Introduction: Despite its high prevalence and impact on health, metabolic dysfunction-associated steatotic liver disease (MASLD) is inadequately addressed in European primary care (PC), with a large proportion of cases going undiagnosed or diagnosed too late. A multi-country European re-search consortium led a project to design and evaluate a patient-centered, integrated model for MASLD screening, diagnosis and linkage to specialty care for European PC settings. Aim: Based on the lessons from this project, the latest research evidence and existing guidelines for the management of MASLD, we sought to develop a set of practice recommendations for screening, referral and management of MASLD in PC. Methods: The Rand/UCLA modified Delphi panel method, with two rounds, was used to reach consensus on practice recommendations. The international panel consisted of experts from six countries, representing family medicine, gastroenterology, hepatology, cardiology and public health. Initially, fifteen statements were drafted based on a synthesis of evidence from the literature and earlier findings from our consortium. Prior to the consensus meeting, the statements were rated by the experts in a first round. Then, in a hybrid meeting, the experts discussed findings of round one, adjusted the statements and reassessed the updated recommendations in a second round. Results: In round one, there was already a high level of consensus on 10 out of 15 statements. After round 2, there were fourteen statements with a high agreement (>90%). One statement was not endorsed. The approved recommendations addressed the following practice areas: risk screening and diagnosis, management of MASLD – Lifestyle interventions, pharmacological treatment of MASLD/MASH, pharmacological treatment for co-morbidity, integrated care, surgical management and other referrals to specialists. Conclusion: The final set of 14 recommendations focuses on increasing comprehensive care for MASLD in PC. The recommendations provide practical evidence-based guidance tailored to PC practitioners. We expect that these recommendations will contribute to the ongoing discussion on systematic approaches to tackle MASLD and support European PC providers by integrating the latest evidence into practice.

In 2002, the Higher Learning Commission, a regional accrediting agency in the US, placed the community college in this study on academic probation for several criteria and many residents of the community believed that closing doors was the best option for addressing these concerns. This study is designed to ascertain data from external stakeholders of the community college regarding their current perceived value of the community college and suggestions about moving from the present to the future. The main question of the study is: What are external stakeholders’ perceptions of the value of the college to the service area? This qualitative approach is used consisting of interviews, focus groups, surveys, and document review to triangulate stakeholder perspectives. Participants included 176 high school seniors from different counties, four counselors, and four focus groups. The findings from the data are presented in this study are planned to be used by community college officials to incorporate into their strategic plans. They showed that the college needs to consider the value that it brings to the service area including economic benefits, specifically community support; accessibility; and cost of tuition.

Proposed fundamental laws of biology and a model of health and disease underscore the importance of the lymphatic system. The lymphatics are responsible for two of the laws of biology and the fulcrum of health and disease balancing proliferation with regeneration through the immune system. It is responsible for protection from the environment and repair of senile and damaged tissue. Life is constantly bombarded by forces that increase entropy. Lymphatics provide negative entropy to maintain health. Lymphatics help maintain cellular homeostasis removing products of metabolism. Using these principles, the role of lymphatics is investigated in salt sensitivity hypertension, cardiorenal system, the new pillar of heart failure and kidney disease - Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitors, and brain diseases. The realization of organ lymphatics in maintenance of health and disease opens the avenue to new therapeutics. This is the unrealized potential of lymphatic study.

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

With the rapid development of wind power generations, the inertial response of wind turbines (WTs) are widely concerned recently, which is important for grid frequency dynamic and stability. This paper recognizes and understands the inertial response of type-3 and type-4 WTs from the view of equivalent internal voltage, in analogy with typical synchronous generators (SGs). Due to the dynamic of the equivalent inertial voltage different from SGs, the electromechanical inertia of WTs is completely hidden. The rapid power control loop and synchronization control loop is the main reasons that the WT's inertial response is disenabled. On the basis of the equivalent internal voltage's dynamic, the existing inertia control method for WTs are reviewed and summarized as three approaches from the view of WT's control, i.e. optimizing the power control or synchronization control or both. At last, the main challenges and issues of these inertia controls are attempted to explain and address.

Disease, trauma, and aging account for a significant number of clinical disorders. Regenerative medicine is emerging as a very promising therapeutic option. The design and development of new cell-customized biomaterials able to mimic ECM functionalities represent one of the major strategy to control the cell fate and stimulate tissue regeneration. Recently, hydrogels have received a considerable interest for their use in the modulation and control of cell fate during regeneration processes. Several synthetic bioresponsive hydrogels are being developed in order to facilitate cell-matrix and cell-cell interactions. In this review new strategies and future perspectives of such synthetic cell microenvironment will be highlighted.

The sustainability of agricultural commodities produced in the Southern U.S. under irrigation is increasingly at risk due to erratic rainfall patterns, inadequate water supplies and compromised water quality. This study assessed the needs of crop growers in the United States Department of Agriculture (USDA) Southern Region. The purpose was to identify growers’ critical water resource management concerns to identify research priorities from the perspective of growers in this region. To obtain this information, a questionnaire was developed and distributed to growers throughout the Southern Region in 2020. The final sample included 112 crop (row and specialty) production growers from the Southern Region. Overall, respondents named the water available to irrigate as the greatest water resource management priority. Within all the water availability priorities asked, respondents’ first choice was declining water supply in the future. Declining water supply and the cost of irrigating presently were the next most frequently named water availability priorities. Growers named both increasing the efficiency of irrigation and development of farming practices to improve soil moisture retention as the first and second focus of future irrigation research, respectively. These results will aid in strengthening existing and developing new initiatives for water research and Extension in this region.

This study delves into the dynamic field of medical education research, emphasizing the integration of research training within medical curricula. It seeks to understand the impact of such integration on the competencies of future medical professionals. The primary aim is to systematically categorize and analyze the current trends and future directions in medical education research. This involves assessing the influence of research training on medical students' skills and the methodologies used in such research. Methods: The research employs an extensive bibliographic literature review across multiple databases. It classifies studies into categories like experiential or case studies, editorials, and original research articles. This classification is based on criteria such as geographical location, research objectives, theoretical frameworks, and methodologies. Results: Findings reveal a diverse landscape in medical education research, with a significant emphasis on research training. The research showcases varying methodologies and approaches used globally, highlighting the thematic focus and geographical distribution of these studies. Conclusion: Medical education research is a globally expansive and evolving field. It underscores the importance of continuous investigation, particularly focusing on integrating research elements at curricular levels and exploring innovative educational strategies. The study also points out potential gaps in research, especially in underrepresented regions, indicating directions for future research efforts.

This review examines additive manufacturing for refractory tungsten (W) and its alloys. It emphasizes the primary challenges and determining factors involved in additive manufacturing pure W, W alloys, and composites. Our focus in this regard extends to both process and alloying strategies designed to address critical issues such as densification, micro-cracking, and mechanical properties in tungsten-based components produced through additive techniques. Throughout the review, we organize existing knowledge and insights into convenient tables, serving as valuable resources for researchers embarking on a deeper exploration of these topics.

Radio-dynamic therapy (RDT), as an emerging cancer treatment method, has attracted attention due to its remarkable therapeutic efficacy using low-dose, high-energy radiation (such as X-rays), and has shown significant potential in cancer treatment. The RDT system typically consists of scintillators and photosensitizers. Scintillators absorb X-rays and convert them to visible light, activating nearby photosensitizers to generate cytotoxic reactive oxygen species (ROS). Challenges faced by the two-component strategy, including low loading capacity and inefficient energy transfer, hinder its final effectiveness. In addition, the tumor microenvironment (TME) with hypoxia and immunosuppression limits the efficacy of RDTs. Recent advances introduce one-component RDT systems based on nanomaterials with high-Z metal elements, which effectively inhibit deep-seated tumors. These novel RDT systems exhibit immune enhancement and immune memory, potentially eliminating both primary and metastatic tumors. This review comprehensively analyzes recent advances in the rational construction of RDTs, exploring their mechanisms and its application in the treatment of deep-seated tumors. Aimed at providing a practical resource for oncology researchers and practitioners, the review offers new perspectives for potential future directions in RDT research.

Air pollution has become one of the biggest problems throughout the world. Smog has a severe effect on the pulmonary and circulatory systems, which causes a significant number of deaths globally. Therefore, the remediation of air pollutants to maintain ecosystem processes and functions and to improve human health is a crucial problem confronting mankind today. This review aims to discuss the health effects of smog on humans. This review will also focus on the bioremediation of air pollution (smog) using bacteria, fungi, phytoremediation, nanotechnology, and phylloremediation (using plants and microbes). Phyllo-remediation is the most effective technology for removing air pollution naturally. The future perspective presents a great need to produce an ecosystem where microbes, plants, and nanoparticles synergistically control smog. In addition, further advancements would be needed to modify the genetic makeup of microbes and plants. Biotechnological approaches like CRISPR-Cas9 can be applied to the editing and cutting specific genes responsible for the bioremediation of VOCs, NOx, SOx, and harmful hydrocarbons. The extracted genes can then be expressed in biologically modified microorganisms and plants for enhanced bioremediation of smog.

Merkel cell carcinoma (MCC) is a rare, highly aggressive skin cancer characterized by two etiologies: the first one, observed in most cases, is attributed to Merkel cell polyomavirus (MCPyV), a DNA tumor virus, while the second one is due to ultraviolet (UV) radiation exposure. Currently, there are limited diagnostic, prognostic, and therapeutic biomarkers available for MCC. MicroRNAs (miRNAs) are small RNA molecules that do not code for proteins but regulate various cellular processes, including cell cycle progression, proliferation, differentiation, and apoptosis. The dysregulation of miRNAs has been associated with a wide range of cancers since they can act as either tumor suppressors or oncogenes. This paper aims to collect, summarize and re-organize the recent discoveries concerning miRNAs, whose dysregulation in the pathogenesis and progression of MCC is slowly emerging. Furthermore, the potential clinical applications of miRNAs as diagnostic biomarkers, possible differentiation between MCPyV-related and unrelated MCC, predictors of response to therapy and prognostics are also discussed. From this review, it emerges that miRNAs may have, in the near future, the potential to become clinically significant in improving the diagnostic accuracy, prognostic evaluation, and therapeutic options of MCCs. Finally, the new perspectives on the poorly explored field of artificial intelligence in MCC are provided.

In order to harness the potential of mobile technologies to enhance the quality of clinical research, it is critical to first understand how to engage patients and research sites when planning and conducting mobile clinical trials. The Clinical Trials Transformation Initiative has developed the first comprehensive, evidence-based set of recommendations for incorporating patient and site perspectives in mobile clinical trials, which can aid in engaging stakeholders, addressing site challenges, and maximizing value for participants.

Recent advancements in vascular organoid (VO) and vessel-on-chip (VoC) technologies have revolutionized our approach to studying cardiovascular diseases (CVDs), offering unprecedented insights through more physiologically relevant models. VOs generated from human pluripotent stem cells exhibit remarkable self-organization capabilities, forming complex three-dimensional structures that closely mimic human blood vessel architecture and function, while VoCs engineered with groundbreaking microfluidic systems that meticulously recreate the physical and functional attributes of blood vessels. These innovative constructs serve as powerful tools for investigating vascular development, disease progression, and therapeutic efficacy. By enabling the creation of patient-specific VOs and VoCs, they pave the way for personalized medicine approaches, allowing researchers to delve into genetic variations, intricate cellular interactions, and dynamic processes with exceptional resolution. The synergy between VOs and VoCs with cutting-edge technologies such as single-cell sequencing and high-resolution imaging has further amplified their potential, unveiling novel mechanisms underlying CVDs and identifying promising therapeutic targets. Herein, we summarize different types of VOs and VoCs and present an extensive overview on the generation and applications of VOs and VoCs in CVDs. We will also highlight clinical and translational challenges and future perspectives around VOs and VoCs.

Purpose: Arab Americans are one of the largest ethnic groups in the United States. The mental health of Arab Americans and opinions on mental health, however, remain understudied despite higher rates of mental illness and lower rates of treatment. Unique cultural conceptualizations of mental illness may generate stigma, contributing to disparities in treatment. This study aimed to assess the attitudes and perspectives of Arab Americans regarding mental illness in order to address barriers to treatment. Methods:Using an anonymous bilingual Qualtrics survey, we assessed Arab and non-Arab participants (n = 294; ages 18+) on their conceptualizations of the causes of mental illness and on their stigma towards mental illness and mental health treatments. Comparisons were performed between Arabs and non-Arabs, as well as among Arabs. Results:Compared to non-Arabs, Arabs reported higher average mental illness stigma and were more likely to rate psychiatric medications as addictive and unhelpful. Among Arabs, being Christian, male, and older (>29 years old) were each associated with higher stigma. Arabs were less likely than non-Arabs to believe in a biological explanation for mental illness. Conclusion: Our results demonstrate higher levels of stigma towards mental illness among Arab Americans, especially Christian, male, and older Arabs, potentially related to a weaker belief in a biomedical model for mental illness. These are among the first findings describing mental illness stigma and beliefs about mental health in an Arab American community and may inform future interventions providing culturally competent care to Arab Americans.

The rapid expansion of Bangladesh's financial infrastructure, coupled with the increasing digitization of banking services, underscores the critical importance of cybersecurity. Machine learning and deep learning methodologies have emerged as potent tools in combating cyber threats such as intrusion, malware, and fraud. By harnessing artificial intelligence and data-driven analysis, these techniques enable real-time scrutiny of vast banking data, facilitating proactive defense against cyberattacks. Bangladesh's evolving financial landscape, characterized by governmental digitalization initiatives and a national financial inclusion strategy, heightens the imperative for robust cybersecurity measures. This paper explores the application of machine learning and deep learning techniques in bolstering banking cybersecurity within the context of Bangladesh's burgeoning digital economy.

Background: In response to the COVID-19 pandemic, the European Association of Urology (EAU) Guidelines defined priority groups to guide the prioritization of surgery for urological malignancies. The objective of this study was to evaluate the impact of the COVID-19 prioritization recommendations on tumor pathological characteristics in a real-world setting at our academic referral Institution. Methods: We compared baseline and pathological tumor features of all patients with urological malignancies treated during the pandemic period (2020-2021) versus in the post-pandemic period (2022-2023). Our institution adhered to the International recommendations and prioritized those cases defined as “high-risk”. Results: Data of 9196 patients treated for urological malignancies were reviewed and grouped according to period of surgery (4401 in the pandemic vs 4785 in non-pandemic period). The overall number of surgical procedures was comparable for all diseases except for the number of radical prostatectomy (1117 vs 1405; p=0.03) and partial nephrectomy (609 vs 759; p=0.02) which were significantly lower in the pandemic period. Regarding tumors’ pathological features, none of the recorded variable was found to differ according to period of surgery, including disease stage, tumor grading, presence of necrosis, lymphovascular invasion, histological variants. Conclusion: A correct policy of prioritization of oncological pathologies during emergency periods and a centralization of oncological cases in reference centers reduces the possible risk of worsening cancer disease features related to the reorganization of healthcare resources.

Urban tourism has witnessed significant growth in recent years, driven by various factors that foster the transformation of urban areas into tourist hotspots. These factors include a rising interest in culture and heritage, ongoing urban redevelopment and conversion processes, and the introduction of new experiences and activities. Two particularly influential factors contributing to this growth are low-cost travel, which facilitates more accessible access to urban destinations, and the emergence of new types of accommodation, such as short-term rental (also known as local accommodation or Airbnb-type accommodation). This sudden and continuous growth of this type of tourist accommodation brings new challenges to cities and local communities. On the positive side, it contributes to job opportunities, the dynamism of the local economy, and urban revitalization. On the other hand, it also represents more difficulty in retaining the local population in city centers, as more and more buildings are converted into hostels and tourist apartments. In this context, it becomes essential to conduct studies evaluating the impacts of these dynamics in urban areas and how they influence residents' and visitors' perspectives. Therefore, this study aims to identify the main transformations resulting from short-term rental (STR) development, focusing on the impacts felt by tourists and residents in Porto. A questionnaire was distributed to tourists and residents in Porto's city center in June 2023. The results reveal differences in opinions between tourists and residents, particularly concerning historical heritage preservation, local population relocation, and reduced housing availability for residents. Nevertheless, there is a similarity in their opinions regarding the stimulus that local accommodation brings to the economy and the rehabilitation of buildings and urban areas. This study reinforces the need to pay more attention to the future development of tourist accommodation in city centers, especially regarding local policies and territorial planning, to balance better tourism development and local communities' quality of life.

Annually, more than 1.5 million preventable new hepatitis B (HBV) infections continue to occur, with an estimated global burden of 296 million individuals living with chronic hepatitis B infection. This substantial health challenge results in over 820,000 annual deaths attributed to complications such as liver cirrhosis and hepatocellular carcinoma (HCC). HBV vaccination remains the cornerstone of public health policy to prevent chronic hepatitis B and its related complications. It serves as a crucial element in the global effort to eliminate HBV, as established by the World Health Organization (WHO), with an ambitious 90% vaccination target by 2030. However, reports on global birth dose coverage reveal substantial variability, with an overall coverage rate of only 46%. This comprehensive review thoroughly examines global trends in HBV vaccination coverage, investigating the profound impact of vaccination on HBV prevalence and its consequences across diverse populations, including both high-risk and general demographics. Additionally, the review addresses the formidable challenges and facilitating factors essential for achieving WHO's HBV vaccination coverage objectives and elimination strategies in the coming decade and beyond.

Non-coding RNAs have been described as crucial regulators of gene expression and guards for cellular homeostasis. Some recent papers are focused on vault RNAs, one of the classes of non-coding RNA, and their role in cell proliferation, tumorigenesis, apoptosis, cancer response to therapy, and autophagy, which made them potential therapy targets in oncology. In the human genome, four vault RNA paralogues can be distinguished. They are associated with vault complexes, considered the largest ribonucleoprotein complex. The protein part of these complexes consists of a major vault protein (MVP) and two minor vault proteins (vPARP and TEP1). The name of the complex, as well as vault RNA, comes from the hollow barrel-shaped structure that reminds a vault. Their sequence and structure are highly evolutionary conserved and show many similarities in comparison with different species, but vault RNAs show various roles. Vaults were discovered in 1986, and their functions remained unclear for many years. Although not much is known about their contribution to cell metabolism, it has become clear that vault RNAs are involved in various processes and pathways associated with cancer progression and modulating cell functioning in normal and pathological stages. In this review, we discuss known functions of the human vault RNAs in the context of cellular metabolism, emphasizing processes related to cancer and cancer therapy efficacy.

Industrial fires at facilities including waste management sites, warehouses, factories, chemical works and fuel storage depots are relatively frequent occurrences. Often, these fires occur adjacent to urban communities and result in ground-level airborne pollutant concentrations that are well above guideline values. Land, water, livestock and crops may also be contaminated by the emissions and by firefighting activities. Moreover, impacted communities tend to have a higher proportion of minority ethnic populations, individuals with underlying health vulnerabilities, as well as those of lower socio-economic status. Nevertheless, this is an aspect of air quality that is under-researched, and so this review aims to highlight the public health hazards associated with industrial fires and the need for an effective, coordinated, public health response. We also review the range of monitoring techniques that have been utilised in such fires and highlight the role of dispersion modelling in predicting plume trajectories and in estimating population exposure. We recommend establishing 1-h guideline values for particulate matter to facilitate timely public health interventions and we highlight the need to review regulatory and technical controls for sites prone to fires, particularly in the waste sector.

Background: In recent years, the integration of robotic systems into various aspects of daily life has become increasingly common. As these technologies continue to advance, ensuring user-friendly interfaces and seamless interactions becomes more essential. For social robots to genuinely provide lasting value to humans, a favourable user experience (UX) emerges as an essential prerequisite. Aim: This article aimed to evaluate the usability of the MINI robot, highlighting its strengths and areas for improvement based on user feedback and performance. Method: In a controlled lab setting, a mixed-method qualitative study was conducted with ten individuals aged 65 and above diagnosed with mild dementia (MD) and mild cognitive impairment (MCI). Participants engaged in individual MINI robot interaction sessions, completing cognitive tasks as per written instructions. Video and audio recordings documented interactions, while post-session System Usability Scale (SUS) questionnaires quantified usability perception. Ethical guidelines were followed, ensuring informed consent, and the data underwent qualitative and quantitative analyses, contributing insights into the MINI robot's usability for this demographic. Results: The study addresses the ongoing challenges that tasks present, especially for MD individuals, emphasizing the importance of user support. Most tasks require both verbal and physical interactions, indicating that MD individuals face challenges when switching response methods within subtasks. These complexities originate from the selection and use of response methods, including difficulties with voice recognition, tablet touch, and tactile sensors. These challenges persist across tasks, with individuals with MD struggling to comprehend task instructions and provide correct answers and individuals with MCI struggling to use response devices, often due to the limitations of the robot's speech recognition. Technical shortcomings have been identified. The results of the System Usability Scale (SUS) indicate positive perceptions, although there are lower ratings for instructor assistance and pre-use learning. The average SUS score of 68.3 places device usability in the "good" category. Conclusion: Our study examines the usability of the MINI robot, revealing strengths in quick learning, simple system and operation, and integration of features while also highlighting areas for improvement. Careful design and modifications are essential for meaningful engagement with people with dementia. The robot could better benefit people with MD and MCI if clear, detailed instructions and instructor assistance are available.

The current management of colorectal cancer liver metastasis (CRCLM) patients involves a multidisciplinary approach with surgical resection remaining the primary curative option. The advances in liver surgery have improved outcomes, enabling more patients to undergo surgery successfully. In addition, the development of imaging software has improved the preoperative planning and patient selection for surgery and other interventions. Systemic therapies, such as targeted therapies and immunotherapies have enhanced the chances of complete resection. Targeted agents in combination with chemotherapy, have shown efficacy in downstaging tumors and increasing resectability.

The field of personalized medicine is undergoing a transformative shift through the integration of multi-omics data, which encompasses genomics, transcriptomics, proteomics, and metabolomics. This synergy allows for a comprehensive understanding of individual health by analyzing genetic, molecular, and biochemical profiles. The generation and integration of multi-omics data enable more precise and tailored therapeutic strategies, improving the efficacy of treatments and reducing adverse effects. However, several challenges hinder the full realization of personalized medicine. Key hurdles include the complexity of data integration across different omics layers, the need for advanced computational tools, and the high cost of comprehensive data generation. Additionally, issues related to data privacy, standardization, and the need for robust validation in diverse populations remain significant obstacles. Looking ahead, the future of personalized medicine promises advancements in technology and methodologies that will address these challenges. Emerging innovations in data analytics, machine learning, and high-throughput sequencing are expected to enhance the integration of multi-omics data, making personalized medicine more accessible and effective. Collaborative efforts among researchers, clinicians, and industry stakeholders are crucial to overcoming these hurdles and fully harnessing the potential of multi-omics for individualized healthcare.

The physical roots, interpretation, controversies and precise meaning of the Landauer Principle are surveyed. Landauer's principle is a physical principle pertaining to the lower theoretical limit of energy consumption of computation. It states that an irreversible change in information stored in a computer, such as merging two computational paths, dissipates a minimum amount of heat kBTln2 per a bit of information to its surrounding. The Landauer Principle is discussed in the context of fundamental physical limiting principles, such as the Abbe diffraction limit, the Margolus-Levitin limit and the Bekenstein limit. Synthesis of the Landauer bound with the Abbe, Margolus-Levitin limit and Bekenstein limits yields the minimal time of computation, which scales as τmin~hkBT. Decrease in a temperature of a thermal bath will decrease the energy consumption of a single computation, but, in parallel, it will slow the computation. The Landauer principle bridges between John Archibald Wheeler “it from bit” paradigm and thermodynamics. Experimental verifications of the Landauer Principle are surveyed. Interrelation between thermodynamic and logical irreversibility is addressed. Generalization of the Landauer principle to the quantum and non-equilibrium systems is addressed. Landauer Principle represents the powerful heuristic principle bridging the physics, information theory and computer engineering.

In August 4 2011, United Nations Environmental Program (UNEP) submitted an unprecedented, scientific, groundbreaking Environmental Assessment Report (EAR) of Ogoniland, to the Nigerian government. This was the outcome of a 14–month intensive evaluation of the extent of pollution. It was intended that UNEP’s recommendations would be implemented to restore the devastated environment, on the one hand, and on the other, counteract the numerous environmental health issues that have for decades, plagued Ogoniland. However, five years post EAR, and, despite the seriousness of the situation, no significant resolution has occurred, both on the part of the government, and on the part of Shell Petroleum Development Company (SPDC) or Shell. To date, millions of Niger Delta residents, particularly those living in the oil-bearing communities, continue to suffer severe consequences. Although, the assessment was conducted in Ogoniland, other communities in the Niger Delta are also affected. This article explores prevailing issues, using Ogoniland (a microcosm of the Niger Delta) as an example. A multidisciplinary approach for sustainable mitigation of environmental health risks in the Niger Delta is paramount, and Environmental Management tools offer valuable strategies. Adopting UNEP’s recommendations for addressing environmental health problems requires implementing the Environmental Management/Environmental Management System (EM/EMS) model.

Systemic inflammation and coronary microvascular endothelial dysfunction are essential pathophysiological factors in heart failure with preserved ejection fraction (HFpEF) that support the use of statins. The pleiotropic properties of statins, such as anti-inflammatory, antihypertrophic, antifibrotic, and antioxidant effects, are generally accepted and may be beneficial in HF, especially in HFpEF. Numerous observational clinical trials have consistently shown a beneficial prognostic effect of statins in patients with HFpEF, while the results of two larger trials in patients with HFrEF have been controversial. Such differences may be related to a more pronounced impact of the pleiotropic properties of statins on the pathophysiology of HFpEF and pro-inflammatory comorbidities (arterial hypertension, diabetes mellitus, obesity, chronic kidney disease) that are more common in HFpEF. This review discusses the potential mechanisms of statin action that may be beneficial for patients with HFpEF, as well as clinical trials that have evaluated the statin effects on left ventricular diastolic function and clinical outcomes in patients with HFpEF.

This pioneering study explores the geospatial and temporal patterns of natural and human-induced disasters from 1900 to 2024, providing essential insights into their global distribution and impacts. Utilizing the comprehensive international EM-DAT database, our analysis reveals significant trends and disparities in disaster occurrences and their widespread consequences. Results showed a dramatic escalation in both natural and man-made (technological) disasters over the decades, with notable surges in the 1991-2000 and 2001-2010 periods. A total of 25,836 disasters were recorded worldwide, of which 69.41% were natural disasters (16,567) and 30.59% were man-made (technological) disasters (9,269). The most significant increase in natural disasters occurred from 1961-1970, while man-made (technological) disasters surged substantially from 1981-1990. Seasonal trends reveal that floods peak in January and July, while storms are most frequent in June and October. Droughts and floods are the most devastating in terms of human lives, while storms and earthquakes cause the highest economic losses. The most substantial economic losses were reported during the 2001-2010 period, driven by catastrophic natural disasters in Asia and North America. Our research highlights Asia as the most disaster-prone continent, accounting for 41.75% of global events, with natural disasters making up 61.89% of these events. Oceania, despite experiencing fewer total disasters, shows a remarkable 91.51% of these as natural disasters. Africa is notable for its high incidence of man-made (technological) disasters, which constitute 43.79% of the continent's disaster events. Europe, representing 11.96% of total disasters, exhibits a balanced distribution but tends towards natural disasters at 64.54%. Examining specific countries, China, India, and the United States emerged as the most frequently affected by both natural and man-made (technological) disasters. The impact of these disasters has been immense, with economic losses reaching their highest during the decade of 2010-2020, largely due to natural disasters. The human toll has been equally significant, with Asia recording the most fatalities and Africa the most injuries. Particularly, the decade from 2001 to 2010 experienced the greatest economic losses, primarily driven by natural disasters in Asia and North America. These insights highlight the urgent need for tailored disaster risk management strategies that address the distinct challenges and impacts in various regions. By understanding historical disaster patterns, policymakers and stakeholders can better anticipate and manage future risks, ultimately safeguarding lives and economies.

Button batteries pose a significant threat to young children and are found in many household items and children’s toys. Along with product manufacturers and retailers, parents and caregivers have a role in button battery ingestion prevention through vigilance regarding items containing button batteries in the home, and knowledge of button battery ingestion symptoms. There is limited information available about parent and caregiver perspectives towards button battery safety. Identifying the areas where increased education is required is important for informing safety campaigns and delivering targeted education. This study aimed to examine parent and caregiver elemental perspectives on button battery safety. One hundred and seventy-four parents and caregivers of children aged 0 to 5 completed a cross-sectional online survey. Distribution occurred via social media. The survey contained multiple-choice questions pertaining to button battery perspectives, and one open-ended question. Respondents recognized the dangers of button battery ingestion, yet only 37% reported being familiar with button battery ingestion symptoms. While 68% knew of household items containing button batteries, only 21% were aware of product recall information sources. Approximately 64% understood immediate post-ingestion steps and 17% found current safety labels unsatisfactory. In an open-ended question, parents and caregivers provided comments about button battery safety that revealed five broad themes; supervision and education; safe storage of button batteries in the home; ensuring children cannot access button batteries; disposing of button batteries safely; and avoiding purchasing items containing button batteries. This study provides a foundation for ongoing investigation of parent and caregiver perspectives on button battery home safety.

This research investigates entrepreneurial attitudes among 415 students in the academic sports domain. Utilizing a 15-item questionnaire, participants were categorized into four groups based on their sports background: individual and team sports with competitive history, amateur athletes, and non-practitioners. The questionnaire exhibited good internal consistency (Cronbach's alpha coefficient = 0.755). Statistical analysis using the Chi-Square Test of Homogeneity across criteria such as gender, competitive sports involvement, type of competitive sports, and engagement in amateur sports revealed significant differences in nine out of 60 comparisons. Furthermore, this study employs an explanatory approach to elucidate the distinctions among athletes, amateur, and non-athlete students in academic sports programs regarding assumption of responsibilities, proactive initiative, determination to establish their own businesses, perception of the comfort zone, and the perception of post-sports career adaptation. Additionally, a gender comparison is conducted concerning the perception of business risk, comfort and security in a stable workplace, and the applicability of sports-oriented approaches in business. These results provide valuable insights into how sports backgrounds shape entrepreneurial perspectives, thereby contributing to the development of customized entrepreneurial programs. Moreover, the study seeks to offer a nuanced comprehension of the diverse factors influencing the entrepreneurial attitudes and perceptions of students in sports academic programs.

This review deals with the developmental origins of extraocular, jaw and laryngeal muscles, the expression, regulation and functional significance of myosin heavy chains (MyHCs) they express and changes in MyHC expression during phylogeny. Myogenic progenitors from mesoderm in the prechordal plate and branchial arches specify craniofacial muscle allotypes with different repertoires for MyHC expression. To cope with very complex eye movements, extraocular muscles express 11 MyHCs, ranging from the superfast extraocular MyHC to the slowest, non-muscle MyHC IIB. They have distinct global and orbital layers, singly- and multiply-innervated fibres, longitudinal MyHC variations, and palisade endings that mediate axon reflexes. Jaw-closing muscles express the high-force masticatory MyHC, cardiac or limb MyHCs depending on the appropriateness for the acquisition and mastication of their food. Laryngeal muscles express extraocular and limb muscle MyHCs but shift towards slower MyHCs in large animals. During postnatal development, MyHC expression of craniofacial muscles is subject to neural and hormonal modulation. The primary and secondary myotubes of developing EOMs are postulated to induce, via different retrogradely transported neurotrophins, the rich diversity of neural impulse patterns that regulate the specific MyHCs they express. Thyroid hormone shifts 2A MyHC towards 2B in jaw, laryngeal muscles and possibly extraocular muscles.

(1) Background: This study aims to investigate differences in the perspectives of exercise intensity for resistance exercise of healthcare professionals (HCPs) and adults living with spinal cord injury (SCI) in Asian countries. Also, it verifies the appropriateness of the conventional indicators for resistance exercise intensity in an Asian context; (2) Methods: 121 certified HCPs and 107 adults with SCI participated in a survey conducted in Indonesian, Japanese, Korean and Thai languages. The survey asked what principles are important for prescribing resistance exercise, and if ‘moderate’ and ‘vigorous’ were appropriate terms for indicating an intensity level. Perspective differences were examined between both groups and, further, between countries from a psychosocial perspective; (3) Results: Of the HCPs, 92% perceived that resistance exercise intensity was far more important than frequency, time or type of exercise while frequency (61%) followed by intensity (58%) was perceived as important by respondents with SCI. Only Japanese respondents with SCI agreed with HCP’s perception of intensity. Both HCPs and respondents with SCI showed unfavorable responses on the usage of ‘moderate’ and ‘vigorous’ for describing resistance exercise intensity, especially Japanese HCP and respondents with SCI from Indonesia; (4) Conclusion: Our findings suggest that non-HCPs must improve their perceptions of exercise intensity. Findings also suggest the need for more explicit and user-friendly terms or expressions indicating the level of intensity in a local (Asian) context.

Background: The commonly known assumption that combinations of several herbs in one formulation can have better efficacy due to additive or synergistic effects has not been systematically studied despite some evidence supporting the synergy concept. Study aim: The study aimed to reveal the molecular interactions in situ of host cells in response to the intervention of BHP and justify the benefits of implementing BHP in clinical practice. Results: This overview provides the results of recent clinical and network pharmacology studies of botanical herbal preparations (BHP) of Rhodiola with other plants, including Ashwagandha, Green Tea, Eleutherococcus, Schisandra, Eleutherococcus, Leuzea, Caffeine, Cordyceps, Gingko, Black Cohosh, saffron, and L-carnosine. Conclusions: The most important finding from network pharmacology studies of BHP was the evidence supporting the synergistic interaction of BHP ingredients, revealing unexpected new pharmacological activities unique and specific to the new BHP. Some studies show the superior efficacy of BHP compared with mono-drugs. At the same time, some a priori-designed combinations can fail, presumably due to antagonistic interactions and crosstalk between molecular targets within molecular networks involved in the cellular and overall response of organisms on the intervention. Network pharmacology studies help predict the results of studies to discover new indications and unpredicted adverse events.

Background/Objectives: Congenital Radioulnar Synostosis (CRS) is a rare elbow joint disorder resulting from abnormal fusion of the radius and ulna during fetal development. Methods: Although predominantly sporadic, familial cases exist with autosomal dominant inheritance. Diagnosis relies on clinical evaluation and radiological findings, showcasing synostosis. Surgical decisions hinge on factors like age and symptom severity. Results: Multiple surgical treatments have been described but derotation osteotomy offers predictable results. Challenges include potential complications and cultural considerations influencing final forearm positioning. Conclusions: A nuanced approach is crucial for optimal management, highlighting the need for ongoing research to refine diagnostic and therapeutic strategies for improved outcomes in CRS patients.

There are numerous hazards found on the farms. Most of them are ignored, which might cause the farmer to pay later in terms of his ill health, potential injuries or death. The current article discusses some of the common issues such as dust and air quality concerns; environmental (weather) stressors and psychological stressors; noise and hearing protection; and tractor safety and seatbelt use. And finally, the recommendations to overcome the hazards are discussed.

The issue of suicide has garnered considerable attention in refugee scholarship, where research examines how unique forced migration and resettlement challenges exacerbate risks and vul-nerabilities to suicide. However, there are gaps in understanding the social and cultural factors shaping the lived experience of suicide in refugee communities. Using the example of Afri-can-background young people in Australia, this paper presents a collaboration among two aca-demics and two South Sudanese youth advocates to explore the sociocultural factors impacting suicidality through reflexive discussions and collaborative poetry. This combined approach of-fered a unique and nuanced conceptual and methodological framework to contribute culturally specific narratives to critical suicide studies and challenge western-centric and biomedical per-spectives on suicide. The process highlighted (i) the lack of dialogue about suicide in the South Sudanese community, and (ii) an absence of community-based support structures to address sui-cide. This paper provides useful insights on the culturally specific context of suicide, adding ref-ugee perspectives to the discipline of critical suicide studies.

Rationale: Genetically modified (GM) foods have the potential to reduce food insecurity and address economic and environmental issues. Despite these benefits, GM foods continue to face significant criticism and there is limited information on public awareness and understanding of their nutritional and environmental health benefits in Nigeria. This study aims to fill this gap by investigating public knowledge and perceptions of GM foods in Victoria Island, Lagos. Methods: A convenience sampling method was used to recruit 369 respondents from Victoria Island, Lagos. Data were gathered using a structured questionnaire. The target population comprised employed adults either residing or working on Victoria Island. Statistical analyses were conducted to examine the relationship between sociodemographic factors and awareness of GM foods. Results: The study found that a majority of respondents (62.9%, n=232) were knowledgeable about GM foods and their associated issues. However, many believed that their community was not well-informed on the topic. Awareness of GM foods was significantly associated with sociodemographic factors such as marital status and education (P<0.01). Most respondents were well-informed about the environmental and health benefits of GM foods, with 61.8% believing that GM food production could sustainably reduce reliance on chemical pesticides, fertilizers, and other energy inputs, thus mitigating their ecological impacts. Additionally, most respondents did not feel that purchasing or consuming GM foods conflicted with their beliefs or would affect their food choices. Conclusion: The study concludes that while individual awareness of GM foods is relatively high, there is a perception that community awareness is low. Sociodemographic factors play a significant role in shaping public awareness and perceptions of GM foods. Recommendations: This includes government should actively educate the public on the ecological and health benefits of GM foods and address any safety concerns; Implement strict border controls and food labeling for GM products to protect consumer rights and preferences for organic foods, provide sufficient technical and financial assistance to farmers who participate in organic seed programs to enhance national food security. Significant Statement: This study highlights the importance of public education on GM foods and underscores the need for government intervention to ensure informed consumer choices and support for sustainable agricultural practices.

Cardiovascular diseases (CVDs) and their risk factors are a major cause of illness and death worldwide, especially in low- and middle-income countries like Cameroon. Physiotherapist-led health promotion (PLHP) has proven effective in improving health and reducing CVD risks. Understanding patient perspectives is crucial for designing effective, context-specific PLHP interventions. This study explored patients' views, experiences, perceived usefulness, acceptability, and preferred methods of PLHP through a sequential explanatory mixed-methods approach. The quantitative data highlights a significant burden of CVD conditions and risk factors among patients seen in physiotherapy services. Qualitatively, three themes were identified and included: 1) perspectives and experiences of people at risk or with CVDs (pwCVDs) on PLHP; 2) Perceived usefulness and acceptability of PLHP; 3) Preferred delivery methods of PLHP. Participants reported positive feedback on PLHP and physiotherapy services. Barriers to effective PLHP included high workloads for physiotherapists, limited service access in rural areas, and prohibitive costs. Despite these challenges, participants expressed strong confidence in physiotherapists' competence, though they also called for improved regulation and ongoing professional development. PLHP components, especially physical treatment and dietary advice, were deemed highly useful and acceptable. Patients suggested various delivery methods, including peer support groups, home visits, and mass media interventions. This study highlights the need to improve the scope of practice, competence of physiotherapists and accessibility of physiotherapy services in Cameroon for pwCVDs. It is necessary to adopt multidisciplinary approaches to achieve better outcomes for risk factors like diabetes and hypertension in context.

This paper investigates women’s empowerment and their active involvement in governance aimed at promoting sustainable development. The study focuses on examining the roles and processes of co-creation of nature-based solutions (NBS) for water management in Milan. Three research directions were explored: 1) to determine gender-based roles within local governance; 2) to detect semantic groups of NBS based on stakeholders' gender; c) to analyze gender-based linguistic and conceptual patterns of NBS. To achieve our objectives, we converted a sample of audio-video interviews of local stakeholders into textual data along with metadata indicating speakers' roles and gender. Descriptive statistics were applied to explore the governance's roles. We employed a combination of textual analysis and network analysis to identify thematic groups of NBS, and applied a word embedding approach to uncover linguistic patterns indicative of semantic sub-structures. The findings revealed significant demographic diversity. Male stakeholders perceive sustainable development as a process driven by the circular economy and the coordination of territorial authorities, while female stakeholders envision a transformative approach rooted in science, culture, and collaboration. The semantic sub-structure analysis highlighted a tendency among male governance to emphasize specialized skills, whereas female governance placed greater emphasis on problem definition rather than resolution.

This article seeks to provide an improved and more comprehensive understanding of the concept and theories on wasteland. It achieves this by focusing on the Indian context allowing us to unpack the importance of including multiple perspectives of wasteland narratives; this means including more positive narratives of the potential of wasteland to inform and improve prospects for land policies in the global south. Wasteland is commonly recognized as an underutilized category of land that may transform into a valuable resource base with proper management measures. The term waste has multiple angles that carry different notions ranging from fallow to agroforestry land in the global south and Brownfield to green space in the global north. We conduct a narra-tive review approach to qualitatively analyze the concept wastelands studied in pre-existing lit-erature from 1970 to present. The unsystematic literature review approach incorporates multiple elements of wasteland discourse, like understanding the meaning of the term on a global scale, setting out the meaning of the term waste into multiple perspectives explicitly in the Indian con-text, along with different classes and management approaches of wasteland from a national per-spective. The multiple perspectives of wasteland not only generate misconception on land resource but spawn difficulties in land use policy particularly for Indian scenario. For sustainable land use policy, reclaiming wasteland would be the best possible way for India and other countries in Global South, which requires a comprehensive methodological overview on wasteland narrative.

Nephrolithiasis affects around 10% of the population and is frequently associated with impaired dietary factors. The first one is insufficient fluid intake inducing reduced urine volume, urine supersaturation, and subsequently urinary lithiasis. Kidneys regulate 24-hour urine volume, which, under physiological conditions, approximately reflect daily fluid intake. Increasing fluid intake has a preventive effect on the risk of developing a first kidney stone (primary prevention) but also decreases the risk of stone recurrence (secondary prevention). Current guidelines recommend increasing fluid intake at least at 2.5L /day to prevent stone formation, and even at 3.5-4L in some severe forms of nephrolithiasis (primary or enteric hyperoxaluria or cystinuria). Fluid intake must also be balanced between day and night, to avoid urinary supersaturation during the night. Patients should be informed and supported in this difficult process of increasing urine dilution, with practical ways and daily routines to increase their fluid intake. The liquid of choice is water, which should be chosen depending on its composition (such as calcium, bicarbonate or magnesium content). Finally, some additional advices have to be given to avoid some beverages such as those containing fructose or phosphoric acid, which are susceptible to increase the risk of nephrolithiasis.

The global trend towards increased demand for organic food, greener environments, and the integration of biological control agents into pest management strategies has greatly enhanced the need for biological pesticides (biopesticides). Biopesticides are generally environmentally friendly and are made from micro-organisms or other natural substances. Despite their great potential, relatively few have been registered and commercialised in Nigeria compared to other African countries such as South Africa and Kenya. Biological active agents are so diverse such that ap-plying the same safety standards or environmental conditions to all of them is almost impossible. A review of risk assessment processes and comparative assessments of Nigeria's biopesticide regulations with other developing African countries and developed regions was conducted. Prolonged field testing, lack of bridged risk assessments and technical checklists have been identified as key factors hampering the timely development and commercialisation of biopesti-cides in Nigeria. Recommendations on necessary changes to the existing Nigeria biopesticide regulations have been made. Risk assessment matrices for microbial and biochemical biopesti-cides and a scientific/technical checklist have also been developed. Harmonisation and data ex-change among other countries in the region will also enhance the advancement of scientific and technical knowledge for sustainable regulation and cross-border trade.

Aleutian mink disease virus (AMDV) is known to cause the most significant disease in the mink industry. It is globally widespread and manifested as a deadly plasmacytosis and hyperglobulinemia. So far, measures to control viral spread have been limited to manual serological testing for AMDV-positive mink. Further, due to the persistent nature of this virus, attempts to eradicate Aleutian disease (AD) have largely failed. Therefore, effective strategies to control viral spread are of crucial importance for wildlife protection. One potentially key tool in the fight against this disease is by immunization of mink against AMDV. Throughout many years, several researchers have tried to develop AMDV vaccines and demonstrated varying degrees of protection in mink by those vaccines. Despite these attempts, there are currently no vaccines available against AMDV, allowing the continuation of the spread of Aleutian disease. Herein, we summarize previous AMDV immunization attempts in mink as well as other preventative measures with the purpose to shed light on future studies designing such a potentially crucial preventative tool against Aleutian disease.

Ransomware, a combination of "ransom" and "malware," is a type of malicious software designed to encrypt or block access to a victim's data or system, demanding a ransom for its release Initially targeting individuals, ransomware has evolved to attack businesses for greater financial gain. It mainly exists in two forms: encrypting ransomware, which holds data hostage, and non-encrypting ransomware, which blocks system access and displays a ransom note. The energy sector has been notably targeted by ransomware, exemplified by the 2021 attack on Colonial Pipeline by the DarkSide group, which led to a temporary shutdown and a significant fuel shortage on the US East Coast. Similarly, in 2023, Russian hackers using LockBit ransomware disrupted Royal Mail, halting international deliveries and incurring millions in recovery costs despite no ransom payment. These incidents underscore the need for comprehensive cybersecurity strategies that combine human vigilance with advanced technologies like AI and machine learning. By adopting a multi-layered protection approach, organizations can better prepare for and mitigate the risks posed by ransomware attacks safeguarding sensitive data and ensuring business continuity.

: The global impact of the COVID-19 pandemic has resulted in substantial morbidity and mortality rates. Consequently, there is a pressing need for clinical research focused on the prevention, diagnosis, and treatment of this disease. To comprehensively study the course of COVID-19 in the Philippine population, it is essential to have a comprehensive dataset that includes relevant treatment and diagnostic information. While individual patient reports related to the disease are available at various institutions in the Philippines, there is a need for a more extensive and representative database to facilitate robust analysis. The purpose of this review is to elucidate various challenges and opportunities as well as propose solutions for the development and implementation of a prospective COVID-19 patient registry within a regional context in the Philippines. The primary clinical objective of establishing this registry was to enhance the accuracy of disease diagnosis. In this review, we present a comprehensive explanation of the systematic rationale, design, and execution of a COVID-19 patient registry in the Western Visayas region of the Philippines. Based on this review, several factors exist that hinder the implementation of a COVID-19 patient registry in the regional setting in the Philippines including lack of funding, facilities, infrastructure, manpower, expertise, and unwillingness of some hospitals to pursue research. We also discussed herewith the proposed program implementation for the establishment of such registry in a regional setting in the Philippines.

The contemporary treatment for metastatic castration-sensitive prostate cancer (mCSPC) has evolved significantly, building on successes in managing metastatic castration-resistant prostate cancer (mCRPC). Although androgen deprivation therapy (ADT) alone has long been the cornerstone of mCSPC treatment, combination therapies have emerged as the new standard of care based on recent advances, offering improved survival outcomes. Landmark phase 3 trials demonstrated that adding chemotherapy (docetaxel) and androgen receptor pathway inhibitors to ADT significantly enhances overall survival, particularly for patients with high-volume, high-risk, or de novo metastatic disease. Despite these advancements, a concerning gap between evidence-based guidelines and real-world practice remains, with many patients not receiving recommended combination therapies. The challenge in optimizing therapy sequences, considering both disease control and treatment burdens, and identifying clinical and biological subgroups that could benefit from personalized treatment strategies remains. The advent of triplet therapy has shown promise in extending survival, but the uro-oncology community must narrow the gap between evidence and practice to deliver the most effective care. Current research is focused on refining treatment approaches and utilizing biomarkers to guide therapy selection, aiming to offer more personalized and adaptive strategies for mCSPC management. Thus, aligning clinical practices with the evolving evidence is urgently needed to improve outcomes for patients facing this incurable disease.

This comprehensive review examines the role of fenoldopam, a selective dopamine-1 receptor agonist, in preventing and treating acute kidney injury (AKI) during cardiac surgery. AKI remains a significant complication in cardiac surgery, associated with increased morbidity, mortality, and healthcare costs. The review explores fenoldopam's pharmacological properties, mechanism of action, and clinical applications, synthesizing evidence from randomized controlled trials, meta-analyses, and observational studies. While some studies have shown promising results in improving renal function and reducing AKI incidence, others have failed to demonstrate significant benefits. The review discusses these conflicting findings, explores potential reasons for discrepancies, and identifies areas requiring further research. It also compares fenoldopam to other renoprotective strategies, including dopamine, diuretics, and N-acetylcysteine. The safety profile of fenoldopam, including common side effects and contraindications, is addressed. Current guidelines and recommendations for fenoldopam use in cardiac surgery are presented, along with a cost-effectiveness analysis. The review concludes by outlining future research directions and potential new applications of fenoldopam in cardiac surgery. By providing a thorough overview of the current state of knowledge, this review aims to facilitate informed decision-making for clinicians and researchers while highlighting areas for future investigation.

Chronic gastroduodenal symptoms are prevalent worldwide, and there is a need for new diagnostic and treatment approaches. Several overlapping processes may contribute to these symptoms, including gastric dysmotility, hypersensitivity, gut-brain axis disorders, gastric outflow resistance, and duodenal inflammation. Gastric Alimetry® (Alimetry, New Zealand) is a non-invasive test for evaluating gastric function that combines body surface gastric mapping (high-resolution electrophysiology) with validated symptom profiling. Together, these complementary data streams enable important new clinical insights into gastric disorders and their symptom correlations, with emerging therapeutic implications. A comprehensive database has been established, currently comprising >2,000 Gastric Alimetry tests, including both controls and patients with various gastroduodenal disorders. From studies employing this database, this pa-per presents a systematic methodology for Gastric Alimetry test interpretation, together with an extensive supporting literature review. Reporting is grouped into four sections: Test Quality, Spectral Analysis, Symptoms, and Conclusions. This review compiles, assesses, and evaluates each of these aspects of test assessment, with discussion of relevant evidence, example cases, limitations, and areas for future work. The resultant interpretation methodology is recommended for use in clinical practice and research to assist clinicians in their use of Gastric Alimetry as a diagnostic aid, and is expected to continue to evolve with further development.

In this research, we investigate the healthcare expenditure patterns in Uzbekistan, analyze their economic implications, and provide policy recommendations. The study focuses on the time frame from 2000 to 2019, employing quantitative data analysis, theoretical frameworks such as Wagner’s Law, and an economic geography perspective. Our objective is to gain insights into the relationship between economic development and healthcare spending, identify spatial disparities, and forecast future trends. The findings reveal fluctuations in per capita healthcare spending, emphasizing the necessity for sustainable financing mechanisms and preventive measures. Ultimately, our study underscores the significance of aligning healthcare expenditure decisions with economic objectives while prioritizing the well-being of the population.

Ocular light exposure has important influences on human health and well-being through modulation of circadian rhythms and sleep, as well as neuroendocrine and cognitive functions. Current patterns of light exposure do not optimally engage these actions for many individuals, but advances in our understanding of the underpinning mechanisms and emerging lighting technologies now present opportunities to adjust lighting to promote optimal physical and mental health and performance. A newly developed, SI-compliant standard provides a way of quantifying the influence of light on the intrinsically photosensitive, melanopsin-expressing, retinal neurons that mediate these effects. The present report provides recommendations for lighting, based on an expert-scientific consensus and expressed according to this new measurement standard. These recommendations are supported by a comprehensive analysis of the sensitivity of human ‘non-visual’ responses to ocular light, are centred on an easily measured quantity (melanopic equivalent daylight (D65) illuminance), and provide a straightforward framework to inform lighting design and practice.

COVID-19 has created anxiety not only in individuals but also in health organizations, and countries worldwide. Not a single industry is left un-influenced and loss is being estimated in billions of dollars. The widespread of this pandemic disease has challenged researchers all over the world. Some of the researchers are working to invent its cure while, others are applying computing technologies to stop its spread, by analyzing and identifying patterns for prediction and forecasting. This is by no doubt the hottest area of research for the last 100 years. This survey has targeted the research published in computing sub-domains to combat the pandemic. The survey has clustered the scientific efforts into logical groups: surveillance, metrological effects, social media analytics, image processing and business and economy, analysis and modeling. It will serve as a leading source for the followings: researchers who want to identify what has been achieved in different computing sub-domains, those who need fresh authenticated datasets openly accessible for different research contexts and what are future directions in this area of research. The findings of analysis and modeling can be also useful for government agencies who want to set priorities and formulate policies.

Mathematical models of cognition measure individual differences in cognitive processes, such as processing speed, working memory capacity, and executive functions, that may underlie general intelligence. As such, cognitive models allow identifying associations between specific cognitive processes and tracking the effect of experimental interventions aimed at the enhancement of intelligence on mediating process parameters. Moreover, cognitive models provide an explicit theoretical formalization of theories regarding specific cognitive process that may help overcoming ambiguities in the interpretation of fuzzy verbal theories. In this paper, we give an overview of the advantages of cognitive modeling in intelligence research and present models in the domains of processing speed, working memory, and selective attention that may be of particular interest for intelligence research. Moreover, we provide guidelines for the application of cognitive models in intelligence research, including data collection, the evaluation of model fit, and statistical analyses.

This review highlights the potential and limitations of mRNA vaccines with a particular focus on mucosal delivery as an alternative to parenteral administration. The strengths of mRNA vaccines are: a) Versatility: they can be adapted to target a wide range of pathogens; b) Faster development: designed and produced more quickly than traditional vaccines; c) High efficacy: effective in preventing severe disease, as demonstrated during the COVID-19 pandemic. Current challenges: a) Delivery: current methods (mainly intramuscular injection) may not be optimal for inducing mucosal immunity; b) Stability: mRNA is fragile and needs to be protected from degradation; c) Safety: potential side effects, including myocarditis, blood clotting, allergic reactions need further investigation. Mucosal delivery could be more effective in preventing the transmission of pathogens and is generally better accepted by the population. Pros: offers the potential to induce local immunity at the site of pathogen entry, potentially providing broader protection; Cons: developing effective delivery systems and adjuvants for mucosal delivery is difficult. Extracellular vesicles as a mucosal delivery system are promising and offer a potentially safe, scalable, and needle-free approach. Future directions: a) Optimizing mRNA constructs: strategies like codon optimization and self-amplifying RNA can improve stability and translation efficiency; b) Rigorous pre-clinical studies are essential before human trials.

For centuries, crop plants have represented the basis of the daily human diet. Among them, cereals and legumes, accumulating oils, proteins and carbohydrates in their seeds, distinctly dominate modern agronomic practice. Indeed, these plants play an essential role in the food industry and fuel production. Therefore, the seeds of crop plants are intensively studied by food chemists, biologists, biochemists, and nutritional physiologists. Accordingly, not only seed development and germination, but also age- and stress-related alterations in seed vigor, longevity, nutritional value and safety can be addressed by a broad panel of analytical, biochemical and physiological methods. Currently, functional genomics is one of the most powerful tools, giving direct access to characteristic metabolic changes, accompanying plant development, senescence and response to biotic or environmental stress. Among individual methodological platforms, proteomics represents one of the most effective ones, giving access to cellular metabolism at the level of proteins. Here we discuss the main methodological approaches employed by seed proteomics in the context of physiological changes related to seed development, ageing and response to environmental stress.

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

As the demand for aromatic and medicinal herbs increases, so does the pressure to intensify production, increasing the risk of overexploitation of these natural resources. Sustainability corresponds to the preservation of something that exists in the present and must be maintained in the future, implying accountability and obligation. However, in order to maintain the conditions and essential goods for the survival of future generations, consumers and businesses must commit to sustainable practices. The circular economy is considered one of the solutions to promote a sustainable system and can be defined as a transition from a linear model, where resources are transformed, used and discarded, to a circular (regenerative) model, where materials are reused whenever possible. An ecologically correct approach to waste reuse avoids the negative impacts associated with improper disposal of agro-industrial wastes, such as mass proliferation of microorganisms, production of greenhouse gases, loss of energy potential, and other negative impacts on the environment or human health. The objective of this study is to provide a compilation of good agricultural practices that promote sustainability in the production of medicinal and aromatic herbs, particularly in the areas of cultivation, harvesting, drying, extraction, and packaging, and to highlight the potential for evaluating processing residues in medicinal and aromatic herbs.

This research work describes an architecture for building a system that guide a user from a forecast generated by a machine learning model through a sequence of decision-making steps. The system is demonstrated in manufacturing demand forecasting use case and can be extended to other domains. In addition, the system provides means for knowledge acquisition by gathering data from users. Finally, it implements an active learning component and compares multiple strategies to recommend media news to the user. Such media news aims to provide additional context to demand forecasts and enhance judgment on decision-making.

Today, LLMs are not good at personalization providing recommendation. They advise physicians and financial advisors to ask professionals in respective fields for help, even having user information available. Answering questions of software professionals, LLM needs to deliver in-depth answers with codes or algorithms, whereas for professionals in other fields would need definitions and main concepts. The intent of this chapter is to make LLM answer tailored to the needs of users, taking into account available information about them. To do that, we need to generalize available information about a person like her health record, maintaining the privacy of this person. We rely on meta-learning techniques to design a LLM prompt to produce a personalization prompt to obtain a suitable relevant information. Such “meta-prompt” is produced by generalization operation applied to available documents for the user. These documents need to be de-identified so that they are sufficient for personalization on one hand and will maintain user privacy on the other hand. The second neuro-symbolic technique to support personalization is abductive reasoning, acting in parallel to LLM fine-tuning. Traditional recommendation and personalization techniques as well as modern, deep learning – based are presented, and the comparison is drawn to the proposed approach. We also share the evaluation and comparative analyses of these approaches. We consider an example for how to build personalization LLM systems coming from Langchain platform. We will explore how to construct chains to form a personalization profile for a user and apply it to user search and recommendation requests.

The dawn of Artificial Intelligence (AI) in healthcare stands as a milestone in medical innovation. A plethora of different medical fields are heavily involved and pediatric emergency medicine is no exception. These new tools do not merely provide more advanced and efficient systems for patients’ diagnosis, management and treatment. They rather concern a strict shift from traditional methods based upon broad categories towards a more personalized healthcare. AI offers many promises in pediatric emergency medicine with a wide range of applications involving clinical decision making, patients’ flows management and prioritization. Main barriers to a widespread diffusion involve technological challenges but also ethical issues and the paucity of extensive datasets in pediatric contexts. We conducted a narrative review structured in two parts. The first part explores the theoretical principles of AI, providing all the necessary background to feel confident with these new state-of-the-art tools. The second part presents an informative analysis of AI models in pediatric emergencies, pointing out the actual applications and challenges until future feasible research perspectives.

Power quality problem is a hot area in power systems and drives that has drawn the attention of many researchers. This is because of the threat it poses on the health of electrical systems and the cost incurred on utility bills. The problem arises as a result of the need for reactive power to be supplied alongside active power in power transmission and distribution. Unfortunately, reactive power is consumed by almost all components of the system, leading to a shortage. To solve this problem, there is a need to compensate for the lost reactive power. Several researchers have proposed various approaches to mitigate this problem such as thyristor switched capacitor bank, series compensator, series reactor, series var compensator (SVC), Static Synchronous Compensator (STATCOM), synchronous condenser and others. In order to further draw attention in this area, this work investigates a number of research papers on power compensation techniques and draw up challenges from each work that can be considered for further investigation. To this end, each research paper reviewed is evaluated in terms of problem solved, technique used, and results obtained. It therefore offers ample opportunities for researchers to explore in improving power quality and power system safety.

Colorectal cancer is a frequent neoplasm in western countries, mainly due to dietary and behavioral factors. Its incidence is growing in developing countries for the westernization of foods and lifestyles. An increased incidence rate is observed in patients under 45 years of age. In last years the mortality for CRC is decreased, but this trend is slowing. The mortality rate is reducing in those countries where prevention and treatments have been implemented. The survival is increased to over 65%. This trend reflects earlier detection of CRC through routine clinical examinations and screening, more accurate staging through advances in imaging, improvements in surgical techniques and advances in chemotherapy and radiation. The most important predictor of survival is the stage at diagnosis. The screening programs are able to reduce incidence and mortality rates of CRC. The aim of this paper is to provide a comprehensive overview of incidence, mortality and survival rate for CRC.

Saponins are a diverse group of naturally occurring plant secondary metabolites present in a wide range of foods ranging from grains, pulses, green leaves to sea creatures. They consist of a hydrophilic sugar moiety linked to a lipophilic aglycone, resulting in an amphiphilic nature and unique functional properties. The amphiphilic structures enable saponins to exhibit surface-active properties, forming stable foams and complexes with various molecules. In the context of food applications, saponins are utilized as natural emulsifiers, foaming agents, and stabilizers. They contribute to texture and stability in food products and have potential health benefits, including cholesterol-lowering and anticancer effects. Saponins possess additional bioactivities that make them valuable in the pharmaceutical industry as anti-inflammatory, antimicrobial, antiviral, and antiparasitic agents to name a few. Saponins can demonstrate cytotoxic activity against cancer cell lines and can also act as adjuvants, enhancing the immune response to vaccines. Their ability to form stable complexes with drugs further expands their potential in drug delivery systems. However, challenges such as bitterness, cytotoxicity, and instability under certain conditions need to be addressed for effective utilization of saponins in foods and related applications. In this paper, we have reviewed chemistry, functionality, and application aspects of saponins from various plant sources and have summarised the regulatory aspects of food application of Quillaja saponins. Further research to explore the full potential of saponins in improving food quality and human health has been suggested. It is expected that this article will be a useful resource for researchers in food, feed, pharmaceutical and material science.

As the world's population ages and the resulting health problems become more serious, medical and health policies in developed countries are focused on how to prevent and treat the diseases of the aging population and how to maintain their quality of life. Typical age-related diseases include deafness, cataracts, osteoarthritis, chronic obstructive pulmonary disease, diabetes mellitus, and dementia. Although the mechanisms by which these diseases develop differ, they are all caused by the accumulation of molecular and cellular damage over time. In addition, age-related diseases can cause a decline in physical and mental functions and the ability to perform activities of daily living, as well as the loss of roles in society and a sense of fulfillment in life. Therefore, there is a need for treatment and measures to accurately grasp and maintain their quality of life.

Real-world evidence (RWE) is increasingly involved in the early benefit assessment of medicinal drugs. It is expected that RWE will help to speed up approval processes comparable to RWE developments in vaccine research during the COVID-19 pandemic. Definitions of RWE are diverse marking the highly fluid status in this field. So far, RWE comprises information produced from data routinely collected on patient’s health status and/or delivery of health care from various sources other than traditional clinical trials. These sources can include electronic health records, claims, patient-generated data including in home-use settings, data from mobile devices as well as patient, product and disease registries. The aim of the present update was to review the current RWE developments and guidelines mainly in the U.S., the UK, Europe and Germany field during the last decade. RWE has already been included in various approval procedures of regulatory authorities reflecting its actual acceptance and growing importance in evaluating and accelerating new therapies. However, since the RWE research is still in a transition process and since a number of gaps in this field have been explored, more guidance and a consented definition are necessary to increase the implementation of real-world data.

Attempts to find and quantify the supposed low entropy of organisms and its preservation are revised. Absolute entropy of the mixed components of non-living biomass (around -1.6 x 103 J K-1 L-1) is the reference to which other entropy decreases would be ascribed to life. Compartmentation of metabolites and departure from the equilibrium of metabolic reactions account for 1 and 40-50 J K-1 L-1, respectively, decreases of entropy and, though small, are distinctive features of living tissues. DNA and proteins do not supply significant decreases of thermodynamic entropy, but their low informational entropy is relevant for life and its evolution. No other living feature contributes significantly to the low entropy associated to life. The photosynthetic conversion of radiant energy to biomass energy accounts for the most of entropy (2.8 x 105 J K-1 carbon kg-1) produced by living beings. The comparative very low entropy produced in other processes (around 4.8 x102 J K-1 L-1 day-1 in human body) must be rapidly exported outside as heat to preserve the low entropy decreases due to compartmentation and non-equilibrium metabolism. Enzymes and genes are described whose control minimize the rate of production of entropy and could explain selective pressures in biological evolution and the rapid proliferation of cancer cells.

The orchid market is a dynamic horticultural business in which novelty and beauty command high prices. The development of miniature to large and showy flowers, in addition to fragrance, is mainly of interest. Overall organ size might be modified by doubling the chromosome number, which can be accomplished by careful study of meiotic chromosome disjunction in hybrids or species. Meiosis is the process in which diploid (2n) pollen mother cells recombine their DNA sequences and then undergo two rounds of division to give rise to four haploid (n) cells called sporads. Thus, by interfering in chromosome segregation, one can induce the development of diploid recombinant sporads called dyads. These dyads may be used for breeding polyploid progenies with enhanced fertility and large flower size. This review gives an overview of developments in orchid breeding placed in the large context of ploidy breeding in higher plants to facilitate innovation

In a previous paper, the authors dealt with the current showstoppers for morphing systems and with the reasons that have inhibited their commercial applicability. In this work, the authors ex-press a critical vision of the current status of the proposed architectures and the needs that should be accomplished to make them viable for installation onboard of commercial aircraft. The distinc-tion is essential because military and civil issues and necessities are very different, and both the solutions and difficulties to be overcome are widely diverse. Yet, still remaining in the civil seg-ment, there can be other differences, depending on the size of the aircraft, from large jets to com-muters or general aviation, in turn classifiable in tourism, acrobatic, ultralight and so on, each with their own peculiarities. Therefore, the paper wants to try to trace a common technology de-nominator, if possible, and envisage a future perspective of actual applications.

Ehretia laevis Roxb. (Boraginaceae) has been extensively used as a traditional remedy for the treatment of a diverse range of ailments related to the respiratory system, the gastrointestinal tract, the reproductive system, and against several infections. This review critically assesses and documents, for the first time, the fragmented information on E. laevis, including its botanical description, folklore uses, bioactive phytometabolites and pharmacological activities. The goal is to explore this plant therapeutically. Ethnomedicinal surveys reveal that E. laevis has been used by tribal communities in Asian countries for the treatment of various disorders. Quantitative and qualitative phytochemical investigations of E. laevis showed the presence of important phytoconstituents such as pentacyclic triterpenoids, phenolic acids, flavonoids, fatty acids, steroids, alkaloids, aliphatic alcohols, hydrocarbons, amino acids, carbohydrates, vitamins and minerals. Fresh plant parts, crude extracts, fractions and isolated compounds have been reported to exhibit broad spectrum of therapeutic activities viz., antioxidant, antiarthritic, antidiabetic, anti-inflammatory, antiulcer, antidiarrheal, antidysenteric, wound healing and anti-infective activities. E. laevis is shown to be an excellent potential source of drugs for the mitigation of jaundice, asthma, dysentery, ulcers, diarrhea, ringworm, eczema, diabetes, fissure, syphilis, cuts and wounds, inflammation, liver problems, venereal and infectious disorders. Although few investigations authenticated its traditional uses but employed uncharacterized crude extracts of the plant, the major concerns raised are reproducibility of therapeutic efficacy and safety of plant material. The outcomes of limited pharmacological screening and reported bioactive compounds of E. laevis suggest that there is an urgent need for in-depth pharmacological investigations of the plant.

This paper explores the suppression of ideas within academic scholarship by academics, either by self-suppression or because of the efforts of other academics. Legal, moral, and social issues distinguishing freedom of speech, freedom of inquiry, and academic freedom are reviewed. How these freedoms and protections can come into tension is then explored by an analysis of denunciation mobs who exercise their legal free speech rights to call for punishing scholars who express ideas they disapprove of and condemn. When successful, these efforts, which constitute legally protected speech, will suppress certain ideas. Real-world examples over the past five years of academics who have been sanctioned or terminated for scholarship targeted by a denunciation mob are then explored.

Africa is a home to growing number of biosafety organisations that work to enhance public health in their nations by bringing attention to the significance of biosafety and biosecurity. Since many African countries are low-resource countries, they frequently confront a number of obstacles that seriously limit their ability to create or grow a sustainable capacity for managing biosafety and biosecurity. The goals of biosecurity and biosafety protocols are to reduce both intentional and unintentional biological risks that could have disastrous effects on a nation's health system, agriculture, security, political and economic stability. Regrettably, on a national, regional, and international level, biosecurity and biosafety are frequently given insufficient priority.Eventhough, Africa are home to a growing number of biosafety organisations that work to enhance public health in their nations by bringing attention to the significance of biosafety and biosecurity, Standard Biosafety and Biosecurity Measures to contain hazardous infections are missing across the African continent. In this paper the current state, challenges, and future prospects of biosafety and biosecurity status of African nations discussed.

The sexual health needs of female immigrant adolescents in Canada have been largely unmet and have increased in magnitude over the last few years. Evidence suggests that immigrant adolescents lack sexual and reproductive health knowledge and use fewer sexual health-related services and sex education resources than do non-immigrant youth. In Pakistani immigrant adolescents, this difference appears to be associated with socio-cultural and religious practices. This paper aims to describe how first-or-second generation Pakistani-descent female adolescents, living in Canada, describe their perspectives on developing sexuality and well-being. In addition, this paper explicates female adolescents’ perceptions of their needs to support their sexuality while going through the adolescence stage. Using a qualitative interpretive descriptive design, individual interviews were conducted in combination with drawing timelines. A purposive sample of 21 female adolescents who were first- or second-generation Pakistani-descent was obtained. A thematic analysis approach was used for data analysis. Findings suggest that immigrant female adolescents encounter mental health concerns as a result of confusing messages they received from their parents related to sexuality. Also, discrimination, exclusion from sex education classes, and lack of knowledge on sexual health can result in social exclusion, avoidance of health care, and poor mental health outcomes such as depression and anxiety. These participants related experiences are potentially contributed by the lack of communication with parents about sexuality and lack of health care providers who can understand and speak to their needs and realities as immigrant individuals. Female adolescents expressed their need to break the silence around the topic of sexuality, to have a non-judgemental and blame-free attitude from adults, and for open, honest, and stigma-free conversations. This study provides preliminary qualitative evidence of the interplay between experiences of developing sexuality and overall well-being, particularly psychological wellbeing in female adolescent immigrants. It is crucial to involve, listen to, and incorporate adolescent girls’ voices when planning and implementing interventions to support healthy sexuality among immigrant adolescents.

This paper studied the solar PV frequency control in the U.S. Eastern Interconnection (EI) and Texas Interconnection (ERCOT) systems. The studied frequency control approaches include droop frequency control, inertia control, and droop-inertia-combined frequency control. The control effects of different frequency controls of PV in the EI and ERCOT are studied using actual high PV penetration interconnection grid models to provide suggestions to the future revision of future PV frequency control standards.

The current global COVID-19 pandemic is compounding on populations susceptible to tropical illnesses like dengue in different developing countries like Bangladesh. The growing concern is that Bangladesh is a dengue-endemic zone and the peak transmission occurs in the monsoon season (June to October). In the most recent monsoon, a total of 354 dengue cases have been confirmed until 27^th July 2020, data-driven from only 41 hospitals alone. A fifty-three-year-old male patient was found to be co-infected with COVID-19 and dengue fever. Concerns arise as hospitals are increasingly denying to admit the patients. Moreover, reports of the false-positive results in dengue screening tests recorded in different countries further exacerbate the issue. These conditions could postpone the early diagnosis of COVID-19 cases and aggravate the situation. In addition, the overwhelming wave of the dengue cases would be a challenge for the vulnerable health care system of the country which is already under strain due to the COVID-19 pandemic. Failure to establish and implement proper policies might lead to the dengue outbreak with the burdens of the concurrent COVID pandemic, resulting in the collapse of the health and social system, as well as the economic growth of the country.

Despite epidemiological findings of improvements in cardiovascular risk factors with a light-to-moderate intake of alcohol, many misconceptions remain regarding alcohol intake and the risks and benefits of consumption. We sought to examine physician attitudes and recommendations regarding alcohol intake in a cohort of Argentine physicians and to establish their sources of knowledge. An online national survey was distributed through the Argentine Federation of Cardiology (FAC) to cardiologists, internal medicine specialists, general and other subspecialty physicians in Argentina. The survey was completed by 745 physicians, of whom 671 (90%) were cardiologists. In total, 35% of physicians viewed moderate alcohol intake to be beneficial for cardiovascular health, 36% believed only wine offered such benefits, 24% viewed any intake to be harmful, and 5% had other opinions. More than half (57%) self-reported their knowledge to come from academic sources. Regarding knowledge of drinking guidelines, only 41% of physicians were aware of the concept of ‘standard drink’. Physicians were generally not comfortable converting ‘standard drinks’ into other metric units, however men tended to be more comfortable than women (p=0.052). Physicians were not satisfied with their knowledge of drinking guidelines (3.01 ± 2.73, on a 0-10 scale). Physicians were generally comfortable in counselling patients regarding safe-limits of consumption (6.22 ± 3.20, on a 0-10 scale). Argentine physicians were not satisfied with their knowledge of alcohol consumption guidelines or their understanding of the reported metrics. Only one-third of study participants viewed moderate alcohol intake as beneficial for cardiovascular health. This study shows the necessity to optimize the sources of knowledge.

Poliomyelitis, commonly known as “polio” is a paralytic and perilous disease caused by the poliovirus. Due to its highly contagious nature, the virus was a challenge to the world in the late 1980s. . Since 1988 the collective work of the Global Polio Eradication Initiative (GPEI), Centre for Disease Control and Prevention (CDC), and World Health Organization (WHO) through immunizations, communication awareness, and monitoring have helped the world exonerate polio. The mission of polio-free Pakistan was herculean and had confronted enormous challenges in different ways but came out with positive results. In 2019, with only two remaining polio-endemic countries, Pakistan and Afghanistan, GPEI launched an “Endgame strategy 2019-2023” which aims to eradicate polio globally, with a targeted focus, especially on polio-endemic countries, the plan emphasizes the early detection of polio cases for complete eradication and to restrict the spread of polio. Pakistan has achieved a milestone in combating polio despite having a web of factors that have thwarted Pakistan’s polio eradication efforts, but this is not the end, the struggle continues until we really get an internationally verified certification of Polio free nation, for this WHO has designed a multidisciplinary strategy 2022-2026 to really end this polio for once and for all.

Poor soil health is a critical problem in many urban landscapes. Degraded soil restricts plant growth and microorganism activity, limiting the ability of urban landscapes to perform much needed ecosystem services. Incorporation of approximately 33% compost by volume into degraded soil has been proven to improve soil health and structure over time while avoiding the financial and environmental costs of importing soil mixes from elsewhere. However, additions of high volumes of compost could potentially increase the risk of nutrient loss through leaching and runoff. The objective of our study was to consider the effects of different compost amendments on soil health, plant health and susceptibility to nutrient leaching in order to identify ranges of acceptable compost characteristics that could be used for soil remediation in the urban landscape. We conducted a bioassay with Phaseolus vulgaris (Bush Bean) to measure the effect of nine composts from different feedstocks on various plant health parameters. We collected leachate prior to planting to measure nutrient loss from each treatment. We found that all compost amendments improved soil health. Nutrient-rich, manure-based composts produced the greatest plant growth, but also leached high concentrations of nitrate and phosphorus. Some treatments provided sufficient nutrients for plant growth without excess nutrient loss. We concluded, when incorporating as much as 33% compost by volume into a landscape bed, the optimal compost will generally have a C:N ratio of 10-20, P-content <1.0% and a soluble salt content between 1.0 and 3.5 mmhos/cm. These recommendations should ensure optimal plant and soil health and minimize nutrient leaching.

The EXO+ hip protector was developed to minimize the risk of hip fractures in seniors following falls. This study evaluated its usability in a Singapore nursing home from the perspective of staff, focusing on Learnability, Efficiency, and Satisfaction. A mixed-method design was employed, with nursing home residents wearing the EXO+ daily for 8 weeks. Quantitative data on wear time was collected alongside qualitative insights from four repeated focus group discussions with care staff. In total, 15 residents (including 8 residents with cognitive impairments) and 9 staff participated. The analysis revealed six themes and fourteen subthemes related to EXO+’s usability. Residents wore the device for an average of 1.54 hours per day, with those having cognitive impairments showing increased wear times, especially in the mornings and on weekdays. Findings indicated that the EXO+ was learnable and satisfactory for nursing home use, provided there are adequate supporting features. The efficiency of the EXO+ was not fully measured since no falls were reported during the study period. The study offers valuable insights for potential design modifications and workflow adaptations to enhance the implementation of hip protectors in healthcare settings, highlighting facilitators and barriers to support device uptake.

The prevalence of patients on buprenorphine therapy presenting for elective surgery has increased. Buprenorphine is a widely used medication for management of patients with chronic pain. It is also used for maintenance therapy for patients with a history of opioid use disorder (OUD). Due to lack of standardized protocol for managing patients on buprenorphine peri-operatively, we performed a retrospective analysis to compare pain score outcomes and post-operative opiate requirements between patients who continued versus discontinued buprenorphine. We identified 35 patients, 11 continued buprenorphine and 24 discontinued buprenorphine. The average Post-Anesthesia Care Unit (PACU) pain score was 7.54 for those who discontinued pre-operative buprenorphine and 5.59 for those who continued (P value 0.0339). The average post-operative Morphine Milligram Equivalent (MME) use was 86.13 for those who continued pre-operative buprenorphine and was 107.70 for those who discontinued buprenorphine (P value 0.6439). The results from our study correlate with several previous studies which showed lower PACU pain scores in patients who continued buprenorphine. There is a benefit of decreased pain post-operatively when pre-operative buprenorphine is continued and having a decrease in relapse in those with a history of OUD.

The integration of artificial intelligence (AI) into academic settings in Sabah, Malaysia, is transforming education and research landscapes. While AI technologies promise to enhance teaching, learning, and scholarly activities, they also pose challenges such as ethical concerns and skill gaps among academic staff. This study addresses the multifaceted impacts of AI adoption on academicians in Sabah, focusing on two key research questions: the impact of AI-based intelligent tutoring systems on student engagement, learning outcomes, and educational equity, and the challenges and opportunities in building academicians' capacity to integrate AI technologies effectively. Through a multidisciplinary approach, incorporating insights from education, computer science, social sciences, and ethics, this research aims to evaluate the effectiveness of AI tools in educational settings and identify strategies for skill development and infrastructure support. The study recommends empirical assessments within Sabah's educational institutions, considering contextual factors and fostering collaborative partnerships with local communities. Professional development programs, collaboration with industry partners, and improved access to AI infrastructure are proposed strategies. Longitudinal studies and interdisciplinary research initiatives are suggested for future research, along with qualitative methods to capture diverse perspectives. Ultimately, by embracing a collaborative and multidisciplinary approach, Sabah's academic community can harness the transformative potential of AI to advance education, research, and scholarship while promoting ethical and inclusive practices.

Bacterial vaginosis (BV), the most common cause of vaginal discharge, is characterized by a shift in the vaginal microbiota from lactobacillus dominance to a diverse array of facultative and strict anaerobic bacteria which form a multi-species biofilm on vaginal epithelial cells. The rate of recurrence after therapy is high, often >60%. While the BV biofilm itself likely contributes to recurrent and/or refractory disease after treatment by reducing antimicrobial penetration, antimicrobial resistance in BV-associated bacteria including those, both within the biofilm and the vaginal canal, may be the result of independent, unrelated bacterial properties which are discussed in this paper. Our current recommendations for the treatment of refractory and recurrent BV are also provided.

Importance: The rapidly expanding 2019 novel coronavirus pandemic (COVID-19, caused by the SARS-CoV-2 virus) has challenged the medical community to an unprecedented degree. Physicians and healthcare workers are at added risk of exposure and infection during the course of the patient care. Due to the rapid spread of this disease through respiratory droplets, healthcare providers such as otolaryngologists-head & neck surgeons who come in close contact with the upper aerodigestive tract during diagnostic and therapeutic procedures are particularly at risk. Here we present a set of safety recommendations based on our review of literature and communications with physicians with first-hand knowledge of safety procedures during the 2019 COVID-19 pandemic.Observations: A high number of healthcare providers were infected during the first phase of the pandemic in Wuhan province. Subsequently, by adopting strict safety precautions, other regions were able to achieve high levels of safety for healthcare providers without jeopardizing the care of patients. We reviewed the most common procedures related to the examination and treatment of upper aerodigestive tract diseases. Each category was reviewed based on the potential risk imposed to healthcare workers. Specific recommendations were made, based on the literature, when available, or consensus best practices. Specific safety recommendations were made for performing tracheostomy in COVID-19 patients. Conclusions and Relevance: Preserving highly skilled healthcare work force is a top priority for any community and healthcare system. Based on the experience of healthcare systems in Asia and Europe, by following strict safety guidelines, the risk of exposure and infection of healthcare providers could be significantly reduced, while providing high levels of care. The provided recommendations could be used as broad guidance for all healthcare workers who are involved with the care of COVID-19 patients.

The aim of this review was to search in literature, data regarding the inflammasome, involvement in, oral pathologies (mainly periodontitis) and other diseases and the approaches to control the inflammasome-related pathogenic mechanisms. The review also investigated how phytochemicals and pharmaceutical substances could be used to inhibit the inflammasome activity. Inflammasomes are involved in inflammatory, autoimmune and autoinflammatory diseases. Pharmaceutical substances can control the inflammasome by three mechanisms: inhibiting of intracellular signaling pathways (Allopurinol and SS-31), blocking inflammasome components (VX-765, Emricasan and VX-740), and inhibiting cytokines mediated by the inflammasome (Canakinumab, Anakinra and Rilonacept). Phytochemical inhibit the inflammasome, by neutralization of reactive oxygen species. Biomaterials functionalized by the adsorption of therapeutic agents on different nanomaterials may represent a future research direction to facilitate multimodal and sequential treatment in oral pathologies.

As part of a project ordered by the Ministry of Science, Technology and Innovation of Brazil, an assessment of Brazilian biological collections was conducted by the Brazilian Societies of Botany, Microbiology, Virology and Zoology to obtain data on the current state of these collections. The goal was to provide subsidies for future public policies, including financial support and prioritization policies. Herein, we present the results of the microbiological collections, which play a fundamental role in the ex situ conservation of biodiversity and support research, development and innovation. A survey was sent to public and private institutions in Brazil and answered by 168 microbiological collections from 79 different institutions. Among these, 73 comprise public research institutions and universities, demonstrating the State's importance in preserving and safeguarding Brazilian microbial diversity. The main taxonomic groups are bacteria (present in 70.24% of the collections) and fungi (52.98% of the collections) from different Brazilian ecosystems and biomes, including several type strains. Furthermore, the collections preserve microorganisms with biotechnological potential for application in environmental protection, public health, industry, and agribusiness. However, despite all these economic and biotechnological potentials, the data analysis showed serious limitations and fragilities, especially regarding physical infrastructure and human resources, and raises alerts about the risk that Brazilian collections are subjected to.

(1) Background: The definition of value addition is based on the process or processes which are used to transform physically the initial raw material in the final food or non-food article. Diversification can enhance the possibility of increased gains. The aim of this work is to give a reliable description of value addition when speaking of coconut-based beverages among all possible derivatives; (2) Methods: a systematic review of main papers on the argument has been critically examined and discussed; (3) Results: Processing degree is a consequence of consumers’ requests. Three different drivers for value addition have been considered: packaging, durability, and size options; sensorial features; and sustainability. Results of this investigation have highlighted the added value of several products because of recyclable packaging materials, intermediate or long durability expectations, different available sizes, and good or excellent sensorial performances; (4) Conclusions: There are different value-added coconut-based beverages with interesting perspectives. On the other side, sustainability and eco-friendly policies may be a problem for those products which are produced similarly to non-coconut based beverages. The opportunity of certified organic and/or fair-trade products could help the industry of coconuts in the next future. More research is still needed in this ambit.

Traumatic brain injury (TBI) is among the leading causes of mortality and long-term impairment globally. TBI has a dynamic pathology encompassing a variety of metabolic and molecular events that occur in two phases, primary and secondary. An external forceful blow to the brain initiates the primary phase, which is followed by a secondary phase that involves the release of calcium ions (Ca2+) and the initiation of a cascade of inflammatory processes, including mitochondrial dysfunction, rise in oxidative stress, activation of glial cells, and damage to the blood-brain barrier (BBB), resulting in paracellular leakage. There is currently no FDA-approved drug for TBI, but existing approaches rely on delivering small and macromolecular treatments, which are severely constrained by the BBB, poor retention, off-target toxicity, and complex pathology of TBI. Therefore, there is a demand for innovative and alternative therapeutics with effective delivery tactics for diagnosis and treatment of TBI. Tissue engineering and use of biomaterials is one such alternative approach. With this approach, neuronal stem cell therapy is combined with synthetically generated tissue materials such as hydrogels, self-assembling peptides, and electrospun nanofibers, which may induce neurite outgrowth, differentiation of human neural stem cells, and nerve gap bridging in TBI. This review examines tissue engineering and the use of biomaterials as potential treatments for TBI, including their synthesis, mechanisms of action, and limitations. The review also discusses challenges facing tissue engineering and biomaterial technology including survival rate of transplanted stem cells and the development of biodegradable, biocompatible, and mechanically flexible biomaterials. A better understanding of the mechanisms and drawbacks of these novel therapeutic approaches will help guide the design of future TBI therapies.

For a comprehensive exploration of the Bimolecular Fluorescence Complementation (BiFC) approach, we critically assess whether protein pairs establish direct or indirect interactions within this context. Emphasizing the multifaceted nature of protein interactions, this review underscores the imperative of delineating macromolecular complex characteristics across five distinct levels: composition, stoichiometry, copy number, topology, and dynamics. A pivotal discussion revolves around the challenges introduced by the overexpression of target proteins and the potential artificial ramifications of fusion proteins. The significance of stoichiometry in protein interactions is illuminated, with the HOXA9/PBX1 interaction serving as a pertinent case study. The research identifies and elaborates on the inherent limitations of prevailing large-scale BiFC screenings, advocating for the incorporation of rigorous negative controls. A novel proposition is introduced in the form of a high-throughput multicolor BiFC strategy, exemplified using the HOXA9 and PBX1 proteins. The paper culminates with an insightful discourse on the implications of tags within the BiFC system, presenting the TriFC (Tripartite Fluorescence Complementation) assay as a promising alternative.

It is yet unknown how the formation of aneurysm inside the human body occurs. Thus, the understanding and analysis of the Coanda effect will result in a better overview of the overall fluid mechanics that develops inside such a structure, leading not only to better treatment plans, but also to diminished postoperative risks. This paper presents how the fluid behaves in this situation, and takes into consideration how this physical phenomenon influences the hemodynamics inside numerous anatomical regions, located in the central nervous system, where aneurysms usually develop. Analyzing the three main areas in which cerebral aneurysms form the Coanda effect can potentially lead to the rupture of the aneurysm, by changing the blood flow trajectory, it should be taken into consideration when choosing a treatment plan, especially in postoperative care. In addition, there are other factors that can influence the evolution of an aneurysm such as shape, size, localization and the patient’s health condition. Understanding and analysis of the Coanda effect will result in a better overview of the overall fluid mechanics that develops inside such a structure, leading not only to better treatment plans, but also to diminished postoperative risks.

Targeted radionuclide therapy is become increasingly prominent as a nuclear medicine subspe-cialty. For many decades, treatment with radionuclides has been mainly restricted to the use of iodine-131 in thyroid disorders. Currently, radiopharmaceuticals, consisting of a radionuclide coupled to a vector that binds to a desired biological target with high specificity, are being de-veloped. The objective is to be as selective as possible at the tumor level, while limiting the dose received at the healthy tissue level. In recent years, a better understanding of molecular mecha-nisms of cancer, as well as the appearance of innovative targeting agents (antibodies, peptides, small molecules) and the availability of new radioisotopes, have enabled considerable advances in the field of vectorized internal radiotherapy with a better therapeutic efficacy, radiation safety and personalized treatments. For instance, targeting the tumor microenvironment, instead of the cancer cells, now appears as particularly attractive. Several radiopharmaceuticals for therapeutic targeting have shown clinical value in severals types of tumors and have been or will soon be approved and authorized for clinical use.

The human body is inhabited by unique microbial communities that protect and regulate the host against pathogens and inflammation. To address issues related to disrupted microbial composition, microbial transfer therapy (MTT) has emerged as a potential treatment option. The most popular form of MTT is fecal microbiota transplantation (FMT), which has been successful in treating various diseases. Another emerging form of MTT is vaginal microbiota transplantation (VMT), transferring of the vaginal microbiota from a healthy female donor to a diseased patient's vaginal cavity, which aims to restore normal vaginal microbial composition. However, VMT is vastly unexplored due to safety concerns and lack of research. This paper explores the mechanisms involved in VMT's therapeutic effect and discusses future perspectives. Further research is needed to advance VMT's clinical applications and techniques.

Euglenoids are a common component of primary producers in high acidic and organic shallow freshwater systems. They are free-living photosynthetic motile flagellates exhibiting rapid responses to various external stimuli including chemical pollution. The unique combination of diverse physiological processes of Euglena such as photosynthesis, movement, and orientation offers a range of sensitive criteria that respond to aquatic pollutants. This has led to the development of several acute and chronic assay methods to monitor the adverse impacts of potent toxicants in aquatic ecosystems. Euglenoids also reflect the consequences of physical stress factors such as UV radiation. This review summarizes the ecotoxicity studies using euglenoid flagellates as model species and their potential to contribute toward rapid screening of ecological impacts of pollution in the aquatic environment. Factors determining the reliability of Euglena tests are outlined.

Reticulate evolution through the interchanging of genetic components across organisms can impact significantly on the fitness and adaptation of species. Bread wheat (Triticum aestivum subsp. aestivum) is one of the most important crops in the world. Allopolyploid speciation, frequent hybridization, extensive introgression, and occasional horizontal gene transfer (HGT) have been shaping a typical paradigm of reticulate evolution in bread wheat and its wild relatives, which is likely to have a substantial influence on phenotypic traits and environmental adaptability of bread wheat. In this review, we outlined the evolutionary history of bread wheat and its wild relatives with a highlight on the interspecific hybridization events, demonstrating the reticulate relationship between species/subspecies in the genera Triticum and Aegilops. Furthermore, we discussed the genetic mechanisms and evolutionary significance underlying the introgression of bread wheat and its wild relatives. An in-depth understanding of the evolutionary process of Triticum species should be beneficial to future genetic study and breeding of bread wheat.

Safety and quality are key issues for the food industry. Consequently, there is a growing demand to preserve the food chain and products against substances toxic, harmful to human health such as contaminants, allergens, toxins, or pathogens. For this reason, it is mandatory to develop highly sensitive, reliable, rapid, and cost-effective sensing systems/devices such as electrochemical sensors/biosensors. Generally, conventional techniques are limited by long time of analyses, expensive and complex procedures, and they require skilled personnel. Therefore, the development of performant electrochemical biosensors can significantly support the screening of food chain and products. Here, we report some of the recent developments in this area and analyze the contributions produced by electrochemical biosensors in the food screening and the challenges to address.

Targeted Protein Silencing (TPS) is an elegant approach to investigate protein function and its role in the cellular landscape, overcoming limitations of genetic perturbation strategies. In contrast to CRISPR/Cas9 and RNA interference, these systems act in a reversible manner and reduce off-target effects. Several TPS have been developed and wisely improved, including compartment delocalization tools and protein degradation systems. In this review, we focus on Anchor-Away, deGradFP, auxin inducible degron (AID) and dTAG technologies, and discuss their recent applications and advances. Finally, we propose Nano-Grad, a novel nanobody-based protein degradation tool to specifically proteolyze endogenous tag-free target protein.

The Cosmic-Ray Extremely Distributed Observatory (CREDO) is a project dedicated to global studies of extremely extended cosmic-ray phenomena, the cosmic-ray ensembles (CRE), beyond the capabilities of existing detectors and observatories. Up to date cosmic-ray research has been focused on detecting single air showers, while the search for ensembles of cosmic-rays, which may overspread a significant fraction of the Earth, is a scientific terra incognita. Instead of developing and commissioning a completely new global detector infrastructure, CREDO proposes approaching the global cosmic-ray analysis objectives with all types of available detectors, from professional to pocket size, merged into a worldwide network. With such a network it is possible to search for evidences of correlated cosmic-ray ensembles. One of the observables that can be investigated in CREDO is a number of spatially isolated events collected in a small time window which could shed light on fundamental physics issues. The CREDO mission and strategy requires active engagement of a large number of participants, also non-experts, who will contribute to the project by using common electronic devices (e.g. smartphones). In this note the status and perspectives of the project is presented.

This article describes the challenges, pharmacological strategies, and recommendations for managing multidrug-resistant breast cancer in Sub-Saharan Africa (SSA). By examining the current breast cancer treatment landscape, region-specific challenges, and promising pharmacological interventions, the objective is to bring to light the insufficient research on breast cancer and its multidrug resistance in this part of the world and guide healthcare professionals, policymakers, and researchers in developing evidence-based strategies for improved breast cancer care in SSA. Breast cancer is the leading cause of cancer morbidity in SSA, necessitating continuous advancements in its management. This overview explores the evolution of breast cancer treatment, including surgery, targeted therapy, immunotherapy, radiotherapy, and chemotherapy. Despite these advancements, multidrug resistance poses a significant challenge, impacting treatment efficacy and patient outcomes.The article provides insights into various breast cancer treatment modalities, emphasizing surgery, targeted therapy, immunotherapy, radiotherapy, and chemotherapy. Each approach is discussed in detail, highlighting its significance in managing breast cancer. The effectiveness of these treatments is contingent on timely diagnosis and intervention. Multidrug resistance is examined as a critical obstacle in breast cancer treatment, elucidating its impact on treatment failure and patient outcomes. Mechanisms such as the efflux system, enhanced DNA repair, apoptosis inhibition, alterations in drug targets, and the tumor microenvironment contribute to multidrug resistance, emphasizing the need for a multifaceted understanding.The unique challenges faced in SSA regarding multidrug-resistant breast cancer are delineated. These include the lack of comprehensive data, late presentation and diagnosis, poor genomic studies, limited access to specialized care, financial constraints, inadequate infrastructure, and psychosocial support issues. Addressing these challenges is crucial for devising effective strategies. In response to multidrug resistance, the article discusses contemporary treatment strategies such as P-glycoprotein inhibitors, combined chemotherapy, and immunotherapy. Notable advancements, including the use of Tariquidar and synergistic effects of combined chemotherapy, are highlighted, presenting promising avenues for overcoming resistance.The article proposes recommendations to enhance breast cancer management in SSA, encompassing strengthening primary healthcare services, creating specialized oncology facilities and long-term monitoring and data collection. Breast cancer management in SSA is multifaceted, marked by challenges and evolving solutions. Multidrug resistance remains a significant hurdle, demanding a holistic approach. Promising advancements in pharmacological interventions offer hope, while comprehensive recommendations serve as a roadmap for progress. By implementing these strategies, SSA can substantially improve multidrug-resistant breast cancer care and overall patient well-being.

Antimicrobial resistance (AMR) is a global health problem threatening safe, effective healthcare delivery in all countries and settings. The ability of microorganisms to become resistant to the effects of antimicrobials is an inevitable evolutionary process. The misuse and overuse of antimicrobial agents has increased the importance of a global focus on antimicrobial stewardship (AMS). This review provides insight into the current AMS landscape and identifies contemporary actors and initiatives related to AMS projects in eight African countries (Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Uganda, and Zambia), which form a network of countries participating in the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme. We focus on common themes across the eight countries, including the current status of AMR, infection prevention and control, AMR implementation strategies, AMS, antimicrobial surveillance, antimicrobial use, antimicrobial consumption surveillance, a one health approach, digital health, pre-service and in-service AMR & AMS training, access to and supply of medicines, and the impact of COVID-19. Recommendations suitable for adaptation are presented, including the development of a national AMS strategy and incorporation of AMS in pharmacists’ and other healthcare professionals' curricula for pre-service and in-service training.

One of the most notable changes in the Esophageal Cancer (EC) epidemiology is the rising incidence and prevalence of esophageal adenocarcinoma (EAC) in developed countries, likely due to lifestyle and/or environmental factors that may play an important role in EAC onset. The aim of this systematic review was to collect and summarize all the available evidence regarding lifestyle, diet and EAC risk. We searched the PubMed and Scopus databases in January 2021 for studies providing information about lifestyle, diet, WCRF/AICR recommendations and EAC risk. A total of 106 publications met the inclusion criteria. Body mass index (BMI) and waist circumference (WC) are associated with increased EAC risk. Physical activity does not appear to have a significant direct role in EAC risk. A diet rich in fruit, vegetables, and whole grains appeared to be more protective than a diet rich in animal fat, red meat, and processed meat. Alcohol does not seem to be related to EAC whereas smokers, particularly heavy smokers, have an increased risk of EAC. Primary prevention remains the best option to avert EAC. BMI and WC, along with low consumption of red and processed meat, high consumption of plant food, and the avoidance of smoking are pivotal for EAC prevention.

Abstract: Sustainable use of Native American heritage places is viewed in this analysis as serving to preserve their traditional purposes and sustain the cultural landscapes that give them heritage meaning. The research is about the potential impacts of heritage tourism to selected Native American places at Arches National Park, Canyonlands National Park, and Hovenweep National Monument. The impacts of tourists to a heritage place must be understood as having both potential effects on the place itself and on an integrated cultural landscape. Impacts to one place potentially change other places- functions in a Native American landscape and the integrity of the landscape itself. The analysis is based on 696 interviews with representatives from nine tribes and pueblos, who in addition to defining the cultural meaning of places, officially made 349 heritage management recommendations. The U.S. National Park Service interprets Natives American resources and then brings millions of tourists to these through museums, brochures, outdoor displays, and ranger-guided tours. Native American ethnographic study participants argued that tourist education and regulation can increase the sustainability of Native American places in a park and can help protect related places beyond the park.

Background: Early diagnosis of postoperative complications is an urgent task, allowing timely prescribing of appropriate therapy and reducing the cost of patient treatment. Prognostic models based on various data could help in the early diagnosis of postoperative complications after cardiac surgery. Objectives: The purpose of the study was to determine whether an integrated approach based on clinical data along with metabolites and biomarkers had greater predictive value than the models built on less data. Methods: The study included patients (n=62) admitted for planned cardiac surgery (coronary artery bypass grafting with cardiopulmonary bypass), who were retrospectively divided into two groups depending on the presence (n=26) or absence (n=36) of postoperative complications of all types. Clinical and laboratory data on the first day after surgery were analyzed. Additionally, patients' blood samples were collected before and on the first day after surgery to determine biomarkers (interleukin-6, procalcitonin, NT-proBNP, high-sensitivity troponin T) and metabolites (8 aromatic and 2 dicarboxylic acids were detected using gas chromatography-mass spectrometry). Results: Patients before surgery, compared with healthy donors, differed in the concentration of metabolites (p &lt; 0.05), and had concentrations of a number of biomarkers exceeding the corresponding reference values. Multivariate PLS-DA models, predicting the presence or absence of postoperative complications, were built using clinical data (ROC-AUC=0.71), concentrations of metabolites and biomarkers (ROC-AUC=0.60), and the entire data set (ROC-AUC=0.75). For comparison we built univariate models using the EuroScore2 (ROC-AUC=0.59) and SOFA (ROC-AUC=0.76) scales; concentrations of lactate (ROC-AUC=0.71), the dynamic changes of 4-hydroxyphenyllactic acid (ROC-AUC=0.69), and the sum of three sepsis-associated metabolites (ROC-AUC=0.70). The proposed complex model using entire data set was comparable to the SOFA scale, which confirms the expediency of searching for new predictive models based on a variety of factors.

Milk serves as a crucial source of natural bioactive compounds essential for human nutrition and health. The gastrointestinal digestion of milk proteins releases various biologically active peptides that positively impact human health and enhance physiological performance. With the growing production of cheese, Greek yogurt, and other dairy products, the volume of unutilized acid whey is significantly increasing. Acid whey, containing almost all whey proteins and approximately one-quarter of casein, presents a valuable raw material for generating peptides with potential health benefits. These peptides exhibit properties such as antioxidant, antimicrobial, anti-inflammatory, anticarcinogenic, antihypertensive, antithrombotic, opioid, mineral-binding, and growth-stimulating activities, contributing to improved human immunity and the treatment of chronic diseases. Enzymatic hydrolysis of milk proteins has been developed as a method to produce these peptides, facilitating their use in food fortification. To incorporate whey into functional beverages, it undergoes fermentation by lactic acid bacteria with proteolytic activity. To specifically enrich these beverages with peptides exhibiting targeted bioactivities, it is essential to select lactic acid bacteria strains possessing the requisite protease profiles. Additionally, the sensory properties of the final product can be enhanced using starter cultures with diverse metabolic capabilities, even in the absence of added flavoring agents. Given the imperative to develop waste-free technologies and enhance the profitability of the dairy industry, there is a growing need to efficiently utilize and transform acid whey into a broad spectrum of valuable products and food additives. This approach is justified not only by the nutritional benefits of the bioactive components in whey but also by the commercial potential of safe and health-enhancing products.