range, while PBIAS indicated very good performance with slight underestimation. The study concludes that the calibrated HEC-HMS model provides a reliable tool for simulating the Gumti River's hydrology, though there's room for improvement. Integration with flood frequency analysis, water quality monitoring, and climate change projections is recommended for comprehensive water resource management, alongside the implementation of Sustainable Water Resource Management principles and community engagement strategies.

This paper presents a comprehensive analysis of the financial factors and risk management strategies essential for optimizing disaster resilience within the Serbian defence industry's critical infrastructure. The significance of this sector is multi-faceted, impacting national security, economic stability, and technological advancement. Primarily, the Serbian defence industry ensures the preservation of vital defence interests, maintaining Serbia's independence from foreign sources for weapons and military equipment in both peacetime and wartime. Economically, it is a significant employer of the working-age population, directly affecting local employment rates, fostering economic development, and ensuring the sustainable growth of this crucial sector. This, in turn, stimulates broader economic activity and enhances social cohesion while strengthening the national balance of payments through increased export potential. From a technological perspective, the defence industry drives scientific, technological, and industrial development, reinforcing Serbia's global political and military standing within the Western Balkans and on the international stage. Consequently, the paper aims to examine the risk management and protection of the Serbian defence industry's critical infrastructure, offering concrete and actionable measures to improve and develop these systems with a particular emphasis on security. The research's utility and contribution lie in identifying similarities and differences in the operational performance of defence industry companies, a vital segment of the national economy. The presentation of these findings focuses on the protection of critical infrastructure. The results will form the basis for further investigation into the underlying causes of business performance and the effective management of critical infrastructure security.

Digital technologies have changed the way supply chain operations are structured. In this article, we conduct systematic syntheses of literature on the impact of new technologies on supply chains and the related cyber risks. A taxonomic/cladistic approach is used for the evaluations of progress in the area of supply chain integration in the Industrial Internet of Things and Industry 4.0, with a specific focus on the mitigation of cyber risks. An analytical framework is presented, based on a critical assessment with respect to issues related to new types of cyber risk and the integration of supply chains with new technologies. This paper identifies a dynamic and self-adapting supply chain system supported with Artificial Intelligence and Machine Learning (AI/ML) and real-time intelligence for predictive cyber risk analytics. The system is integrated into a cognition engine that enables predictive cyber risk analytics with real-time intelligence from IoT networks at the edge. This enhances capacities and assist in the creation of a comprehensive understanding of the opportunities and threats that arise when edge computing nodes are deployed, and when AI/ML technologies are migrated to the periphery of IoT networks.

This study assesses the impact of nurse-originated changes in central venous catheter (CVC) management on the incidence of central line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI). It is a single-center retrospective cohort study conducted at an urban, tertiary referral, and academic center serving pediatric patients. The study cohort comprised 236 patients and 323 CVCs seen between 2012 and 2022. CLABSI and CRBSI were defined according to the Centers for Disease Control and Prevention definitions. Oncology nurse leaders developed CVC-specific educational modules for CLABSI prevention. All relevant information during the CVC maintenance period was noted in the patient's CVC logbook. 24 (7%) cases of confirmed CLABSI were identified. The incidence of CVC-related infections was 0.32 cases per 1000 catheter days. The incidence decreased by 40% between the first and second three-year study period. Documented exit-site infection was reported in 32 (10%) cases. The correlation between exit-site infection and CLABSI was found in 9 (28%) cases. Our CVC-related infection rates are significantly lower than the incidence reported by the Italian Association of Pediatric Hematology and Oncology, which settles at 3-5 cases per 1000 catheter days. Our data confirm the effectiveness of local CVC management guidelines in preventing CVC-related infectious complications.

Placing a nasogastric tube (NGT) is a frequent nursing technique in intensive care units. The gold standard for its correct positioning is the chest X-ray due to its high sensitivity but represents a radiation source for critically ill patients. Our study aims to analyze whether the ultrasound performed by an intensive care nurse is a valid method to verify the NGT’s correct positioning and to evaluate the degree of interobserver agreement between this nurse and an intensive care physician in the NGT visualization using ultrasound. Its correct positioning was verified by direct visualization of the tube in the stomach and indirect visualization by injecting fluid and air through the tube ("dynamic fogging" technique). 23 critically ill patients participated in the study. A sensitivity of 35% was achieved using direct visualization, increasing up to 85% using indirect visualization. The degree of interobserver agreement was 0.88. Therefore, the NGT indirect visualization by an intensive care nurse using ultrasound could be a valid method to check its positioning. However, the low sensitivity obtained by direct visualization suggests the need for further training of intensive care nurses in ultrasonography. According to the high degree of agreement obtained, ultrasound could be performed by both professionals.

In recent years, the management of health systems is a main concern of governments and decision makers. Home health care is one of the newest methods of providing services to patients in developed societies that can respond to the individual lifestyle of modern age and the increase of life expectancy. The home health care routing and scheduling problem is a generalized version of the vehicle routing problem, which is extended to a complex problem by adding special features and constraints of health care problems. In this problem, there are multiple stakeholders such as nurses for which an increase of their satisfaction level is very important. In this study, a mathematical model is developed to expand traditional home health care routing and scheduling models to downgrading cost aspects by adding the objective of minimizing the difference between the actual and potential skills of the nurses. Downgrading can lead to a dissatisfaction of the nurses. In addition, skillful nurses have higher salaries and high-level services increase equipment costs and need more expensive trainings and nursing certificates. Therefore, downgrading can enforce hidden huge costs to the managers of a company. To solve the bi-objective model, an -constraint based approach is suggested and the model applicability and its ability to solve the problem in various sizes are discussed. A sensitivity analysis on the Epsilon parameter is conducted to analyze the effect of this parameter on the problem. Finally, some managerial insights are presented to help the managers in this field, and some directions for future studies are mentioned as well.

Although the dopamine hypothesis of schizophrenia explains the effects of all the available antipsychotics in clinical use, there is an increasing need for developing new drugs for the treatment of positive, negative, and cognitive symptoms of chronic psychoses. Xanomeline-trospium (KarXT) is a drug combination that is based on the essential role played by acetylcholine in the regulation of cognitive processes and the interactions between this neurotransmitter and other signaling pathways in the central nervous system, with a potential role in the onset of schizophrenia, Alzheimer’s disease, and substance use disorders. A systematic literature review that included four electronic databases (PubMed, Cochrane, Clarivate/Web of Science, and Google Scholar) and the US National Library of Medicine database for clinical trials detected 21 sources referring to 14 studies focused on KarXT, out of which only four have published results. Based on the results of these trials, the short-term efficacy and tolerability of xanomeline-trospium are good, but more data is needed before this drug combination may be recommended for clinical use. However, on a theoretical level, the exploration of KarXT is useful for increasing the interest of researchers in finding new, non-dopaminergic, antipsychotics that could be used either as monotherapy or as add-on drugs.

In this paper we present an understanding of cyber risks in the Internet of Things (IoT), we explain why it is important to understand what IoT cyber risks are and how we can use risk assessment and risk management approaches to deal with these challenges. We introduce the most effective ways of doing Risk assessment and Risk Management of IoT risk. As part of our research, we also developed methodologies to assess and manage risk in this emerging environment. This paper will take you through our research and we will explain: what we mean by the IoT; what we mean by risk and risk in the IoT; why risk assessment and risk management are important; the IoT risk management for incident response and recovery; what open questions on IoT risk assessment and risk management remain.

In this paper, we define the consumer preference relation from scratch. We study algebraic and topological properties for the preference magma that reflects the consumer. We also consider the influence of society on an individual's preference.

Insect behavior is coordinated mainly by smell, through the diverse odor-binding proteins (OBP) that allow them to identify and recognize their environment. Sensory information collected through smell is then analyzed and interpreted in the brain, allowing for correct insect functioning. The behavior of honey bees (Apis mellifera L.) can be affected by different pathogens, such as deformed wing virus (DWV). In particular, DWV variant A (DWV-A) is capable of altering olfactory sensitivity, reducing the gene expression of different OBPs, including those associated with nursing behavior. DWV is also capable of replicating itself in the sensory lobes of the brain, further compromising the processing of sensory information. This study evaluated the behavioral response of nurse honey bees exposed to a pheromone compound and the alterations in the gene expression of pre- and post-synaptic neuronal genes neuroxins-1 and neurogilin-1 in the bee heads and OBP proteins in antennae of nurse bees inoculated with DWV-A. The behavioral response of nurse bees exposed to the larval pheromone compounds benzyl alcohol was analyzed using a Y-tube olfactometer. The viral load, gene expression of OBP5 and OBP11 in antennae and the neuroxins-1 and neurogilin-1 in the bee heads were analyzed by qPCR. High viral loads significantly reduced the ability of 10- and 15-day-old nurse honey bees to choose the correct pheromone compound. Also, the gene expression of OBP5, OBP11, neuroxin-1 and neurogilin-1 in nurse honey bees decreased when they were highly infected with DWV-A. These results suggest that a DWV-A infection can disturb information processing and cause nurse honey bees to reduce their activity inside the hive, altering internal cohesion.

Family support is offered to Australian parents of young children using a mix of targeted and universal child and family health services. A feature of the universal services is the ability for nurses to work in partnership with families and to offer flexibility depending on need. This model of progressive universalism relies on the voluntary engagement of families, including families with complex needs. In this study, the capacity to engage and retain families, including those at risk for child maltreatment and family violence, was examined. Child and Family Health Nurses (n=129) participated in a pragmatic, multilevel mixed-methods study using the McCurdy and Daro (2001) Integrated Theory of Parent Involvement. A questionnaire was used in the first phase of the study to collect the quantitative data. Focus groups were then held with 27 participants recruited from phase one. Both homogeneous and heterogenous practices identified from the questionnaire were the focus of the discussions. Three phases of practice were identified and described: enrolment, retention and conclusion of the nurse-parent relationship and are presented and discussed in this paper. The retention of families with complex needs relies on flexible, advanced, and multidimensional nursing practices.

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

Tawny nurse shark (Nebrius ferrugineus) is a species of carpet shark distributed across the tropical Indo-Pacific region. Tawny nurse shark is listed as “Vulnerable” on IUCN Redlist and rarely seen, recorded and studied in Indonesia. We recorded this species during SCUBA diving activity in Morotai waters in April 2022. Scientific record of the species is highly important for conservation and habitat management, particularly in Morotai, a region in North Maluku famous for shark-based marine tourism.

A fascinating topic that has not been recently revisited by bioethics is the ethics of human experimentation within the military context, in keeping with the pace of modern technology development. Many research innovations stem from military research, where emerging technologies are first applied in the field then eventually repurposed for civilian contexts. This commentary presents an ethical framework for the usage of military personnel as research subjects, within the context of modern military research such as epigenetic technology development in soldiers. Tensions are raised between existing military versus civilian bioethical frameworks for human experimentation and compared to risk-benefit assessments within and beyond the military context. A harmonized ethical framework is proposed for the use of research subjects within the military. The pace of modern scientific research, particularly in genomics, poses new ethical considerations of genetic profiling, consent, risk, and data privacy that urges a timely revisit of military bioethics.

This study aims to examine how the activation of nursing roles and professional identification as a nurse can influence moral judgments in terms of deontological and utilitarian inclinations. In Study 1, a priming technique was used to assess the impact of activating the nursing concept on moral reasoning. Participants were randomly assigned to either a nursing prime or neutral prime condition. By using a scrambled-sentences task, participants were prompted to think about nursing-related or neutral thoughts. Following the priming task, participants were asked to respond to 20 moral dilemmas. The process dissociation approach was employed to measure the degree of deontological and utilitarian tendencies in their moral reasoning. In Study 2, participants completed the nursing profession identification scale and the moral orientation scale before engaging in moral judgments similar to those in Study 1. The findings revealed that priming the concept of nursing roles resulted in an increase in deontological clinical inclinations, while having no significant effect on utilitarian inclinations. Additionally, a positive correlation was observed between identification with the nursing profession and deontological clinical inclinations, whereas a negative correlation was found with utilitarian inclinations. Deliberation orientation acted as a complete mediator in the relationship between nursing professional identification and deontological tendencies, and as a partial mediator for utilitarian tendencies.

(1) Aims: To analyse the relationship between demographic and clinical characteristics and particular kinds of suicidal behaviour and its relationship with a nurse-led suicide prevention program. (2) Methods: A 5-year cross-sectional study design. Study performed in the region of Osona (Catalonia) during 2013-2017. Suicidal behaviour was classified as suicidal ideation, interrupted self-directed violence, suicide attempt and completed suicide. (3) Results: The sample included 753 patients ─ of whom 53 died by suicide─ and encompassed 931 suicidal behaviour episodes. Men represented 38.4% of the sample but 81.1% of deaths by suicide. Mental disorders were associated with suicidal behaviour in 75.4% of the sample. 66.4% of the individuals were engaged in the nurse-led Suicidal Behaviour Case Management Program, of which 0.8% (n=4) died by suicide. (4) Conclusion: The main risk factors were female sex for suicidal behaviour, and male sex and older age for suicide. Mental disorders, widowhood and retirement were also associated with suicide. A high proportion of patients was engaged to the nurse-led suicide prevention program with a low proportion of suicides.

We present an updated design process for adapting and integrating existing cyber risk assessment approaches for impact assessment for the risk from IoT to the digital economy. The new design process includes a set of changes to the original standards (e.g. NIST) that are adapted for the IoT cyber risk in this paper. This paper also presents a new framework for impact assessment of IoT cyber risk, specific for the digital economy.

This research article reports the results of a qualitative case study that correlates academic literature with five Industry 4.0 cyber trends, seven cyber risk frameworks and two cyber risk models. While there is a strong interest in industry and academia to standardise existing cyber risk frameworks, models and methodologies, an attempt to combine these approaches has not been done until present. We apply the grounded theory approach to derive with integration criteria for the reviewed frameworks, models and methodologies. Then, we propose a new architecture for the integration of the reviewed frameworks, models and methodologies. We therefore advance the efforts of integrating standards and governance into Industry 4.0 and offer a better understanding of a holistic economic impact assessment model for IoT cyber risk.

Background: Military pilots show high visuo-spatial skills. Previous studies demonstrate that they are better in mental rotating a target, in taking different perspectives, in estimating distances, in travel planning and in topographic memory. Here, we compared navigational cognitive styles between military pilots and people without flight experience. Pilots were expected to be more survey users than non-pilots, showing higher navigational strategies. Method: 106 jet military pilots of Italian Air Force and 92 non-pilots were enrolled in order to investigate group differences in navigational styles. Participants were asked to perform a reduced version of the Spatial Cognitive Style Test – SCST, consisting of six tasks that allow to distinguish individuals in landmark (people orient themselves by using a figurative memory for environmental objects), route (people use an egocentric representation of the space) and survey (people have a map-like representation of the space) users. Results: In line with our hypothesis, military pilots mainly adopt a survey style, whereas non-pilots mainly adopt the route style. In addition, pilots outperformed non pilots in both the 3D-Rotation task and Map Description Task. Conclusion: Military flight expertise influences some aspects of the spatial ability, leading to enhance human navigation. Although, it must be considered that they are a population whose navigational skills were already high at the time of selection at the academy before formal training began.

There is some evidence that aspects of nurse-doctor communication are associated with the quality of care and treatment patients receive whilst they are in hospital. To date, no studies have examined stakeholder perceptions of how patient care is influenced by clinical communication between nurses and doctors. We conducted a concept mapping study to generate a deep understanding of how clinical communication impacts patient care. Concept mapping has six phases: preparation, idea generation, structuring, representation, interpretation, and utilization. Twenty patients, 21 nurses, and 21 doctors participated in the study. Brainstorming generated 69 discreet statements about how nurse-doctor communication impacts patient care. The structuring (rating and clustering) phase was completed by 48 participants. The data interpretation workshop selected a five-cluster solution: effective communication, trust, patient safety, impediments to patient care, and interpersonal skills. On the final concept map, the five clusters were arranged in a circle around the center of the map. Clusters were relatively equal in size suggesting, each concept makes a broadly equal contribution to how nurse-doctor communication influences patient care. Our study suggests that there are multiple aspects of clinical communication that impact patient care. Candidate interventions to enhance nurse-doctor communication may need to consider the complex nature of interprofessional working. Registration: This study was prospectively registered with the Open Science Framework (OSF) (https://osf.io/9np8v/) prior to recruiting the first participant.

The practice of nurse health coaching (NHC) draws from the art and science of nursing, behavioral sciences, and evidence-based health coaching methods. This secondary analysis of the audio-recorded natural language of participants during NHC sessions of our recent 8-week RCT evaluates improvement over time in cognitive-behavioral outcomes: Change Talk, Resiliency, Self-Efficacy/Independent Agency, Insight & Pattern Recognition, and Building Towards Sustainability. We developed a measurement tool for coding, Indicators of Health Behavior Change (IHBC), that was designed to allow trained health coach experts to assess the presence and frequency of the indicators in the natural language content of participants. We used a two-step method for randomly selecting the 20-minute audio-recorded session that was analyzed at each time point. Fifty-six participants had high-quality audio recordings of the NHC sessions. Twelve participants were placed in the social determinants of health (SDH) group based on the following: low income (<$20,000/year), early-onset hypertension, and social disadvantages. Our analyses significantly improved Change Talk and the other four factors over time. Our factor analyses indicated two distinct factors at each measurement point of the study, demonstrating the stability of the outcome measures over time. Our newly developed measurement tool, IHBC, proved stable in structure over time and sensitive to change. This NHC program shows promise in improving cognitive-behavioral indicators associated with health behavior change in both non-SDH and SDH individuals.

Methylation is a biochemical process involving the addition of a methyl group (-CH3) to various chemical compounds. It plays a crucial role in maintaining the homeostasis of the endothelium, which lines the interior surface of blood vessels and has been linked, among other conditions, to coronary artery disease (CAD). Despite significant progress in CAD diagnosis and treatment, intensive research continues into genotypic and phenotypic CAD biomarkers. This review explores the significance of the methylation pathway and folate metabolism in CAD pathogenesis, with a focus on endothelial dysfunction resulting from deficiency in the active form of folate (5-MTHF). We discuss emerging areas of research into CAD biomarkers and factors influencing the methylation process. By highlighting genetically determined methylation disorders, particularly the MTHFR polymorphism, we propose the potential use of the active form of folic acid (5-MTHF) as a novel CAD biomarker and personalized pharmaceutical for selected patient groups. Our aim is to improve the identification of individuals at high risk of CAD and enhance their prognosis.

Background: To investigate the association between enteral feeding and the risk of pneumonia in critical care adult patients. Methods: An updated literature review of studies discussing between 2016 and 2023. CINAHL, Cochrane, Embase, PubMed, Scopus, and Web of science databases were used to explore studies regarding our subject, the association between enteral feeding and the risk of pneumonia in critical care adults. Results: Enteral nutrition (EN) has been linked to a significant reduction in pneumonia, as well as shorter ICU or hospital stays, and decreased mechanical-ventilation duration in numerous studies. Conversely, pneumonia risk and other infections, as well as the fatality rate, has been found to increase with EN. Early initiation of EN within 48 hours, along with a low-calorie diet containing (< 600 Kcal/day) demonstrated a notable decrease in the occurrence of Ventilator-Associated Pneumonia (VAP) when contrasted with delayed EN and a high-calorie diet. EN was associated with a marked decrease in adverse events including aspiration pneumonia, emesis, and the escalation of respiratory support. Conclusion: EN is safe and effective in critically ill patients. It is advisable for future research to investigate the monitoring of larger sample sizes to ascertain the most effective feeding methods in the intensive care unit.

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

Background: Exclusively breastfeeding your newborn while in the hospital is imperative for suc-cessful breastfeeding at home. This study will investigate if having a nurse on-site during rooming-in can enhance the proportion of exclusive breastfeeding. Methods: We carried out a prospective cohort study to assess exclusive breastfeeding in the first three months of life among two Neona-tology Units in Southern Italy with different hospital settings. The Ente Ecclesiastico Miulli of Ac-quaviva delle Fonti had on-site nurses available 24/7 (on-site group), while the Policlinico of Bari had nurses available on call 24/7 from the Neonatology Unit (on-call group). Results: Between January 3rd and March 31st, 2018, a total of 564 sets of mothers and babies were admitted - 299 on-site and 265 on-call. The exclusive breastfeeding rate for the entire group was 76.4% at 90 days, demonstrating the positive impact of rooming-in and nursing, regardless of the setting. Infants delivered via ce-sarean section in the on-site group demonstrated higher rates of exclusive breastfeeding at both 30 and 90 days of life. Conclusions: Our research indicates that having a nurse available at all times is crucial for promptly identifying any problems with breastfeeding. We highly suggest having an on-site nurse present during rooming-in for mothers who have had a caesarean delivery. This nurse should continuously promote exclusive breastfeeding until the baby is three months old.

In 2014, the outbreak of adenoviral pneumonia occurred in Korean military training center. However, there is limited data on characteristics of fever and its response to antipyretics therapy in immunocompetent adults with adenoviral positive community-acquired pneumonia (CAP). Medical records of patients who were admitted to Armed Forces Chuncheon Hospital for treatment of CAP between January 2014 and December 2016 were retrospectively analyzed. We evaluated demographics, clinico-laboratory findings and radiologic findings at admission were compared between adenovirus positive (Adv) group and adenovirus negative (non-Adv) group. Out of 251 military personnel with CAP during the study periods, 67 were classified into Adv group while 184 were Non-Adv group. Patients with Adv group had a longer duration of fever after admission and symptom onset. Adv group patients had a higher mean temperature at admission and more observed over 40 and 39 to 40℃. Adv group patients had more commonly observed no response to antipyretic treatment and adverse events after antipyretics use. Length of hospital stay had no significant difference between two groups and no patient died in both groups. In our study, Adv positive CAP in patients with immunocompetent military personnel had distinct characteristics of fever and response to antipyretic treatment.

The Internet-of-Things (IoT) enables enterprises to obtain profits from data but triggers data protection questions and new types of cyber risk. Cyber risk regulations for the IoT however do not exist. The IoT risk is not included in the cyber security assessment standards, hence, often not visible to cyber security experts. This is concerning, because companies integrating IoT devices and services need to perform a self-assessment of its IoT cyber security posture. The outcome of such self-assessment needs to define a current and target state, prior to creating a transformation roadmap outlining tasks to achieve the stated target state. In this article, a comparative empirical analysis is performed of multiple cyber risk assessment approaches, to define a high-level potential target state for company integrating IoT devices and/or services. Defining a high-level potential target state represent is followed by a high-level transformation roadmap, describing how company can achieve their target state, based on their current state. The transformation roadmap is used to adapt IoT risk impact assessment with a Goal-Oriented Approach and the Internet of Things Micro Mart model.

The performance of a small reconfigurable unmanned aerial vehicle (UAV) is evaluated, 1 combining a multidisciplinary approach in computational analysis of additive manufactured struc- 2 tures, fluid dynamics, and experiments. Reconfigurable UAVs promise cost savings and efficiency 3 without sacrificing performance, while demonstrating versatility to fulfill different military mission 4 profiles. The use of computational fluid dynamics (CFD) in UAV design produces higher accuracy 5 aerodynamic data, which is particularly important for complex aircraft concepts such as blended 6 wing bodies. To address challenges relating to anisotropic materials, the Tsai-Wu failure criterion is 7 applied to structural analysis, using CFD solutions as load inputs. Aerodynamic performance results 8 show the low-speed variant attains an endurance of 1 hour, 48 minutes, whereas for its high-speed 9 counterpart, it is 29 minutes at 66.7% higher cruise speed. Each variant serves different aspects of 10 small UAS deployment in combat, with low-speed envisioned for close surveillance, and high-speed 11 for incursions. Experimental and simulation results suggest room for design iteration, in wing area 12 and geometry adjustments. Structural simulations demonstrated the need for airframe improvements 13 in the low-speed configuration. This paper highlights the potential of reconfigurable UAVs to disrupt 14 the industry, advocating for further research and design improvements.

The purpose of this study was to evaluate the bioactivity and cell response of a well-characterized Nurse´s A-phase (7CaO•P2O5•2SiO2) ceramic and his effect compared to a control (tissue culture polystyrene-TCPS) on the adhesion, viability, proliferation and osteogenic differentiation of ahMSCs in vitro. Cell proliferation (Alamar Blue Assay), Alizarin Red-S (AR-s) staining, alkaline phosphatase (ALP) activity, osteocalcin (OCN) and collagen I (Col I) were evaluated. Also, field emission scanning electron microscopy (FESEM) images were acquired in order to visualise the cells and the topography of the material. The proliferation of cells growing in a direct contact with the material was slower at early stages of the study because of the new environmental conditions. However, the entire surface was colonized after 28 days of culture in growth medium (GM). Osteoblastic differentiation markers were significantly enhanced in cells growing on Nurse´s A phase ceramic and cultured with osteogenic medium (OM), probably due to the role of silica to stimulate the differentiation of ahMSCs. Moreover, calcium nodules were formed under the influence of ceramic material. Therefore, it is predicted that Nurse´s A-phase ceramic would present high biocompatibility and osteoinductive properties being a good candidate to be used as a biomaterial for bone tissue engineering.

In this paper, we study the problem of controllability of impulsive neutral evolution integrodifferential equations with state dependent delay in Banach spaces. The main results are completely new and are obtained by using Sadovskii's fixed point theorem, theory of resolvent operators, and an abstract phase space. An example is given to illustrate the theory.

The present study aims to evaluate the antibacterial activity of five commercially available essential oils (EOs): Lavender (LEO), Clove (CEO), Oregano (OEO), Eucalyptus (EEO), and Peppermint (PEO) against the most-known MDR Gram-positive and Gram-negative bacteria - Staphylococcus aureus (ATCC 25923), Escherichia coli (ATCC 25922) and Pseudomonas aeruginosa (ATCC 27853) - alone and in various combinations. Gas Chromatography-Mass Spectrometry (GC-MS) analysis established their complex composition. Then, the antibacterial activity was investigated in vitro by diffusimetric antibiogram method, using sterile cellulose discs with Ø 6 mm impregnated with 10 µl of sample and sterile borosilicate glass cylinders loaded with 100 µl of sample; MIC (µg/mL) for each EO was calculated from IZD values (mm) measured after 24 hours. The following EO combinations were evaluated: OEO+CEO, CEO+EEO, CEO+PEO, LEO+EEO, and EEO+PEO. Then, the influence of each dual combination on 3 conventional antibacterial drugs – Neomycin (NEO), Tetracycline (TET), and Bacitracin (BAC) - activity was investigated. The most active EOs against S. aureus and E. coli were LEO and OEO (IZD = 40 mm). They were followed by the CEO and EEO (IZD = 20-27 mm); PEO exhibited the lowest antibacterial activity (IZD = 15-20 mm). EEO alone showed the highest inhibitory activity on P. aeruginosa (IZD = 25-35 mm). It was followed by the CEO, LEO, and EEO (IZD = 7-11 mm), while PEO proved no antibacterial action against it (IZD = 0 mm). Only one synergic action was recorded (OEO+CEO against P. aeruginosa); EEO+PEO revealed partial synergism against S. aureus and CEO+PEO additive behavior against E. coli. Two triple associations with TET showed partial synergism against E. coli, and the other 2 ones (with NEO and TET) evidenced the same behavior against S. aureus; all contained EEO+PEO or CEO+PEO. Most combinations reported indifference. However, numerous cases were of antagonism between constituents included in double and triple combinations, and EOs with the strongest antibacterial activities belong to the highest antagonistic combinations. A consistent statistical analysis supports our results, showing that EOs with moderate antibacterial activities could generate combinations with higher inhibitory effects based on synergistic or additive interactions.

Modern war is sudden and rapid, and once the battle starts, the demand for equipment maintenance and guarantee will show an outburst situation, which puts equipment maintenance and guarantee capability to a severe test. To accurately grasp the civil-military integration of aviation maintenance and guarantee capabilities, it is necessary to evaluate their capabilities. To this end, the evaluation indicator system is established by using the three-dimensional indicator system construction model of "maintenance task → task demand → capability demand", and the evaluation method based on intuitionistic fuzzy entropy and normal grey cloud model is proposed, using intuitionistic fuzzy entropy theory to determine the expert weights and indicator weights, and the grey cloud model theory to determine the capability evaluation level. Finally, the application process of the evaluation model is demonstrated through specific examples, and the evaluation results are analyzed to verify the effectiveness of the evaluation model.

Modern war is sudden and rapid, and once the battle starts, the demand for equipment maintenance and guarantee will show an outburst situation, which puts equipment maintenance and guarantee capability to a severe test. To accurately grasp the civil-military integration of aviation maintenance and guarantee capabilities, it is necessary to evaluate their capabilities. To this end, the evaluation indicator system is established by using the three-dimensional indicator system construction model of "maintenance task → task demand → capability demand", and the evaluation method based on intuitionistic fuzzy entropy and normal grey cloud model is proposed, using intuitionistic fuzzy entropy theory to determine the expert weights and indicator weights, and the grey cloud model theory to determine the capability evaluation level. Finally, the application process of the evaluation model is demonstrated through specific examples, and the evaluation results are analyzed to verify the effectiveness of the evaluation model.

Background: in 2016 an IT system was developed at MUL for the documentation of nursing practice. Preparing nursing students for the implementation of eHealth solutions under simulated conditions is crucially important for achieving digital competencies necessary for the health care systems in the future. Scientific evidence demonstrates that the use of an IT system in clinical practice shortens the time required for preparation of documentation, increases the safety of clinical decisions and provides data for analysis and for creation of predictive models for the purposes of HB HTA. Methods: The system was created by cooperation of an interprofessional team at the Medical University of Łódź. The ADPIECare system was implemented in 2016 at 3 universities in Poland, and in 2017 a study of its usability was conducted using a questionnaire made available by Healthcare Information and Management Systems Society “Defining and Testing EMR Usability MASTER V2 Final” on 78 nurses — students of MA in Nursing at Medical University of Łódź. Findings: Over 50% of the surveyed nurses have indicated the usability of the system for the “effectiveness of documentation” variable. The same group of respondents have confirmed that a positive attitude towards patient care planning with the use of the assessed system. In the opinions of the examined parties positive opinions predominated, such as e.g.: “the system is intuitive,” “the system facilitates work,” “all patient assessments are in one place,” “the time needed for data entry would be shortened.”

Epigenetic mechanisms, including histone post-translational modifications (PTMs), play a critical role in regulating pain perception and the pathophysiology of burn injury. However, the epigenetic regulation and molecular mechanisms underlying burn injury-induced pain remain insufficiently explored. Spinal dynorphinergic (Pdyn) neurons contribute to heat hyperalgesia induced by severe scalding-type burn injury through p-S10H3-dependent signaling. Beyond p-S10H3, burn injury may impact various other histone H3 PTMs. Double immunofluorescent staining and histone H3 protein analyses demonstrated significant hypermethylation at H3K4me1 and H3K4me3 sites and hyperphosphorylation at S10H3 within the spinal cord. By analyzing Pdyn neurons in the spinal dorsal horn, we found evidence of chromatin activation with a significant elevation in p-S10H3 immunoreactivity. We used RNA-seq analysis to compare the effects of burn injury and forma-lin-induced inflammatory pain on spinal cord transcriptomic profiles. We identified 98 DEGs for burn injury and 86 DEGs for formalin-induced inflammatory pain. A limited number of shared differentially expressed genes (DEGs) suggest distinct central pain processing mechanisms between burn injury and formalin models. KEGG pathway analysis supported this divergence, with burn injury activating Wnt signaling. This study enhances our understanding of burn injury mechanisms and uncovers converging and diverging pathways in pain models with different origins.

Background: Self-esteem is a psychological term that, since its emergence in 1890 with William James, has been widely studied. Furthermore, this construct has been examined in different areas of psychology, including the clinical field, where its relationship with mental health and low levels of depression has been demonstrated. In the realm of positive psychology, its connection to resilience and life satisfaction has also been established. Objective: To evaluate validity based on internal structure from the perspective of Classical Test Theory (CTT) and Item Response Theory (IRT), to obtain evidence of validity based on the relationship with other variables and to estimate the reliability of the Rosenberg Self-Esteem Scale (RSES). Method: To this end, 584 military personnel from the three ranks of the Spanish Army (officers, non-commissioned officers, and professional soldiers and sailors) were evaluated, of which 511 were men (87.70%) and 72 were women (12.30%), with an age range of 18 to 66 years (M = 33.17, SD = 7.38). Results: The results indicate that the unidimensional structure of the RSES shows adequate fit indices (CFI = .94, TLI = .91, SRMR = .05), while the difficulty and discrimination parameters exhibited favorable values. Additionally, an acceptable reliability value was found (ɷ = .81; α = .80). Conclusions: Therefore, it is concluded that the RSE-JGA presents adequate psychometric properties of validity and reliability, making it a useful and relevant instrument for measuring self-esteem in military personnel of the Spanish Army.

Injuries from exposure to blasts are of significant concern in military operational settings, including tactical training, and is associated with self-reported concussion-like symptomology and physiological changes as increased intestinal permeability (IP) investigated herein. Timeseries gene expression and IP biomarker data were generated from “breachers” exposed to controlled, low-level explosive blast during training. Samples from 30 male participants at pre, post, follow-up blast exposure the next day were assayed via RNA-seq and ELISA. A battery of symptom data was also collected at each of these time points that acutely showed elevated symptom reporting related to headache, concentration, dizziness, and slowed thinking, dissipating ~16hrs following blast exposure. Evidence for bacterial translocation into circulation following blast exposure was detected by significant stepwise increase in microbial diversity (measured via alpha-diversity p=0.049). Alterations in levels of IP protein biomarkers (i.e., Zonulin, LBP, Claudin-3, I-FABP) assessed in a subset of these participants (n=23) further evidenced blast exposure associates with IP. The observed symptom profile was consistent with mTBI and was further associated with changes in bacterial translocation and intestinal permeability, suggesting that IP may be linked to a decrease in cognitive performance. These preliminary findings show for the first

Postpartum depression (PPD) has serious effects on maternal and infant morbidity and mortality. This study aimed to determine the prevalence of postpartum depression in mothers of under-twos in military barracks in Lagos. The Edinburgh Postnatal Depression Scale (EPDS) and a modified version of the General Help-Seeking questionnaire (GHSQ) were administered to 316 mothers of under-twos in 3 of 12 military barracks in Lagos, Nigeria to determine PPD and major depressive events (MDE). Risk of PPD was established at EPDS scores of >12. Good help-seeking practices were ascribed to scores of 20 or more on the GHSQ. Risk of PPD was found in 15.5% of respondents, and good help-seeking in 3.8% and 11.4% for personal/emotional and harming self/baby respectively. Bivariate analysis using Chi square showed statistically significant positive associations between lower scores for EPDS and higher educational levels of respondents, perception of partner support and being in lower wealth quintiles (p<0.05). Use of the EPDS was accepted among mothers of children aged under two years. Opportunities to educate pregnant women and new mothers about PPD using existing social networks, perinatal and infant screening programmes in the barracks can be leveraged upon to improve mental health delivery as part of maternity care.

The dynamic development of robotics is affecting people's lives. Flying robots replace pilots and crews in performing dangerous tasks. There are various designs of the above-mentioned robots such as multi-rotors, fixed-wing aircraft, helicopters, among which wing-in-ground (WIG) units can also be distinguished. WIG vehicles, which utilize ground effect to enhance efficiency and stability, share similarities with UAVs in their control and aerodynamic challenges. The article presented the results of the autopilot test for the NeoX UAV, which have the potential to be utilized in WIG UAVs. The NeoX was developed at the Air Force Institute of Technology as a reconnaissance flying robot and is a tailless mini UAV. It has a characteristic feature which is the flying wing with a small fuselage. The electric engine with the pusher propeller ensures thrust. The tailless airplane has a greater drag-to-lift ratio than a conventional airplane, but this airplane configuration needs a control system that ensures a stable flight. The structure of auto-pilot for the horizontal flight phase (a cruise phase), the climbing, and the descending phase were presented. The authors concentrated on the longitudinal channel of autopilot and showed the recorded results from the flight tests. The research focused on developing autopilot system that could be adapted for use in WIG craft, which operate with similar aerodynamic principles but require unique control adaptations due to their proximity to the water or ground. The findings from the NeoX UAV tests are instru-mental in enhancing the stability and performance of these specialized crafts, ensuring safer and more efficient operation in their respective environments.

Despite the technological advancements of 3-D city models, the 3-D shape abstraction methods for urban vegetation are recent and still limited to support spatial analysis of individual or groups of trees and forest patches. In this paper, a scheme for individual urban tree abstraction, which retains the semantic complexity of the object, is proposed. Our contribution is three-fold. First, an initial tree structure based on a new 3-D aggregation operator is proposed. Second, we developed Gestalt rules for 3-D urban vegetation mapping. Third, current state-of-the-art deep learning is adapted for the abstraction of individual urban trees. Quantitative and qualitative results show the effectiveness of our proposed approach in accurately reducing the spatial density of trees and the degree of fragmentation of the total green area, which can access information about the location, size, and spatial distribution of mapped urban trees.

In this paper, the mechanism of combined process of ion beam sputtering (IBS) and HF acid etching on the chemical structure defects of fused silica and its laser damage resistance perfor-mance were investigated. During the removal process of surface material, the sputtering effect causes lattice atoms to detach from their original positions, forming a large number of unsaturated structures on silica surface, which improves the chemical activity of Si and O atoms, accelerates the chemical reaction process between surface atoms and water molecules, increases the content of hydroxyl (OH-) groups in the shallow layer, and enhances the photothermal weak absorption intensity. However, the presence of OH- groups reduces the bonding strength of Si-O, destroys the spatial network structure of silica bulk, and reduces the mechanical strength of silica surface, resulting in a decrease in its laser damage resistance performance. The paper reveals for the first time the mechanism of IBS to change the structure characteristics of silica material, accelerate the surface hydroxylation process, and thereby reduces the laser damage resistance performance. This work provides technical guidance for effectively suppressing chemical structure defects on silica surface and improving laser damage resistance performance of optical components under high-flux laser irradiation.

The Internet-of-Things (IoT) triggers new types of cyber risks. Therefore, the integration of new IoT devices and services requires a self-assessment of IoT cyber security posture. By security posture this article refers to the cybersecurity strength of an organisation to predict, prevent and respond to cyberthreats. At present, there is a gap in the state-of-the-art, because there are no self-assessment methods for quantifying IoT cyber risk posture. To address this gap, an empirical analysis is performed of 12 cyber risk assessment approaches. The results and the main findings from the analysis is presented as the current and a target risk state for IoT systems, followed by conclusions and recommendations on a transformation roadmap, describing how IoT systems can achieve the target state with a new goal-oriented dependency model. By target state, we refer to the cyber security target that matches the generic security requirements of an organisation. The research paper studies and adapts four alternatives for IoT risk assessment and identifies the goal-oriented dependency modelling as a dominant approach among the risk assessment models studied. The new goal-oriented dependency model in this article enables the assessment of uncontrollable risk states in complex IoT systems and can be used for a quantitative self-assessment of IoT cyber risk posture.

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

The military areas in Sardinia are around 234 km2, which constitutes 59.97% of the national surface affected by military easements. This situation is due to its geographic centrality in the Mediterranean. This contribution evaluates the performance of the Local Coastline Plan (LCP) and the Site Management Plan of Community Interest (SCI) in conditions of military constraint. The case study is the Municipality of Villaputzu where an important coastal military easement and the use of the coast for recreational tourism purposes coexist together through specific planning, a consequence of institutional agreements between the Municipal Administration of Villaputzu and the Ministry of Defense. The evaluation of the congruence of the specific objectives of the LCP and the SCI shows how their combined action favors the environmental enhancement of Sardinia, contributing to the formation of ecosystem services, even in particular conditions arising from military easements. These are sites that pass from the status of "anti-commons" to "semi-commons". In fact, the military release process in Sardinia, together with the promiscuous military and civil use, activates unique governance policies of their kind that find a significant field of application in Sardinia to guarantee a sustainable renewal of economic development of the ‘semi-commons’ awaiting to become ‘commons’

This paper investigates the periodic and quasi-periodic orbits in the symmetric collinear four-body problem through a variational approach. In Section 3, we analyze the conditions under which homographic solutions minimize the action functional. We demonstrate that these solutions for four equal masses arranged in a linear configuration are indeed the minimizers of the action functional and compute the minimum value of the action functional for these solutions. Additionally, we employ numerical experiments using Poincaré sections to explore the existence and stability of periodic and quasi-periodic solutions within this dynamical system. Our results provide a deeper understanding of the variational principles in celestial mechanics and reveal complex dynamical behaviors that are crucial for further studies in multi-body problems. The findings have significant implications for theoretical research and practical applications in astrodynamics and space mission planning.

Antimicrobial peptides (AMPs) are short, usually cationic peptides with an amphiphilic structure, which allows them to easily bind and interact with the cellular membranes of viruses, bacteria, fungi, and other pathogens. Bacterial AMPs, or bacteriocins, can be produced from Gram-negative and Gram-positive bacteria via ribosomal synthesis to eliminate competing organisms. Bacterial AMPs are vital in addressing the increasing antibiotic resistance of various pathogens, potentially serving as an alternative to ineffective antibiotics. Bacteriocins have a narrow spectrum of action, making them highly specific antibacterial compounds that target particular bacterial pathogens. This review covers the two main groups of bacteriocins produced by Gram-negative and Gram-positive bacteria, their modes of action, classification, sources of positive effects they can play on the human body, and their limitations and future perspectives as an alternative to antibiotics.

Mapping pavement types, especially in sidewalks, is essential for urban planning and mobility studies. Identifying pavement materials is a key factor in assessing mobility, such as walkability and wheelchair usability. However, satellite imagery in this scenario is limited, and in-situ mapping can be costly. A promising solution is to extract such geospatial features from street-level imagery. This study explores using open vocabulary classification algorithms to segment and identify pavement types and surface materials in this scenario. Our approach uses Large Language Models (LLMs) to improve the accuracy of classifying different pavement types. The methodology involves two experiments: the first uses free prompting with random street-view images, employing Grounding Dino and SAM algorithms to assess performance across categories. The second experiment evaluates standardized pavement classification using the Deep-Pavements Dataset and a fine-tuned CLIP algorithm optimized for detecting OSM-compliant pavement categories. The study presents open resources, such as the Deep Pavements Dataset and a fine-tuned CLIP-based model, demonstrating a significant improvement in the True Positive Rate (TPR) from 56.04% to 93.5%. Our findings highlight both the potential and limitations of current open vocabulary algorithms and emphasize the importance of diverse training datasets. This study advances urban feature mapping by offering a more intuitive and accurate approach to geospatial data extraction, enhancing urban accessibility and mobility mapping.

This randomized control trial aims to test the hypothesis that twice-daily nurse-administered saline enema(SE) is comparable to physician-administrated SE in very low birth weight infants (VLBW) with meconium obstruction of prematurity (MOP). MOP is defined as no bowel opening for 48 h, and treatment failure is defined as the need for additional intervention and safety. Twice-daily SE was administered by accredited nurses, surgeons/neonatologists using standardized protocols. The outcomes were comparability of nurse to physician-administered SE in terms of frequency of administration, catheter insertion length and volume of enema, daily maximum meconium output, and treatment failure, defined as the need for additional intervention. Safety outcomes were evaluated. Twenty-eight infants were managed with SE. 389 SE were administered, 96 and 293 in 750-999g and 1000-1500g birth weight groups, respectively. Nurses administered 72.9% and 81.5% of SE in 750-999g and 1000-1500g birth weight groups, respectively. Physicians performed the rest of the SE. Daily meconium output was comparable in nurse and physician-administered SE in both groups. There were no treatment failures or adverse events in both SE group. SE administered by nurses was found to be comparable in terms of safety, efficacy, and frequency of administration to that of physician-administered SE.

Athlete’s heart is characterised by structural, functional, and electrical remodelling. During an exercise session, the heart increases the use of oxygen, which is associated with decreased vascular resistance in the lungs’ circulation. Left ventricular hypertrophy is an echocardiographic modification especially met in endurance athlete’s heart. Moreover, left atrial dilatation represents another important characteristic of endurance athletes. Electrical modulation in the athletic heart induces neurological modifications leading to sinus arrhythmia, bradycardia, early repolarisation, and first-grade atrioventricular (AV) blocks. Athletes' nutritional status involves the assimilation of macronutrients such as proteins, carbohydrates, and fats. Depending on the duration of physical exercise, ATP can be obtained in aerobic or anaerobic conditions. This systematic review aims to find correlations between different evaluative methods of cardiac adaptation and present the metabolism in performance athletes.

Immune checkpoint inhibitors (ICI’s) are in the forefront of advanced Non Small Cell Lung Cancer (NSCLC) treatment. Still, only 27- 46% of patients respond to initial therapy with ICI’s and of those, up to 65% develop resistance within four years. After disease progression (PD), treatment options are limited, with 10% Objective Response Rate (ORR) to second or third-line chemotherapy. In this context, ICI rechallenge is an appealing option for NSCLC. Most data on the efficacy of ICI rechallenge are based on retrospective real-world studies of small, heavily pretreated, and heterogeneous patient groups. Despite these limitations, these studies suggest that ICI monotherapy rechallenge in unselected NSCLC patient populations who discontinued initial ICI due to PD is generally ineffective, with a median Progression-Free Survival (PFS) of 1.6-3.1 months and a Disease Control Rate (DCR) of 21.4%-41.6%. However, there is a subpopulation that benefits from this strategy, and further characterization of this subgroup is essential. Furthermore, immunotherapy rechallenge in patients who discontinued initial immunotherapy following treatment protocol completion and progressed after an immunotherapy-free interval showed promising efficacy, with a DCR of 75-81%, according to post-hoc analyses of several clinical trials. Future research of ICI rechallenge for NSCLC should focus on better patient stratification, to reflect the underlying biology of immunotherapy resistance more accurately.

Successful implementation of antibiotic stewardship programs (ASP) requires a well-structured approach involving all stakeholders. Despite embracing key responsibilities, nurses’ role remains poorly defined, preventing consistent engagement. We conducted a scoping survey to assess knowledge, attitude and perception of nurses towards nurse-led initial sepsis risk evaluation using the sepsis risk calculator (SRC) of newborns admitted to the mother-baby unit. Single-center, cross-sectional study. Study link was sent to all full-time nurses in mother-baby unit. Survey centered around knowledge of unit’s ASP and attitude and perception towards nurse-led initial sepsis risk evaluation. 89% response rate. 100% agreed that SRC reduced antibiotic use and 66% felt nurse-led sepsis risk evaluation will enhance nurse involvement, but this was offset by extra burden of work (66%) and low confidence in differentiating stable from clinically unstable infants (46%). Other facilitating factors included greater nurse/patient ratio (100%), targeted education (89%) and incorporation of the SRC into EMR (78%). Only 11% were willing to serve as champions for it. There was no significant correlation to age or experience however, greater number of fresh grads were interested in championing this effort. Our study identifies a need for strong foundation of knowledge and greater nurse/patient ratio as two main factors for improving nurse-led use of the SRC. Multi-site studies scoping barriers to nursing involvement for successful implementation of ASPs are necessary.

Current microbiological methods for pneumonia diagnosis require invasive specimen collection and time-consuming analytical procedures. There is a need for less invasive and faster methods to detect lower respiratory tract infection. The analysis of volatile metabolites excreted by pathogenic microorganisms provides the basis for developing such a method. Given the synergistic role of Candida albicans in increasing the virulence of pathogenic bacteria causing pneumonia and the cross-kingdom metabolic interactions between microorganisms, we compare the emission of volatiles from Candida albicans yeasts and the bacteria Staphylococcus aureus using single and mixed co-cultures and apply that knowledge to human in vivo investigations. Gas-chromatography-mass spectrometry (GC-MS) analysis resulted in the identification of sixty-eight volatiles that were found to have significantly different levels in cultures compared to reference medium samples. Certain volatiles found in co-culture originated mainly from C. albicans metabolism (e.g., isobutyl acetate), whereas other volatiles primarily came from S. aureus (e.g., ethyl 2-methylbutyrate). Isopentyl valerate reflects synergic interactions of both microbes, as its level in co-cultures was found to be approximately three times higher than the sum of its amounts in monocultures. Hydrophilic-lipophilic balanced (HLB) coated meshes for thin-film microextraction (TFME) were used to pre-concentrate volatiles directly from bronchoalveolar lavage (BAL) specimens collected from patients suffering from ventilation-associated pneumonia (VAP) that was caused explicitly by C. albicans and S. aureus. GC-MS analyses confirmed the existence of in vitro-elucidated microbial VOCs in human specimens. Significant differences in BAL-extracted amounts respective to the pathogen causing pneumonia were found. The model in vitro experiments provided evidence that cross-kingdom interactions between pathogenic microorganisms affect the synthesis of the volatile compounds. The TFME meshes coated with HLB particles proved to be suitable for extracting VOCs from human material, enabling the translation of in vitro experiments on the microbial volatilome to the in vivo situation involving infected patients. This indicates the direction that should be taken for further clinical studies on VAP diagnosis based on volatile analysis.

Breast cancer remains a significant health concern worldwide, necessitating early detection and treatment. The rapid appearance or a change in the shape of skin lesion on the breast or just of the nipple-areola complex(NAC), especially if it is unilateral needs to be evaluated. Several primary or secondary tumours such as inflammatory skin lesions can affect this body area. Ultrasound, mammography, or magnetic resonance imaging (MRI) are the most used non-invasive diagnostic techniques for breast cancer, but in recent years reflectance confocal microscopy (RCM) and optical coherence tomography have emerged as additional tools to diagnose cases characterized by cutaneous changes.The introduction of new techniques such as reflectance confocal microscopy (RCM), may open new perspectives in the non-invasive diagnosis of mammary paget disease (MPD). RCM is a non-invasive diagnostic technique that allows high-resolution images of the skin at microscopic level in real time. It is non-invasive, painless and repeatable, making it a valuable tool in the early diagnosis and monitoring of skin diseases. We describe an atypical clinical presentation of mammary paget disease early diagnosed by reflectance confocal microscopy evaluation.

Some of the recent large-scale national projects in South Korea are delayed or suspended due to belated responses to risk occurring on site. Currently, the Far East District (FED) project is being implemented to relocate the US Army bases from Yongsan to Pyeongtaek. Because of lack of experience and understanding about the characteristics of such a project, the deadline of taking over to the US Army Korea has been missed. This study identifies problems of each participant in the Yongsan Relocation Plan (YRP) of the US Army Korea with respect to construction project management and establishes a risk management strategy reflecting characteristics of FED project. To derive significant risk factors influencing YRP, various field data like weekly and monthly reports and other reports on construction condition are analyzed, and experts’ advices are collected and a survey is conducted. Mediators and latent variables are ultimately obtained. Furthermore, a structural equation model is used to both analyze and evaluate complex causal relations among many variables of YRP. The impact of risk factors on the schedule, quality and cost of the project is analyzed. In particular, the case of Site A is examined to see how the project is affected by those risk factors.

Background and Objectives: ARNE score was developed for the prediction of difficult airway for both general and ENT surgery with a universal cut-off value. We tested the accuracy of this score in the case of laryngeal surgery and provided an insight of its combination with flexible laryngoscopy. Materials and Methods: This prospective pilot clinical study included 100 patients who were being scheduled for microscopic laryngeal surgery. We have calculated ARNE score for every patient and flexible laryngoscopy was provided preoperative. Difficult intubation was assessed according to intubation difficulty score (IDS). Results: A total of 33% patients had difficult intubation according to IDS. ARNE score showed to be accurate for prediction of difficult intubation in laryngology with P&lt;0.0001 and AUC 0.784. Flexible laryngoscopy showed to be an independent parameter with P&lt;0.0001 and AUC 0.766. We have defined a new cut-off value of 15.50 for laryngology, according to AUC curve. After the patients were divided in two groups, according to the new cut-off value and provided cut-off value, AUC improved to 0.707 from 0.619 respectively. Flexible laryngoscopy improved the prediction model of ARNE score to AUC 0.882 and of new cut-off value to AUC 0.833. Conclusions: It is recommended to use flexible laryngoscopy together with ARNE score in difficult airway prediction in patients with laryngeal pathology. Also, universally recommended cut-off value of 11 can not be effectively used in laryngology and a new cut-off value of 15.50 is recommended.

In the last two decades, the application of composite structures in many industrial sectors has been made progressively. For the current major scientific and technological challenge, the energy transition with sustainable and eco-friendly initiatives, the polymer matrix laminated composites have been revealed as an excellent alternative for the renewable energy sector. In this context, the knowledge about mechanical behavior of multiphase materials is required. Then, researches related to macro, mesomechanical and multiscale approaches are very important to improve accuracy of the models to predict effective mechanical properties and to develop a better understanding about complex phenomena such as progressive damage, creep and fatigue. Due to theses needs, this research is a synthesis of fundamentals and advanced topics concerning to global modeling of laminated composite structures, layerwise analyzes and micro-macromechanical models, in which mainly fiber, matrix, interface and damage characteristics are studied and used in the macroscale approach. At the end of this study, some final remarks and a trend analysis are proposed based on literature consulted, in other words, expectations for the future works are made by the authors.

Cardiac autonomic neuropathy (CAN) is a severe complication of diabetes mellitus (DM) strongly linked to a nearly five-fold higher risk of cardiovascular mortality. Patients with Type 2 Diabetes Mellitus (T2DM) are a significant cohort in which these assessments have particular relevance to the increased cardiovascular risk inherent in the condition. This study aimed to explore the subtle correlation between the Ewing test, Sudoscan-cardiovascular autonomic neuropathy score, and cardiovascular risk calculated using SCORE 2 Diabetes in individuals with T2DM. The cohort consisted of 211 patients diagnosed with T2DM with overweight or obesity without established ASCVD, aged between 40 to 69 years. The prevalence of CAN in our group was 67.2%. In the study group, according SCORE2-Diabetes, four patients (1.9%) were classified with moderate cardiovascular risk, thirty-five (16.6%) with high risk, and one hundred seventy-two (81.5%) with very high cardiovascular risk. On multiple linear regression, the SCORE2-Diabetes algorithm remained significantly associated with Sudoscan CAN-score and Sudoscan Nephro-score and Ewing test score. Testing for the diagnosis of CAN in very high-risk patients should be performed because approximately 70% of them associate CAN. Increased cardiovascular risk is associated with sudomotor damage and that Sudoscan is an effective and non-invasive measure of identifying such risk.